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Westminster Hall

Volume 708: debated on Wednesday 9 February 2022

Westminster Hall

Wednesday 9 February 2022

[Yvonne Fovargue in the Chair]

Special Educational Needs and Children’s Mental Health Services

I beg to move,

That this House has considered special educational needs and children’s mental health services.

It is a pleasure to serve under your chairwomanship, Ms Fovargue. It is timely to be holding this debate in Children’s Mental Health Week. Today I want to focus on one aspect of mental health—specifically, the conditions that fall under the wider banner of special educational needs.

The difficulty that families in West Berkshire experience in seeking a diagnosis has been raised with me since I was first elected, but it was not until I conducted a constituency-wide survey last summer that I understood the extent of its prevalence and urgency. For many people in West Berkshire, accessing CAMHS—child and adolescent mental health services—for diagnosis of a potential learning difficulty is an extraordinary uphill battle. Waiting times regularly exceed two years for an autism diagnosis and can be substantially longer. I know that this problem also exists in other parts of the country.

When I was preparing for this debate, I asked affected families to get in touch with me, and was overwhelmed by responses, which came from everyone from mums and dads through to headteachers and GPs. The Minister whom I expected to respond to the debate, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is not in her place, but I had a word with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), in advance. The issue as it affects West Berkshire is less about a lack of funding—the Berkshire West clinical commissioning group has received additional investment for this—and more about accountability and the adequacy of the service. I have had too many letters and emails to refer to them all, but I would like to tell hon. Members about three of my constituents, whose stories capture the issue more widely.

The first is Steffi Whelan, who told me about her 11-year-old son. He has been waiting more than two years for a CAMHS appointment. His problems began seriously in year 4. What began as outbursts of screaming in class evolved into something more disruptive. Sometimes he would tear up work or behave in a way that was completely unsustainable for the teacher. In time, he was moved from that primary school to another, and his parents have been told that he will not be emotionally able to move on to an ordinary secondary school. He is now nearing the end of year 6, and despite all of that, the family are still waiting for their first appointment.

Melanie Fenemore told me about her nine-year-old son, Archie, who was strongly suspected to have autism. Melanie was first referred to CAMHS in October 2018. She filled out a load of complicated forms, and in January 2019 was told that her son was on the waiting list and to expect a 20-month delay. In fact, she waited 27 months before he was seen in April last year. At the time of the assessment, the view was formed that he probably did not have autism spectrum disorder but had something more equivalent to attention deficit hyperactivity disorder, and he was referred to the ADHD team. Again, Melanie was sent a bunch of forms, which she described as “pretty much identical” to the previous ones, and her son was sent back to the bottom of a waiting list. The family have been told to expect a 36-month wait. If that projection is correct, Archie will have been on a waiting list for six years, from the age of six to 12, by the time he receives his first appointment. During this time, Archie’s mum tells me, he has

“expressed a desire not to be alive.”

He has a tendency towards violence, born out of frustration. She says:

“I am sometimes at the receiving end of Archie’s violent outbursts which hurt more as he gets older.”

The Buller family’s young daughter, Daisy, has been waiting more than two years for an autism diagnosis. By the time her mum contacted me last July, her daughter was self-harming and barely attending school, even though she was in the crucial year 10. Her mum wrote to me:

“This is 5 years since we first started struggling and we are no closer to helping my daughter. Simply one question Laura, in today’s age, how is this Ok.”

One headteacher of a primary school described the waiting times as “absolutely awful”, with another saying that the situation has got worse in recent years. Valiant efforts are made by West Berkshire Council to offer support through its Emotional Health Academy, but that is not a substitute for a clear diagnosis. A head at a primary told me that until they get a CAMHS diagnosis,

“The child may be excluded or at risk of exclusion, their anxiety will often worsen and they don’t attend school, the school can try but it cannot put in the support that it is required until there is an Educational Health Care Plan in place and CAMHS diagnoses are critical to this.”

The headteacher of Kennet School in Thatcham said,

“While schools will have an indication of what a pupils needs may be, a diagnosis through CAMHS leads to targeted work and accessing additional services to further support the child and their family. A huge part of a SEND diagnosis is the support”.

It enables the young person to

“understand themselves. Where a diagnosis is not yet given, this delays the essential step for the young person, causing more erratic behaviours and often fall-out at home as well as at school.”

The short point is that a timely CAMHS diagnosis is often crucial for life chances. It hardly needs to be said that a child who is repeatedly excluded can easily end up in a pupil referral unit. People with neurodiverse conditions are significantly over-represented in the prison estate and the youth estate. Their employment opportunities are often compromised, anyway—it is said that only one in five people with autism sustain full-time employment—and in teenagers there is a significant correlation with depression and self-harm. Timely diagnosis and the correct support is crucial for addressing that.

I want to focus on the Government response so that my speech does not sound like a barrage of criticism. I know that the Government attach significant importance to improving outcomes for those who are neurodiverse. The SEND review, to be published soon, is a testament to that, as is the work being done to ensure that children with autism will have a designated key worker within the next year or so. Hundreds of millions of pounds of additional funding was made available for CAMHS in the spending review, and I have to concede that West Berkshire is one of the first 25 areas that will pilot the schools-based mental health support teams.

I said at the start of my speech that Berkshire West CAMHS received significant investment from the Government last year—£1.6 million in April 2021. In fact, when I spoke to the service a few months ago, it said that funding was no longer the problem. The money will enable it to recruit another 27 members of staff that it so badly needs, although so far it has managed to recruit only 12.

Despite a detailed local transformation plan published last September, in which some laudable ambitions were set out, including a goal of reducing waiting times for diagnoses to just a year by next month, when I spoke to Berkshire West CAMHS, it conceded that there is in fact no fixed deadline for reaching that target, so it is not really a target at all; it is nothing more than a general ambition. There is no consequence if the service fails to reduce waiting times. I regret to say that that is not good enough.

The overall impression of Berkshire West’s child and adolescent mental health service is that there is a serious lack of urgency or accountability. Dr James Cave, the well-respected medical director of the Downland Practice in my constituency, wrote to me:

“I think it is important that you understand the depths of despair GPs feel about the local CAMHS service. Remote, unresponsive, closed, uncommunicative sums them up. It feels as if they are always looking for a way NOT to have to see a child. They demand detailed referral forms from us…and then find reasons not to see a child. If they do accept a referral the wait is forever and then often the intervention is a fixed predetermined intervention that does not take”

into account

“the needs of a child.”

I am not seeking to humiliate anyone, but families in West Berkshire are being failed, and it is my role and my responsibility to fight for them.

The Health Secretary has said time and again that the Health and Care Bill currently making its way through the House will deliver better accountability. Speaking in the debate in July, he stated:

“The third theme of the Bill is greater accountability.”—[Official Report, 14 July 2021; Vol. 699, c. 430.]

He said that people have the right to expect “clear lines of accountability” for how every priority is delivered. So my plea—a cri de coeur—from the many families in West Berkshire is that the Department demands better accountability from CAMHS in West Berkshire and across the country. We want details of how that £1.6 million will be spent, and firm commitments to reduce waiting lists, with consequences if managers fail to deliver.

The issue is not confined to West Berkshire, but it is stark within it, and I therefore speak today for the families that I represent and all those families across the country who are experiencing the same struggle.

As there is considerable interest in the debate, I will set a formal time limit of four minutes for speeches.

I thank the hon. Member for Newbury (Laura Farris) for securing this important debate. I was not expecting to be called quite so early.

I will focus my remarks on my own personal experience of having ADHD, dyslexia and dyspraxia, none of which were recognised during my schooling. I want to highlight this because it is a journey of things going wrong and children not being fully supported.

By the age of 12, the average child with ADHD has received 20,000 more negative comments about their behaviour than their peers. “Lazy,” “distracted,” “too chatty,” “fidgety,” “failing to meet potential,” “disorganised” and “in disarray”: those were all comments that were levelled at me as a child, and they stick in my brain to this day and make me consider all my actions daily. This has led to huge feelings of anxiety and depression—a feeling that I am always doing something wrong. My ADHD was diagnosed only last year, and I have only just started taking medication, which has been life-changing.

There are two sides to the coin on this issue. When children and young people are supported at home and in school with the love and understanding that they deserve and need, they can flourish, as I feel I have flourished. I thank my family for the support that they showed me throughout my education to enable me to get to where I am today.

However, I meet too many children whose stories are still the same: their needs are not recognised or are not severe enough to merit critical help, and they are stuck in the middle, reaching their potential in some subjects and failing in others. They also feel that they are not listened to, that they cannot access support and that there is something critically wrong with them. They internalise negative comments about themselves, which is really damaging in the long term.

There are also lots of huge positives to being neurodivergent. Neurodivergent people are more likely to be entrepreneurs, and to take the risk of setting up businesses. However, the dark side is that they are more likely to try illicit drugs and to get involved in crime. There really are bright and dark sides. To any young person who is struggling at school, I say: “Don’t worry. There is always something else for you to strive towards. You just need to find what you are good at, and you will relish that opportunity.” No one should be held back because they have a diagnosis of ADHD, autism, dyslexia or dyspraxia. All children should be supported to get the best out of themselves.

However, far too often our education system is one-size-fits-all. I am really proud to chair the all-party parliamentary group for special educational needs and disabilities. It is so important that we change the classroom and home environment for these children, so that their behaviours are understood, and they can fully experience school and get to where they need to be.

So many things have gone wrong during the pandemic. Some children with autism have flourished through online learning, but others have found themselves isolated from their friends, peers, teachers and support. Several organisations are yet to start providing the therapeutic interventions that they are meant to provide under children’s education, health and care plans, and this is causing huge disruption to the ability of those children to thrive. Three quarters of disabled children have seen progress in managing their conditions and overall development regress in the pandemic. This is urgent and critical. Those who receive a diagnosis of dyslexia should also be screened for ADHD or other neurodivergent conditions, because the crossover is huge. We are letting our young people down by not helping them to get the tools they need to understand themselves—first and foremost—and how they fit in with the world.

I hope that the Minister will think more about how we can intervene as early as possible to avoid young people becoming incredibly depressed and anxious about just who they are—because they are round pegs trying to fit into square holes. It is critical that we support young people to thrive and give back to our society and economy by being the great pioneers and entrepreneurs that we all want to see.

I also have the privilege of having someone with autism in my family—

It is a pleasure to serve under your chairmanship, Ms Fovargue, and a real pleasure to follow the hon. Member for Sheffield, Hallam (Olivia Blake), who made a powerful speech. Sharing her personal experience in this place is a brave thing to do. It has informed our debate, and I am sure that the Minister will refer to that when she sums up.

I congratulate my hon. Friend the Member for Newbury (Laura Farris) on securing the debate. Like her, I have been contacted by so many distressed parents of children with special educational needs. Their experiences of trying to get support for their children are summed up in exactly the word she used: a battle—it is really a battle. EHCPs are the entry ticket to specialist support, but the whole application and appeal processes seem designed to be difficult and time-consuming. As my hon. Friend said, too many times people have to repeat things that they have already said again and again. We must ensure that we have a tell-it-once approach to such things, however long the waiting list might be—she spoke movingly about that as well.

My constituent Samantha King’s four-year-old, for example, was receiving one-to-one nursery support in Wales before they moved to Newcastle-under-Lyme. She supplied extensive documentary evidence of the child’s need when they moved, yet she described having her child’s application refused on the basis that she had not included the reports that she had in fact submitted. That is all too common—things get lost and people have to fill in almost exactly the same form again or for another authority. It is extremely tedious and it breaks people down, and that is why this is such a battle.

Parents then find that they have to appeal to SENDIST, the special educational needs and disability tribunal, as the main route to access an EHCP. We need to analyse the proportion of successful appeals. If local authorities are turning down applications that are successful on appeal, those at the top of that league table need to think about why that is the case. They need to consider applications more carefully in the first place.

Even when someone gets an EHCP, the battle continues. Parents in my constituency report annual reviews not taking place, or the plans not being updated for months following review, severely impacting on a child’s progress through education. A lot of things go wrong in the transitions between stages of education or into work.

I am grateful to my hon. Friend for mentioning transition, because it is there that a condition such as autism or ADHD can turn into a mental health condition. Does he agree that one of the key issues for the Government to consider is the training and availability of clinicians? Funding is now much better than it was, but we still do not have the trained clinicians who could cut through the waiting lists, which are causing so much frustration to far too many families.

My right hon. and learned Friend is absolutely correct about the availability of clinicians. His intervention also speaks to the point made by the hon. Member for Sheffield, Hallam that if these conditions are not treated at school, they can lead to severely negative mental health outcomes later in life.

My constituent Mr Winkle has fought for many years to obtain suitable educational and therapeutic support for his son. Following a tribunal decision last month, he was sent a revised EHCP that still contained a number of inaccuracies, including out-of-date details about his son’s residential placement. I want to talk a little about residential placements, which have not been raised much so far, because the lack of suitable placements causes distress to many families.

One constituent described how the 14-year-old in her care only receives an hour’s at-home tuition a day, because a suitable therapeutic placement with a small and consistent staff team cannot be found. Alternatively, children are given residential educational provision that is unsuitable, which can cause them to regress and even, in one case, to self-harm.

Another common complaint is that social workers change too regularly, so the social worker does not truly know the child. Parents may not be told who the new social worker is and many have described the difficulty they experience when trying to get in touch with professionals, as telephone calls are not returned.

Despite parents being the ones with the most knowledge of the child or young person they are caring for, they struggle to be heard. Should they then complain, they describe encountering a complaints process that is frankly not fit for purpose: timescales are not followed; complaints sometimes seem to be ignored completely; and it is only possible to complain to the ombudsman with a final response, but that often never seems to arrive, and even when they do complain, it will take months for the ombudsman to reply. Furthermore, adults involved in the care of children can become fearful of complaining, in case there are reprisals in the form of their contact with the child being blocked.

Added to that is the struggle to obtain adequate mental health treatment. One constituent of mine was told that the priority waiting list for CAMHS—not the list to which my hon. Friend the Member for Newbury was referring earlier—is 11 months in Staffordshire. That is the priority list. Only this week, a constituent described how she is desperate for respite provision, having accepted a child back into her care on the basis that the local authority would support her.

The local authority has been good at keeping in touch, but its hands have been tied by what it says is a lack of resources. As well as struggling to find an educational placement for the young person, it has only just found an agency to take him on outings twice a week. After five and a half months of caring 24/7, my constituent is exhausted and in the terrible position of considering having to say that she can no longer look after the young man. She has been let down by a breach of implied trust—the local authority told her that it would support her, but it has not been able to.

As Members of Parliament, we inevitably hear the failures, rather than the success stories, but I welcome any support that can be given to improve the experience of so many. As my constituent Mr Winkle said:

“In this journey I have communicated with many regulatory bodies each claiming to have the child’s interests wishes and safety at the forefront of their agenda...but as I have experienced this is certainly not assumption is that it’s a closed circle and these entities do not know how to facilitate or co-ordinate any kind of solution and just want it to ‘Go Away’.”

I am sure that is not the full truth of it, but that is the experience that people are having out there.

I welcome the imminent Green Paper and the additional funding, but too many people have been failed for far too long. I hope the Minister will be able to address that when she responds.

It is, as always, a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing the debate. I also pay tribute to my hon. Friend the Member for Sheffield, Hallam (Olivia Blake). I have a friend who was diagnosed with ADHD in his 50s. He is a very talented musician but he really struggled at school and with the basic things in life. He, too, says that the medication has made a huge difference.

As we have heard, life is a never-ending battle for many parents of children with SEND. They have to deal with their child’s physical and mental health needs, trying to get the right diagnosis and all sorts of things on top of that: hospital appointments, physiotherapy, daily meds, vulnerability to viruses, communication issues, issues with trying to get their child to eat properly, and behavioural problems. They face all those things at home, and then they have to battle with bureaucracy, and they often feel that they are at war with the very people who are meant to be there to help them. They feel that the system is stacked against them and that sometimes people would rather they went away and stopped being such a nuisance—what the hon. Member for Newbury said about CAMHS in that context very much resonated with me.

The first battle that parents often face is to get the right diagnosis for their child. Then there is a battle to get the EHCPs. Then the councils say they do not really have the power to enforce them. If a child develops mental health problems, it is often a battle to get support from CAMHS, and parents of neurodivergent children, in particular, sometimes find that they are being bounced around between CAMHS and SEND provision, with nobody stepping in to help them.

In 2019, it was estimated that 6.8% of children in Bristol had special educational needs or disabilities, and it is true that Bristol City Council has struggled to meet the needs of those children—as we have heard, that seems to be case with many councils. We had a pretty damning Ofsted report in 2019, and the council says it is now absolutely committed to trying to do better with its Belonging strategy and a three-year, £6.1 million education transformation programme. There are concerns about getting schools to buy into that, and some parents have said that a significant number of schools are batting away struggling pupils even though they have a legal duty to meet the needs of SEND children.

Children should never be put in the “too difficult” box, but I have heard many examples of children being out of school without any support or just having part-time schooling or perhaps hospital school tutoring—if a child has to go into hospital because of their underlying physical disabilities or illness, they will have education there, but not when they are at home. Parents complain about schools having a one-size-fits-all approach to dealing with children with additional needs, while there are complaints from schools that they can no longer afford teaching assistants, who are so valuable in providing children with the one-to-one attention they need.

Delay can make a huge difference to children’s wellbeing and future attainment, as we have heard. We know that half of all mental health problems are established by the age of 14. Tragically, in some cases, young lives will be lost if we do not intervene early. In 2017, suicide was the most common cause of death for both boys and girls aged between five and 19.

I would like the Minister to commit to provide mental health support in every school, early interventions so that we can spot the signs—otherwise, problems will increase in severity—and respect for a child’s individuality. I know that that costs more and needs more resources, but the problem with these pathways—the hon. Member for Newbury talked about fixed, predetermined interventions—is that it does not help to refer a child with autism for counselling based on cognitive behavioural therapy, because their minds just do not work like that. Finally, we also need better in-patient services, because sending children hundreds of miles away from home, when they need intensive support, is absolutely unconscionable.

It is a pleasure to serve before you, Ms Fovargue. I commend my constituency neighbour in Berkshire, my hon. Friend the Member for Newbury (Laura Farris), for securing the debate. I also pass on the best wishes of our right hon. Friend the Member for Maidenhead (Mrs May), who regrets that she cannot be here today. She asked me to point out that she fully supports every effort to increase the provision of mental health support for children in Berkshire and beyond. Finally, I want to welcome Dr Priya Singh, who is the new chief executive of the Frimley integrated care system and who I met yesterday to discuss this issue.

Time is short but, in brief, local NHS CCGs spent £12 billion in 2020-21 on mental health support. NHS England spent a further £2 billion, making a total of just over £14 billion. That is great, but I was horrified to learn that CCGs spent 14 times more on adult mental health support than on services for children. We need to invest much more heavily in that area.

East Berkshire, where I reside, has £2.6 million in funding for children’s mental health, including £1.4 million for CAMHS and £200,000 for eating disorders. That is not enough, which is my opening contention to the Minister. The Berkshire Healthcare NHS Foundation Trust, based in Bracknell, does a fantastic job, but the demand for mental health assessment in children has gone up by 60% in the past five years. Since the pandemic, it has gone up by a further 27%. We have a problem. A constituent wrote to me only yesterday to tell me that the current wait for a child to be seen by CAMHS is 30 months; prior to the pandemic it was 18 months. Families are being left unsupported at this time.

As politicians, we spend lots of time admiring the problem, but perhaps not enough time thinking about the solution. What do we need to do? The first thing I would say to the Minister is that the SEND review is still awaited. It was promised last year and has failed to materialise. Will she please ensure that we get it as soon as possible? We also need to invest in our children with SEND as never before. That requires money, patience, determination and a much clearer Government strategy.

Why might that work? By providing the right care in the right settings we can give our children the focus they need to be productive, employable, law-abiding and responsible citizens. Prisons are sadly full of people who have made the wrong decisions or acted impulsively, perhaps because they were not diagnosed at an early age. Let us invest in more specialist educational settings, so that people’s needs can be addressed. Yes, that is expensive and resource-heavy, but the cost of not doing so will always be greater, and this is non-discretionary spending.

I would like to see every local authority in the UK comprehensively reviewing its SEND provision, so that it becomes available in every area. Specialist and dedicated settings are the way forward for those who need them. We need to give our teachers better training with education, health and care plans. Those should not become a magic bullet—a passport for the lucky few—but a rightful passport for every child to get the support they need.

Lastly, CAMHS across the UK need 20,000 volts put straight through them. For families to wait two and a half years for a consultation is not only immoral but frankly inept. The irony will not have escaped anybody here that a GP cannot prescribe medication for ASD, ADHD, oppositional defiant disorder, Asperger’s or any other mental health condition, without a diagnosis from CAMHS. We have to focus on CAMHS right now.

To conclude, let us please get spending, diagnosing and treating, and let us give all our children, not least in Berkshire, the future they deserve.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this timely debate in Children’s Mental Health Week.

Over the past year—frankly, five years—the number of parents writing to me about their children and the lack of support has grown exponentially. I was a teacher before I was an MP, and I commend the speech made by the hon. Member for Sheffield, Hallam (Olivia Blake), because she is right that this is about allowing young people to be themselves. The word “special” is the right one: just look at the number of Nobel prize winners with neurodiversity in their make-up. When I taught maths and physics, these children were often the brightest, most interesting people in the room. They should never be seen as a burden.

The way the system treats families and children who are neurodiverse makes it so difficult for them that it is understandable how that goes on to affect their mental health. One family contacted me about Poppy—I have changed her name—who is 12. As previously described, there was violent behaviour in the household, and the family was incredibly worried. It took months to even get the GP to refer to CAMHS. The mother said to me:

“Mrs Moran, to be honest, you are my last hope. I am suffering with both my physical and mental health and quite honestly I do not have the energy left to continue fighting the system.”

We are also in a perverse situation where even more professionals are writing to me. I would be curious to know if that is the same for other hon. Members. This is new. GPs are also writing to me, as are educational psychologists, because they all recognise that CAMHS is broken. I had one psychologist write to me saying that he no longer refers to CAMHS. He said that social services and CAMHS are so broken that the only thing he can do is keep children on his books because he worries that if he loses contact with them they will not get anything at all. How is this system not failing our young people? It absolutely is.

My first question to the Minister is on the lack of educational psychologists in this country. My local county council is doing its very best; it is one of the F40 councils and is twelfth-lowest in the country when it comes to the high needs block. I said, “If you had a magic wand and could ask for anything from the Minister, what would it be?” and the council said, “More educational psychologists.” We currently fund only 200 training places in the country. There is only one educational psychologist for every 5,000 young people, which is nowhere near enough. Tackling that issue would go a huge way towards immediately helping to alleviate the backlog.

In the interim, there are amazing third-party groups that are helping. There is Shift, which is an informal parent group in Abingdon, set up by Sally and Andy Foulsham. They run it, provide support and help families navigate the system. There is also The Abingdon Bridge, which is the only wellbeing and mental health charity for young people in Vale of White Horse. It focuses on 18 to 25-year-olds. It is particularly worried about the 16 to 18-year olds that it finds because, if they are referred to CAMHS, the waiting lists are so long that they then drop off that cliff edge. Strangely, the charity cannot access funding from the CCG because of the way that the funding works. Could the Minister help me help The Abingdon Bridge to access more funding?

To conclude where I started, we absolutely must appreciate that these children deserve the best, and deserve more, but the current system is failing them. There is a perverse disincentive in the system, where a school must basically pay the first £6,000 of the funding. We need a national SEND strategy that solves the problem once and for all. Without that, we risk failing our children and our country in the future.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing forward this important debate.

I do not think we realise the crisis that our children face on mental health. It is hard growing up—we all remember growing up—but our young people face an even more traumatic time following the pandemic. I truly believe that our children and young people have been badly affected by the pandemic and also by social media—we did not have social media, growing up, with that extra, 24/7 pressure.

On educational attainment, I have a 17-year-old daughter going through A-levels and a 15-year-old son going through GCSEs, and I can speak with authority about just how much pressure they are under. However, I cannot imagine how families cope with all the extra pressure when that is compounded by a special educational need.

I want to speak about people’s actual experiences in schools. I recently spoke to the head of a Westminster secondary school, who is a very experienced teacher. She said that she has never, in her 20-plus years as a teacher, known such a crisis in the mental health of young people and particularly teenagers. The pandemic has obviously compounded that, but we are now seeing far more anxiety, self-harming and suicidal thoughts. That is what she explained to me. The pressure that that head and her staff are under—to help and support the young people going through these things—has created even more of a burden for them. They are taking advantage of the Mind counsellors and the extra help that the Government are providing, but it simply is not enough.

There seems to be a disconnect between the Department for Education and the Department of Health and Social Care, because there is no one Minister taking control, and I ask the Minister to really consider that point. We cannot just leave it to schools to try to navigate special educational needs and support for families. We must make sure that there is one place for teachers to go for that support. There is such pressure on budgets now in schools. The head I spoke to told me how much they were now spending on extra support for pupils, which comes out of the general budget. I plead with the Minister to try to secure more funding for this issue from the Department for Education.

In Children’s Mental Health Week, I pay tribute to the local authorities in my constituency. This week, Westminster launched a trial of a keyring, which will reach 4,000 young people. They simply scan a QR code to take them to a special hub, which will give them the advice and support they need. That is the kind of practical help we need to give our children, but this is also about getting the funding that our schools need, to ensure that our young people have the future they deserve.

It is a pleasure to serve under your chairship, Ms Fovargue. I pay tribute to the hon. Member for Newbury (Laura Farris) for calling this important and timely debate. It is always a pleasure to follow the hon. Member for Cities of London and Westminster (Nickie Aiken). I agree with everything she said. Our young people are facing a mental health crisis. They need vital support and funding in our schools.

For my Vauxhall residents, the mental health impacts of measures to tackle covid-19 have been some of the hardest of the seismic effect of the pandemic. Since March 2020, people have had severe restrictions on who they can meet and where they can go. We have seen park benches taped up. As a mother of two young children, that was difficult for me as well. People have seen their friendship groups shrink. They have had to deal with being shut at home, not going out and not seeing loved ones. They have missed loved ones for many months. In some cases, they have missed those vital last minutes. That situation has taken a toll on all of us but, most importantly, it has taken a toll on our young people.

Schools develop vital skills in subjects such as maths and English, but for our young people they are also a place to make friends, solve conflicts and develop vital interpersonal skills that help us all to navigate our lives. Those skills are vital in developing mental health resilience in our young people.

The Health and Social Care Committee has found that 1.5 million children and young people under 18 will need new or additional mental health support after the pandemic. That places a tremendous strain on already stretched mental health provision. Although extra funding has been promised, too few children are getting the treatment they need.

Several hon. Members have highlighted the many difficulties that parents, carers and, most importantly, young people face in accessing SEND provision. I am sure the Minister is aware of the data on the disparity and the barriers that black and minority ethnic children and their families face in accessing that provision.

I went to visit Lansdowne School in my constituency last December. Lansdowne is a specialist school for young people with autism, communication difficulties and speech and language delay. On my visit, I spoke to the headteacher about the fantastic work teachers and carers did during lockdown, providing vital support for children with challenging needs. I also spoke to the head boy and head girl and said that, in return for their giving me a tour round their school, I would give them a tour round my workplace, here in Parliament. They had such smiles on their faces; they beamed with joy. I saw a mural that students have worked on with local artists. With the right support and funding, our young people with special educational needs will flourish. We have to believe in them.

For many young people with special educational needs, finding the right support is vital. I am proud that the National Autistic Society decided to open another school in my constituency, on Kennington Road—the Vanguard School. Unfortunately, because of the many lockdowns, we have not been able to have the official opening, which has been postponed three times. I hope that when that opening finally takes place, the Minister will come to visit this excellent school, which provides state-of-the-art services for young people with additional needs.

As chair of the all-party parliamentary group on knife crime and violence reduction, and through my work on youth violence, I see the effects of youth violence and mental health trauma faced by our young people. If we fail to tackle the mental health crisis among them, we will continue to see them develop lifelong problems and not have access to vital SEN provision. Most importantly, we may see some of those young people taken too soon. I urge the Minister to look at providing vital support in this area now.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I pay tribute to my hon. Friend the Member for Newbury (Laura Farris) for securing this debate, which, as many hon. Members have identified, is important for all present.

Identifying special educational needs and early diagnosis is a particular problem given the complexities surrounding this issue. Early diagnosis is absolutely key. I have heard from constituents many harrowing stories of people trying every channel and route possible, including schools and local GP services, to identify special educational needs at an early stage.

Children’s mental health and special educational needs are complex. Their conditions can often be misdiagnosed or not even identified at an early stage. The signs of autism, for example, can be put down to a child experiencing a dislike for something such as going to school. Of course, the recent challenges of the pandemic have not made things easier.

Early diagnosis is key, but the process of getting a formal diagnosis is far too inaccessible and long-winded for many of my constituents. One constituent told me that there was no point in even entertaining the process, because they would have to wait three or four years for their child to receive a diagnosis. That is completely unacceptable. Likewise, private companies that offer such services are currently working their way through a huge backlog that accumulated during the pandemic. Too many of my constituents also find themselves priced out of any private offering.

In spite of those difficulties, there are a number of fantastic groups across Keighley and Ilkley that support young people with special educational needs and mental health issues. Take Margaret Nash, Helen Millar and the rest of the team at AWARE—Airedale and Wharfedale Autism Resource—which provides support to families with children and young adults on the autistic spectrum, with no formal diagnosis required. My thanks also go to Lesley Brook and everyone at the Nebula Girls Group, a Keighley-based organisation that helps young girls in Keighley who suffer with special educational needs.

I want to emphasise the issues of appointments and referrals. Battling their way through the bureaucracy and red tape, parents and young children find that the challenges of navigating a complex diagnosis system are not easy at all. As many hon. Members have identified, the transition from primary to secondary school—and then into the job sector—is extremely difficult, whether or not a person has been diagnosed.

That is where I would like more emphasis from the Government. Emphasis should be put on not only funding and providing targeted support, but providing businesses with the support they need to help people with special educational needs beyond the education system and into the work environment.

I appreciate that this issue is not being ducked by the Government, and I recognise that the Department for Education will continue to increase funding for children and young people with the most complex needs. However, we cannot stop there. All hon. Members present have recognised that CAMHS is not fit for purpose—we must ensure that it is. Like my hon. Friend the Member for Newbury, I call on the Minister to make sure that the SEND review is released at the earliest possibility so that we can try to get better mechanisms in place. There are some fantastic efforts being made at a local level, but we cannot rely on voluntary groups to sort this issue out. The Government, local authorities and CAMHS have got to do the utmost to make the whole process fit for purpose.

Thank you, Ms Fovargue. I apologise to the hon. Member for Newbury (Laura Farris) for not being here earlier—I was at the launch of an inquiry that I chair. I spoke to you, Ms Fovargue, to ask for permission and I thank all hon. Members for the opportunity to make a contribution.

Special needs education is a key issue. When the news of lockdown for schools came, my initial concern was for those going through exams. My next train of thought was for those special needs children whose parents simply could not take them on. They were difficult times, as everyone present knows, and the hon. Member for Newbury knows that better than most.

We had parents ringing our diverted phones crying because they literally could not settle their special needs child who was waiting on their school bus and could not understand the concept of lockdown and what it meant. For special needs children, it is important to have a routine and a simplified version of life, so that they can try to cope with it. It is not an exaggeration to say that children with special needs were distraught, and it quickly became clear that the impact on them was large. I was thankful for the Tor Bank School, the special needs school in my area, which kept its doors open for its own pupils and took a small number of students from other schools that were unable to open. Our office referred one pupil whose mother was distraught, and they took the child in until their own school reopened. These schools took special steps to enable things to happen, and we are in debt to them for that.

My thanks go to Peter Weir MLA, the former Education Minister, for allocating specific funding to special needs schools for tailored catch-up programmes and mental health support, as well as to mainstream schools for the wellbeing of pupils. Recognising the impact of isolation on individual children, and on children as class groups, is an essential part of helping them process and deal appropriately with the remnants of isolation. I am thankful that Ministers have rightly acknowledged the difficulty of lockdown for our children and that it is our duty to do our utmost to repair it.

The briefing that I received from Parentkind merely underscored my opinion of the damage done to all schoolchildren, but particularly children with special educational needs. I want to quote from it because it illustrates the problem. I know people say there are lies, damned lies and statistics, but I tell you what: these statistics tell a story. I hope nobody else has stated them already.

Some 55% of children with special educational needs experience homework-related stress, as opposed to 37% of children without SEN. Anxiety affects 55% of children with SEN, as opposed to 34% of ordinary children. Other figures include 46% versus 32% for exam stress; 45% versus 27% for bullying; 34% versus 16% for pressure to constantly engage with social media; 38% versus 11% for depression; 35% versus 11% for cyber-bullying and online abuse; 30% versus 6% for self-harm; 28% versus 5% for eating disorders; 25% versus 4% for sexual harassment; and 23% versus 3% for substance misuse.

Those statistics clearly illustrate the impact on those with special needs. These figures underscore the greater vulnerability and the higher risk facing children from less advantaged backgrounds or with additional needs or disabilities. The data shows that they were more susceptible to mental health impacts and social challenges in their peer group. It is clear, as this debate shows, that there is a problem, and we in this House need to ensure that the solution is available and is long term.

It is good to see the Minister in her place. We have a special friendship, and she does extremely well when it comes to answering these issues. We look to her to address the impact on England. This issue is not her responsibility when it comes to Northern Ireland, but it is always good to bring a Northern Ireland perspective to these debates, as well as to illustrate to the hon. Member for Newbury that we in Northern Ireland have similar pressures.

It is a pleasure to speak in this debate. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing this important issue forward. I hope that Members will forgive me because, based on the contributions that have already been made, I am going to give a completely different speech from the one I had intended to make.

I certainly do not like doing this, but I feel that I have to bring my personal experiences to the debate. My son is on the autistic spectrum.

It is fine. My wife and I waited many, many months for a diagnosis. When we had the diagnosis, it was a relief, but when it happened we were told, “Well, nothing changes. Just carry on as normal.” We were not referred to services—we have not been referred to services throughout the whole of my son’s time in education. We have been given a diagnosis and essentially asked to carry on as normal. My son is a beautiful boy, and he is in mainstream schooling. He has challenges, but he does not have the complex needs that other families have, and that was it.

I can tell Members from personal experience that the length of time people have to wait for a diagnosis is a disgrace, but in many cases nothing happens afterwards. To help, aid and support my son, we are reliant on the special educational needs co-ordinator at his school. SENCOs are brilliant people, but they often do not have the expertise we would hope them to have in these situations. If the levelling-up agenda is to mean anything—and I fully believe in our Government’s levelling-up agenda—we have to find ways to ensure that those people with challenges in their lives are able to achieve and maximise their potential. I have not raised the issue of my son for any other reason than this: I do not believe that the support that he has received, and that other children are receiving at this moment in time, allows that to happen.

I was in a debate yesterday with many Members who are in this Chamber today. The issue of funding is a very legitimate concern to raise, but my borough in Bury has spent £40 million over the past financial year on special educational needs and mental health. We have to go beyond just saying, “Give more money”. We have to have local accountability, strategies and bespoke support services for each individual child in our country to allow them to achieve their potential.

I support one of the things that the Labour party said yesterday, and I support what the Government are doing. We have many family hubs, which I support, and they provide fantastic support for this agenda. The shadow Minister, the hon. Member for Dulwich and West Norwood (Helen Hayes), talked yesterday about mental health hubs. We can call them anything we want, but every town in our country needs a bespoke, 24/7 support service that schools, individuals and families can turn to in the knowledge that they are not just a statistic—they are human beings—and so that local services can respond to the individual needs of each individual child, who we must cherish.

It is an honour to follow my hon. Friend the Member for Bury North (James Daly).

In a few months, I will have been in this place for 12 years, but we are still having the same debate and saying the same things, so I want to give voice to a few constituents who have been in touch with me. One wrote that

“my son (6 in April) is diagnosed autistic…I had to fight to get an appointment with a paediatrician…I cannot express to you how stressful this was and for two years we didn’t get any support…We did find some support once he started school but…I am now paying for this privately…at £70ph…There is no one place to work out what support is out there. It is all piece meal. I’ve learnt far more from speaking to other parents of autistic children about available support than through official channels…if support was given beforehand, so many of these mental health difficulties could be prevented. The majority of parents I know of autistic children are burnt out and stressed—even when they have money to provide private help”.

Another constituent wrote:

“It was apparent at pre-school that he was experiencing difficulties, he was seen briefly by a speech therapist…He transitioned into primary school, where I still remember that fateful day where he just crumbled. Due to a lack of external help we sought the advice of a child psychiatrist…This cost us thousands. Eventually we received, with primary school SENCO help, admittance onto the CAMHS pathway for autism assessment. After many years of waiting we were discharged…We were then dropped from any further care and given a leaflet with web links for information…Any request for help that we have made has been firmly shut down…to navigate the system requires an MSc level of education, legal knowledge, money (we are on benefits!) and time. All at an emotional cost to one’s self.”

Another constituent wrote:

“We only get one childhood and it is proven that it has an impact on the rest of a person's life. I hear so many times of people being turned away from CAMHS and struggling to get support, even when their child is suicidal”,

and another said:

“SEN parents are really stretched to the limit. I cannot begin to tell you what a battle it is and how a more global approach would be of benefit...rather than the fragmented system of try the school, try the GP, try CAMHS etc.”

Another constituent wrote:

“Our experience of CAMHS? Well there isn’t much as we haven’t been able access any treatment for him!…My husband and I referred our son on the CAMHS online referral form in November last year. I wrote on the form that he was using the palm of his hand to slap his forehead out of frustration to get the compulsive thoughts out of his head…We didn’t hear anything so I sent an email asking them to confirm that they had received our referral form. The confirming email asks parents not to inquire about waiting list times...A member of the School Welfare Team phoned me to say that there is a waiting list of 18 months…As a family we are frazzled and I feel like I’m hanging by a thread. Where do we go from here?”

Another one wrote that

“the situation is abysmal. My family have been ripped apart by my daughter’s mental health and she is just SIX years old.”

Finally, another constituent wrote:

“Last night my nine-year-old son said, ‘I would rather have no life than this life’.”

None of those emails makes for easy reading. I have had so many emails, and the key thread I take from them is that, as many have said, early diagnosis is what is missing. As a result, children fall further down. They are helped later, and the help they need is consequently significantly more acute. Covid has been a disaster for children and young people’s mental health, so let us not compound that now by this constant asymptomatic testing.

“Don’t ask us how long the wait is.” I would love the Minister to explain how that message fits with the physical waiting list on My Planned Care, which was launched this week. Where is the parity? I have been really moved by what I have received this week. My constituents do not care about six people being shuffled around the same jobs in Government. They care about the services that they are paying a lot of money for and are not getting. One constituent said to me:

“Childhood is short but it also lasts a lifetime.”

We cannot have this debate for the next 12 years.

It is a pleasure to serve under your chairmanship, Ms Fovargue, and to speak in this debate on behalf of the Scottish National party and also as chair of the all-party parliamentary group for disability, a role that I have been proud to champion in my six or seven years of being in Parliament.

We must thank the hon. Member for Newbury (Laura Farris) for realising how vital this debate is and for securing it. She spoke eloquently of her concerns, which were reinforced in just about every speech. Her questionnaire asking constituents about services is a fantastic initiative, getting to the frontline and the heart of what is happening.

When I visit local services in my area, they often give me statistics and tell me how things are improving, but it is not until I speak to people and ask about their experiences that I see whether it has translated into changes for the children who need the services. The hon. Lady emphasised that a timely CAMHS diagnosis is absolutely necessary for someone’s chances in life. That is the key message from today.

The hon. Member for Sheffield, Hallam (Olivia Blake) spoke from her heart about her personal experience. That is a very powerful thing to do in this House. She is a real champion for the screening of neurodivergent conditions. Because of her own struggles, she has been a role model for so many. It is important that she uses her voice, as she has done so powerfully today.

The hon. Member for Newcastle-under-Lyme (Aaron Bell) spoke of the battle faced by parents in his constituency and of the lack of staffing. It is not just about money; it is about training and staffing and making sure that there is an appropriate workforce plan. I hope that the Minister will address that point.

The hon. Member for Bristol East (Kerry McCarthy) eloquently said that the system as it stands is stacked against parents. From what we have heard, I think that is so true. There has to be mental health support in every school, and it has to be at a local level. We cannot expect families and children who are already extremely vulnerable to travel a huge distance for the care that they need.

The hon. Member for Bracknell (James Sunderland) said that 14 times more money is spent on adult services than on children’s services. I worked in psychology prior to coming to this House, and children’s services were always seen as a Cinderella service—entirely wrongly, in my opinion. Investing in our children is investing in our society for the future, and we really need to understand that.

The hon. Member for Oxford West and Abingdon (Layla Moran) described what many of us experience: that people come to us and say that their MP is the last hope for their family. That is how we feel, because that is what people tell us: “You are my last hope; I have tried everything.” It is unacceptable that families have to battle the system to that extent. The Disabled Children’s Partnership contacted me prior to the debate and said that 60% of families with disabled children have sought mental health support for themselves, which shows just how desperate the situation is.

The hon. Lady mentioned another really important issue, which the British Psychological Society has also raised with me: the lack of educational psychologists in the UK. There is only one for every 5,000 young people. That is a really crucial issue that the Minister should take forward. To make a difference, we must have the correct professionals in place to undertake the required diagnoses.

The hon. Member for Cities of London and Westminster (Nickie Aiken) spoke really well about the trauma experienced by children in the pandemic. We must not underestimate that. Their childhood has been different from that of every other generation: the trauma that that cohort has experienced, the loss that many have experienced, the loss of their daily structure and the loss of contact with their loved ones, which was snatched away at a critical time. We need to improve services not just generally but very specifically for the most vulnerable children with special needs.

The hon. Lady also spoke about the impact of social media. I have heard so many negative things about online algorithms and the impact of constant social media use on children and young people’s mental health. That has such a negative impact that we should look at taxing social media companies specifically to raise money to increase mental health support. That must be addressed in the Online Safety Bill.

The hon. Member for Vauxhall (Florence Eshalomi) spoke about her excellent work helping those from diverse backgrounds in her constituency and the important issue of knife crime. She said that, when people are failed in childhood, they can go on to engage in antisocial behaviours; they are steered down that path because the system has failed them. We must ensure that we avoid that at a much earlier stage.

The hon. Member for Keighley (Robbie Moore) spoke about the importance of early diagnosis and the battle against bureaucracy, and the hon. Member for Strangford (Jim Shannon) about the impact of the pandemic and the lack of structure on children with special needs, which has been severe. In my own constituency, we are still struggling to get services back up and running at the level that they were before the pandemic. Parents are continually contacting me, worried that the pandemic may be used as a rationale to reduce services. That must never happen; we are here to champion those parents and to make sure that that does not happen. The hon. Member for Strangford also underlined all of the very bleak statistics that show the greater impact of the pandemic on children with special needs.

The hon. Member for Bury North (James Daly) spoke emotionally and powerfully about his son. The hon. Gentleman came here to listen, but decided to give us the benefit of his own experience. That is one of the bravest and most important things we can do when we come here to raise our voices for others. That personal experience resonates with everybody more than statistics or anything else that the rest of us have to say.

The hon. Member for Winchester (Steve Brine) said that he has been a Member of Parliament for almost 12 years and has been talking about these issues for 12 years. Clearly, these issues have to be taken forward. What I will say—this is slightly different from the speech that I prepared—is that having worked in the services, it is very clear to me that CAMHS cannot manage diagnosis and assessment for children with special needs, as well as the overwhelming number of children who are there for mental health issues. There has to be a streamlined diagnostic service that is available locally, at local authority level, where children can have that intervention, that assessment, because one year in a child’s life is a huge amount of time. The six years that we heard about is almost one third of their childhood. The developmental milestones that have gone by can never be caught up on, so early diagnosis is crucial. There has to be the development of a streamlined service with specialist practitioners who can do the diagnosis and also, from the diagnosis, provide intervention. Why wait six years for a diagnosis only to be told, “You’ve got your diagnosis, but nothing follows it”? That is totally unacceptable.

The all-party parliamentary group for disability would be keen to engage with the Minister, who I know wants to do her very best on these issues, and the Department to look at, where possible, streamlining services for diagnosis and treatment for those children with special needs who deeply require it—we have all said the same thing today—and to learn from best practice right across the UK. There are things that we are doing well in Scotland, and there are things that we can learn from as well. At the heart of this are children, and we must do our best for those children. I want to work collaboratively to try to ensure that we do, together, across this House.

It is a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this very important debate during Children’s Mental Health Week. She has been a powerful advocate for her constituents who are struggling to access the support that they need for their children. I thank all the hon. Members who have spoken this morning. We have heard many powerful and distressing examples of the impact that the combination of the pandemic and the underlying gaps in support for disabled children is having on their mental health and the mental health of their families.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) spoke movingly about her own experience and the impact that a lack of access to diagnosis can have, even into adulthood. The hon. Members for Newcastle-under-Lyme (Aaron Bell) and for Keighley (Robbie Moore) spoke about the battles that families in their constituencies face and about the need for a “tell it once” approach when dealing with services. My hon. Friend the Member for Bristol East (Kerry McCarthy) and the hon. Member for Cities of London and Westminster (Nickie Aiken) made a really important point about the lack of co-ordination among health, education and social care services, which leaves so many families being passed from pillar to post and without the support that they need.

My hon. Friend the Member for Vauxhall (Florence Eshalomi) paid tribute to the brilliant work of Lansdowne School, which is also attended by many children in my constituency, who progress to Lansdowne from Turney Primary School in my constituency. Both schools provide a brilliant education for their children.

It was very moving to hear the hon. Member for Bury North (James Daly) speak about his own experience and the battle that his family have faced and continue to face on behalf of his precious son. It is so important that the hon. Member has brought here today the insights into the system as a whole that that personal experience has provided. I do hope that his son is able to access the support that he needs in order to enable him to continue to flourish in the future.

The hon. Member for Winchester (Steve Brine) made a really important point—there is far too much distraction at the top of Government just now. The disgraceful reality of that is illustrated no more powerfully than by the plight of disabled children, up and down the country, who are struggling to access the support that they need.

From listening to those accounts and looking at the evidence on disabled children’s mental health, it is impossible not to draw the conclusion that the most vulnerable children are being profoundly failed by this Government. According to research by the Disabled Children’s Partnership, nine out of 10 disabled children have been socially isolated during the pandemic, with 72% of parents and carers reporting that their child was often unhappy, downhearted or tearful. The impact of the withdrawal of vital support services, both in and out of school, has been devastating. The situation is of course complex, because many disabled children have physical health vulnerabilities that increased their risk in relation to covid-19 and it was important that protections were put in place.

I pay tribute to the staff working in SEND education and support, who adapted their services very quickly to provide online learning and undertake home visits. I recently visited Cherry Garden School in Southwark, a brilliant primary school for children with special educational needs. I heard from staff about the rapid action they took to develop an online curriculum and the learning packs that were delivered to children via home visits. I know that those visits were a lifeline for many families.

Despite the undoubted commitment of professionals, there was no systematic approach. The necessary precautions that were taken to reduce the risk of covid infection were, all too often, not supplemented with any additional support. At the start of the pandemic, 76% of families surveyed by the Disabled Children’s Partnership said that the vital care and support they relied on had stopped altogether, leaving parents and siblings taking on all care responsibilities around the clock. The support has been very slow to come back. As late as June 2021, more than 70% of disabled children were still unable to access pre-pandemic levels of therapies and health services. The pandemic has been challenging for everyone. It has been particularly gruelling and exhausting for far too many families with disabled children.

However, we know that the challenges facing disabled children and their families are not only a consequence of the pandemic. Some 60% of families with disabled children have sought NHS mental health support due to the stresses of fighting for basic services. That is the story, again and again and again. Every Member of this House will know constituents who are battling with a system that simply does not work as it should, with thresholds for support that are getting higher and higher, and have been doing so for a decade. Parents battle for assessment and diagnosis, they battle for EHCPs, they battle for the right support or the right school place, and in many cases they battle for housing that is suitable for their children’s needs.

I have mentioned many times in this House my constituent Matthew Garnett. I am pleased to say that Matthew is now thriving as a young adult in supported housing, pursuing the things he loves, including his project to visit every football ground in the country. Matthew, who has autism and a learning disability, first came to my attention when he was, like far too many children, in a secure hospital, held under the Mental Health Act 1983.

I supported Matthew’s parents in their battle to get him out of hospital. As part of that battle, the then Mental Health Minister commissioned a review of Matthew’s care. The review made devastating reading. It documented, year by year, his parents’ struggle, over more than a decade, to get their son the support he needed. The consequence of the system failure they encountered was that Matthew, like far too many autistic children and children with learning disabilities, ended up in a secure hospital, far away from his loved ones, with his health deteriorating week by week.

According to the Disabled Children’s Partnership, only 4% of parents and carers of disabled children feel they get the right support to care safely for their disabled children; 53% have had to give up work to care for their child; and 40% have experienced relationship breakdown since their child was diagnosed.

The Minister will, I am sure, mention the £30 million of funding for short breaks for families with disabled children. That is very welcome, but short breaks should be genuine respite. They should not be respite from a system of support that breaks people. It is not enough to substitute for a system that is failing in its entirety the promise of access to a short break every now and again.

The SEND review was originally promised in September 2019. It is now shamefully overdue. The pandemic is simply not an adequate excuse for the lack of urgency in that work, given the impact that the pandemic itself has had on disabled children. It sends its own message about the level of priority the Government place on families with disabled children. I hope the Minister will set out today a firm date for its publication. We need the review to set out clearly the gaps in current provision and in resourcing, so that the Government can set out a clear plan for ensuring that every disabled child in the country is able to access the support they need.

The current system is failing far too many families, and the impacts are being felt in devastating consequences for their mental health. This cannot go on, and I hope the Minister will set out a plan for change today.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for securing this important debate on special educational needs and children’s mental health services. As we can see by the number of Members who have attended the debate, this is clearly a significant issue across many parts of the country. Unfortunately, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is unable to be here today because she is self-isolating, so I will do my best to answer hon. Members’ questions. I am sure we can follow up on anything that I am not able to cover in my remarks.

I thank the hon. Member for Sheffield, Hallam (Olivia Blake) for sharing her personal experience, which illustrates some of the struggles that people face. She outlined the positives and negatives in her remarks. I also thank my hon. Friend the Member for Bury North (James Daly) for sharing his son’s experience, which is unfortunately not uncommon.

My own postbag reflects many of the comments that have been made in the debate. Children are often not getting the help and support they need at the early stages, which often leads to more difficult interventions later that could have been avoided if the support was in place. The collaboration locally between health and education is often not where it should be. I am here not to deny any of the remarks made in debate, but to set out what is being done to address these issues, which have been in place for many years. I agree with my hon. Friend the Member for Bury North that funding is not necessarily the only factor here; it is also about how services are brought together. As my hon. Friend the Member for Newbury said, it is about accountability for how those services are delivered.

In March last year, we published the covid mental health and wellbeing recovery action plan, which includes £31 million to improve autism and learning disability services. There is £42 million to continue funding projects to support young people and families with special educational needs. There are funding pots available, but we are hearing that they are not making it to the families who need them or to the services being provided. In the short time that I have, I hope to be able to set out how we aim to resolve some of those issues.

The demand for services has increased. There is no doubt that the demand for CAMHS, ADHD assessments, autism assessments and diagnosis has increased over time, but waiting times are also dismally short of where they should be. According to the National Institute for Health and Care Excellence, which provides evidence-based guidance on many of these areas, children and young people who are referred for an autism diagnosis should have a diagnostic assessment within 13 weeks. We have heard from many colleagues, including my hon. Friend the Member for Newbury, that it takes around two years. My hon. Friend the Member for Bracknell (James Sunderland) cited three years. Of course, my hon. Friend the Member for Bury North cited his son’s experience, and the hon. Member for Vauxhall (Florence Eshalomi) also spoke about this issue. We can see that it is a problem across the country.

For ADHD diagnosis, NICE guidelines do not recommend a specific waiting time, but they set out recommendations for how services should support and manage children who need a diagnosis and their families, for how such children should be supported through education, and for general support as well. We want every area of the country to meet NICE guidelines but, sadly, that is not happening in many places. To make sure that we get on top of the situation and reduce the delays, we want to work towards providing an assessment within the recommended 13 weeks in order to deliver a timely diagnosis—not just so that they get a diagnosis, but so that the interventions are there to help and support young people and their families.

There are three key areas where I think we can improve things. The SEND review, which was touched on a couple of times in the debate, is a joint collaboration between the Department for Education and the Department of Health and Social Care. It is in progress, and we expect its findings to be announced fairly soon—I am talking about weeks, rather than months. Following the recommendations from that, a Green Paper will be published. It will follow a 12-week period in which I encourage all Members to take part in the process and to highlight many of the experiences that we have heard today. We have talked about the funding that is being announced, but often that goes to health and does not get into schools. I met representatives from one of my schools only last week, and the joined-up working locally between education and health just is not happening. That reflects the point made by my hon. Friend the Member for Newbury that accountability for who is responsible for doing what, and the joint working, is currently not happening.

Will the Minister comment on access to funding for third-sector organisations, which are often more expert at offering advice and support that families need?

Absolutely. Services are commissioned locally. Part of the issue is that there is no accountability for when services are not commissioned. The funding that is put forward needs to look at all service providers, and the third sector is often well placed to provide those services.

To touch on long waits, NHS England is working to ensure that CAMHS have embedded diagnostic pathways for autism and ADHD as a core part of their work. A sum of £13 million is going in to improve those pathways and identify those at risk of crisis; £2.5 million of that funding will test different approaches to diagnostic pathways and ensure that they are backed by research and are evidence-based. In addition, NHS England wants to develop a single point of access to ensure that referrals are triaged, and that individuals do not stay on lengthy waiting lists. We have heard today of the difficulties caused by not having a single point of access. I have met families in my constituency. As the hon. Member for Oxford West and Abingdon (Layla Moran) said, we are the last refuge and point of contact when they cannot get anywhere else.

We know that school settings can provide an invaluable opportunity to identify autistic children early in life. We are investing £600,000 in significantly expanding an autism early diagnosis pilot in Bradford. That will test at least 100 schools over the next three years to assess whether new approaches to achieving a faster diagnosis can be rolled out across the country. The early findings from that pilot are positive. Education staff report that they are better able to identify children and put in place the support they need to thrive in education. Local areas will look to upskill mainstream staff to better identify children’s needs. In Manchester, a project to support early identification and diagnosis in young children involves health visitors identifying those who show signs associated with autism and fast-tracking their assessment, with additional post-diagnostic support for families.

The issue for many years has been the lack of a national strategy, but that is changing. What we want, when pilot studies show good initial results, is to roll them out across the country. In the next year, on top of the £1.5 billion spent in the past two years, we are providing an additional £1 billion of high-needs funding for the education of children with more complex needs. The aim of that funding is to reduce waiting lists and variations in practice, make navigation pathways less complex, and improve the speed and quality of diagnosis.[Official Report, 28 February 2022, Vol. 709, c. 5MC.]

Those points tackle some of the issues around waiting lists, but accountability was the main thread of the introductory remarks of my hon. Friend the Member for Newbury. At the moment, no one is held accountable locally if services are not commissioned. The integrated care system will be put on a statutory footing from 1 July, if the Health and Care Bill goes through on time, and ICS boards will be the accountable bodies for commissioning services. Their chief executive officer will be the accountable officer for the NHS locally and will be responsible for bringing those services together and will be accountable if that is not happening.

Since November 2019, NHS Digital has reported on waiting times for autism assessments, trying to ensure transparency in how services are delivered and highlighting areas where improvements are needed. It is incredible that, up until now, we have not had the data to hold people’s feet to the fire when services are not provided.

On accountability, can the Minister shed any light on the issue of CAMHS in Hampshire telling parents not to ask how long, or will she take it away? It means that they cannot plan, for instance, decide to sell the car. Those are the choices that people are facing. They cannot plan for what is next. Does that sound right to her, that people have been told not to ask?

No, that does not sound right. That is exactly why we want to bring some accountability to local services, so that when such statements are made, we can look at what the problems and the blocks in the system are to try to overcome them.

Local authorities also need to be held to account for how they support schools, because schools do a huge amount of work, going above and beyond in most cases to support children with special educational needs. That is why we continue to work with Ofsted and the Care Quality Commission to develop a new area of SEND inspections, which will look at how services and support are delivered in practice on the ground. That will hold local areas to account, so that there is no gap in oversight before full implementation of any new reforms resulting from the SEND review. It also recognises the importance of inspections in SEND services by highlighting areas of good practice and areas to improve on.

I reassure colleagues across the Chamber that that is an area of high priority. The SEND review will be published shortly, and the Green Paper will follow swiftly on from that. I encourage all colleagues to share their powerful experiences in that process, as they have today, so that we can improve services for the children and their families who at the moment are not getting the service that they deserve.

I thank every Member and colleague who spoke in the debate, from five different political parties, revealing the power and privilege of being a Member of Parliament. We can represent the concerns of families at their most acute, with all the detail and desperation in the emails and letters that we have all received.

My time is limited—I am not sure how limited—so if I do not mention every single Member who spoke, they must not think that I am not grateful for what they said. I pay particular tribute to my hon. Friends the Members for Bracknell (James Sunderland), for Winchester (Steve Brine) and for Bury North (James Daly), all of whom have children with special educational needs. My hon. Friend for Bury North showed absolutely directly what the emotional effect on the family means and how much that consumes the thoughts and all the deepest concerns of the parents about the outcomes wanted for their child.

I also pay tribute to the hon. Member for Sheffield, Hallam (Olivia Blake). One of the things that she said, which was reflected in so many of the emails that I got, was that when someone has a child considered to have autism, ADHD or something equivalent, often there is a period in the child’s school life when they are being told that they are a failure or disruptive. Headteachers told me that one of the things that happens is that not only is the child sometimes not popular, missing out on sleepovers, play dates out and so on, but the parents are not popular, because the other parents think that they have this difficult child. They cannot do anything about it.

One Member present today shone the light on what I am trying to achieve with the debate, and that was my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland). When he was Justice Secretary, he had a direct interest in neurodiversity, and he was appalled by the correlation between neurodiversity and autism, and the prison estate. We can all agree that it is never the responsibility of the Justice Secretary—from whichever party—to deal with that, but as a society we have failed if that is the end destination of people with autism.

We can draw a few strands together. I think that everyone present agrees that the need for intervention is urgent and that most of the problems could be identified at primary school, but there is much greater need for accountability. Where the Government have commendably made money available to commission locally, those services need to set out what is achievable and then to deliver them, with consequences for not doing so.

The Minister talked about integrating services and about improvement, all of which was music to my ears—joined-up working between education and health services. It must be the case that families in all the constituencies that we represent can have reasonable expectations. When their child is considered possibly to have a learning difficulty, the families should expect a diagnosis in a timely way and that some form of educational support will be made available. Almost—not all, but almost—every family who receives adequate educational support has seen a transformational impact on the life of their child.

Question put and agreed to.


That this House has considered special educational needs and children’s mental health services.

Supported Exempt Accommodation

Before we begin, I remind hon. Members to observe social distancing and to wear masks. I will call Shabana Mahmood to move the motion, and will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates. Members who intend to speak should have asked for permission from the Minister and the Member who secured the debate. I call Shabana Mahmood to move the motion.

I beg to move,

That this House has considered regulation of supported exempt accommodation.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I am pleased to have secured the debate today to discuss something that is a huge problem in my constituency, in my city, and in many other places across the country.

If someone had asked me a few years ago what supported exempt accommodation was, I would not have been able to tell them. I know it confuses people even now. Given my difficulties in dealing with the issue in my own constituency, I have become quite a world expert. I will set out for all exactly what we mean when we talk about supported exempt accommodation.

Supported accommodation is a broad term that describes a range of housing types: group homes, hostels, refuges, sheltered housing, and so on. An offshoot of supported accommodation is referred to as “exempt”. It is basically a resettlement place or accommodation provided by a council, housing association, charity or voluntary organisation, where a person or organisation provides the claimant with—in theory—care, support or supervision. I say “in theory” because too often that is not the case in reality, and that is what I will discuss in detail in my speech.

Exempt accommodation is supported housing that is exempt from housing benefit regulations. If we provide someone with that type of housing, we get access to enhanced housing benefit and can access more money to house this group of mainly vulnerable tenants who are in need of care, support or supervision. We can see why that has happened. The cost of housing vulnerable people—care leavers, women fleeing domestic violence, ex-offenders, people with addiction issues, and so on—is higher. The costs of helping those individuals are higher, so the exemption from housing benefit regulations—the ability to access higher payments to house such people—was designed to allow providers to access adequate sums of money to help individuals as they seek to turn their lives around. Too often, that is very much not what happens in practice.

I stress that there are some good, legitimate providers of this type of housing, who do important work with people in desperate need of housing and help. There are still those who are committed to a social and indeed moral mission to help people to get back on an even keel, recover from addiction, turn their lives around and play a full part in society once again. However, there are too many rogue—I describe them as cowboy—providers who have clocked that this is a lucrative money-spinning opportunity and who take full advantage. They get access to larger sums of money to house housing benefit claimants who need care, support or supervision, and then they do not provide it.

In law, it is the case that all a provider has to do is provide care, support and supervision that is, in legal terms, “more than minimal”. Those three words have plagued me as I have navigated the complex world of supported housing while trying to help my constituents—those who live in such properties and those in communities where there is a proliferation of those types of properties.

That is the nub of it, is it not? The hugely greater rents and support that landlords can get means that families are priced out of streets, and the problem spreads rapidly down these streets. The behaviour of many of those who get no support makes those streets places where people no longer wish to live. My hon. Friend talks about shady landlords, but is there not a real danger that there is so much money to be made now that organised crime is moving in, in a big way?

My right hon. Friend is exactly right. I will come to his point about the connection with organised crime, which is becoming a real problem. He is right that the distortion in the housing market in these communities means that working families are being priced out of good, viable family homes. Other social tenants cannot access them either; when a person cannot get enhanced housing benefits, they are subject to the local housing allowance

In fact, this lucrative loophole is causing huge problems not only for the tenants, who often get trapped in unsuitable properties, but for the communities living in those in those areas and those who might wish to live in them, too. It is exactly those nefarious operators moving into the sector who are causing problems in my constituency and across the country.

In practice, “more than minimal” means hardly anything at all. I have heard providers say that installing CCTV in communal areas or having a manager who might visit the property once in a blue moon counts as adequate supervision of vulnerable people. That sort of so-called supervision would certainly pass the “more the minimal” test, but the idea that that is what was meant by the regulations that determine access to larger pots of housing benefit is utterly outrageous.

Cowboy operators know that they can access more money per tenant, and they do not have to spend very much—or indeed anything at all—to demonstrate that they are providing care, support or supervision. So, what is the upshot? Lots of cash is available for those who know how to game the system.

As my hon. Friend knows, I introduced a ten-minute rule Bill on this matter a couple of years ago because of concerns about a property in my constituency where it took providers two days to discover someone’s body after he died. That is not supervision or support. Councils just do not have powers to deal with this issue. The Charity Commission got involved. Does my hon. Friend agree that we absolutely need better mechanisms by which to intervene when we are worried about a supported housing project?

I thank my hon. Friend for her intervention and her work in this area. I know of the shocking case in her constituency. It really speaks to the problems caused by providers in this sector not doing what they are supposed or intended to do. I will come on to the regulations that I think need to change later in my speech, and I very much hope the Minister will take those on board.

If someone knows how to game the system, the next stage is obtaining properties, which these providers do by leasing them from owners. With that lease-based model, providers do not have to shell out large sums of money to buy property of their own; they do not have to spend lots of money adapting it, either. They simply lease houses, turn them into houses in multiple occupation—or HMOs—and, frankly, watch the money roll in.

This is the other aspect of the exemption in relation to this type of housing: providers are exempt from not only housing benefit regulations but other regulations, such as planning and licensing laws that enable councils in other areas to limit the types and proliferation of HMOs. Those rules do not apply to supported exempt accommodation. Having a so-called article 4 direction in a city or area—as we do in Birmingham—does not stop the proliferation of this type of housing.

In theory, we can see what was being attempted with those rules: to provide more money to cover the additional cost of housing associated with vulnerable tenants, and to allow enough appropriate units to be set up to ensure that an adequate quantity of housing is available. Again, however, that is not how things have worked in practice. The exemption from licensing rules and regulations that applies to other types of HMO does not apply here. Whole streets and communities are becoming saturated with family homes converted into HMOs providing exempt accommodation, housing vulnerable tenants and creating problems for the whole community, while failing the tenants by placing them at risk of very real further harm. It is a system that is failing everyone.

I thank my hon. Friend for securing this important debate and for the fantastic work she has done on this matter. As she said, I was alerted by constituents to the rise in crime because of some of these properties, with drug dealing, begging and sex work taking place. I undertook a spot check and saw first hand vulnerable people who were not getting the support they need and living in really substandard, filthy conditions—somewhere none of us would actually choose to live. It was only with West Midlands police, Birmingham City Council and our local residents that we got that place shut down last year. It is the first in the country that we have been able to shut down. Does my hon. Friend agree that the sector is fundamentally in need of reform and that we cannot put this task off any longer?

My hon. Friend has been doing huge amounts of work on this issue in her constituency. Many of my Birmingham colleagues are in this Chamber today. This is a big problem in our city, and I thank my colleagues for their interest in this debate and for the work they are doing in their own constituencies. My hon. Friend is absolutely right about regulation, and I will come to some of the regulations that will be needed.

Some might be thinking that there is surely someone regulating the system and carrying out the very checks to which my hon. Friend just alluded. There is a regulator for social housing, but it simply does not have the powers to deal with rogue operators, because those people know how to game the system. They have set themselves up as small operators, so they are outside of the direct purview of the regulator. They can make lots of money with little to no scrutiny, which is leaving too many people in my patch in utter despair. More than 150,000 households in the country are living in exempt accommodation—this represents a 62% increase in five years—and there are 1,600 such properties in my constituency alone. There has been a massive increase, and we are seeing these problems all over the country.

As I have said, the tenants are too often being let down. Many of my constituents come to me with their problems, and many of my colleagues have raised in the House, and with the city directly, the issues that their constituents face with their properties. It is not unusual to find properties that are in complete disrepair and that we would not consider fit for human habitation in any way. It is not unusual for vulnerable women to be housed with dangerous men in these properties—for them to be at risk of attack or, in fact, to have been attacked.

I am becoming a broken record. I have brought a case to the Department of a 19-year-old rape victim who is waiting for trial and has been housed, without any regulation, with men who have been released from prison for the exact same crimes that she wishes to put people in prison for.

To respond to the point made by my hon. Friend the Member for Bristol East (Kerry McCarthy), two women in the last three years have been murdered in “exempt, supported” accommodation. In one case, the key worker did not notice that the woman had been murdered. After visiting the property, she said to the woman’s mother, “Oh, she’s absolutely fine”—but the person she had seen was the person who had murdered the woman. That is the level of support that vulnerable women are getting in this accommodation. It is dangerous, and it must stop.

My hon. Friend is absolutely right. She has raised those horror cases in her constituency at regular intervals, directly with the Department and in this House. Those cases of women left at real risk of harm, having truly suffered at the hands of dangerous men who they should have never been housed alongside, are not unique.

It is not unusual, when I have investigated cases in my constituency, to discover that the housing contract that was approved has forged signatures on it. There are multiple layers of subcontractors that get involved with the providers in this sector, and it is not unusual to see faked documents. I have had constituents come to me and say that they are being held to a contract that they have never seen before. It is also not unusual for people to be left without any hot water or electricity.

It is often the case that the tenants, who are desperately in need of care, support or supervision, are left to rot in disgusting properties and at real risk of physical danger. The residents who live alongside them are also being let down: over-concentration in particular areas just loads more need and deprivation into areas that are already struggling. Crime and antisocial behaviour has massively increased. I have had constituents break down, explaining that they are worried that their children are witnessing public drug taking, people collapsing in the street having drunk too much or urinating in their front gardens, all on what were once modest, quiet residential streets that were home to tight-knit communities. That is why so many people in my patch and my city are in utter despair.

I appreciate the point that my hon. Friend is trying to make. This weekend, a lady came to my constituency surgery to complain of exactly that issue: prisoners on release have been put next door to her and are making her life absolute hell, and she is not able to do anything. Not just that—the environment around the place is becoming filthy. It is creating a huge problem in the environment across the whole of the constituency, and our communities are breaking down because of the under-regulation that is taking place.

My hon. Friend is absolutely right. The example he describes is something I see too often in my own advice surgeries. People really are in despair. This situation is attacking the heart of the social spirit we need to help vulnerable people turn their lives around. People generally want to do the right thing by people who are in trouble. They want to have mixed communities where everybody can play a part in uplifting and supporting each other, but when there is an over-saturation of need, without the necessary supporting services, that breaks down the social fabric of our communities and the spirit of social solidarity.

So many times I meet people in complete despair at the change they have seen in their local areas as a result of the proliferation of exempt accommodation units. In many cases, they are desperate to move out and leave the places they have always loved, because they can tolerate the degradation of the living conditions of the whole community no longer.

This is all happening in plain sight. Only the Government have the power to act. I implore the Minister today to commit to taking the necessary action. No more pilots or evidence are needed. We have plenty of evidence; we have been shouting about the evidence for years. It is high time that we see some action.

As others have also said, I have been convinced for some time that some rogue operators in this sector have links to organised crime. I know that the police have raised concerns at a national level. The sector has the advantage of having zero chance of a jail term, so we can see why criminals, previously involved in drugs or whatever, are now concluding that this is a better business to get into. What do the Government need to do? They need to destroy the business model of the rogue operators. Good providers spend the additional money they receive in the ways in which it was always intended, so they will have no difficulty meeting higher legal tests or proving themselves, but that is not the case with rogue operators.

The Department for Work and Pensions needs to tighten up the welfare regulations. We need a proper legal test for access to enhanced housing benefit. The regulations have to be toughened up, and a proper test for what counts as care, support or supervision has to be set out in law. We have to cut off the ease with which this extra cash can be accessed.

From the Minister’s Department, we need tougher regulations and a regulator that has the full range of powers needed to deal with the problem. I want to see a tough “fit and proper persons” test that has to be passed before any provider is allowed anywhere near the sector, no matter how big or small the operator or how many units they have at their disposal. It need to be the law that they should all have to pass such a test.

Local authorities need the power to reject applications for exempt accommodation on grounds of saturation or over-supply in a specific area, and to insist on community impact assessments that have the power to prevent over-saturation. That is the only way we will be able to stop the overloading of high need into already difficult areas.

All tenants in exempt accommodation need to have some sort of local link to the area. Birmingham has become, in the words of some council officials I have spoken to, a dumping ground for people from elsewhere. A local link will not always be appropriate. I fully accept that in cases of domestic violence and occasionally in respect of ex-offenders, a local link needs to be broken to help somebody turn their life around, but we cannot simply allow a system where local authorities or national Government agencies are displacing huge amounts of vulnerability and need into other parts of the country, with no thought whatever for the people left to cope with the changes being made to their communities against their will.

Once a provider has shown that they are fit and proper, and we have prevented over-saturation, we need an inspections regime to keep providers on their toes and a regulator that has full powers of enforcement to clamp down on those who might still flout the system. We need a whole package of regulations to clamp down on the many abuses in the sector.

I know the Minister has been looking into the matter, and the Minister for Welfare Delivery has sent me written assurances that he is considering changes to benefits regulation. They must understand the desperation we are feeling as vast swathes of our communities are changing right before our very eyes, and we have no powers to do anything about it. I hope that in his response today he is able to give us some assurance that this Government will finally take decisive action to turn this absolute horror around.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank the hon. Member for Birmingham, Ladywood (Shabana Mahmood) for securing this important debate. It is a topic that she and I, and a number of familiar faces across the Chamber today, have spoken about.

It goes without saying that problems with supported exempt accommodation are a serious matter that impacts not just the housing benefit bill but hundreds—possibly thousands—of vulnerable individuals across the country. Having previously worked as the deputy chief executive of YMCA Birmingham, I have seen at first hand the challenges that vulnerable people face and the real difference that good-quality support can make. I am grateful to the hon. Lady for mentioning the fact that there are good-quality providers who make a difference. I have a strong personal interest in improving the quality of exempt accommodation, and more importantly the life chances of those people living in it.

As a Government, we are determined to tackle the problems that have dogged the sector for too long, but we also want to do more to support the high-quality supported housing providers that deliver services to some of the most vulnerable people in society. We really need them to continue to operate successfully, so that people who need supported housing receive support and a roof over their head.

As the Minister responsible for homelessness and rough sleeping, I know the key role that good support and the right accommodation play in helping those who have fallen on hard times to get back on their feet and rebuild their lives. As the hon. Lady said, this kind of support is not always given. Right now, there are too many cases of rogue providers benefiting from taxpayers’ money without providing anywhere near the right kind of services for residents. The growth of exempt accommodation concentrated in specific areas of towns or cities is also creating neighbourhood issues, antisocial behaviour and criminal behaviour, as a number of hon. Members highlighted.

The Government are doing everything in their power to tackle rogue providers. Officials in the Department for Levelling Up, Housing and Communities have engaged with Birmingham City Council and local charities to build a better understanding of the issues, including the scale of the problem, the drivers of its growth, and its impact on residents and local communities.

Birmingham is obviously not the only city to experience such problems—the hon. Member for Bristol East (Kerry McCarthy) raised concerns about her area. At a national level, the Government have raised the bar on the standard of exempt accommodation across the board. In 2020, the Department published “Supported housing: national statement of expectations”, setting out the Government’s vision for better ways of working in supported housing and a much higher minimum standard of accommodation. The guidance was critical in showing what good looks like, and highlighted where providers and councils are working in joined-up and innovative ways to drive up quality. Ministers and officials have engaged with councils, housing providers, the regulator of social housing and other regulatory bodies to improve standards and our understanding of the issues.

That effort has been matched with proper Government funding. The hon. Member for Birmingham, Ladywood will, of course, be aware of the pilots. We have provided £5.4 million for a year-long pilot in five local authority areas in England. The pilots have been critical in helping us to understand the issues and the differences that we can make. The participants, including Birmingham, bring together teams from across different services, such as housing, revenue and benefits, environmental health, social care and, in some cases, the police and probation services, to address the different issues that residents face. Although I have not yet received the final report from the independent evaluation team, I know that the pilots are delivering real results and acting as models of good practice for councils to adopt.

Birmingham has developed a new charter of rights for residents of supported housing, along with a programme of support reviews and scrutiny of housing benefit claims. In Blackpool, the council has carried out a review of the support provided in accommodation for victims of domestic abuse to ensure that there is sufficient and tailored support.

The problems with exempt accommodation are spreading rapidly because all sorts of crooks are getting in on it. Neighbourhoods are being ruined. Quite frankly, they want action now. When will the Minister bring forward regulations to enable councils to do something about this?

I fully accept the right hon. Gentleman’s point, but part of the purpose of the pilots is to understand not just the scale of the problem, but, more importantly, what type of interventions work most effectively. It is all very well saying, “We know what the problem is. Therefore, we know how to address it.” I am not sure that is completely the case, given that different interventions have had different successes in different pilot areas. It is important, having spent £5.5 million, that we get the full value from the pilots and understand the best-quality interventions to make.

Would the Minister agree that one of the fastest ways to get action in this area is to destroy the business model of the rogue operators? That will not impact on good operators doing the right thing, because they are using the extra cash to do the right thing. It is the rogue operators that need the scrutiny and the blunt instrument of tougher regulations and a proper test in law.

I understand the hon. Lady’s frustration and the case she is making. Having worked for a good-quality provider, I understand the marginal prices that they work on. It is possible to put good-quality providers out of business through unintended consequences of applying tougher restrictions right across the sector. We need to be careful that we do not throw out the good with the bad when making the suggested changes.

I also used to run one of those accommodations, and we had an inspection regime before we were ever entitled to advance with the Department for Work and Pensions. That is not happening today. Every single year that we were given enhanced benefits at Women’s Aid in the Black Country, which serves the Minister’s constituents, there was an inspection. Cuts to councils have ended those inspections. I had to prove what we were doing. I had to show CCTV. That does not happen now. In Birmingham, £100 million a year is being given to rogue providers with no inspection, yet my individual constituents trying to get welfare and disability benefits from the DWP have a greater inspection regime than the people making £100 million.

I understand the hon. Lady’s experience, which we share, but to a degree she proves the point of the pilots; some councils have invested in staff to carry out inspections—as I mentioned when referring to Blackpool—and as a result of carrying out the inspections to which she refers, they have been able to cut their benefit bills. Councils are making the choice as to whether to invest in those staff. I remember such inspections myself. There must be an element of choice, because some councils are making choices.

Time is rapidly running out, but I will give way. Before I do, I just want to say that I completely understand the case that is being made by Opposition Members. I share their frustration and have a genuine, dedicated intention to tackle the issue. This will not be the last opportunity to discuss the matter. I look forward to discussing it outside of this Chamber.

I thank the Minister for giving way. Does he agree that councils across the country need regulations so that they can take action against rogue operators? My hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill) mentioned that she was successful in closing down a rogue operator in her constituency, but that it then opened up in a neighbouring constituency. Councils need the powers and regulations to shut them down permanently.

The best way to conclude would be to say that we certainly will not rule out the use of legislation if that proves to be the most important tool that we could deploy. Hopefully we will learn from the pilots when we have the final report, so that we understand which interventions work best and can develop future models that include them.

Question put and agreed to.

Sitting suspended.

Endometriosis Workplace Support

[Geraint Davies in the Chair]

I beg to move,

That this House has considered the matter of supporting people with endometriosis in the workplace.

What a pleasure it is to have you in the Chair this afternoon, Mr Davies.

It would take 20 days, at 24 hours a day, to name every woman in this country who suffers from endometriosis. That is the scale of the problem that we are dealing with. It is bad enough that it takes eight years on average to get a diagnosis, and that there is a lack of settled opinion on the surgery required. It is also bad enough that the blunt truth is that, even in today’s age, the main coverage given to this debilitating disease seems to be when a man stands up and talks about it. I have fantastic support from people such as the hon. Member for Livingston (Hannah Bardell) and other hon. Members, who have supported at every step of the way the debates that I have brought to the House; there is absolute cross-party support for tackling women’s health issues.

Unfortunately, I am often asked, “Why are you doing this, as a man?” I remind people that as Members, we represent everybody in our constituencies, and for most of us, probably over 50% of our constituents are women. It seems bizarre to question why a Member of Parliament would raise issues about the opposite sex; to me, a constituent is a constituent. Endometriosis is such a wide-ranging affliction that affects so many women, and it is so unrecognised.

Today I seek to talk about women’s suffering in the workplace, which mainly comes about through a complete lack of knowledge about this disease. I will start by describing endometriosis. I am grateful to Heather Guidone, board certified patient advocate and surgical programme director at the Centre for Endometriosis Care, for sending me the text entitled “A riddle wrapped in a mystery inside an enigma”, which states:

“Endometriosis is a systemic, inflammatory disease characterized by the presence of endometrial-like tissue found outside the uterus. Endometriosis has significantly negative impact on the physical, emotional, reproductive, and sexual health, financial security, relationships, careers and schooling of those affected. Commonly located in the abdominopelvic region, the disease has also been found in virtually every organ system including the lungs. Mistakenly referred to by some as simply ‘painful periods,’ symptoms are not limited to menstruation and often become chronic over time. It is also entirely possible for those who do not menstruate e.g., adolescents, post-hysterectomy, post-menopause to struggle with endometriosis. This extraordinarily complex illness has body-wide impact, with sustained inflammation, angiogenesis, adhesions, fibrosis, scarring, and local and neuronal infiltration leading to a multitude of systemic issues. Chronic pain, anatomic distortion, adhesions, organ dysfunction, non-menstrual abdominal and pelvic pain, infertility and pregnancy loss, painful sex, bowel and bladder pain and dysfunction, lower back and leg pain, severe bloating, crippling fatigue, debilitating period pain among those who menstruate, even lung collapse and much more are hallmark of endometriosis. Despite the preponderance of systemic symptoms and effects, however, many patient complaints are unfortunately trivialized or outright dismissed at the healthcare level. The disease is also rarely present alone and is commonly associated with multiple comorbidities and secondary pain drivers including various gynepathologies; chronic fatigue; coronary heart disease; rheumatoid arthritis; adverse obstetrical outcomes like loss, preterm birth, spontaneous hemoperitoneum in pregnancy, obstetric bleeding, pregnancy-induced hypertension, preeclampsia and more; painful bladder syndrome; and even an increased risk of certain cancers. Often called a ‘disease of theories,’ definitive causes have been under debate for over a century, yet no single theory yet explains endometriosis in all affected. Most likely, a composite of several mechanisms is involved.”

With millions of sufferers and long-standing recognition of the disease, it is shocking that women suffer such enormous discrimination in the workplace for a common disease. To summarise, I will quote from a paper I was sent by Victoria Williams, a researcher at the Open University, from her PhD thesis, “The experience of endometriosis in the workplace and the influence of menstrual policy: leaning to precarious work to manage a ‘precarious condition’”. She says:

“Endometriosis often hinders the ability to work to the same capacity every hour on every day of a traditional working calendar, and as such participants talked of not being able to hold down full time work, leading to multiple part time roles or precarious work situations, drawn by the flexibility they offered. However, the supposed flexibility is often a double bind with lack of stable contracts, loss of state provisioning and the financial impact of having to take time off for surgery (often multiple surgeries). As such, precarious work may be appealing to people with endometriosis because of the promise of flexibility but they may equally feel and be even less protected.”

I want to expand on that by talking about the sufferers of this terrible disease and the effects it has in the workplace.

We have all been ill. Unfortunately, we have all had a rather nasty stomach upset at some point. We may have been at work when we were suddenly taken short and had to nip out to the bathroom. I do not want to get too graphic—we all know what that feels like. I am sure we have all had a very embarrassing incident at some point in our life. Mr Davies, can you imagine experiencing that fear—and, indeed, that incident—every single day in the workplace?

I have been given examples of that particular situation by women who have been at work, in a meeting, when a sudden bowel movement has given them seconds to get out and get to the right place. Yet one person who gave me such an example told me that her employers tutted and said she was unreliable: “She’s always nipping off to the bathroom.” I do not believe that people are mean or bad. I fundamentally believe that most human beings in society want to do the right thing by people, but if people do not know about the situation, ignorance can have some very nasty consequences. We have to start raising a higher level of awareness of this issue.

National Endometriosis Survivors Support has sent me a catalogue of quotations, with more than 60 patients outlining their experiences. I am going to share about 20 of them with hon. Members.


“Having endometriosis has made my career a mine field. I cannot progress how I wish to due to time taken off sick. I have been undermined and people have compared my condition to other conditions with complete ignorance:—suggesting that I was exaggerating my symptoms. Working life is not compatible with suffering from endometriosis—it’s too much and no one understands!”

No. 2:

“I was asked what I was going to do to make things better and stop myself being sick. It’s an incurable disease.’

No. 3:

“I’ve almost lost my job due to discrimination because I couldn’t work as fast when I was in crippling pain.”

No. 4:

“Almost lost my job in a major company despite them saying they’d treat endometriosis occasions of absence separately that wasn’t the case. Also wouldn’t let me home when I was covered in blood to change my clothes and made me go purchase new clothes and told me to use work showers.”

No. 5:

“I was in hospital due to my endo a little over a month ago, I couldn’t walk. Had to call in for work, which I rarely do unless I genuinely can’t help it, they asked if I was being admitted because if I wasn’t they wanted me to ‘make up for it’ by working the next day.”

These are real experiences from real people in the workplace. There is lots of evidence out there.

No. 6:

“Due to the fact that I had two laparoscopies, I had a large gap in my employment record. Despite a very good CV, my applications were rejected because employers saw only the employment gap.”

No. 7:

“I haven’t been able to work for 7 years now and it depressing.”

No. 8:

“Was misdiagnosed as IBS for 4 yrs, my boss said I was exaggerating it, refused to let me do flexi time to help. After surgery, I was signed off for an additional week, and when I called to tell her, she swore and slammed the phone down. Ended up severely depressed. I was suicidal. She brushed it off, and kept calling me Menopausal Mandy.”

I have said it before on the Floor of the House and I will say it again: women are dying. They are killing themselves. They are spending day after day in chronic, crippling pain and do not even have the support of a workplace. That level of destruction of women’s lives is killing women, and it has got to stop. We have to get a better understanding of what millions of women are going through in this country.

The right hon. Gentleman is making an incredibly powerful speech. The issue is absolutely about conditions like endometriosis, but does he agree that it is also about a basic lack of compassion for women who have periods every month? In January, Dr Rosie Baruah backed the British Medical Association’s call for period products to be provided in all NHS staff toilets. She said the products should be viewed as a basic necessity, not a luxury. The outcry from some men was utterly appalling. The lack of understanding of how challenging it can be for someone when they bleed through their clothes and do not have access to products or toilets was shocking. We need to do much more to get a basic understanding across society and to put policies in place—for endometriosis, but also just for periods.

I am so grateful to the hon. Lady, who raises a point that comes up time and again. I do not believe that the majority of people are that unkind, but they just do not know what they are talking about. Her point speaks to a wider issue. People think it is acceptable for there to be an outcry about supporting women in the workplace. That is the problem we face. We have to change societal thinking on these issues.

I will continue sharing the experiences of patients. No. 9:

“I have to use my annual leave after operations in case I get ill during the year and need time off.”

No. 10:

“The problem, they find another way to get you out. They go for competency & make your life hell, picking up on every little point & you don’t have a leg to stand on. I’m so miserable at the moment.”

No. 11:

“This debate couldn’t come at a better time my boss is starting to give me a rough time because I was really rough last week and I even collapsed in work and ended up in hospital and he still expected me to be back in work the following day and this week he gave me a warning letter about my days off and now it’s really worrying me.”

No. 12:

“I was off sick and recently dismissed whilst off sick.”

No. 13:

“I lost my job years ago due to having a few periods off sick for surgeries and some emergency surgeries. All of these were for endometriosis. I worked for the NHS!!! They don’t care whether you have genuine reasons or not, other people take time off for a common cold etc whereas I went to work in severe pain most days; but the hard work I put in was not appreciated.”

What we are dealing with here is constructive dismissal, which is illegal in this country, but is just being swept under the carpet.

No. 14:

“I’ve unfortunately been put on redundancy notice. My Endometriosis sickness has been scored against me as well as my productivity not being the same as everyone else. I have an occupational health report stating to reconsider my targets due to me taking codeine to manage the pain. My question is, is Endometriosis classed as a disability? Is this discrimination?”

No. 15:

“At 18 I was sacked from a nursing home due to having too many days off related to endometriosis flare ups.”

No. 16:

“I was recently dismissed from work whilst off sick because I was off so long so now jobless. I’m 35.”

No. 17:

“I’m 28 currently in full time work but due to the lack of knowledge of this awful disease I’m currently under investigation for fitness to do my job. I work in a nursery. This is all due to having sick days (which I don’t get paid for). With more knowledge and research more women wouldn’t have to try and fight with their management to prove they are sick and can still do their job.”

No. 18:

“At age 21 I was dismissed for having too many sick days due to endo. At age 25 my contract was terminated while I was laid in a hospital bed, after emergency surgery due to endo. At age 28 my job was suspended and then terminated due to them not believing the reasons for absence, i.e. Endometriosis, and I was laid in a hospital bed the day I had my hysterectomy when they emailed me to tell me. I’m 29 now.”

No. 19:

“I was forced to resign from my permanent teaching position while I waited for surgery. The new head didn’t believe how ill I was. I’m much better off mentally being self employed, but not financially.”

I emphasise the examples about teaching and the NHS. When we raise such issues, people sometimes think that we are talking about private employers. We may have a vision of the bad boss who says, “Silly woman!” and that sort of thing, but I am actually giving examples from the public sector. I will be bringing forward debates later this year for the Department of Health and Social Care and the Department for Education to respond to, but does not the fact that a teacher was dismissed because the headteacher did not understand endometriosis paint an even more worrying picture—that girls are not being told what a healthy period is, and none of them knows what this disease is? How can someone possibly know that they have a disease if they do not know that that disease exists?

The examples are piling up. I had over 60 examples, which I have whittled down to this list. Here is the final quotation on this point:

“Benefits—DWP are not recognising endo as a disease/pushing you to work. When I have completed a work capability assessment they found me suitable for work, have had to push again for a mandatory reconsideration. This goes for UC & PIP as I am currently going through the process of both.”

However, there were some positives. One person said:

“From age 11 I spent the week off school each time my period arrived. I couldn’t move as the pain was too much and so heavy I was changing pads far too often than would be allowed to leave a class to go to the toilet. The school called me and my mum in for a meeting and I was made to go in or face a disciplinary. Quite a few times I bled through which meant taking spare clothes. As a teenager this was mortifying. Now as an adult (32) I have made my employers and colleagues aware and I’m in a job where I can just nip to the toilet. I am also very lucky to have supportive colleagues that help when I am doubled over.”

Here is another one:

“When I was 14 I was sent home from school for being violently sick. Kept being sick continuously until later that day my time of the month started. I work in a pub and over the last 5 years have collapsed in the bathroom, in the back room. I have to have moments in the back room because I’m in so much pain I can’t stand up. Let alone smile at customers. I’ve been sent home a few times when it becomes clear there is no way it is possible for me to stay there. I have to have extra time to sit down and my boss and I have had to put lifting bans in place or by the end of the night, when I start off OK, I can’t walk and I’m in agony from lifting too much and pulling all the organs around. I often have to sleep for hours the day after to try and recover from my shift as it physically takes it out of me and I find it increasingly hard to push through. Thankfully I have a really supportive team or I wouldn’t be able to support myself to live. But I think back to previous bosses and all I can think is how I wouldn’t be there anymore if I still had any of them. Because they wouldn’t have tolerated and accommodated my health.”

In 2020, the all-party parliamentary group on endometriosis published an inquiry, some of which I will read out. This is about the impact of a supportive employer:

“For the last 9 months I have missed almost a week per month, but my work have been very supportive of this as they know I have been undergoing tests. I am very lucky to have an employer who is so understanding”

Another woman said:

“Only one workplace classified me as having a disability which was extremely helpful on days where I was in pain, my boss was fully informed and would have no issue with me saying to her, I have to head home straight away, and I will be back in 2 days.”

Here is another one:

“I have been very lucky that my work have been wonderful. They make adjustments for me working from home when needed and it’s no problem if I can’t work because I’m in too much pain.”

The report also talked about employee rights and employer obligations. The Equality Act 2010 states that a person is disabled if they have a physical or mental impairment that

“has a substantial and long-term adverse effect on…ability to carry out normal day-to-day activities.”

When endometriosis is debilitating, due to the symptoms experienced and/or the long-term impact of surgery, it meets the Act’s definition of disability, as with other chronic conditions.

Employees with endometriosis who experience debilitating symptoms have the right to ask their employer for reasonable adjustments at work that would enable the individual to continue working or would reduce the disadvantage suffered due to having a disability, in this case a chronic condition. Reasonable adjustments include, though are not limited to, flexible or reduced working hours; reassigning work or duties; time off for medical appointments; and working from home. Employers must consider requests for reasonable adjustments and cover the cost of adjustments agreed. However, we know of cases where women with endometriosis have requested reasonable adjustments, for example, to work a particular shift pattern or reduce working hours, and have had those requests refused.

The pandemic has had a significant impact. The report on endometriosis and working from home says:

“Both the 2020 APPG inquiry and our 2021 Covid Impact Survey found that those with endometriosis who were able to work from home reported it as a positive development, in particular in relation to better managing symptoms, including…Being able to undertake physical pain management techniques more easily…Being able to take breaks/lie down when needed…Not having to commute to work when experiencing painful symptoms.

Some reported a positive impact on mental health due to enabling better symptom management.

Our 2021 Covid Impact Survey found that 69% of those working entirely from home found it positive, as did 51% of those working partly from home.”

Respondents to the 2020 APPG inquiry made comments about the positive impact of working from home:

“Now have option of working from home, so this helps with not having time sick and then missing pay.”

“I am lucky with my work now I am able to work from home if too unwell to travel.”

“I work from home so I got my hours around the times I feel okay. When my symptoms are bad I am often so tired I just have to sleep for most of the day.”

It is not a completely negative story that I am painting today. There are good employers out there and good examples of where employers have been able to work around it. That brings me on to endometriosis-friendly employers. Endometriosis UK has an endometriosis-friendly employer scheme, which supports organisations to make simple adjustments for those with endometriosis to work effectively while managing a chronic condition. Employers sign up to the endometriosis-friendly employer principles and commit to working to implement them. The principles are: leadership and management support; tackling stigma and cultural change; communications to increase awareness of endometriosis; and promoting the support available for employees with the condition.

We can draw quite a lot of comfort from that, but I put to the Minister that we have got to push that out to employers. I am not going to ask the Minister for new legislation, for new Bills to come forward to the House. I believe that there is plenty of law in place, but it is not being properly used. That is more than likely because employers do not know about this terrible, debilitating disease.

As I draw to a conclusion, I would like to highlight the opportunity to link the issue with the menopause taskforce. The Government press release on Friday stated:

“Minister for Women’s Health and co-chair of the UK Menopause Taskforce Maria Caulfield, said: ‘For too long women have gone unsupported and unheard when it comes to specific women’s health issues. This is especially true when it comes to the understanding of and treatment for the menopause’ It was agreed the taskforce will meet every 2 months, and future meetings will be scheduled by theme which will include…healthcare provision…education and awareness…research evidence and data”,

and “menopause in the workplace”. So we are recognising one condition of women in the workplace—the menopause —but not recognising endometriosis. There is no taskforce out there to do that. I know this matter is not the responsibility of the Minister’s Department. It will have to be something that works across Departments in many different ways.

There are still women at a huge disadvantage in the workplace when they try to start a family, especially those with fertility problems. I am grateful to Dr Larisa Corda for passing me information from an organisation called Fertility Matters at Work, who sent me the following statistics: 72% said that their workplace did not have a fertility policy in place; 83% said that covid-19 had made managing fertility treatment while at work easier; 68% said the treatment had a significant impact on their mental and emotional wellbeing; only 1.7% had a fertility policy that met their needs; and 69.5% took sick leave during the treatment.

Although this debate is primarily focused on supporting sufferers of endometriosis, I urge the Minister to look at the range of women’s barriers in the workplace that still exist today—in the 21st century! Our society should surely have moved beyond the glass ceiling. In fact, it is not so much a glass ceiling as bulletproof glass. There are probably weaker windows in President Biden’s Beast. The glass ceiling is almost impenetrable.

Perhaps today’s debate will start to move the issue forward, because we are going to keep the pressure up. I started this debate in October 2019. Then we had a general election and a pandemic, and we have had to start again. Can it be that nothing happened in two years because we were not raising it here, when we had already raised it in a debate in October 2019? It is important that we do not let this issue go.

I have five asks of the Minister today. First, promote the endometriosis-friendly employer scheme. Secondly, work with other Departments to interact with the menopause taskforce and the shocking lack of support for women with fertility problems. Thirdly, get the Department for Work and Pensions to recognise that endometriosis can be a disability. Fourthly, ensure employers fully understand the Equality Act to protect endometriosis sufferers in the workplace. Fifthly, create a scheme to promote endometriosis-friendly employers.

We are only halfway through this Parliament—I know it seems a lot longer. We have plenty of time to do plenty about the issue in this Parliament, and we have to. The time has come to settle this terrible, debilitating strain on women who are owed so much more. This society—never mind what the Government and Parliament do—is letting them down.

We have five speakers and half an hour before the wind-up speeches, so that is about six minutes each. I call Alex Davies-Jones.

Diolch. It is always a pleasure to serve under your chairmanship, Mr Davies. I offer hearty congratulations to the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) on securing this debate today and on making a fantastic speech, which I agree with wholeheartedly. I commend him on his vociferous campaigning and support for women experiencing and suffering from endometriosis. It is so important that we have male allies speaking up and talking about the issue. Let us be honest: if the condition affected men, we would not need this debate in the first place. I have spoken passionately about this topic on numerous occasions, so I will try my best to keep my comments brief.

Endometriosis really is an issue that cuts across the political divide, as we have seen today, and I am pleased to see it increasingly receive the attention it deserves, both in this place and on the national and international stages, too. Only a few months ago I spoke, along with colleagues here, in a petitions debate relating to research into endometriosis and polycystic ovary syndrome, and I am sorry to say that, despite the success of both the petition and the debate that followed, little has changed in terms of Government action.

We all know that the number of women living with endometriosis is colossal. Some 1.5 million women are dealing with symptoms ranging from chronic pain and fatigue to infertility, and the research, awareness and support for those suffering from what—as we have heard —can be an extremely debilitating condition is still lagging far behind, and is lacklustre at best. It is clear from speaking to constituents and personal friends of mine who live with endometriosis that there is a lot of work to be done to educate people about the symptoms that can be involved for those suffering.

That is why I am so pleased that today’s debate is focusing on the issues faced in the workplace when living with endometriosis. I genuinely believe that we are making progress in terms of the conversation around gynaecological conditions such as endometriosis. We are seeing a more open approach to topics such as the menopause, period poverty, polycystic ovary syndrome, infertility and many more, and while of course there is always more to be done, I welcome the slow steps that we are taking towards making these perfectly normal conditions part of mainstream dialogue. Sadly, the impact that endometriosis can have on working women is an area that requires more positive change. Coronavirus has shown how quickly working environments can adapt when necessary. From increased working-from-home guidance to flexible hours, small logistical changes can have a huge impact on the quality of life of those suffering with the debilitating pain that endometriosis can often bring.

Part of the issue is the stigma that still remains, which means that in some circumstances, women cannot feel comfortable taking time off or requesting flexible working conditions in order to work around their symptoms. The right hon. Member for Elmet and Rothwell mentioned fertility; I have spoken openly about my experiences with in vitro fertilisation, and I took sick leave from my employment because I was scared to speak to my employer about what that meant. We were going through a restructure, and I wondered whether if he knew that I was potentially going to have a baby through IVF or would need to take time off, that would jeopardise my chances in the workplace, so I completely understand what so many people are going through. Even more worryingly, I have heard from constituents who have spoken out about the lack of understanding they have received from their employer, from outright dismissal of their condition as simply a woman’s problem to genuine fears over losing their job due to unavoidable absences.

It is not good enough, and I am frustrated because it is clear that education matters. That is the key to supporting people with endometriosis in the workplace, and I am pleased that under a Labour Government in Wales, women’s health, including endometriosis, is taken seriously. Colleagues from across the border may be interested to know that five years ago under a Labour Government, a task and finish group was established to review endometriosis services in Wales, with the aim of improving access to support for women who are affected. When it was published in 2018, that report recommended research in several areas, including the development of an effective symptom awareness tool; evaluation of the follow-up process after surgery; a multidisciplinary approach to symptom management; development of educational resources; and ongoing monitoring of patient outcomes. I am pleased that all of those matters are being taken forward by the Women’s Health Implementation Group and Health and Care Research Wales.

However, we must acknowledge that while progress has been made, we still have room for improvement when it comes to supporting people with endometriosis in the workplace. That is why schemes such as Endometriosis UK’s endometriosis-friendly employer scheme, which encourages organisations to show a commitment to employees who are living with endometriosis, are so important and need Government support. For the 1.5 million people living with endometriosis, workplaces need to be making fair adjustments wherever possible. Given the very valuable contributions that women make to the workplace across so many different sectors, I sincerely hope that the Minister will support this, and outline exactly what the Government are doing to ensure that all those living with endometriosis are able to fulfil their full potential.

It is a pleasure to serve under your chairmanship, Mr Davies. I once again congratulate the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) on having raised this issue, and thank him for doing so. Less than a week ago, we were in this Chamber together debating the Cumberlege report and the terrible treatment of women who have suffered from the hormone pregnancy drug Primodos. It feels very much like we are here time and time again discussing how women are being systematically discriminated against in our society, in 2022 and 21 years since endometriosis was first debated in the House of Commons—Members may not know that. I read recently that the people who will lose out most when covid is over are women, who are less likely than men to return to work because of the challenges of childcare. It is always women who seem to lose out: as the hon. Member for Pontypridd (Alex Davies-Jones) said, if this were a man’s issue, I suspect we would not even be having this debate. However, we need men in the debate and in the round, discussing with us and pushing ahead, because this issue will affect them, their families, their partners, their children and the people around them.

We all have local endometriosis groups in our constituency, and I pay tribute to those local groups, particularly to Candice and Claire from Endo Warriors West Lothian. They are both sufferers of endometriosis and they fight relentlessly for sufferers in their area. Endo Bonds is another Scottish group I have met with recently, and Endometriosis UK does fantastic work. As the new co-chair of the all-party parliamentary group, along with the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy), we pay tribute to Sir David Amess and his work on the issue. He was an important and doughty champion for those who suffer from endometriosis.

It feels like endometriosis is to do with policies and legislation, which are dry, dull and boring, but it is the reality for women and endo-sufferers every single day of their lives that they are being discriminated against. That might not be the intention of the employer. I think it sometimes might be accidental, because the legislation and policies in place across the UK do not support, understand or recognise endometriosis as a chronic and debilitating condition that one in 10 women suffer from—so many women. It is a hidden condition and there is little or no awareness of it—although I think the hon. Member for Pontypridd is right that things are changing.

Sceptical and unaccommodating employers in the workplace can have a devastating impact on sufferers. In our APPG inquiry in 2020, we found that 55% of sufferers had taken time off work as a result of their endometriosis; 38% were afraid of losing their jobs due to the condition; and 35% reported reduced income as a result. One sufferer said,

“I left my teaching career due to the exhaustion of endometriosis. I loved education so took a position as a teaching assistant which saw a drop in finance of £18,000/year… I feel pressured not to take any other time off and work through pain frequently.”

The right hon. Member for Elmet and Rothwell spoke passionately and graphically about the reality of endometriosis. As a woman who has had such bad periods that I have bled through at school, university and work, I know how embarrassing and devastating it can be, and I have what would be classed as relatively normal periods. Endometriosis sufferers are passing out in their workplaces or in the street. They are not able to get to the toilet or be given basic dignity. We are not in a third-world country, but it feels like that. The treatment of those who suffer from endometriosis feels like they are existing in a third-world country. Endometriosis is on the NHS’s list of the top 20 chronic pain conditions, but we would not know it. The right hon. Gentleman spoke about chronic pain and the support for it, and that is incredibly important.

We are robbing women and those who suffer from endometriosis of the ability to maintain and progress in their careers and to provide for their families, and of financial stability and independence. So often, they experience devastating mental health problems. It should not have taken a global pandemic for us to review how we support flexibility in the workplace, but it has. The irony of the situation is that the waiting times for endometriosis are even worse than before the pandemic, but the pandemic has, in some ways, facilitated a rethink and a reimagining of what flexibility people need and should have at the very basic level, because trying to work or just live with endometriosis is debilitating. The Department for Work and Pensions and the Government of the day must recognise that, and employers and educational institutions need to be supportive and be given the information.

Endo Warriors West Lothian has developed the most incredible educational video for young people in schools, and the group worked with Professor Andrew Horne at the University of Edinburgh to develop and fund it. We want to roll it out across Scotland, the UK and the world, and we want to get content, policies and laws that support endometriosis sufferers to make sure they do not have to live in pain and suffer in the way that many of those who we are speaking up for do. I hope the Minister will listen and not just give lip service today but real tangible action.

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) on his fantastic opening speech and continued advocacy on this issue. It is so important.

As a member of the APPG on endometriosis and as someone who lives with endometriosis, I am always pleased when it makes it on to the parliamentary agenda. It gives Members an opportunity to discuss the policy changes that need to be introduced. We have heard that the first time it was discussed was 21 years ago, and not enough progress has been made.

During the last debate on endometriosis and polycystic ovary syndrome, I took the time to share my own experience and the difficulties that I and others have daily. I spoke of the general process of going through diagnosis and treatment, because it is not in any way easy. The symptoms go from physical to mental, and it can ruin every single day. Members have been reminded today, and may recall from the last debate, that it takes up to eight years for the average woman to be diagnosed in the UK.

I would like Members to consider what that actually means for people who live with endometriosis every single day. It is eight years, potentially, of living in excruciating pain, waiting for a GP to diagnose the cause of the pain and being gaslighted by the GP and other health professionals while continuously asking about the pain. The pain is so severe that it can prevent someone from carrying out everyday activities, and it can be incredibly disruptive to working.

When I shared my experiences, I did not have the time to talk about how I dealt with my pain at work. When my endometriosis became bad and I was starting to look for a diagnosis, I actually worked here as a parliamentary assistant. Without a diagnosis, people are finding that they have nothing to show their employer to explain why they need time off. When their symptoms are really bad, they have nothing to point to as a legitimate request, in an employer’s eyes, for flexible working.

I thank the hon. Lady for giving way, and I congratulate her on the comments she is making. I also congratulate my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) for securing today’s debate and for speaking in such a powerful manner.

The hon. Lady speaks from personal experience, and she talks about working in this place and working with an employer who is undoubtedly sympathetic and supportive. To help the Minister address the problems raised in this debate, could she explain what her employer did that made a difference, and what can the Department do to address the problem?

I thank the hon. Member for his very well-timed intervention; I was just about to get to that. I was very fortunate in that my employer, my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), did not even wait for me to request flexible working measures. She thrust them upon me.

I had to go to hospital at one point, and when I explained to my right hon. Friend that they were looking towards an endometriosis diagnosis, she began reading up on it. She sent me links almost every day. She understood, and she allowed me to come into work later, because I was having quite bad evenings. She would shout at me if I was doing too much—the only time she would shout at me, just to let Members know. She gave me an entire month off after my botched laparoscopy, after which she threatened to go to the hospital and tell the doctors about themselves. We are not necessarily asking for people to be that extreme in making flexible working arrangements and allowances for their employees, but there are instances where people can be very good.

After becoming a Member of Parliament, I spoke to our accommodation Whip, my right hon. Friend the Member for Alyn and Deeside (Mark Tami). At first, I was told that the way to get a better, more suitable office was to be very nice to him. I spent my time complimenting his ties, and I eventually explained to him what my issue was—not in much detail, but he understood immediately. He did not ask too many questions. He gave me the type of office I needed—one that made it easier for me to get around Parliament. Those are examples of things that employers can do to support women with endometriosis.

We need to urgently bring down waiting times, because going through this can be very difficult. It is not just about waiting times for a diagnosis. It is about follow-up. It is all well and good to diagnose a woman with endometriosis, but if it is not followed up with further treatment after a laparoscopy, it continues. Endometriosis does grow back. Those living with endometriosis need, once they are diagnosed, to be able to understand what they are experiencing and to be able to talk to their employers about their condition, and employers need to take the time to be informed about the condition. But it does not end there. We know that there is no cure for endometriosis, and that treatment at the moment may only be able to ease the pain.

We know just how much endometriosis impacts on people at work. It is worth mentioning again the report of the all-party parliamentary group on endometriosis: 55% of people with the condition having to take time off work is not a small thing, and 27% missing out on promotions because of the condition is not a small thing. Those are issues that women in general already face in the workplace. The report also found that 40% of those with the condition worry that they will lose out in their jobs and further studies, and one in six actually have to give up their work—all because we are not taking care when we need to. We need to support those with endometriosis in the workplace, so that it does not affect their career advancement.

When I was thinking about becoming a Member of Parliament, I had to consider whether I actually could, because I was in so much pain. I had to consider whether I would be able to campaign in the way that we are meant to, and do all the things that we are meant to do. That is not fair for any woman. It is hard enough for women in the House in the first place, and for women in many other workplaces right across the country. For someone to have to think about whether they should continue in a job, or go for a job that they would love, simply because of their condition—simply because that condition does not have the level of importance in policy that it deserves—is not fair at all.

There are several steps that the Government could take. They have to start by clarifying whether endometriosis is covered by the Equality Act 2010. We have to be very clear here. The Equality Act states that a person has a disability if they have a “physical or mental impairment” that

“has a substantial and long-term adverse effect on”


“ability to carry out normal day-to-day activities.”

If endometriosis prevents an individual from carrying out their day-to-day tasks—and I promise hon. Members that it absolutely does—they should be entitled to the same protection under the Equality Act that those with diabetes currently have. We know that endometriosis affects as many women as diabetes does. Further clarity on that would go a long way to ensuring that those with endometriosis are not discriminated against in the workplace.

I also join campaigners in calling on this Government to adopt an open culture when discussing menstrual health. For far too long, women have been made to feel ashamed or embarrassed when discussing their bodies. For example, when I was at school we had various names for it—people would say their “cousin had come to stay” or that “the red river was flowing,” and people would pass each other sanitary towels under the table. When it comes to our periods, it is all meant to be shame and embarrassment. Further, the Government have to work with the NHS to ensure that people with endometriosis have the right access and support when it comes to time off work.

I know that I am going on longer that I should, but now is a good time to pay tribute to all of the endo warriors: the many different endometriosis organisations and blogs. There are women like me who would not have coped if they had not had all of that information from other women. It should not have to be like that—we are not always medical professionals—but I would not have been able to physically campaign and put myself forward to stand in this House if I had not read all of those things online, most of which were provided by other women. I am so very grateful to them, but the Government really have to step up to the plate.

It is a pleasure to serve under your chairmanship, Mr Davies. I thank the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for securing this important debate, and for his work as an advocate on this important issue.

I have previously spoken about the importance of better supporting everyone living with endometriosis. As a member of the Petitions Committee, I was proud to speak up last year when more than 100,000 people signed a petition calling for endometriosis to be prioritised after years of being overlooked. I have said it before, and I must say it again: endometriosis is a mainstream healthcare issue that we cannot afford to sideline. That, of course, means that it is a workplace issue as well. More than 3 million people live with either endometriosis or PCOS in the UK, and we cannot afford to neglect or ignore them.

Before being elected to Parliament, I worked in the NHS as a pharmacist. I met patients living with endometriosis and saw the pain and difficulty that they face in their day-to-day lives—we have heard many examples of that today. They face chronic pain, difficulties with breathing and, in the worst cases, hospitalisation. As we have heard, endometriosis is a disease that we cannot afford to take lightly, which is why it is so important that everyone living with endometriosis is supported in the workplace with the job security, adjustments, flexibility and protection that they rightly deserve. I know that my party has been very clear about how we would help to achieve that.

A Labour Government would proudly stand alongside our trade unions as they push for better workplace practices and take on rogue employers. A Labour Government would fight for flexible working, with the option for workers to work remotely from home. A Labour Government would end the fire-and-rehire con so that insecure and low-paid work is a thing of the past, and they would campaign to ensure that all workers have full employment protection from day one. That would go some way towards giving everyone with endometriosis the workplace security that they rightly deserve.

I would like to touch on the subject of diagnosing endometriosis and treatment, which many Members have spoken about today. Depressingly, it currently takes an average of eight years for somebody to be diagnosed with endometriosis in England. Although the treatment available for endometriosis is incredibly limited, many women battle with the disease for years without a proper diagnosis, often with very limited information provided by their GPs. Therefore, it is essential that, in the meantime, employers better understand the potential impact of endometriosis, even before diagnosis is eventually made. Employees living with endometriosis may need to take sick leave, work remotely or have adjustments made in the workplace before waiting for a diagnosis, and employers have to be able to accommodate that. The situation at present is not sustainable, and more must be done to improve the efficiency and effectiveness of diagnosis and treatment.

We have heard from many hon. Members that the lack of resources dedicated to diagnosis and treatment means that too many people are working with endometriosis in silence, which is completely unacceptable. Only by cutting the waiting time for diagnosis, and by investing in potential future treatments for endometriosis, can we truly change this for so many patients living with the disease. The Government’s overdue women’s health strategy is a perfect opportunity to set out that change, but their vision for the strategy, which was recently published, made no clear promises to alleviate any of the concerns. This is something that I will be watching closely to see how the Government choose to tackle endometriosis. I urge them to take the issue seriously.

Endometriosis in the workplace needs to be at the front and centre of women’s health. It is currently just a footnote, which means that the Government are failing more than 3 million people living with endometriosis. The Government have the opportunity to make a positive change, and I really hope that they do not waste it, because the women’s health strategy will go a very long way in improving the lives of the more than 3 million women who are currently living with endometriosis.

It is a pleasure to speak in this debate. I thank the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for bringing this issue to the House. I can recall speaking, as did others present, in his October 2019 debate on endometriosis and workplace support, so it is great to be back. He highlighted that two years have passed and little or nothing has improved, so the purpose of this debate is to raise the issue again and to seek what we hope will be a positive response from the Minister.

Like the hon. Member for Livingston (Hannah Bardell), I wish to put on the record that I remember Sir David Amess, who was the chair of the APPG on endometriosis and whom we greatly miss. Like others, I remember his family dearly in my prayers, given the gaping loss in their lives.

I am honoured to work in an office with six girls, so I am outnumbered by six to one. I have a male employee who works in another office, but they are all girls in my office. Two of them suffer from endometriosis. My mother had it; my sister had it. When I married my wife, she also suffered with endometriosis. I remember it well: the doctor at the time probably did not mean to sound the way he did, but he said, “You know, Sandra, if you have a baby, it will sort itself out.” Well, it did not. Three babies later—three young boys later—it still was not sorted. She suffered with that all her life, until a short time ago, so I am well aware of the impact that endometriosis has—although I am not as knowledgeable as the women who have spoken today. They have spoken really well.

Some 1.5 million women and girls in the UK suffer from endometriosis. It often takes eight years for the condition to be diagnosed, as the right hon. Member for Elmet and Rothwell said. One of my staff members has been waiting for more than two years for a consultation for surgery, with no sight of surgery to date. That worries me as well. Endometriosis often leaves women in debilitating pain that paracetamol cannot fix; often, much stronger pain relief is needed.

Some 23,500 women and girls in Northern Ireland are awaiting a consultancy appointment with a gynaecologist. As of April 2021, the number of those awaiting treatment for endometriosis has doubled to 1,236. It is definitely higher than that now. Although this debate is about employers, I need to make the case for a UK-wide provision for those who suffer from endometriosis.

Employers must have the correct guidelines in place to ensure that women feel supported. It is really important for that to be in place. Endometriosis UK has released an employer’s guide to managing endometriosis at work, which provides an in-depth discussion of how to manage sickness pay, flexible working and understanding the impacts of the condition.

When my staff member was going through treatment, it required a high number of doctor’s appointments. It was essential that she had flexibility at work to attend those appointments without worrying about the reaction to asking for time off. I like to think of myself as a fair and honest employer, and I believe I am. Whenever someone presents me with a problem like that, I want to make sure that they have a flexible working situation and the time off and that they feel understood. It probably helps to have ladies in the office—especially if they have had it as well—who can discuss these matters and then they can be dealt with in a constructive and positive way. At the time, it was very difficult for my staff member.

Endometriosis affects women’s health and quality of life. Sufferers should be encouraged to open up to their colleagues and bosses about it. The pain has been described as unbearable, which I honestly believe, based on the experiences of my wife and those in my office.

The condition also impacts on mental health. I want to comment on that in the time I have. It is not just a physical disability—it has a mental impact. It has an impact on families and everyone around, who are often touched by what is happening as well, ever mindful that we are trying to be helpful to the person who is in the centre of it.

I am grateful to all the women across this House who have raised their experiences of endometriosis. We all have a platform to normalise this condition. Employers must provide structured support when required. Endometriosis has been neglected, misunderstood and ignored by employers for too long. That is little wonder, given that even some in the medical profession unfortunately say that they do not get enough specialist support, either. We simply need to do better for the 1.5 million women across the UK.

I conclude by saying that I hope this debate will be recognised by many Departments, but I specifically look to the Minister, who is always responsive on the issues we bring to the attention of the Department for Work and Pensions, to do a full assessment on what further action can be taken to give full support to women who suffer with endometriosis in the workplace, as well as recognition in schools of the difficulties faced by our young ladies who struggle with the early symptoms of endometriosis. As a man, I am happy to add my support; although not in the way the women present do, I understand, in a small way, what happens to them and the support they need.

It is a pleasure to serve under your chairmanship, Mr Davies. We always thank hon. Members for bringing debates to the Floor—it is a format we use all the time—but I really want to thank the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for bringing this debate and for his knowledgeable, emotional and compelling speech on endometriosis. I want to say that I am even happier because he is a man: it is still true that the fact that a man brought this important debate makes it even more powerful and will probably get it noticed even more. For that, I think we are all grateful.

It has been referred to already, but the 2020 inquiry by the APPG on endometriosis found that those in work had terrible experiences. I will not go over them, because all the hon. Members who have spoken in this debate have already referred to them. They have also referred to their own personal experience—the hon. Member for Streatham (Bell Ribeiro-Addy) was one of those who did so—and I think it is always more powerful if we hear about lived experience in any debate and in anything that this House does.

One issue that I want to raise is statutory sick pay. This UK Government must reform statutory sick pay. It disproportionately harms people with disabilities. There has been an argument here today for endometriosis to come under the Equality Act 2010. When people have chronic conditions and have to take time off work, they have to be able to support themselves during that time. The SNP has called continually for statutory sick pay as a minimum to be increased in line with the real living wage, for extending it to 52 weeks instead of 28 and for people to get it from the first day they are sick. This was able to be done during the pandemic; it should be able to be done as we go forward.

We must all continue to raise awareness and fight stigma when discussing menstrual and reproductive conditions, such as endometriosis, in the workplace and in the health sector. I know the difficulties of raising issues in relation to specific illnesses, conditions and diseases—for example, sarcoma, which my husband died of. The issue is getting the medical profession to understand. That is not something that the Government can do directly, but we all can and should raise conditions such as endometriosis frequently, so that information about it gets out there among the general public.

The Scottish Government have a women’s health plan. That aims to take an intersectional approach, recognising that many women and girls in Scotland will face multiple and often overlapping disadvantages and barriers to accessing good healthcare. This UK Government should do something as well. It absolutely is important. I am heartened as an old woman—I am a lot older than I look—when I hear people in the Chamber or here in Westminster Hall discussing the menopause, periods and all these things that were taboo. My late husband was mortified when I was ill and sent him to the chemist to buy me some sanitary towels. This taboo is going, and the further and faster we lose these taboos, the better—especially for women who are suffering.

In Scotland, menstrual health, including endometriosis, is included in the Scottish curriculum, and the Scottish Government have made resources available online for young people, teachers, parents and carers; they are tailored to different age groups. My hon. Friend the Member for Livingston (Hannah Bardell) referred to a video. I sincerely hope that that is one of the things being used, because it is education that will help to end taboos and ignorance.

The Scottish Government are also exploring opportunities to partner with Endometriosis UK and sponsor projects that will raise awareness and support the diverse needs of people living with this condition. They have recently funded an Endometriosis UK project, which will help to increase awareness and support for those awaiting diagnosis. Can I ask the UK Government to do something similar? I pay tribute to Endometriosis UK for all its work, for producing its employer’s guide and for its stalwart work in pushing this agenda forward.

Employment law is reserved to the UK Government, but the Scottish Government will continue to use their fair work policy to promote fairer working practices and to press for the full devolution of employment powers, because we want to do more and we are stymied by the fact that an awful lot of this work is reserved. The SNP’s ambition, shared by the Fair Work Convention, is for Scotland to be a leading fair work nation in 2025. That sits at the heart of the Scottish Government’s ambition to move towards a wellbeing economy and it is central to supporting economic recovery and renewal. As the SNP spokesperson on disabilities, I stand up in many of these debates, and we have to take forward the talents and abilities of people with chronic conditions and disabilities, and use them to the benefit of the entire UK. That is vital.

The Scottish Government have also taken steps to close the gender pay gap through the gender pay gap action plan. That is important, because the condition affects women, and we need to ensure that women are not double, triple or quadruple handicapped by having a chronic condition such as this.

I wish to leave lots of time for the Opposition spokesperson and for the Minister, so I will just say that this UK Government must introduce their much-awaited employment Bill and take forward a progressive agenda for workers’ rights, including a day one right to request flexible working, guidance to employers on reasonable adjustments—which we have heard about—and a statutory timescale for those adjustments to be implemented. Such debates as this are important, consensual though they are. We must all push forward and press for better rights for women who have endometriosis and other chronic conditions.

It is a pleasure to see you in the Chair this afternoon, Mr Davies.

I congratulate the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) on securing the debate and on the comprehensive and excellent way in which he introduced the subject. He has done much to highlight the condition, raising awareness in this place and across the country. I echo the tribute paid to the late Member for Southend West, who was a tireless campaigner on endometriosis, having chaired the APPG in 2018.

Every hon. Member who spoke today made an excellent speech, all making similar points and stressing the importance of the issue. My hon. Friend the Member for Pontypridd (Alex Davies-Jones) spoke with great sincerity and passion. She hit the nail on the head about the importance of education on not just this issue, but other women’s health issues. She gave a good example from Wales of how the Welsh Assembly has been working on that.

My hon. Friend the Member for Streatham (Bell Ribeiro-Addy) spoke about her own experiences, as she has on previous occasions. Members who speak from their own experience send an important signal to those suffering out there that they are not alone and that there is help. It was good to hear about the positive experience that she had had with her employer. We should recognise and celebrate it when an employer does the right thing. As Members of Parliament, we should lead the way in ensuring that workplace rights are respected and upheld.

My hon. Friend the Member for Coventry North West (Taiwo Owatemi) was absolutely right: I agree that endometriosis is not only a mainstream health issue, but a workplace issue. I was pleased that she quoted extensively from the Labour party green paper on employment rights, which the Minister may have a copy of any time he wants, should he seek inspiration for the employment Bill, which—as has been mentioned—we are still waiting for.

As Members may know, I have spoken in the past about the challenges that my wife has as a fibromyalgia sufferer, with debilitating physical symptoms, unpredictability and delays in getting diagnosis, and the lack of understanding among the public and employers. For me, there are a great many parallels between the two conditions. However, today we are talking about endometriosis.

We know from BBC research in 2019 that many sufferers reported a negative impact on their work, in particular when their symptoms were debilitating, to the extent that some were unable to work on a regular basis, and had no choice but to give up their job and seek benefits such as the employment and support allowance or personal independence payments, which I will come back to later.

As we have heard, the all-party parliamentary group on endometriosis conducted a much-needed inquiry, which found that more than half of women affected had taken time off work as a direct result of their condition, and more than a third were afraid of losing their job due to their condition or reported reduced income as a result. Those are significant numbers, but of course, we are not just talking about numbers: we are talking about real people’s lives and the concerns and anxieties they face on a daily basis.

One respondent to the inquiry said:

“It’s been terrifying worrying about losing my only income. I’ve barely managed to keep my job, but I’ve lost opportunities as a consequence and it’s held my career back. I’ve been too unwell to do any training. Being so unwell has cost me lots financially.”

Another said:

“I feel pressured not to take any other time off and work through pain frequently. It has a negative impact on my mental health and general well-being.”

I am sure Members will agree that those examples, and the many others we have heard about today, are simply unacceptable. People should not be put in the invidious position of having to decide between their work and their health. Much more needs to be done to ensure that workplace support is available for all.

Just on the point about workplace support, one of the things that I did not get a chance to mention is that there are some great examples out there. BBC Scotland has become an endo-friendly workplace, and Fiona Stalker, the journalist and presenter, has done a huge amount of work on this. She is herself a supporter, and she gave evidence to our Scottish evidence session and spoke passionately about the work she was doing. It is important that we recognise that there are some good examples out there, and that those employers can share their experience and what they are doing with others across the UK.

I thank the hon. Member for her intervention: she did very well to get in that important reference to the good work that is happening up in Scotland. The relevant Government Departments can take a lead from examples such as those.

People have told us that employers lack understanding about this condition. They sometimes do not realise that it is an ongoing condition that requires ongoing treatment and multiple surgeries and, of course, involves debilitating pain. We really should not have to highlight those facts when we are talking about a recognised medical condition that affects 1.5 million people and certainly meets the definition of a disability under the Equality Act 2010. We need to make it easier for employers to feel comfortable talking about this condition with their staff, who will then in turn hopefully feel more supported in opening dialogue. Endometriosis UK provides much-needed support for employers in the form of information and guidance, but it is frustrating that workplace guidance from the Government themselves is still lacking. Given that we have an average diagnosis time of eight years, we could be doing so much more to tackle this problem.

Endometriosis meets the Equality Act’s definition of a disability and, therefore, the reasonable adjustments requirement. There are many ways that that requirement can be met, including through flexible working, reduced hours, reassigned work or duties, and time off for medical appointments. All those things can be done by most employers, but as we have heard, that does not always happen. That is why there is a call for endometriosis to be specifically referred to in the Equality Act as an example of a fluctuating and recurring condition that falls under the definition of a disability. When the Minister responds, I would be grateful if he could indicate whether that is something the Government intend to pursue.

As was mentioned earlier, there are areas in which statutory sick pay can be improved for sufferers of this condition. Outside the pandemic, SSP only applies after four days of sick leave, so somebody needing only two or three days of sick leave would not qualify. Of course, it is also the case that periods of the same cause of sick leave must be eight weeks apart or fewer to count as linked, which can exclude those with fluctuating endometriosis symptoms. It has also been noted that SSP is only available to an employee for a period of sickness for a maximum of three years, which, again, penalises people with chronic long-term conditions such as this. As we have said many times over the past few years, there are millions of people—in particular, many women in low-paid work—who do not qualify for SSP at all. More than two years ago, in the last debate, there was a commitment to engage fully with the APPG’s review, and a promise to improve how we handle benefits. Can the Minister update us on whether there has been any movement in that area, and what plans there are to review SSP for fluctuating conditions such as this?

On access to benefits, which I touched on earlier, respondents to the APPG inquiry reported being assessed by someone who did not understand the condition. Several respondents reported being told by DWP staff or contractors that endometriosis was not even considered a disability, which demonstrates a complete lack of understanding, as well as showing that endometriosis needs some strengthening of protection under the Equality Act 2010.

Those with endometriosis should not be told that they do not qualify for any support and have to appeal many times to get the support they are eligible for. One respondent, who had to go to tribunal to claim PIP, described the situation as “stressful and upsetting”. I am sure we all have constituents who have had to go through that rigmarole many times. Although I know it is not his Department, I wonder whether the Minister can tell us anything about how disability employment advisers are being supported to ensure that the right recognition is given.

As we have touched on already, some employers have not waited for the Government to bring forward guidance and have shown leadership and support by bringing in their own endometriosis-friendly employer schemes, which aim to provide support to organisations to make simple adjustments to help those with endometriosis to work effectively. It is very encouraging to hear that more than 80 employers have joined the scheme so far. They represent a wide range of organisations from financial services companies to medical technology companies, to police forces and NHS organisations.

We want all employers to provide their employees with the right support. There should be no excuse for any Department, or Parliament, not to be part of that scheme. I hope the Minister can tell us whether there have been any attempts to get a standard across the entire public sector. We have had a good debate today, but it is clear that we need to do more to encourage women to feel supported and to deal with this condition in the workplace.

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) not only on securing this debate, but on his bravura performance in setting out the case. He gave examples that were difficult to listen to, to help us to understand what women are going through on a day-to-day basis.

I thank hon. Members who have taken part in the debate for their thoughtful and insightful comments. I would just pick out two contributions: the personal experience of the hon. Member for Streatham (Bell Ribeiro-Addy) and the example of his wife that the hon. Member for Strangford (Jim Shannon) shared. I thank them both for sharing those examples and what we can learn from them.

A number of Government Departments could have led the response to the debate, because endometriosis sits within a range of wider Government initiatives and strategies. The Department of Health and Social Care is developing the women’s health strategy. The Department for Work and Pensions and DHSC are following through on the “Health is everyone’s business” consultation response. The Government Equalities Office carries out wider work on equalities, and there is of course my Department’s work on labour market questions, such as how to make flexible working the default.

We each talk to businesses and employers on a range of issues. I am pleased to reflect the words of the “Women’s Health—Let’s talk about it” call for evidence. The more we talk about women’s health, the more we tackle the stigma and the taboos. Before I became a Minister, I was a vice-chairman of the all-party parliamentary group on women’s health. I am really pleased that this issue is being debated today and that we keep on addressing it and tackling the stigma.

In the interests of time, I will not describe the condition of endometriosis again, but we know that it is a condition that can be especially debilitating for many people. There are some factors, such as time to diagnose, which can exacerbate the situation. Endometriosis has a debilitating impact on a significant number of women across the UK. A respondent to the call for evidence said:

“I have had my endometriosis over looked and just told it was period pain and to deal with it. ‘It’s part of being a woman.’…‘my period is normal and I am exaggerating my pain, it’s all in my head’.”.

That is just plain wrong. No one’s pain and discomfort should be dismissed out of hand and nobody should be told: “It’s just part of being a woman”. We have got to do better.

To understand how best to support people with endometriosis in the workplace, we need to look across the whole system—at educating society at large, at the health sector and at the role of employers, as well as individuals. Only in that way can we start doing the right things for women’s health.

We know that damaging taboos and stigmas remain around many areas of women’s health. They can prevent women from starting conversations in the first place about their health or seeking support for a health issue. When women do speak about their health, too often they are not listened to.

The Government are determined to tackle these issues, which is why we are embarking on the first women’s health strategy. Last year, on 23 December, the Government published “Our Vision for the Women’s Health Strategy for England”, alongside the results of the “Women’s Health—Let’s talk about it” survey. A number of priority areas for action came through that. On women’s voices, more than four out of five women feel, or are perceived to feel, comfortable talking to healthcare professionals about general physical health concerns. That falls to less than three in five women when discussing mental health conditions.

On information and education, as we have heard, my right hon. Friend the Member for Elmet and Rothwell talked about teachers in schools. If we cannot get it right there, how will we get it right further down the line? Our ambition is for women to have access to high-quality information and education, starting from childhood and continuing right the way through to adulthood, to empower women to make informed decisions.

On access to services, just two in five respondents said that they, or the woman that they had in mind, can conveniently access the services they need in terms of location, and around one in four said the same in terms of timing. On health in the workplace, around one in three respondents said women feel comfortable talking about health issues in their workplace, and one in two said that their current or previous workplace had been supportive with regard to health issues. That clearly leaves a massive gap, which is why we need to go further.

Will the Minister give us an indication of when that women’s health strategy will be implemented, because I know there has been a delay? Will he also make sure that it addresses the profound issues in terms of employment and the DWP? Those matters are not devolved to Scotland, but are still reserved to Westminster, and we will look closely and will want to work with him on those issues.

I appreciate that, and I will discuss the strategy going forward. Health in the workplace will be a priority area for that strategy. We want to support women and ensure that they feel supported in the workplace, that taboos are broken down through open conversation, and that employers feel well equipped to support women in managing their health in the workplace.

In addition, “Menstrual health and gynaecological conditions” will also be a chapter in the final strategy. It will explore ways to improve awareness and the care and treatment of those suffering with severe symptoms from conditions such as heavy menstrual bleeding, endometriosis, and PCOS. The strategy will set an ambitious and positive new agenda to improve the health and wellbeing of women across England, and it will be published later this year.

We are working to put flesh on the bones of the six priority areas. That will need to be marked by effective co-operation and collaboration across Whitehall. As an illustration of that collaboration and co-operation, the Government also have an active agenda on work and health more widely. We want employers and employees in the round, male and female, to have better interactions on work and health to improve employee retention. It is so important to address these issues from both sides of the lens.

I heard what Members said about the gender pay gap, and we could easily make a business case. Employers invest time and resource in training and developing people’s experiences, so why on earth would they then want to lose someone with a long-term debilitating disease and have to start the entire process again? They should do the right thing.

The Government’s response to the “Health is everyone’s business” consultation was published in July last year. It sets out some of the measures that we will take to protect and maintain the progress made to reduce ill-health-related job losses, and will see 1 million more disabled people in work from 2017 to 2027. The consultation was not specifically on endometriosis, because it did not specify any health conditions. It looked at system-level measures to support employers and employees to manage any health condition or disability in the workplace. We are looking at providing greater clarity around employer and employee rights and responsibilities, with a national digital information and advice service.

We are working with HSE to develop a set of clear and simple principles that employers would be expected to apply. We are increasing access to occupational health, especially for small and medium-sized enterprises that we know are currently underserved. Although the measures are not endometriosis-specific, they are key steps in our effort to change the workplace culture around health and sickness. The Department for Business, Energy and Industrial Strategy looks at labour market regulation. We are responsible for a policy that has been mentioned and which we know can be helpful for those who suffer from endometriosis: flexible working. I must correct the hon. Member for Livingston (Hannah Bardell). Flexible working did come out of the pandemic; it started under the previous Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May). We have been able to reset our understanding of flexible working in the light of the pandemic.

A respondent to the women’s health strategy call for evidence said:

“Working from home has helped me hugely, as it gives me flexibility to work in ways that are more comfortable for my body. I can work from my bed on a bad day, or have a hot water bottle on my stomach when I have cramps.”

We are taking forward the manifesto commitment to consult on making flexible working the default, unless employers have good reasons not to do so. That consultation contained measures that would increase the availability and the support of the uptake of flexible working arrangements, including whether to extend the right to request flexible working from the first day of employment. By making it easier for everybody to access flexible working, we hope to help those who may need it most, including women suffering from endometriosis.

That consultation closed on 1 December, having received more than 1,600 responses. We are going through those now and will come back in due course. That consultation also introduced plans for a future call for evidence on the subject of ad hoc flexible working, where we want to explore how non-contractual flexibility works in practice. I discussed that with the flexible working taskforce on Monday. We will ensure that the role of ad hoc flexible working, in supporting women with health conditions, is part of its considerations.

My right hon. Friend the Member for Elmet and Rothwell had five questions. We absolutely welcome the work of Endometriosis UK, in particular the employers’ scheme, which we are pleased to see has a high number of participants. Debates such as this will help to fuel more businesses, of all sizes, to join that scheme and share those practices. All that work clearly needs to come under the remit of the women’s health ambassador. I am looking forward to working with that person once appointed.

My right hon. Friend asked about the definition of disability and whether it is included. We have heard the definition: a person is considered disabled if they have a physical or mental impairment that

“has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.”

We have heard examples where that is absolutely the case.

On benefits and how the definition is approached in practice, the work capability assessment determines eligibility for employment and support allowance, and the additional health-related amounts of universal credit. That will indeed be taken into account. It is difficult to have a number of discrete schemes for employers from Government. None the less, big HR departments can take on these things. What we must do is explain to smaller businesses the benefits of tackling these areas.

To conclude, I want to ensure that, through the women’s health strategy, we can get the culture on work and health right. To ensure that the package is as effective as it can be, we need to continue to collaborate. I am looking forward to working with the women’s health ambassador, and I am determined that BEIS should play a full role in driving this agenda forward. I close by thanking everybody for their excellent contributions in this helpful and informative debate.

I thank you, Mr Davies, and all hon. Members who have taken part in today’s debate. I thank the Minister for the many positive comments he has made. There is much legislation and work coming forward that we will need to assess.

I will take this opportunity to correct the record. My figures at the start were out of date for some reason. I said that it would 20 days at 24 hours a day to count the number of sufferers with endometriosis. That was based on 1.5 million women; it is actually 3 million women, so that is 40 days. As we go into the season of Lent, perhaps people could reflect, on every day in Lent, on just how many names they might be able to list in the time they are awake during those 24 hours each day.

Question put and agreed to.


That this House has considered the matter of supporting people with endometriosis in the workplace.

2002 Gujarat Riots

Before we begin, I remind Members to observe social distancing and wear masks. I will call Kim Leadbeater to move the motion. I would normally then call the Minister to respond, but I think Theresa Villiers wants to make a brief contribution. Any time that is taken will limit the amount of time the Minister has to respond. This is only a 30-minute debate, and there will not be time for the lead Member to respond at the end.

I beg to move,

That this House has considered the 20th anniversary of the 2002 Gujarat riots.

It is a pleasure to serve under your chairmanship, Mr Davies. I am grateful for the opportunity to open this debate, which is my very first Westminster Hall debate.

The riots took place in the days following 27 February 2002 in the Indian state of Gujarat. The precise death toll remains a matter of dispute, even as we approach the 20th anniversary of the events. There is no agreement on the facts of what happened, never mind who was or was not complicit in instigating the violence or allowing it to continue. All we can say with certainty is that, at the very least, 1,000 people lost their lives and that the majority of them were Muslim.

There have been numerous investigations and inquiries, including by the Indian Supreme Court and highly respected organisations, such as the international Human Rights Watch. However, as far as I am aware, none of these has reached conclusions acceptable to all parties, communities and faiths. It is not my role here in the British Parliament—very distant in both time and location from those horrific occurrences—to pass judgment. I would not be able to do so even if I wanted to. What I can do, and what I very much want to do, is consider the legacy of what happened from the point of view of the families of those who lost their lives or were seriously injured. Today is about acknowledging the loss and hopefully providing some comfort, and maybe even some closure, for those families.

Every act of violence has repercussions well beyond those caught up directly in it. Some survivors and relatives will never fully get over the trauma of what happened. For others, while the pain may lessen over time, it will never disappear completely. As hon. Members will know, I have personal experience of this—not just of the loss and the hurt but, crucially, of the desire to never forget our loved ones and to try and learn something from the most horrific of events and so that we do all can to ensure they are not repeated.

I congratulate the hon. Lady on bringing forward her first Westminster Hall debate. I have no doubt that it will be the first of many. Does she not agree that these devastating riots, which led to thousands of deaths, as she mentioned, hold lessons for us, and that we must continue to remember the 2002 Gujarat riots to teach our children the result of intolerance and anger?

I thank the hon. Gentleman for his intervention. I agree 100% with what he has said. We have to learn from the past, and far too often events are not acknowledged and the past is rewritten. We have to find a way to make sure that these things are never forgotten, for the future of our children.

I commend my hon. Friend for having secured this important, sensitive and timely debate to commemorate the 20th anniversary of the 2002 Gujarat riots on behalf of bereaved constituents. Does my hon. Friend agree that the death and destruction of those riots displayed the very worst of humanity? It is crucial that we acknowledge the importance of respect for all religions and the importance of living peacefully side by side. Does she also agree that it is imperative that the victims finally receive justice from the authorities?

I thank my hon. Friend, and I agree absolutely with him. We have to ensure that we find a way, wherever possible, to live peacefully. I will talk about that in more detail shortly.

As I said, many people lost their lives in the riots. I cannot speak for the families of all of them, other than to say that, whatever a person’s background, whatever their faith or religion, and whatever their politics, if they have any, the suffering they feel is no different to anybody else’s. Every family’s story will be different, but I want to talk about one family in particular, as they are constituents of mine in Batley and Spen, and are with us here today in the public gallery, along with relatives and supporters. It is on their behalf that I ask that the anniversary of the Gujarat riots is marked with respect in this parliamentary debate, and that I ask that their belief that justice is yet to be done for what happened is acknowledged.

On 28 February 2002, four tourists were on their way back from visiting the Taj Mahal. It should have been the trip of a lifetime. Their names were Sakil and Saeed Dawood, their 18-year-old nephew Imran, and their childhood friend Mohammed Aswat. Not long after they crossed the state border into Gujarat, their Jeep was stopped at a roadblock. A mob encircled the vehicle, demanding to know their religion. They replied that they were Muslim and that they were British citizens on holiday. In the violence that followed, Sakil, Saeed, Mohammed and their driver were all killed. Miraculously, although Imran Dawood was left for dead, he survived, and is with us today. It is only through his testimony that we know the circumstances of what happened. He remembers Saeed and Sakil pleading for their lives to be spared. It is his fight for justice that brought the international campaign for proper recognition of what happened to my constituency of Batley and Spen.

Nothing that is said or done today can bring Sakil, Saeed or Mohammed back, but that does not mean that nothing can be done to provide some comfort to the Dawood family and, after 20 years, possibly even some sense of being able to move forward with their lives. It causes them enormous hurt that the remains of their three young men have never been returned to them. I ask the Minister to investigate with the Indian authorities whether the repatriation of the remains is possible, and if so, I ask that it should happen as soon as practicable.

The family have also asked about the possibility of an inquest being conducted in this country, a request that I have passed on to the coroner. I have given the Minister notice of my own request that any so-far unpublished report into the rioting carried out on behalf of the British high commission or the Government at the time be made public.

I know how sensitive and emotive this subject is, but at the heart of the debate is a family who are grieving. I know that it means a huge amount to them that we are able to be here today—not just to mark the occasion of the anniversary but to reflect on the issues surrounding it more generally. The Dawood family tell me that recent reports of renewed anti-Muslim violence only make it harder for them to move on with confidence that the terrible events of 2002 could never happen again.

I sincerely congratulate the hon. Lady on securing the debate on this issue, which so tragically impacted the Dawood family, some of whom live in my constituency. This is a terrible story of bigotry-motivated violence. I shall continue to work with her to help my constituents to seek the justice that they have long deserved.

I thank the hon. Gentleman for his intervention and for meeting me earlier to discuss these events.

Once again, let me make it clear that I am not seeking to make a judgment from afar. Undoubtedly, inter-communal violence is, sadly, not unique to India; tragically, we see it in many parts of the world. I am sure that there is agreement across all parties at Westminster that anything and everything that can be done to prevent such violence should be done.

I thank my hon. Friend for the sensitive way in which she has chosen to speak about truly unspeakable events. The burning of the train at Godhra and the chain of violence that erupted saw terrible acts committed and licence given to hatred on both sides of the religious divide. She has focused not on hatred but on healing, not on blame but on balm. I think that the whole House will support her request that everything possible should be done to help her constituents identify the remains of their loved ones, and if possible to return them safely to her constituents here in the UK.

I thank my hon. Friend for his important intervention, and appreciate his support on this matter.

I have spent recent years since the murder of my own sister making the case for stronger, more united communities where we focus on what we have in common as human beings, not the things that might divide us. I believe that if we work together in that spirit, we all benefit; if we allow our differences to define us, we all pay the price. Even before I became a Member of Parliament, I made the case that political leaders have their part to play too, by doing what they can to heal divisions and not make them deeper. In the words of Barack Obama on a visit to India in 2015,

“every person has the right to practice their faith…free of persecution and fear and discrimination.”

Those powerful words and important principles should guide all nations. They cannot be repeated too often. The deeper they percolate down into the heart of communities, the better chance we have of reducing those tensions that all too easily lead to unspeakable violence.

I will close with a few words to the families of all those who died in the riots. If the best wishes of a humble Back Bencher in a faraway Parliament can bring any comfort, I send you mine. When you are grieving a lost one, all the political arguments, accusations and counter-accusations rarely count for much. Every victim is somebody’s son or daughter, somebody’s brother or sister, somebody’s father or mother, somebody’s friend or neighbour. They are never just a statistic; they are human beings whose lives were brutally cut short when they should not have been, so it is right that we remember them here today. I thank right hon. and hon. Members for joining me in doing just that.

I give my condolences to the family as well. I would normally call the Minister straight away and I will give her about 15 minutes, but Theresa Villiers has indicated that, with the permission of Kim, she will speak. Over to you briefly, Theresa.

I am deeply grateful to the hon. Member for Batley and Spen (Kim Leadbeater) and to you, Mr Davies, for allowing me to speak briefly. As the hon. Member has said, this is an important opportunity to remember all the innocent victims of those terrible events in Gujarat 20 years ago, which of course includes the 59 people who died on the Sabarmati express train. Like the hon. Member, I express my condolences to the families of those people, to the hon. Member’s constituents, and to everyone who lost loved ones in that shocking outbreak of violent rioting.

It is important to acknowledge that there have been extensive investigations into the events of 2002, including a special investigation team appointed in 2009 by the Supreme Court of India. A number of people have been convicted and given long prison sentences, and these matters have, of course, also been the subject of extensive scrutiny and debate in the Indian Parliament. The values of respect for the rule of law, parliamentary democracy and constitutional protection of the rights of religious minorities are at the heart of the Indian political system, and those values have shaped the response to the tragic events in Gujarat. There has been a clear determination to learn from what happened, to do everything possible to stop such riots ever occurring again, and to bring to justice the perpetrators of this completely unacceptable violence and rioting.

It is a pleasure to serve under your chairmanship this afternoon, Mr Davies. I congratulate the hon. Member for Batley and Spen (Kim Leadbeater) on having secured today’s debate, which provides us with an opportunity to pause and remember these tragic events and all those affected by them, including the innocent victims from her constituency: Sakil and Saeed Dawood and Mohammed Aswat. My thoughts go out to their families, some of whom are in the Gallery today. There is a deep connection between the UK and India—one of the world’s oldest democracies, and the world’s largest. I recognise the contributions that all Members have made, both through interventions and through speeches, and will try to respond to the points that have been raised.

The intercommunal violence in Gujarat in 2002 was serious and tragic. It is a sobering reminder of the need to continually work for respect and harmony between religious communities—an issue shared by both our democracies. As we have heard, a nephew of two of the British victims, Imran, was injured, but thankfully survived the horrific attack and was rescued by police. As the hon. Member mentioned, he is in the Gallery today.

We have provided consular support to the families of the British victims since 2002, and we will continue to provide assistance as needed. I acknowledge the hurt the families must feel that the remains of their loved ones have not been returned to them. We have been advised by the family’s legal representatives that an application has to be made to the court in India for the remains to be returned, and we stand ready to support that application once it has been made.

Regarding the coroner’s inquest, we stand ready to engage and provide further consular assistance to the Dawood family if requested. We are not aware of any unpublished reports into the riots carried out by the UK Government at the time. During the riots, many women were raped, and Muslim homes and businesses were destroyed. According to official figures, the violence claimed more than 1,000 lives, although many reports suggest that the true figure is higher. The then Prime Minister, Prime Minister Vajpayee, and the Government of India strongly condemned the violence in the months that followed.

The rights and protections of religious communities around the globe is a priority for this Government. We will continue to condemn any incidents of discrimination because of religion or belief regardless of the country or faith involved. India has a strong tradition of diversity, and we look to it to uphold all freedoms and rights guaranteed in its strong constitution. We have a strong relationship with India. We raise the importance of freedom of religion and belief in India, including the impact of legislative and judicial measures, directly with the Indian authorities at appropriate times.

UK Ministers and diplomats also maintain a dialogue with a range of Indian faith leaders and communities across India. Through our high commission in New Delhi, we support a UK-India interfaith leadership programme, which brings together emerging Indian faith leaders to foster understanding and respect. It is because of our close relationship with the Government of India that we are able to raise important issues where appropriate, including on the rights of minorities.

India is central to the UK’s Indo-Pacific tilt, and both Governments are committed to taking the relationship from strength to strength. Our 2030 road map, which was launched by the Prime Minister and Prime Minister Modi last year, will further advance our comprehensive strategic partnership. It benefits people across both countries, and supports regional and global security and prosperity. The UK’s 1.6 million-strong diaspora community provides a unique living bridge of people, commerce, ideas, institutions and culture. More than one in five of all student visas are issued to Indian nationals.

Indian healthcare professionals are the largest non-British group of staff in our NHS. We recently launched negotiations for a comprehensive UK-India free trade agreement, which would particularly benefit the north of England, Wales, the west midlands and Northern Ireland. India, as the pharmacy of the world, plays a vital role in supporting global equitable access to vaccines. Oxford University, AstraZeneca and the Serum Institute of India are collaborating to develop vaccines at scale. We will work together to uphold democratic standards. We are committed to India becoming a permanent member of a reformed UN Security Council, and will work with India as a strong partner to support its COP26 commitments, including through a $1 billion green guarantee and the British International Investment partnership.

Twenty years after those dark days in Gujarat, it is right that we remember the victims of that violence, their families and all those who died in those tragic events, including those from Batley. It is also right that we reaffirm our commitment to do all we can to foster intercommunal understanding and respect around the world and to prevent such events from happening anywhere. That is why the rights of those from minority groups are an essential part of our dialogue and partnership with India—a country whose constitution protects the rights of citizens of all faiths. It is a partnership and friendship that is very important to us, and which brings immense benefits to a diverse range of people in both our countries.

Question put and agreed to.

Sitting suspended.

Edmonton EcoPark: Proposed Expansion

[Stewart Hosie in the Chair]

I beg to move,

That this House has considered the potential environmental and health impacts of the proposed expansion at Edmonton EcoPark.

It is a privilege to serve under your stewardship, Mr Hosie. This debate does not directly have an effect on you, but I hope that you will find something interesting in it that may be applicable elsewhere.

This debate on the proposed expansion at Edmonton EcoPark, with its health and environmental impacts, is critical to those in my area and in my constituency, and I have an apology from the hon. Member for Edmonton (Kate Osamor), who is unable to attend. I want to read out a list of those who have signed letters and been involved in campaigning to stop the proposed incinerator, who include myself and the hon. Member for Edmonton; my hon. Friend the Member for Romford (Andrew Rosindell); my right hon. Friend the Member for Epping Forest (Dame Eleanor Laing), who has expressed her views on this; the hon. Members for Ilford South (Sam Tarry) and for Leyton and Wanstead (John Cryer); the right hon. Member for Islington North (Jeremy Corbyn), who is here; and Assembly Members Emma Best, Joanne McCartney, Siân Berry, Andrew Boff, Caroline Pidgeon, Zack Polanski and Caroline Russell. The AMs obviously could not be here. Some of the Members of Parliament could not be here either, but I thought it would be useful for that list to be read into the record. Those people are all in support of what I am about to say.

The problem is that, for some years, I have been deeply concerned about the way in which the process has been going. The incinerator that was built originally is about to be significantly increased in size. This is a cross-party issue, not one that divides along normal party lines, because it affects ordinary people in the constituencies and areas to which I have referred. They are affected regardless of their political views. I have pretty much never come across a constituent who actually wants this project.

The incinerator sits like an eyesore just below my constituency but, because of the prevailing winds from the south-west, the whole constituency is hit by what comes out of the chimneys. The other day, I happened to visit a shopping centre nearby. It was a cold day and the plume engulfed us as it travelled across my constituency. However, it goes to others as well.

I pay tribute in all of this to the active local campaign group, Stop the Edmonton Incinerator Now, which represents the feelings of many of our constituents. Carina Millstone in particular, and others, have been active on this issue. That is a good sign of how local politics is alive and well and talking about real issues, rather than some of the stuff we sometimes get bound up in in this building.

The project does not represent good value for money, which is the key element of the argument that I am making. In almost everything else we do in the Government or Opposition, we ask whether what we are about to do is good value for money and, further down the road, if costs increase, whether it still represents good value for money. I do not think that the incinerator expansion is a good return for taxpayers in our constituencies. The costs have spiralled, almost doubling from the original £650 million to £1.2 billion now, and nothing has yet been built. The North London Waste Authority has already spent £4.3 million developing plans for the new incinerator. Everywhere, I and other Members have asked for a value for money review of the project, from the Public Accounts Committee right the way through to every single Department and pretty much every single Secretary of State—I do not think I have asked the Defence Secretary, but who knows. The fact is, I have tried to ask everyone.

In normal circumstances, with a budget of £1.2 billion, might someone not want to ask whether a project still represents good value for money? However, nobody seems to say that they will take responsibility for it in Government or local government. It appears that the only body that is capable of reviewing or changing the project is the North London Waste Authority itself. In a way, it sets the exam question and answers it for itself every time. That cannot be right. I hope that my right hon. Friend the Minister will give us some inkling as to whether the Government think that the project carrying on is right.

The high cost is a key reason why we should pause, review and ask fundamental questions about whether this is still the best course of action for our constituents. Let us look at overcapacity. The incinerator is already burning over 320,000 tonnes of waste that could be recycled and composted—just imagine that we are pressing ahead on that basis. Since the plans to expand were originally drawn up, waste generation has actually fallen, because most members of the public are reacting to the drive for recycling and taking greater care in what they do.

The NLWA had a long-standing goal of reaching a 50% recycling and composting rate by 2020, but it is currently still below 30%. If it had got to the 50% marker, there would be even less reason for the incinerator to be there for the local area, and the plan was that it was for the local area—north-west London. I am therefore concerned about the plans because they are no longer about north-west London. To make the project viable, we will now have to drag stuff all the way across London to keep this thing burning. Now we are going to have more traffic on the road, extra fumes and extra environmental damage—just to keep an incinerator going. Why are we so fixed on having this huge thing near my constituency—so much so that we have to drag waste from all over London and clog up the roads just to keep it going? If it does not have enough from the local area as it stands at the moment, what is its purpose?

There are serious health implications for our constituents if the expansion goes ahead. Some 700,000 tonnes of waste will be incinerated every year, releasing what we call ultrafine particulate matter over residential areas. The levels of air pollution over parts of my constituency are already dangerously high. I am informed by Plume Plotter, an independent organisation that plots the plumes of incinerators across the country, that today the plume from the incinerator is blowing right across the whole of my constituency, but particularly the north part, and across the other constituencies I have already named.

We already have many hotspots in my constituency where air pollution is above the World Health Organisation’s air quality guideline levels. Asthma UK and the British Lung Foundation have calculated that 100% of schools, GP surgeries and care homes in my constituency are in areas that are already above the recommended guidelines. Even before any attempts to expand the Edmonton EcoPark, air pollution is having a significant impact on the health of residents across the constituency.

Public Health England has shown that short and long-term exposure to air pollution has significant health risks, including reducing life expectancy and having an impact on lung function, which increases asthma cases and cardiovascular admissions—all extra costs in pure value for money terms, even if we do not think too hard about the terrible health implications.

Seventy NHS GPs from across north London wrote to the Prime Minister last year and said that the plans to expand the incinerator should be pulled. In their letter, they claim that the Prime Minister could save more lives by pulling the expansion than they will save in their entire careers. So here is a big dilemma: the Government tell me that they do not have the power to intervene, but it seems that the waste authority has an unlimited demand for money. Something has gone badly wrong in all this.

The environmental impacts are huge. The issue is that incineration captures only a small amount of carbon from the material it burns. We know that alternative waste disposal methods exist, such as mechanical biological treatment, steam autoclaving and anaerobic digestion. All those things are now being used elsewhere, but not here. Over all the years, we have remained wedded to the idea that we have to burn waste. The methods I have mentioned have all lowered carbon emissions, yet the waste authority continues to push for incineration. Most notable scientific advisers have said exactly the same and questioned the suitability of incineration as a method of waste disposal.

I remind right hon. and hon. Members that the Edmonton EcoPark is right in the middle of a residential area. It is not as though this is some industrial park; it is right in the middle of a very densely occupied residential area, which covers all the constituencies that I named. The chief scientific adviser to the Department for Environment, Food and Rural Affairs said that the UK should move away from incineration and find better ways to use the value of materials, rather than turning them into carbon dioxide.

This is meant to be a competitive bid, but it is not. It is now down to one bidder. In other words, it is a slam dunk—name your own price. Acciona, the company involved, won the contract with no competitors. The chief executive officer of Acciona acknowledged the other day that the proposed plant is significantly larger than it should be. The man who is building it now does not actually think it should be built. It is bizarre. Every day I look at this project and wonder whether this is a parallel universe. The CEO said at a panel event at COP26:

“The massive oversizing of the [Edmonton] plant is something that is beyond our control. It’s a specific issue of the plant.”

I have raised this issue with the Department for Business, Energy and Industrial Strategy, with Housing, with the Chancellor and even with the Prime Minister. Civil servants have said constantly that it is not feasible to intervene, but the North London Waste Authority, surely, somewhere along the line, needs to be held to account on all the points I have made, which I am sure hon. Members will add to. What more evidence do we need?

Here we have the intransigent, inflexible, arrogant North London Waste Authority—and I mean arrogant, because at hearings it has just swept evidence from doctors and scientists to one side—refusing to budge on a policy that is clearly wrong and that is failing. It is a shameful state of affairs when a public body can no longer be held to account, because it no longer represents what the public want.

When something goes so badly wrong, the Government have to look at it again and ask how it can be that, amidst spiralling costs, health damage and pollution issues, we still plough ahead with a technology that is no longer needed and that will damage people’s lives in my constituency and others. I hope that my right hon. Friend the Minister will be able to answer those questions.

Before I call the next speaker, I would just say that if the Back-Bench Members could contain their remarks to around eight minutes we will have plenty time for the Front-Bench speeches. I call Jeremy Corbyn.

It is a pleasure to be in this debate with you chairing it, Mr Hosie. I thank the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) for the energy he has put into obtaining this debate. I also thank the cross-party group that has supported him.

It is essential that we think seriously about where we are going with our environment and our natural world. They are subject to debate all the time, and we have just had COP26. We have to challenge the conventional orthodoxy about waste disposal—that, somehow or other, incineration is a good thing. If we do not, we will continue to damage the lungs of our children and our communities with not just particles but nanoparticles that are very invasive of the human body. The excellent “Pollution from waste incineration” report from the all-party parliamentary group on air pollution, chaired by my hon. Friend the Member for Swansea West (Geraint Davies), describes that issue very well.

I want to say a big thank you to all the local campaigners —those around the incinerator in Edmonton, who my hon. Friend the Member for Edmonton (Kate Osamor) represents so well, as well as the people from all over the seven boroughs that make up the North London Waste Authority.

Before I became an MP, I was a councillor in Haringey. I remember well the discussions about developing the incinerator and cross-borough co-operation to get rid of rubbish. Back in the day—we are talking 40-plus years ago—it was seen as an environmental step forward to burn waste in order to generate electricity, rather than to put it into landfill. It was seen as a good thing to do. I do not think many of us on the council in those days thought very much about what would happen beyond that. Incineration saved landfill and was a way of getting rid of waste. It was lamentable. We should not have done it; I know that. Lots of things should not have been done. But now we have a great opportunity to change the dial on whether we go for further incineration or really put pressure on all of us, local authorities included, to develop a much more effective and comprehensive system for recycling our waste. The technology of the 1970s is not appropriate for the 21st century, and we need to move on from it.

The health effects I have mentioned. The emission effects I have mentioned. But as the right hon. Member for Chingford and Woodford Green said, who actually suffers as a result of the pollution that comes from incineration? I get that the plant now being considered for development at the Edmonton site is a lot better than the one there now. I get that there are filters and all that. I fully understand all of that. The fundamental problem is that we are piling a lot of waste, including plastic, into an incinerator; it burns and gives off emissions that are gas, which clearly cannot be picked up by a filter, and the nanoparticles, which I mentioned a couple of minutes ago, are very invasive of the human body and particularly damaging to children in schools, out in the streets or playing. We are polluting the next generation.

The opposition around the country to incineration is enormous. My hon. Friend the Member for Swansea West will be speaking in a few moments. People defeated the idea of an incinerator in Swansea. There is a huge campaign going on now against a proposed incinerator in Wisbech, Cambridgeshire, and there are many other such campaigns around the country. Why? Because people do not want to be polluted, but also because they recognise that it is simply the wrong direction to take and is outwith everything that was agreed at COP26.

The truth is also that there are now so many new technologies, which others are using, that mean that incineration is no longer necessary. There are other, cleaner ways to get rid of waste.

I absolutely concur. If we look at the processes of waste disposal—perhaps we not talk about waste disposal but about recycling as the priority—that are happening in Germany and Scandinavia, we see that they are far in advance of so much of what we are doing in this country. We could do so much more and do it so much better.

The North London Waste Authority area—the seven boroughs—produces about 820,000 tonnes of waste per annum. Much of that goes into the incinerator. Across the whole area, only 30% is recycled. The recycling rates are abysmal, quite frankly. They are abysmal in many other parts of the country as well. Germany recycles 65%. Other countries achieve that. We are nowhere near.

I remember being appointed as chair of Agenda 21 by Islington Council—this was as the local MP—to try to increase recycling rates. We managed to double the rate, up to 30%, after about 10 years of very hard work, including by my hon. Friend the Member for Hornsey and Wood Green (Catherine West) when she was leader of the council. I just felt so disappointed that we could not get so much further. I get it: this is complicated; it is difficult. The collection systems are complicated. But if we want to give our children clean air, if we want to fulfil the obligations that we have signed up to at COP26, we should not be investing more than £1 billion in an incinerator that the CEO of the company says is over capacity anyway. We should instead be looking to a reduction in incineration over 10 years; we should go from where we are now down to somewhere nearer to zero in 10 years’ time. That would certainly concentrate the mind and help us to bring about much higher rates of recycling.

On the decision that has been taken by the North London Waste Authority, I have heard the financial arguments that it has put. I have been asked, “Well, what’s your alternative if you’re opposed to this?” It has been quite a robust debate. I am not accusing the North London Waste Authority members of being anti-environment. They are not. In their individual boroughs, they have done a fantastic job in improving the environment and recycling rates. But we have to go a lot further and a lot faster, and that is why I want to make the case, and support the case that has been made today by others, for some kind of intervention by the Government to prevent this thing from going ahead and to prevent the expenditure of this huge amount of money through “green” bonds—yes, “green” bonds to pay for an incinerator that is, I think, not needed and not necessary.

I will finish with this point. I have had a long discussion with a number of people, who have spent an awful lot of time and are much more knowledgeable on all of this than probably any of us in this Chamber today, about how we can reduce incineration. They point out all the technology that is now available that was not in the past: the separation of metals, paper and glass, and the reduction in plastics. That has to be accompanied by a much tougher campaign on packaging, waste and plastic production. What we will end up with is a massive incinerator without enough rubbish to fill it from the neighbourhood area. We will import rubbish from other parts of London, or from abroad, to burn in that incinerator, because we are locked into a £1 billion contract to build it. Can we pause for a moment, think of what we are doing and the opportunity we now have to turn the corner from incineration to reuse and recycling? That is surely the legacy we want to leave to all our children.

It is a pleasure to serve under your chairmanship, Mr Hosie, and to follow the former leaders of the Conservative and Labour parties in talking about incineration and looking to the future. I speak as the chair of the all-party parliamentary group on air pollution. Like previous speakers, my focus is on air quality and climate change. We wish to pause the forward direction of incineration, while the Government’s current plan is to double incineration by 2030. The APPG has published research on the impact of ultrafine particulates, which get through filters and are much smaller than the PM2.5 particulates that we normally talk about.

The World Health Organisation has reduced PM2.5 advisory levels from 10 to 5 micrograms per cubic metre, but latest evidence suggests that if 5 micrograms of PM2.5 are broken up into much smaller particulates of less weight, they actually do more damage to the body, because they penetrate immediately into the bloodstream and vital organs, causing permanent chronic damage.

We are concerned about a new incinerator in Edmonton generating carbon, burning 700,000 tonnes of waste. That quantum in an urban environment, where there are often poorer households, will have significant impact on public health at a time when we have not cracked the air quality problem in Britain. We have wood-burning stoves in urban environments, giving rise to 38% of PM2.5, for example, and we still have a problem with diesel cars. If we add this on, it is a real problem.

There are opportunities, as has been pointed out in the case of Edmonton, where the recycling rate is in the region of 30%. My right hon. Friend the Member for Islington North (Jeremy Corbyn) said it would be difficult to get to that, but in Swansea the recycling rate is 62%. If we can double the rate, we can halve the amount we are burning. That is simple mathematics. The Government must ask themselves how to provide the incentive structure to do that. My right hon. Friend said that when he was a councillor, there was an incentive to avoid landfill tax, and therefore the council moved towards burning.

I appreciate that Treasury representatives are not here, but if we had an incineration tax, there would be more focus on recycling. As has been mentioned, new technologies for chemical and mechanical recycling are available. The risk of this venture is that we will end up with excess capacity, and instead of an incentive for more recycling, there will be one for more burning. It could import burning and produce more waste, which is clearly not what we want.

Some environmental impacts can be far-reaching. Studies in Holland showed that eggshells had dioxins in them from incinerator waste 10 kilometres away. There are issues with heavy metals in children’s toenails, which can give rise to leukaemia. A lot of this science is emerging and not known. The science that predicates this particular planning agreement is basically older technology. Technology is moving quickly, as are medical knowledge and science. There is a case for a moratorium to pause and think. Indeed, there is a moratorium on incineration in Wales.

A pre-action letter for judicial review was written on 28 January. It points out that some of the claims that have been made do not stand up to scrutiny. In particular, it is claimed that the incinerator would produce only 28,000 tonnes of carbon; however, according to the North London Waste Authority’s own figures, it will produce 683,000 tonnes of carbon for something like 700,000 tonnes of waste. It is claimed that the incinerator will be developed to be carbon capture ready, but it will not. Again, that is in breach of the Government advice on energy national policy statement, EN-3.

What has been happening is clearly not in compliance with what the Departments for Environment, Food and Rural Affairs and for Business, Energy and Industrial Strategy are saying. The Mayor of London predicts that there will be 950,000 tonnes of excess burning capacity in London if this goes ahead alongside other plans. We need a holistic plan. We may want to substitute some of the dirty incinerators for a cleaner incinerator. However, we need to see that in the round with the best technology available.

On that point, this plan does not include a dedicated pre-sorting device for the extraction of plastics and recyclables that should be used again. Those are resources. We need a broader plan of taxing plastic and having fewer types of plastic, so that it is more cost-effective and profitable to extract, reuse and recycle. We need to use less and we should have a fiscal strategy. We hope that that is the benign future. In this case, however, we are simply locking ourselves into old technologies and old science, even though we know that the precautionary principle would make us think, “Actually, let’s step back and not do this.”

The North London Waste Authority is in breach of the advice from the Climate Change Committee on using the expression “low carbon”; energy from waste is not counted as low carbon. There are questions as to whether changes to the national grid and other changes will be compliant with that.

It has been mentioned that the project will be funded by a new type of green bond. However, when speaking about the future for green bonds, the Chancellor has said that the UK would not embark on a generation of tax, as it was called for many years, for sustainable finances that was not up to at least the standards of the EU. Of course, the EU standards for green bonds exclude energy from waste, and the EU taxes plastic at £650 per tonne as opposed to £200 per tonne.

I think this is a moment to pause. If these green bonds go ahead, they might be the source of the next 50 applications. There will end up being financial risks for the bondholders because, as has been said, there will be excess capacity. We will be in the farcical situation of providing incentives to grow incineration, which, ultimately, will mean more pollution in highly urban areas and will affect all our constituents. I very much welcome this debate and it is a great privilege to be part of it.

It is a pleasure to contribute to this debate under your chairmanship, Mr Hosie. I congratulate the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) on securing the debate and on his outspokenness on this matter, as well as the work he has done on trying to achieve a solution with the Treasury. It is a pleasure to hear from my right hon. Friend the Member for Islington North (Jeremy Corbyn), who has a record going back to the 1970s as a local councillor in Haringey; he is known for his work in the areas of recycling, cycling and generally standing up for a more sustainable planet.

It is also a pleasure to hear from the chair of the all-party parliamentary group on air pollution, my hon. Friend the Member for Swansea West (Geraint Davies), who has talked about his outstanding work in Swansea West and beyond, responding to the challenges presented by COP26 and calling for us to be a bit more ambitious and a bit braver on incinerators. This feels like old technology, and that is why I am pleased that Haringey was the only borough that voted to pause and review when it came to the vote on the bid for the scheme.

I want to put on the record our memory of seven-year-old Ella Kissi-Debrah, who tragically died from air pollution poisoning, as was found subsequently. Her mother, Rosamund, who spoke in this House on health and safety day, has spoken powerfully about how she took Ella’s case to the coroner to have the way that she passed away looked at. Ella was the first person to be formally found to have passed away from air pollution in the UK, and that was put on her death certificate posthumously.

I also want to put on the record that we in this House are all aware that air pollution does not affect us all equally. Pregnant women, babies and children, older people, people with lung conditions and those living in the poorest areas and in ethnically diverse communities are particularly at risk. I want to mention my hon. Friend the Member for Edmonton (Kate Osamor), who worked as a health professional before coming into this House, and also my Haringey colleague, my right hon. Friend the Member for Tottenham (Mr Lammy), who has led on a number of issues to do with ethnically diverse communities and their exposure to pollution, as well as the high numbers of our constituents who suffer from lung conditions. We know that 88% of people with a lung condition are affected by air pollution, and 58% of people with asthma have their condition triggered by air pollution. That is the context of today’s debate.

When the plans were first signed off, when the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) was the Mayor of London, the solution might have been okay, but that was a long time ago and things have moved on. It feels as though the project has not had the COP26 test applied to it, and now would be a good time for the Government to look again and challenge whether there is more that can be done. In particular, with the introduction of the green bonds, this might be a good time to explain exactly how they work—there does not seem to be a proper explanation of that—and to see how the project could introduce some best practice around the green agenda.

We are in a climate emergency, and our constituents want change. They want to recycle more and they want our polluted air to be cleaner. They are anxious that the size of the incinerator will mean there is an incentive to produce more waste in order to feed the associated district energy network. They are concerned about the environmental impact of incineration and the emissions that that process creates. They want 21st-century solutions to the management of waste that do not harm the health of residents or our environment.

Our constituents know that it is the poorest areas that pay the heaviest price, and there is real disappointment about the fact that the request for a pause and review was unsuccessful and the contract has now been awarded. It is vital that the design properly recognises the advances that we all expect to see in carbon capture and storage so that it is ready and equipped to take full advantage of them. Haringey’s council leader has urged the North London Waste Authority to bring forward the carbon capture and storage element of the plant so that it is operational as soon as possible to reduce CO2 emissions, and I fully support her in that goal.

It is important to say that it is very difficult for local authorities to be innovative when they have had cuts of up to 50% to their budgets. Collectively, the eight local authorities’ budgets have been cut back enormously since 2010. The Government have failed to fund local authorities properly for the past 11 years and failed to be ambitious in their approach to waste. I urge the Government to work with the North London Waste Authority and our communities to radically increase recycling levels and to meet and beat the Mayor of London’s target of 50% by 2030.

The other measures that the Mayor of London has introduced around expanding the congestion charge and the ULEZ are painful for many of London’s motorists. It seems that the project that we are debating could make a very big difference with one installation, so it is a pity that we have not looked at its impact on making our air cleaner, as we desire to do.

It is vital to recognise the environmental and health impacts of incineration, but also to make sure that we do not simply push the problem out of London by transporting the capital’s waste to other parts of the UK or overseas. As other Members have mentioned, it would be unenviable to see waste from other parts of London coming back to London because there is capacity in this incinerator. Not only would that be bad for the environment, but it would be socially unjust.

I will conclude with this: all of us in this House care deeply about cleaner air, and about the new information we have regarding the impact of air pollution on asthma sufferers and others with lung conditions. I hope that the shadow Minister, my hon. Friend the Member for Southampton, Test (Dr Whitehead), and the Minister will work to ensure that we belatedly get the best possible outcome for our north London constituents.

Sorry, the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith). My office companion is my hon. Friend the Member for Hornsey and Wood Green (Catherine West), so that is on my mind all the time, as it should be. I need to get my nomenclature absolutely straight.

I congratulate the right hon. Member for Chingford and Woodford Green on having secured today’s debate. The debate appears to be about a specific incinerator in a specific place with specific proposals for its extension, but it encapsulates much wider questions: how do we deal with our waste in modern times, and what are the best ways of dealing with it and, indeed, the energy that might come from it? By examining those wider questions, we loop back to the best thing to do with the North London Waste Authority, and the Edmonton incinerator in particular.

The first thing that is important in addressing this modern debate is to recognise—as my right hon. Friend the Member for Islington North (Jeremy Corbyn) has correctly pointed out—that although we have been talking about waste this afternoon, we should not be talking about it in this way, because the vast majority of waste is actually a resource. In the context of the modern circular economy, the idea that we place a material that we have used into a stream, and then it is gone out of the system one way or another—it used to be buried; now it is incinerated—is clearly not appropriate if we regard that waste primarily as a resource. The duty of authorities dealing with waste should be to make sure that as much of that resource as possible can be recovered for use elsewhere, one way or another.

I thank my hon. Friend for what he is saying. Does he not think we should be recording the level of composting, as well as recycling? Sadly, a huge amount of food waste and green waste probably ends up in incineration or landfill when it could be efficiently composted and provide compost for local people.

My right hon. Friend is absolutely right: that is one of the elements of regarding waste as a resource, because waste—particularly municipal waste—will have a number of elements in it. It will have putrescibles in it, it will have waste from household activities, it may well have wood waste and metal waste and it will certainly have plastic waste. All those types of waste can be reused, recovered and dealt with in different ways. The very last thing that we should do with such products—what we should do only when nothing else can be done with them—is to burn them, even if we think we are recovering energy.

In 1971, when the Edmonton incinerator first came into production, the convention was that we took the rubbish from the bins, put it in a truck, took it smartly down to the local tip and buried it in landfill. That was it. For a long time, we were the worst country in Europe for landfilling our waste. In recent years, that has turned around but, unfortunately, only into the next stage up on the waste hierarchy, which is to incinerate, rather than to bury in the ground. Both the right hon. Member for Chingford and Woodford Green and my right hon. Friend the Member for Islington North mentioned in their excellent contributions that we have come a long way since that sort of analysis—not just whether we should move waste up the hierarchy more efficiently than we used to, but what is available to work with once we decide what we want to do.

I appreciate that the task for a waste authority, such as the North London Waste Authority, is difficult. It has huge amounts of waste coming in every day, it has to do something with it, the task never ends and, in recent years, the Government have not helped, providing little support for innovative and novel ways of dealing with waste, separating resources out and so on. A little while ago, for example, the Government pulled a number of PFI—private finance initiative—plants that local authorities had in the pipeline for waste. Authorities are pretty much left to their own devices to bring forward innovation.

A waste authority under such pressure might well think, “This is a real problem. Here’s the easiest way to solve it without putting it into landfill.” That seems to be what has happened with the Edmonton incinerator. Not only have we had a large incinerator there for a number of years, but plans are now in place to extend it, which would make the past even more nailed down in the future, with that future being incineration. Believe me—this has happened across the country, including in my own county—once a contract for a large-scale incineration facility such as that is entered into, it is with us for a long time. It freezes the technology in time, at that particular point.

As the right hon. Member for Chingford and Woodford Green mentioned, however, that means that, as we begin to go up through the waste hierarchy, we start by taking further fractions out of the waste. It becomes a beast that is more and more hungry to be fed, because of the contracts for the incineration plants. So, waste is pulled in from a wider and wider area and, in the end, it can start to impede efforts to move up the waste hierarchy with all that waste.

Those concerns are over and above the one expressed by hon. Members this afternoon about what comes out of the chimney stack from incineration. We have learnt a lot more these days, than we had in the early ’70s when the arrangements first came into place. Although techniques for dampening emissions such as nitrous oxide, particulates and various other things that come out of the chimney stack have improved, that is still a very real issue, as hon. Members have mentioned, for the health of the neighbourhoods around incineration plants and, indeed, a wider area, as we have seen from studies that have taken place on the subject.

We have a proposal, which I have described on other occasions as a throwback. It tries to take technology from two decades ago into the next decade and land us with it for a long time to come. It should not happen.

There are several other ways, both emerging and in quite widespread practice, of dealing with those waste streams, particularly through fractionalising them out. Another small matter to put at the Government’s door: we still do not have sufficient plastics recycling and reprocessing facilities in this country. We are still in the business, possibly for a long time to come, of exporting plastics waste. We need Government action to make sure that those plastics recycling plants are available so that waste authorities can ensure that their plastics collection is properly dealt with afterwards.

We also know that there are techniques available to gasify waste in general and produce syngas and dimethyl ether for use in vehicles and various other plants. It is a renewable form of gas that could be useful for the future of heating, which is very topical. Those techniques do not produce the sort of emissions that arise from incineration plants. They can deal with massive amounts of waste. Indeed, anaerobic digestion, which is a rather grand way of talking about composting—

Order. I hope that the hon. Gentleman is coming close to the end of his remarks. I want to leave time for the Minister.

Indeed, Mr Hosie, I am approaching the end of my remarks and I am guided by your instruction.

There are modern techniques that can deal with waste. My first plea to the North London Waste Authority is to think about those new techniques in a positive way and not simply decide to take the same old tried and tested routes. There are so much better ways of doing it. My second plea is that, if the North London Waste Authority decides to have a review of the matter, the Government will support that. I know that the right hon. Member for Chingford and Woodford Green has written on several occasions to request the Government’s support for some of the new measures that can deal with waste and resource in a different way.

We have the low carbon future to think about. We have got to get waste and resource management techniques in place that address that, either through carbon capture and storage or new methods of collection and dealing with waste. I am certain that the current proposal, should it go ahead, will not stand the test of the future. We should have our eyes on that future and together make sure that the waste arrangements for north-west London are fit for it rather than harking back to the past.

It is pleasure to serve under your chairmanship today, Mr Hosie. I congratulate my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) on securing this important debate.

The Edmonton incinerator was given development consent in February 2017 after the consideration of relevant issues, including potential environmental and health impacts. The Government have no statutory or financial basis for undertaking a cost review of the Edmonton project. That would be a matter for the local auditors, but I have listened carefully to my right hon. Friend and, having heard what he said today, if I were a council tax payer in his constituency, I would be concerned about whether there is value for money in the project. He reports costs increasing from £650 million to £1.2 billion, which is a huge increase. I am not surprised to learn from him that local people are testing whether the North London Waste Authority has the necessary robust practices in place.

Let me lay out the process. All large energy-from-waste plants in England must comply with strict emission limits and cannot operate without a permit issued by the Environment Agency—in this case, the one granted in 2017. The Environment Agency assesses the emissions from new plants as part of its permitting process and consults the UK Health Security Agency on every application it receives. UKHSA’s position relating to incineration is that modern, well run and regulated municipal waste incinerators are not a significant risk to public health. I will come back in a moment to the arguments about weighing them up versus other means of waste disposal and waste avoidance. The concerns raised by my right hon. Friend’s GPs could usefully be directed towards the UK Health Security Agency, if he thinks that there is evidence that their conclusion does not abide with what is going on locally.

I want to make some more progress. I am going to describe the policy, and then I will respond to the points raised in the debate and, if I have time, I will take some interventions.

In relation to the Edmonton energy-from-waste plant, the Environment Agency issued a permit for the new plant in 2017. Once the plant becomes operational, the Environment Agency has pledged to perform regular inspections and audits to ensure that the plant is complying with the requirements of its permit.

I will now turn to the debate itself. My right hon. Friend the Member for Chingford and Woodford Green is coming up to 30 years in this House. He has had a wide variety of roles, including six years as Secretary of State for Work and Pensions, and has always been an extraordinary champion for his part of London. He is a fellow London MP and has been a brilliant representative on a huge number of fronts, not least this issue, working with local campaign groups. He has raised the issue with the Prime Minister, various Secretaries of State and me. He made some very strong points on value for money and the process.

A number of Members made the point about recycling falling short, and I agree with them. I represent two local authorities, and Hammersmith and Fulham has one of the worst recycling rates in the country, so I have every sympathy with my right hon. Friend and every other Member, including the hon. Member for Southampton, Test (Dr Whitehead), when it comes to recycling.

My right hon. Friend said that there was only one bidder. It is not right for me to comment on the operation of the process, but I think he reported that the winner of the bid said that there was “massive oversizing”. I am not at all surprised that local taxpayers would be concerned to discover those reported comments from the chief executive of the bidding company.

The right hon. Member for Islington North (Jeremy Corbyn) also spoke. Waste incineration with energy recovery should not compete with waste prevention, re-use or recycling. We do not see them as being competing technologies. Notwithstanding new technologies, which he and my right hon. Friend the Member for Chingford and Woodford Green raised, the evidence available shows that it remains the case that the carbon impact of most mixed waste streams is lower if sent to energy-from-waste plants than if sent to landfill. Obviously, that is not a comparison with recycling or waste reduction, but in terms of the strict comparison with landfill—I think that the right hon. Gentleman and I agree on this—energy from waste is better than from landfill. I am not suggesting that he was making an alternative point. I think that his point was that recycling is better. We do not disagree with that at all.

The hon. Member for Swansea West (Geraint Davies) talked about the doubling of incineration. I am afraid that I do not recognise that figure. That is not our understating of what is in the planning pipeline. In line with the commitment in DEFRA’s resources and waste strategy to monitor residual waste capacity, officials are currently assessing planned incinerator capacity against expected future residual waste arisings, so that we can understand what future incineration capacity may be required following the implementation of key commitments in the RWS. There is, therefore, an assessment of our overall waste capacity vis-à-vis the incinerator capacity. That is being carried out by DEFRA, which is the policy lead on the waste element, while I am the policy lead on the energy element.

The hon. Member for Hornsey and Wood Green (Catherine West) rightly drew attention to the tragic case of Ella Adoo-Kissi-Debrah and her mother Rosamund. We London politicians are all keenly aware of the findings in that case and the reverberations that it has had across London and the country for public policy on air quality and air pollution, which has been improving significantly in London since 2010. However, it is still not satisfactory for any of us as Londoners or London MPs. We still have a way to go, and the tragic case of Ella Adoo-Kissi-Debrah is a stark reminder of the important work that has to be done.

Carbon capture, utilisation and storage at the incinerator is a matter for local decision making, but the Government have very ambitious targets on CCUS, including 6 megatonnes of CO2 equivalent by 2030, rising to 9 megatonnes by 2035. We have an industrial decarbonisation and hydrogen revenue support scheme to fund our new hydrogen and industrial CCUS business models. The Government take our air quality obligations extremely seriously, and we are already taking significant action to improve air quality. The Government absolutely recognise that there is more to do to protect people and the environment from the effects of air pollution, and that is why we are taking the action set out in our world-leading clean air strategy, which includes proposals to reduce emissions from domestic burning.

Does the Minister accept that the doubling of incineration that I mentioned is predicated on the 50 consent orders that have been given by BEIS—his Department—for new incinerators? The 2022 standards of technology and health, rather than those of 2017, should surely be applied to the Edmonton EcoPark incinerator, but the main point is that his Department is giving out development consent orders.

The hon. Gentleman raises an interesting point, and I will go back and check that. My understanding is that that is not consistent with the consent orders that have been granted, but I will write to him on the detail as to whether we have the same set of figures and whether we are arguing at cross-purposes. I am very happy to write to him and give him some more detail.

Our clean air strategy includes proposals to reduce emissions from domestic burning, industry and farming, alongside stronger powers and an improved framework for local government to tackle more localised issues. The legacy of our reliance on landfill is responsible for around 75% of the carbon emissions from the waste sector, so it is not simply a matter of switching back to landfilling any non-recyclable waste. That is why we have been clear in the resources and waste strategy that we wish to reduce the level of municipal waste sent to landfill to 10% or less by 2035, and why we are actively exploring policy options to work towards eliminating all biodegradable waste to landfill by 2030.

My right hon. Friend the Member for Chingford and Woodford Green has raised some serious concerns about the North London Waste Authority, the finances of the incinerator at Edmonton EcoPark, and whether it represents value for money. I have listened very carefully, and I am sure local taxpayers will be very concerned at what he reports to the House. I hope the waste authority responds in full, as I have done, to the points that he has raised today. In the meantime, I commend him for securing this important debate, and I hope I have laid out the Government’s views on the overall national policy behind waste and energy.

It has been a very good debate in the short amount of time available, and the cross-party nature of it is important. Nobody has stood to defend the nature of what is going on with the North London Waste Authority. I take the comments from my right hon. Friend the Minister to suggest that, should things be otherwise and should the Government have the capacity as they see it, they would be concerned about the nature of what is going on at the North London Waste Authority. I therefore say that this has been a very important debate. We have flushed out the idea that an organisation is riding roughshod over the views and concerns of local people, and that there are serious health concerns, economic concerns and environmental concerns raised by the massive increase in the size of the incinerator at Edmonton EcoPark. I call on the North London Waste Authority, which will have heard the debate, to act reasonably, to pause the expansion, to review it, and to try to figure out whether there is a better way to achieve the requirements made by both the Government and the local authorities, in order to achieve a better environment for all of us.

Question put and agreed to.


That this House has considered the potential environmental and health impacts of the proposed expansion at Edmonton EcoPark.

Sitting adjourned.