Tuesday 12 September 2023
[Peter Dowd in the Chair]
PANS and PANDAS
I beg to move,
That this House has considered PANS and PANDAS.
It is a pleasure to serve under your chairpersonship, Mr Dowd. I will refer to paediatric acute-onset neuro- psychiatric syndrome—PANS—and paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections—PANDAS—as PANS/PANDAS throughout. Before I begin my speech, I welcome members of the all-party parliamentary group on PANS and PANDAS who are here and those Members who supported the Backbench Business debate application that brought us here. Most importantly, I welcome representatives from PANS PANDAS UK and medical specialists who are here to watch the debate; they will be available to meet MPs in room W3 afterwards.
I acknowledge that there may well be a significant variation in knowledge of the conditions PANS/PANDAS in the room. On the one hand, we are joined by experts and many MPs, including me, who know a little or something about the condition through our casework and campaigning, but I would not be surprised, Mr Dowd, if you did not know what we are here to discuss. The reason that that would not surprise me is because it is also the reason that we are here today: despite becoming increasingly widespread among children and young people, there is little awareness of or treatment for PANS/PANDAS. I hope that colleagues will bear with me if I briefly set out what PANS/PANDAS are.
I congratulate the hon. Lady on securing this debate. She mentioned that awareness is crucial. A family in my constituency of Merthyr Tydfil and Rhymney has been living through what has been described as a living hell—it is a really heartbreaking story—since their daughter first had symptoms back in January. Awareness is low across the country, including in the medical profession in, and the APPG will undoubtedly help with that. I am sure that we are all rallying to raise awareness and support and get awareness out there across the country.
A “living hell” is certainly how it has been described to me in conversations that I have had, not only because of the symptoms themselves and dealing with them, but because of the lack of support compounding that distress.
I will outline what PANS/PANDAS are. PANS is a condition in children and young people that can result from an initial mild infection such as chickenpox or covid. PANDAS is a specific sort of PANS that stems from strep. While the initial infection might be mild, in some cases it triggers a misdirected immune response and/or a brain inflammation that causes the rapid onset of severe symptoms, which can include obsessive compulsive disorder, tics, severely restricted food intake, anxiety, aggression, depression, memory deficiency, poor cognitive function and behavioural and developmental regression. These changes can and do take place literally overnight. Understandably, the impact of those symptoms on a child and their family is monumental. We do not need to be parents ourselves, although many of us here may be, to understand how utterly distressing it must be to have a formerly healthy, happy child suddenly find themselves unable to leave their bedroom, dress, eat, wash, talk to others or attend school and to see them vanish as the illness takes over. Sadly, that distress is compounded and worsened many times over by the lack of available support for patients and their families, as PANS is often not even suggested, considered or acknowledged.
Globally, PANS/PANDAS are recognised and treatment pathways have been set up. The World Health Organisation has explicitly acknowledged the conditions in its latest guidance. However, as things stand, there is neither NHS nor National Institute for Health and Care Excellence guidance on the diagnosis or treatment of PANS/PANDAS in any part of the UK. That leaves patients subject to an unfair and arbitrary lottery. All the evidence suggests that the best treatment is early diagnosis and a two-week course of antibiotics. If that window is missed, antibiotics may become less effective and other treatments are needed.
However, in the UK, without those pathways the vast majority of children are given inappropriate and ineffective treatment for their symptoms, rather than for the underlying cause. That often involves long waits for mental health treatments from child and adolescent mental health services, which I think we all know and recognise are overburdened. In a survey carried out in 2020 for PANS PANDAS UK, 95% of parents said that their GP had not suggested PANS/PANDAS as a diagnosis. Often, they can suggest no diagnosis at all; families must then research and fight for treatment themselves. The reality is that, after months of seeing their child suffer without any explanation, families end up turning to private healthcare, but that it only an option for a few. It is only at that point that a diagnosis is forthcoming.
I suspect that I am like most MPs, in that I became aware of PANS because a constituent approached me for support with her local NHS doctor. In the run-up to this debate, I had the privilege of speaking to some of the children and young people who sit on the PANS PANDAS UK youth advisory board, who shared their experiences with me. Their experiences of being diagnosed are all different, with only one exception: they were all negative. If any of them are watching today, I want to thank them for being able to talk to me about their experiences. It was really important to hear directly from them, and I thank them very much for that.
One of the children on the board talked about the fact that the doctors really did nothing for her. Every time she went to the hospital, she was made to feel like a mystery. Because the doctors did not understand what was wrong with her, it felt as if they were just going to leave it and give up. Another child told us about being sent from place to place, with no medical department taking responsibility. She went through waiting list and waiting list, with no resolution, as the symptoms continued and worsened.
It is really important to remember that the initial recommendation on diagnosis is for two weeks of antibiotics. As a parent, I find it quite difficult to understand why that is not being pursued by GPs, because it treats the initial infection if it is PANS/PANDAS. It would prevent the symptoms from deteriorating further, which might lead to someone needing more mental health support. Frankly, if it is not PANS, the antibiotics will not work and we will be able to rule that out pretty quickly.
Almost all the children I spoke to had received private treatment and given up on the NHS, but private diagnosis and treatment plans are often rejected by local GPs and health boards. One child remembers a doctor saying that he would refuse to treat an American illness. Another was refused ongoing treatment because the consultant did not believe that PANS was real. Many children have their medications stopped when their parents move back to NHS care; indeed, this is something I am supporting one of my constituents with now, with NHS Fife newly refusing to provide prescriptions for privately recommended medication. That is despite the fact that my constituent’s child has had both an NHS and private diagnosis. Imagine being a child and going through the trauma of this change in your life and condition—it is terrifying—then being told by the adults treating you that they do not believe that what you are experiencing is real or exists.
There is a lack of direction from the top. I have asked before about the implementation of the World Health Organisation guidelines that will formally acknowledge PANS/PANDAS and its treatments within our domestic health systems, and I have been told it will take some time. In the meantime, children are suffering needlessly, as are their families. We have to consider the wider impact on the siblings of children experiencing this condition.
I understand that the Minister might not want to pre-empt the independent medical process relating to the NICE guidelines, but if she would confirm her position that PANS/PANDAS is as real as having a broken leg or the flu, I really believe that that would be a significant step. I hope that that will not be a difficult ask.
I am grateful to the hon. Member for securing the debate. I wonder whether they agree that clinical evidence and lived experience across the whole of the UK must inform the evidence base that clinicians and NICE make, and that that must be based on the reality experienced by our constituents who are suffering from PANS/PANDAS. Through this debate, I hope the hon. Member will be able to force that through not just to Ministers, but to the civil servants who are advising them and the clinicians who say that this condition does not exist.
I am conscious that we need to deal with the medical profession in relation to this condition, but we must be able to do things as parliamentarians, and the Government must be able to do things too. Obviously, I am standing here as a Scottish MP, as is the hon. Member. It is about ensuring that there is parity of treatment across the UK.
As I say, I hope it will not be a difficult ask for the Minister to say that PANS/PANDAS is real, because I am privileged to have sight of a letter that she sent earlier this year to another Member, which confirmed such a position. In that letter she noted the common practice of treating infections with antibiotics and that PANS/PANDAS could be treated successfully in that way if caught early enough. I am sure she will also be aware of the PANS/PANDAS working group statement that was issued earlier this year.
The working group consisted of representatives from the British Paediatric Neurology Association, the Royal College of Psychiatrists, the Royal College of Paediatrics and Child Health, the Royal College of Nursing, the Royal College of Occupational Therapists, and the British Paediatric Allergy, Immunity and Infection Group, as well as parents, social workers and campaigners. The statement is an important step. It signposts clinicians to the international peer-reviewed treatment guidance in the absence of peer-reviewed treatment guidance domestically. The position appears to be the same as the Minister set out in her letter. I therefore ask her to use her time today to confirm that to the House and pledge to make a written statement to the same effect. The power of such a statement in the face of doctors refusing to believe in your child’s illness would be literally life changing and potentially life saving. As I have said, as a Scottish MP I would want to see parity of support in Scotland. I hope that when the SNP spokesperson, the hon. Member for Motherwell and Wishaw (Marion Fellows), speaks in the debate she will agree to take forward a request from me to the Cabinet Secretary for health to ensure that we see that parity of care in Scotland.
I commend the hon. Member on the preparation that went into this debate and the information that she sent round to colleagues. One issue that seems to be present in the condition is the crossover with autism spectrum disorder, attention deficit hyperactivity disorder, and pathological demand avoidance and other types of autism. It would be useful to hear more from her about how the symptoms can sometimes be confused.
I accept that the presentation of the symptoms can and does give clinicians pause for thought. The very severe onset of symptoms is clearly very different from other mental health conditions that develop over a period of time. As I say, when a patient presents with those symptoms to a GP there is an opportunity to take the antibiotic step that would allow PANS/PANDAS to be ruled out at an early stage, if that is not the condition that they have. Today’s debate is aimed at raising awareness so that we can separate out the different conditions. I am grateful to the right hon. Member for Skipton and Ripon (Julian Smith) for taking part in the debate.
I hope the Minister will be able to take such vital steps today. Looking to the future, I think we all want to see NHS and NICE guidance and proper research into the conditions and their treatment. I am sure the Minister and her officials have regular meetings with representatives from the NHS, the Academy of Medical Royal Colleges and the National Institute for Health and Care Research. Can she ensure that PANS is discussed in those places, that awareness is raised and that there is home-grown leadership? Medical conditions do not have nationalities and, with political will, there is no reason why the UK cannot be a world leader in treating this one.
I want to look at aspects of dealing with a health condition that do not just stem from medical diagnosis and treatment. I hope the Minister regularly speaks to colleagues from other Departments where their remits cross. There is a remit for the Department of Health and Social Care in building the hospitals, but it is the Department for Transport that makes sure there are roads to get people to them. It is the Minister’s Department that comes up with a cancer strategy, but the Department for Work and Pensions sets the policy on statutory sick pay and disability benefits. In this case, although she has an incredibly important role in ensuring the recognition and treatment of PANS/PANDAS, we need to look at the other impacts on a child who is so poorly.
The first and most obvious point is that a child who is too poorly to get dressed is probably unlikely to be in school. If they are in school, flare-ups of the condition—one of the symptoms is difficulties with cognitive processing—can mean dropping behind. When I recently asked children on the youth board about that, I was told that universally before they were ill they had loved school and had been doing well there. In fact, a survey carried out by PANS PANDAS UK this year found that, pre-onset, only 9% of patients were below the expected academic standard for their age group. After onset, the figure soared to 53%.
As with treatment, support from the school is a lottery for families. Most schools and teachers do not know what PANS/PANDAS is and have no idea how to support students with it. I have spoken to families of children who have been out of education for over a year because they have been too ill to go to school. I have spoken to others who say that the support is so poor that they have moved to home schooling. Others count themselves as lucky, because the special educational needs department has been open to supporting them.
One girl on the youth board told me that the SEN department at school was her safe place, that it was really calm, and that her teachers had researched the condition and made allowances for her school work. That should not be the exception in children’s experience—it should be what we aspire to for all of them. Not being in school is a reality for many children with PANS/PANDAS, particularly if they are not receiving the proper medical support to help them get better.
The hon. Lady is making a powerful speech. Given that we do not know how many children are undiagnosed, is it possible that many of them could be in hugely expensive specialist education for children with autism or ADHD with high student-staff ratios that is wholly inappropriate for them and would not be needed if they had been diagnosed and treated?
It comes back all the time to this root issue: recognition and treatment of this condition mean that outcomes on every level are much better, not only for the individual children and their families, but from a wider societal perspective. When I asked the youth board what it thinks needs to change to help other children with PANS, one of the main responses was more support and information for schools. I know that that is not the Minister’s portfolio, but given the overlap I trust that she will be able to raise that with her colleagues.
Childhood and adolescence are important times in someone’s development, not just educationally but socially. Childhood and teenage friendships are a vital part of how we mature and learn to navigate the world, and never more so than when facing a terrifying illness. It was difficult to hear children on the youth board talk about losing their friendships because as adults there is so little we can do, but I felt that it was important to ask the question because it is fundamental to children growing up. One child told me that they lost most of their friends when they transitioned to secondary school and how hard it was to make new friends when people only see how they act when their illness is in control. Another talked of how they lost all their friends seemingly overnight—they simply became a taboo subject that other children and their families did not talk about.
There were other more positive stories. One mum told me how her daughter’s friends would come and sit outside her bedroom door to try to convince her to come out and that when her daughter finally got the right treatment, her friends were some of the first people there, literally running up to their house to see her. They told her that they felt they had her back, and within a week they were out having fun together. As a parent, I am the first to acknowledge that there is nothing we can do to make children be friends with each other, but when we talk about appropriate treatment and support in school, it is these friendships that are also at stake.
I want to focus on the children and young people who suffer so much with PANS/PANDAS, but of course we need to think about their families too. Putting aside the strains and stresses experienced by a parent who witnesses their child being so ill, caring for them and having to fight battle after battle for treatment, they might face the choice of accepting a prescription for anti-psychotic medication for their 9-year-old child or social workers deciding to remove that child from their care.
Financially, this illness has a huge impact, whether through parents stopping work to care for their child or through seeking private treatment. The PANS PANDAS UK 2020 parents survey found that less than 20% of parents had experienced little or no financial impact. Almost a quarter estimated a financial impact of over £10,000, while over 8% estimated that it was over £100,000. An additional quarter simply said, “substantial” without putting a figure on it. Considering that a substantial financial impact is relative, that might be enough to put a family on the poverty line, whether the actual figure is £1,000 or £100,000. What about those children where private medication or support is simply not an option? The reality is that, at the moment, money matters for someone with a child who has PANS/PANDAS. Without NHS guidance and diagnosis and with so many families relying on private healthcare, we have absolutely no way of knowing how many children are going undiagnosed, as the hon. Member for Brentford and Isleworth (Ruth Cadbury) referenced.
What we do know is we are seeing a crisis in mental health conditions among our young people. Anxiety is skyrocketing, as are compulsive behaviours and tics. We cannot rule out the likelihood that the PANS/PANDAS cases that we know about are just the tip of the iceberg. We need urgent research, treatment and diagnosis to be universally available so that it does not matter where a child lives or what their family means are; their chances for support are the same.
I pay tribute to the support that PANS PANDAS UK and the wider community have given me, but also to families and children around the country. I would like to end by returning to the reflections of some of the children I met; they are so brave. They talked about how confusing and scary it was to suddenly have voices in their head. They talked about the panic of suddenly having to touch the same item in their bedroom over and over again—of not knowing what was happening, of sharing that with anyone in their family, or of having a brain that could not focus. This is their message to adults in Government, and to all of us here today: what is happening to them is not a choice. They care about school, their friends and their lives. They are not naughty children. If after this debate even just one more person understands that, that would help. This is not just a healthcare problem; it is a political problem, a societal problem, and one that increasingly needs urgent attention.
It is a pleasure to serve under your chairmanship, Mr Dowd. I thank the hon. Member for North East Fife (Wendy Chamberlain) for bringing this important debate to the House.
As already detailed, PANS and PANDAS can change a family’s life overnight. That is exactly what happened to my constituent Neil Gilson and his family. His son Jack was 18 months old when he caught tonsilitis, and an otherwise innocuous childhood illness turned their life upside down. Jack went from being a normal and happy little boy to one who was aggressive and anxious. He struggled playing with his friends, would go days without wanting to leave the house, and would not speak a word for long periods of time. His illness was not limited to his mental health but affected his physical health, too; he lost his fingernails and toenails and had very little energy. Neil describes it as,
“it was like there was no-one there”
some days—far from normal behaviour for a young boy.
For years, Neil and his wife sought a diagnosis. Various behaviours were put down to Tourette’s syndrome, an allergy or even just normal behaviour for his age, but one morning, Neil heard a news story about PANS and PANDAS that matched Jack completely. His doctor had never heard of the condition, but after an appointment with a specialist and a course of antibiotics, they had their son back in just two weeks. That is what makes PANS and PANDAS so shocking. It is an inflammation of the brain that can be quickly and effectively treated with a course of antibiotics, but it is so little known that it is impossible to say how many parents’ concerns are being put down to other causes simply because their GP has never heard of PANS and PANDAS. Will the Minister bring in training and guidance, so that obtaining a diagnosis is no longer a matter of chance, and work to raise awareness among healthcare professionals and those involved in childcare, so that families do not have to go through years of anxiety and all the problems that come with an unwell child.
I pay tribute to Neil’s fantastic work in raising both awareness and money for PANS and PANDAS. Since 2019, he has swum marathon distances in Loch Lubnaig and in 2021 became the first person to swim across the Bristol channel from Swansea to Ilfracombe. He attempted to swim the 70 km length of Lake Geneva this summer; he was 56 km in when he developed hypothermia and had to be pulled out by his team, but he has vowed to try again next year. Regardless of the distance, Neil has raised a fantastic amount of money and awareness and will change the lives of many children like his son Jack.
I hope that us coming together today and highlighting the cases in our constituencies will in itself help to raise awareness, so that early access to those antibiotics is more widely available to children who may have PANS and PANDAS.
It is an honour to serve in this debate under your chairship, Mr Dowd. I thank the hon. Member for North East Fife (Wendy Chamberlain) for securing this important debate and the Backbench Business Committee for finding time in the parliamentary timetable.
I also pay tribute to PANS PANDAS UK. The charity has been working tirelessly to raise awareness, provide support to parents and push for change. They are not professional politicians or lobbyists, but simply parents who are fighting for a change, and I thank them for all their work.
As the former co-chair of the APPG on PANS and PANDAS, I am glad that the condition will now find itself inked into the pages of Hansard. Too many young people and children across the UK are suffering from this awful, life-altering condition and are not getting the support that they deserve. In many cases, had that support been available when they first exhibit changed behaviours, it would have drastically improved their recovery—for some, almost immediately.
Like many in the Chamber today, I am here because about seven years ago a couple in my constituency contacted me about their child; a previously outgoing, bright, happy and lively child suddenly had a switch flipped and became ridden with anxiety, was unwilling to leave the house, and suffered from extreme OCD. More recently, another constituent had an experience similar to that described by the hon. Member for North Devon (Selaine Saxby): the doctors did not know what it was. At our first APPG meeting, we saw video evidence from parents about the sudden changes: tics, eating disorders, extreme anxiety, and violent or introverted behaviour. As a parent I found that harrowing to watch, and I can only imagine the anguish and difficulty it must cause for families up and down the country.
For many, there is then a struggle to get treatment as they face the brick wall that is too often formed in the NHS, the near impossibility of getting speedy and helpful treatment, GPs who are not aware of the condition, and a chronic lack of awareness even in specialist units. Professional demarcation lines mean that too often the psychiatrist and neurological specialist will not realise that the cause is a strep infection or similar, which can be sorted fairly quickly. All that is coupled with a scepticism of some, who do not believe or accept that it is a condition. Remember when that happened with myalgic encephalomyelitis? We know of children with the symptoms of PANS/PANDAS who have gone through years of agony and been told to go to therapy. If they finally get lucky and win the lottery for treatment, they are often prescribed amoxicillin—a common antibiotic, which we gave our kids every time they had an ear or throat infection. It makes a huge difference, often almost immediately—within a week or two. Sadly, when those who have had PANS or PANDAS for months or years are finally diagnosed, they often need more complex and thus more expensive treatment, and it is a long haul to recovery.
My hon. Friend the Member for Batley and Spen (Kim Leadbeater), who is unable to be here today, asked me to share the experience of a constituent whose child had PANS. Once the support and help was in place, the child started to recover; they are now thriving, and are starting college this month. With the right treatment and support, children can thrive and succeed, but getting the diagnosis is key.
I welcome the working group that has been set up by stakeholders, including PANS PANDAS UK and various royal colleges. It recommends that all NHS trusts develop comprehensive cross-speciality and multidisciplinary team provision to review and treat children with acute-onset neuropsychiatric symptoms and that children should receive a full medical evaluation. As we have heard, the quick test for whether a child has PANS/PANDAS or something else is to start a course of amoxicillin or a similar antibiotic. If symptoms improve, they have PANS/PANDAS; if they do not, that is the point to move on to more complex diagnostics and treatment to try to work out what the cause is. I hope that change will result from that recommendation.
As we have heard, families are too often forced to get private treatment—spending a small fortune for something they should have been able to get on the NHS. Of course, many of our constituents do not have the money for private treatment, and too many cases—we do not know how many—remain undiagnosed. The formation of the working group shows that we have made some progress since 2019 and 2020, when we first raised the issue in Parliament. In the meantime, more children and families are being affected, and more lives are being ruined and turned upside down because PANS/PANDAS is not being treated quickly and properly.
I look forward to hearing from the Minister and hope that she can tell us what her Department is doing with regard to the working group’s recommendations. I very much hope that she and her officials do not put it into what the former Member for Norwich South called the “too difficult box”.
It is a pleasure to serve under you today, Mr Dowd. I congratulate my colleague on the APPG, the hon. Member for North East Fife (Wendy Chamberlain), on securing the debate and on giving such a comprehensive account in her opening remarks. I also acknowledge the work that the hon. Member for Brentford and Isleworth (Ruth Cadbury) has done on the matter here in the House.
As the chairman of the APPG on PANS and PANDAS, I also extend my gratitude to the organisation PANS PANDAS UK. I have had the privilege of working closely with Vicky and the team, and have seen at first hand their tireless efforts as the only charity in the UK that supports children and families living with the conditions. Their advocacy and community support work continue to prove invaluable for patients, carers and healthcare professionals alike.
Like most of us here in Westminster Hall this morning, I was first made aware of PANS PANDAS UK when a constituent contacted me to discuss their case. Separately and much later, a dear family friend contacted me to say that her daughter had also been affected. I recognise many of the descriptions given by the hon. Member for North East Fife of the circumstances that they had to deal with at home. In my speech today I will set out three key issues that have become apparent to parents and interested professionals over the years: first, the misinterpretation of symptoms; secondly, the subsequent misdiagnoses; and, thirdly, the significant problems that such misdiagnoses cause for children with these conditions.
First, according to a survey by PANS PANDAS UK, 95% of GPs do not know about these conditions, and 19% of affected parents said that their paediatrician was aware of these conditions but considered it too controversial to diagnose a child with any of them. As a result, many children with PANS and PANDAS receive multiple diagnoses, often of more widely recognised conditions with overlapping symptom profiles, including anxiety disorders, sensory processing disorders, ADHD and Tourette’s syndrome; some 31% of children with PANS or PANDAS are diagnosed with autistic spectrum disorder. That shows a clear lack of appropriate training for health professionals and means that the wide-ranging symptoms of these conditions are not being recognised as potentially linked to one of these conditions.
Secondly, continued misdiagnoses cause significant delays in the identification of PANS and PANDAS and the provision of effective treatment. Currently, there is no specific test that will prove or disprove the existence of the conditions, so a diagnosis must be made on the basis of an analysis of the patient’s medical history, a review of their current symptoms and a physical examination. Laboratory work and additional testing can be ordered to identify an infectious trigger, rule out other diagnoses and inform treatment plans, but all of that relies upon a clinician’s basic awareness of these conditions.
PANDAS is listed in the international classification of diseases by the World Health Organisation, and two sets of international peer-reviewed treatment guidelines exist. In fact, it is international clinicians currently working in this field who emphasise the importance of early diagnosis of PANS and PANDAS to reduce the risk of patients developing disabling chronic neurological conditions. Understanding the symptoms and detecting them early is crucial to patient outcomes.
Thirdly, we cannot underestimate the strain that these conditions place on parents, families and the children affected. Many families across the UK struggle to access any healthcare provision at all for these conditions on the NHS. In the same PANS PANDAS UK survey of parents that I referred to earlier, 47% of respondents said they had not received any treatment from the NHS and 37% said that, as a result, they have had to seek private healthcare Too often, access to adequate health provision for families depends upon a parent’s ability to carry out research and advocate for their child, and then fund private assessment and treatment.
As we have heard, the misdiagnosis and misinterpretation of symptoms has led to children being sectioned or admitted to psychiatric hospitals, and subjected to treatments that are ineffective, inappropriate or harmful. Families who have been rejected for referrals, or bounced between doctors and psychiatrists who are reluctant to consider a PANS PANDAS diagnosis or who are unaware of the conditions, must either watch their children deteriorate or somehow scrape together enough money to consult someone who has appropriate experience in the field. Private and overseas treatment must not be the only viable option for appropriate care in a nation that rightly prides itself on having an inclusive and accessible health service.
It is evident that significant change is needed in the UK to ensure that children receive timely and accurate diagnosis and the appropriate treatment and support that they need. We know that the underlying cause of PANS and PANDAS is suspected to be an abnormal immune and inflammatory response to infection, so my first request is that research into post-infectious disorders is given adequate funding and is accelerated across the UK. That is necessary if we are to see an improvement in the training and guidelines given to clinicians regarding these conditions.
Secondly, as the PANS PANDAS working group, we are pressing for the swift development of a UK-wide consensus on the treatment of children presenting with acute-onset neuropsychiatric symptoms. As I have already highlighted, without appropriate training and guidelines, UK clinicians are currently ill-equipped, so thirdly, we need to prioritise the development of clinical pathways to ensure that children and families do not continue to suffer as so many have suffered already.
I thank the UK Health Minister who is here today, the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), for her interest and I invite her to meet members of the APPG, PANS PANDAS UK and representatives of parents to hear their experiences first hand. Listening to the experience of patients is the first step in ensuring both that they receive the support they deserve and that we can secure the changes that are needed.
It is indeed a pleasure to speak in this debate.
First of all, I thank the hon. Member for North East Fife (Wendy Chamberlain) for securing this very important debate and for, as always, setting the scene so well. She and I may be from different political parties, but when we clearly agree on social issues, I am more than pleased to come here and support her. I added my name, as did others, to early-day motion 948, submitted by the hon. Lady to highlight the issue of PANS and PANDAS. It is a reminder that the census estimated that between one in 200 children in the United Kingdom of Great Britain and Northern Ireland are subject to this condition. The numbers are not minuscule; it resonates across the whole UK.
PANS and PANDAS are two related paediatric disorders that can have a profound impact on a child’s life. Those who have spoken before have outlined examples and interventions to illustrate the case being made so well. There is currently no uniform recognition or treatment for the condition, as the hon. Lady set out in her introduction. Although the World Health Organisation guidance recognises the condition and recommends treatment with antibiotics, that has yet to be adopted by the NHS. The Minister knows I have a fondness for her as a Minister. I know she does well and that her instinct is to respond well and to answer the questions that we ask. I look forward to hearing her response.
The NHS not recognising these conditions leaves families devastated as they struggle for treatment. Some families have said that they have been referred to CAMHS as an alternative to NHS treatment. That is not always the most appropriate treatment, by the way, but at least there is some response. Others have outlined the symptoms that PANS and PANDAS can include. We probably have all recognised them in our constituency cases, whether it be OCD, tics, restricted food intake, development regression, anxiety, depression, irritability—even hallucinations and delusions. Those are so great that they cannot be ignored.
The hon. Member for North East Fife sent us some information at our request, which we appreciate. That illustrates the issue the hon. Lady wants to put forward, so we can support her from a constituent’s point of view. When I read what the hon. Lady’s constituent, who is suspected to have PANS and PANDAS, had said, there was a real disconnect given that health is devolved.
The hon. Member for North East Fife referred to the comments of the hon. Member for Motherwell and Wishaw (Marion Fellows), which I know, without even hearing those words, will also support the points of view that we are putting forward today. The devolved nations must now fight harder for an approach.
Briefly on the devolved nations, does the hon. Gentleman recognise that we need to work with our colleagues in the Scottish Parliament, MSPs, with Members of the Senedd of Wales and, if it deigns to sit, Stormont, where MLAs need to reform themselves to make appropriate health policy for devolved nations.
I absolutely do think that. I thank the hon. Gentleman for that intervention. At the end of my contribution, I was going to ask for that very thing. The hon. Gentleman has reminded me and the House of the importance of all the devolved nations working together, in tandem and alongside the Minister here at Westminster.
The symptoms of PANS and PANDAS can make education and school life difficult for children and young people. I know education is not the Minister’s responsibility, but I believe there is a need for the two Departments to work in tandem. Schools have a duty to support children and young people with medical needs, and that wee bit of extra support must be there for our young people. PANS PANDAS UK has been providing free and online CPD-accredited training for a wide range of professionals, including educational psychologists, specialists and support teachers. That is indeed a much welcomed step.
Will the Minister reaffirm what the hon. Member for West Dunbartonshire said in his intervention: ensure that at Westminster the evidential and factual base and the information that the Minister has in her Department is shared with the devolved Administrations? I believe that sometimes here at Westminster, the Government should drive the policy for the devolved nations. I know that matters are evolving and that responsibility lies with the devolved nations, but the Government will not find us wanting. They will not find the Scottish Parliament, the Welsh Parliament or the Northern Ireland Assembly wanting when it comes to working collectively to make life better for our constituents.
We are discussing a devastating condition, which impacts children and their families. The NHS must do more to support parents in learning how to cope with it, and research must be better funded to assist with diagnosing the condition. There is much more to do to support those with the disease.
I thank the hon. Member for North East Fife for raising the matter today, and every right hon. and hon. Member who has contributed through speeches and interventions, and those who will contribute shortly. I look forward to the shadow Ministers’ contributions and particularly to that of the Minister. I say to her that the eyes of all of us will be upon her as the Minister, and upon the Government, looking for the response that we hope to receive.
It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the hon. Member for North East Fife (Wendy Chamberlain) for bringing the debate to the Chamber.
Like all Members who have spoken, I am grateful to the PANS PANDAS UK charity for its definition of paediatric acute-onset neuropsychiatric syndrome. It helpfully describes it in a leaflet as a syndrome that
“involves a misdirected autoimmune process that affects or weakens the blood/brain barrier. The region of the brain primarily affected is basal ganglia which is responsible for the following functions: movement, cognitive perception, habit, executive, ‘logic based’ thinking, emotions and the endocrine system.”
It is useful to put that helpful definition on the record.
I have been in correspondence with the Department on behalf of my constituents on this matter for a while. I had a helpful letter from the Minister on 16 May, for which I am grateful. I was pleased that, in that letter, she informed me that the World Health Organisation had recently added PANS and PANDAS as a discrete disease entity to its international classification of diseases in its 11th revision, ICD-11. The Minister went on to say that the NHS would need NICE to step forward with recommendations and a proper research base. I was therefore disappointed to read in a follow-up letter from NHS England on 26 June that:
“There is currently no specific prescribed service for this condition”,
even though it is an internationally recognised disease. The letter continued:
“It is not NHS England’s role to develop clinical guidance”.
The letter stated that that rested with NICE.
The helpful House of Commons briefing on the debate draws our attention to the fact that a lot international work has been done on this issue. In 2013, there was a PANS consensus conference at Stanford, one of America’s leading universities. There were therefore the beginnings of an international clinical consensus a decade ago. More recently, in April 2021, guidance was issued for the Nordic countries. The link is available in the House of Commons briefing pack. I have read the guidance in advance of the debate, and it covers Sweden, Denmark and Norway, though I note that there was UK research input into the study. It is clear about the definition and the recommended courses of treatment.
I commend PANS PANDAS UK, as all colleagues have done, for the two excellent information leaflets. One is titled “GP Information Leaflet”. After the debate I will be sending physical copies of that very good leaflet to all nine GP surgeries in my constituency. Doctors are very busy people, and they may have done their training a while ago, when this condition was not taught in medical school. They cannot know everything. Sending out that leaflet will be my small effort to ensure that GPs in my constituency have the best information.
I am grateful to Dr Andrew Curran, consultant paediatric neurologist, who is quoted in the leaflet saying:
“By the time parents get to me, they have usually diagnosed their children already and they are usually right!”
There is much helpful information in the leaflet, but I think this is its most important advice:
“Initiate treatment immediately—do not wait for test results”.
From what I understand, that would be provision of the relevant antibiotics.
As the hon. Member for North East Fife said, we must also be aware of the impact of PANS/PANDAS on the whole family. Another PANS PANDAS UK leaflet gives very good tips on how to support a child with the condition. It makes the point that these children are ill, not naughty. Is that not a terrible thought—that they might have been treated as naughty when they are actually ill? There is also information about supporting the parents, who will be under huge strain, and the siblings of children with PANS and PANDAS—we must remember them. It is a really practical, helpful leaflet. It makes the point that these families may have to cancel plans at very short notice and that their friends and family need to understand that, be supportive and make allowances.
I want to finish by reading out a short email that I received yesterday from parents in my constituency who have a child with PANS/PANDAS, because I think they put it really well. I will change the child’s name, but the email reads as follows:
“Sophie is currently in a PANDAS flare, she managed to get 2 hours of sleep last night, her anxiety was overwhelming and she broke out in hives, subsequently missing a day of school. The issue is, there is no one to turn to unless the private route is taken which costs thousands of pounds. Even then the NHS and schools are, the majority of times, not willing to accept the diagnosis as it’s been sought privately.”
Obviously, many people cannot remotely afford private treatment. The email continues:
“CAMHS…have discharged Sophie, there is just no support for these poor children and families suffering with PANS PANDAS.”
Sophie’s parents express hope that this debate
“will start the ball rolling to get the support we so desperately need in regards to a NHS treatment pathway and support in schools so that PANS PANDAS are recognised in their own rights as an illness which has a severe detrimental effect on children with the condition, not only on their mental health but also on their physical health.”
That is so well-written and powerful and makes the point extremely well. I hope the Minister has listened and will respond appropriately.
Thank you for allowing me to contribute to the debate, Mr Dowd. I apologise for being late; I was in an important Delegated Legislation Committee, but I am extremely pleased that the debate is happening and I thought that it was important to try to get here to hear everything that has been said.
I thank the hon. Member for North East Fife (Wendy Chamberlain) for securing this debate to raise awareness of PANS/PANDAS, which sadly continues to be a poorly understood and widely ignored condition. Public awareness of this extremely serious condition remains incredibly low, despite the best efforts of campaigners, who I think we all agree do a brilliant job. Parents and children have to deal with the often severe symptoms of PANS/PANDAS, which are wide-ranging—that is clear from what has been said today—and can cause immense disruption that is difficult to live with. They also face barriers across our health system to get the support they need, as a result of the condition not being fully recognised, or perhaps not being taken as seriously as it needs to be.
I freely admit that I was not aware of the condition until relatively recently, when a constituent approached my office in relation to a child suffering from what she believed to be PANS/PANDAS. The child had been a happy, healthy, normal toddler but, following a bout of chicken pox at a young age, began displaying a number of unusual and alarming symptoms, almost out of nowhere. The symptoms persisted for the next seven years, curiously flaring up with each new infection. Symptoms include high levels of anxiety, aggression, reversion of speech and language, issues around food, obsessive behaviours, and losing the ability to write, among many other things.
Things came to head during the pandemic, when the child contracted covid alongside an infection in his nose. During the nine months that the infection persisted, the child could barely perform the most basic functions. They would get extremely upset and be troubled by persistent anxiety, or become aggressive, angry and destructive. They lost the ability to write, could hardly speak and struggled to eat. That resulted in a sustained period out of school and, as I am sure everyone here can imagine, immense strain and stress on the child and the rest of the family, as they struggled to control the symptoms and feared what could be causing such erratic and disruptive behaviour.
After nine months, the child finally underwent a procedure to remove the infection from his nose, followed by a course of antibiotics. Remarkably, within a week, he was back in school, reading, writing, socialising with classmates and showing every sign of once again being a happy, healthy child.
It is clear from that experience that PANS/PANDAS, or indeed any kind of infection inducing neuroimmune disorder, would be a strong candidate for diagnosis, yet the family have struggled to get the disorder recognised by clinicians and the NHS, never mind getting anywhere near a diagnosis and a treatment plan. A lack of clinical guidelines means that few clinicians across the NHS have even heard of the disorder. As a result, the tests and support the family so desperately need have not been forthcoming. That is despite the condition’s being recognised by countries across the world and by the World Health Organisation.
The struggle to get a proper diagnosis continues for my constituent. It has been suggested to them that the child may be autistic, but that simply does not stack up with the reality of the symptoms and the circumstances in which they appear. A false diagnosis would prolong the issue, potentially causing more complications, further hardship and distress for a family in desperate need of help and support.
My constituent has been forced to resort to seeking the advice of a private doctor here in London. The cost of travel from my constituency in the north-east, accommodation and the appointment itself is immense, and it is made worse by the pressures of the cost of living crisis. Incurring the cost of treatments that have been shown to be effective for fighting PANS/PANDAS is completely out of the question for my constituent and, I am sure, many other affected families across the country.
It is clear from this testimony and hundreds of others that it is time the NHS began to take the condition seriously and get families the support they need. On PANS/PANDAS Awareness Day back in 2020, PANS PANDAS UK claimed that 42% of paediatricians had never heard of PANS/PANDAS, 47% of people with the condition received no NHS treatment, and 95% said their GP did not suggest PANS/PANDAS when presented with their symptoms.
I am not here to chastise the NHS, which does a fantastic job under extremely difficult circumstances. There is an easy solution that can be worked towards to help the NHS to diagnose and treat patients more efficiently, while getting families the support that they desperately need. That would not only help patients and families to get on with their lives, but save us millions of pounds in the long run. Treatments could reduce the need for extra support and care for children and young people experiencing severe symptoms at a relatively low cost, reducing the strain on the NHS and adult social care budgets.
As more and more stories emerge of children suffering from PANS/PANDAS, it is only a matter of time until we can no longer pretend that the condition does not exist or can be explained away elsewhere. Let us put an end to that as soon as possible, get support to the families who need it and reduce the strain on schools, the NHS and social care services, which are all left to pick up the pieces.
It is a pleasure to serve under your chairship, Mr Dowd. I thank the Backbench Business Committee for granting, and the hon. Member for North East Fife (Wendy Chamberlain) for securing, this really important debate. I also thank PANS PANDAS UK for its briefing and for the work that it is doing to make more people aware of this terrible condition.
The hon. Member, in her very interesting speech, covered all the various things that families suffer when their children have PANS or PANDAS. It is terrifying for me, as a mother and grandmother, to listen to the horrifying stories from across the Chamber. I am a frequent visitor to Westminster Hall, but I have scarcely ever heard things more profoundly distressing or more echoed across the Chamber. There is a united presence here, and we really need to hear something from the Minister today.
I will not rehearse everything that the hon. Member for North East Fife and other Members said, but the fact that families are having to turn to private healthcare is really upsetting. I know from personal experience how difficult it can be to raise awareness of lesser known conditions and illnesses; I work closely with Sarcoma UK. Let me say this to the folk in the Public Gallery: “Keep at it—keep raising awareness. You have people on board here, in Parliament, and you just need to keep plugging away.”
Anything and everything that we say here today is important, and I know the importance of cross-party support. As the hon. Member for North East Fife knows, I am not in government, but my hon. Friend the Member for West Dunbartonshire (Martin Docherty-Hughes) has been in touch with Scottish Ministers. I will also speak to our health spokesperson and I too can write to the Scottish Health Minister on this issue.
I understand how difficult it is for GPs to know everything. I am well aware that, with regard to sarcoma, I was very lucky that my husband’s condition was picked up by our GP. He has had only two cases of that in the last 40 years he has been in practice. For PANS and PANDAS, we need to get the message out there through training and by taking up the very good suggestion by the hon. Member for South West Bedfordshire (Andrew Selous) that we should all send leaflets to our local GPs. As we say in Scotland, many a mickle makes a muckle. Even if we do only small things, we need to push forward with this.
I urge clinicians to recognise the condition, as that will help to ensure that NHS boards and trusts, and the equivalent in England, provide the necessary support. I also urge all parties—I can only do this in relation to Holyrood, for Members outwith the UK Parliament—to gain a better knowledge and understanding and really push the Scottish Government from that angle as well. I am sure that the hon. Member for North East Fife would agree that if folk, and MSPs especially, know about this condition, that will empower them to challenge the Scottish Intercollegiate Guidelines Network to ensure that people move this issue forward.
I think it is really important that the Minister responds to the points that have been raised. There are many people in this room—especially behind me in the Gallery—who want to hear what she has to say. Families across the UK need NHS help in their distress and for their children. I look forward to hearing what the Minister has to say.
It is a pleasure, as always, to serve under your chairship, Mr Dowd, and it is my pleasure to speak for the first time in my new shadow ministerial role.
I congratulate the hon. Member for North East Fife (Wendy Chamberlain), and thank her for championing this important issue, which she has eloquently raised. She has previously raised it on a number of occasions, and has in particular talked about her constituent, the nine-year-old girl who I believe is still facing this incredibly challenging condition. The hon. Member spoke on behalf of her constituents today, as other people in the debate have. She has been a champion on the issue by talking about how the conditions affect people—from raising it in Prime Minister’s questions and her work on the all-party parliamentary group on PANS and PANDAS, to securing today’s Westminster Hall debate. I thank her for her work.
I also thank everybody who has contributed to the discussion. They have also spoken passionately about their affected constituents. For example, the hon. Member for North Devon (Selaine Saxby) talked about her constituent Jack. My hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) talked about the chronic lack of awareness and about how getting a diagnosis is key, which was echoed by the hon. Member for Aberconwy (Robin Millar). I commend the hon. Member for South West Bedfordshire (Andrew Selous) for his leadership in taking the time to circulate literature to GPs, who I am sure will find that information useful. I also echo what was said by my hon. Friend the Member for Wansbeck (Ian Lavery): this debate raises further awareness about the condition.
As hon. Members have mentioned, PANS and PANDAS are a set of conditions that result in an inflammation of the brain, which gives rise to an array of symptoms such as OCD, tics and dietary restrictions. It is a cruel condition that can affect a child overnight and out of the blue. The conditions are often misdiagnosed and blamed on bad behaviour or poor parenting. The symptoms can manifest suddenly and bring about profound life changes, as we know not just from the data but from the stories shared by hon. Members in the debate. I found it particularly concerning that as little as 10% of NHS doctors have heard of the condition. That means many children are being misdiagnosed and mistreated. The charity PANS PANDAS UK estimates that approximately 8,500 children experience the disorders. I send my sincere empathy to everyone who faces those challenges and all the families affected.
Those who need treatment and support face major barriers. There is currently no guidance for PANS and PANDAS written or endorsed by bodies such as the National Institute for Health and Care Excellence, NHS England or the royal colleges. As Members have mentioned, those barriers result in many families being forced to seek expensive private treatment to prevent further suffering.
Recent years have seen a number of important developments on the issue. In April 2021, the British Paediatric Neurology Association published a consensus statement that recognised the lack of high-quality scientific studies and urged
“further research so that robust treatment guidelines may be formulated.”
I would be grateful if the Minister could tell us whether she is aware of that and what engagement she has had with the British Paediatric Neurology Association on the matter. Late last year, the PANS PANDAS working group, in collaboration with the BPNA and others, began the process of developing standards of care, pathways and service models, which it hopes will assist all primary and secondary clinicians. The working group has also recommended that all NHS trusts develop a comprehensive cross-speciality and multidisciplinary team provision to support patients.
On top of that important work and collaboration is the effort made by campaigners to raise awareness of this issue. I thank all campaign groups, families, Members present and members of the public who have signed petitions or written to their Member of Parliament to bring this issue out of the shadows. Having heard from Members of different parties about the disease, the research and the stories of those affected, it is important that the Minister provides clarity about the Government’s position. She confirmed in an answer to a written question earlier this year that her Department had had no discussions with NHS England on the adequacy and consistency of treatment pathways for children living with PANS and PANDAS. Could she please confirm today that the situation has changed? It is also important to know what discussions are being held in the Department and with stakeholders on the development of care pathways for children and young people living with this condition. Finally, what steps is the Department of Health and Social Care taking to ensure that children and young people living with PANS and PANDAS receive effective, patient-centred care?
We must also consider the wider issues. The Government must acknowledge their failures over 13 years to support our health and care providers up and down the country. Patients face day-long waits in A&Es, a record number of workers are off sick, and millions are on waiting lists. In fact, not only are the Government failing on the Prime Minister’s pledge to cut NHS waiting lists, but they have presided over a disastrous decade of growing waiting lists and waiting times. Children suffering from PANS and PANDAS may have to wait many months for their first NHS paediatrician appointment. As stories from the PANS PANDAS UK charity have shown, that is exactly what is happening. Christopher’s parents say:
“The soonest NHS paediatrician appointment was 8 months away, so we arranged to see a private specialist who could help us. This was the best thing we ever did. We came away with answers to what was happening and a care plan, which our GP follows. At present we are still waiting for our first NHS paediatrician appointment.”
The reality is that we need a Government who will build an NHS that is fit for the future. Labour’s first goal is to deliver an NHS that is there when people need it. This includes doing all we can to get waiting lists down and getting people treated on time, just like under the last Labour Government. We have a 10-year plan for change and modernisation, which will include one of the biggest expansions of the NHS workforce in history. We also plan to put individual care and mental health treatment—an issue that has been in the shadows for too long—at the heart of our mission.
Labour’s approach will be different, especially for children and young people. A Labour Government will treat mental health as seriously as physical health. We plan to recruit over 8,500 more mental health professionals to cut waiting times for treatment. We will provide access to specialist support in every school, and every community will have an open-access mental health hub for young people. With Labour, more care will be delivered on people’s doorsteps, out of hospital and in the community. Most importantly, we will focus on prevention and a move towards transformational new technologies. It is Labour that has a plan and a mission to build an NHS that is fit for the future and there for people when they need it.
It is a pleasure to serve under your chairmanship, Mr Dowd, and to respond to this debate. To be clear, I can respond only on healthcare services in England, and not on behalf of Ministers in Scotland, Wales and Northern Ireland, because health is a devolved issue. I can, however, give a commitment to hon. Members that I am happy to work with colleagues in the devolved nations on this very important issue.
I welcome the shadow Minister, the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), to her place. It is slightly disappointing that she chose to be so political—I thought we had quite a good cross-party consensus in this debate. I thank the hon. Member for North East Fife (Wendy Chamberlain) for providing the opportunity to raise awareness of paediatric acute-onset neuropsychiatric syndrome, or PANS, and paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, known as PANDAS.
We have heard from Members how important the issue is. I thank them for describing the experiences of their constituents and the issues that they have faced. I recently met the chair of the all-party parliamentary group on PANS and PANDAS, my hon. Friend the Member for Aberconwy (Robin Millar), to discuss the lack of guidance on diagnosis, treatment and assessment for children who suffer from either of those conditions, and about the lack of awareness across the medical profession in all parts of the health service. I absolutely agree that we need more research and evidence to improve our understanding of the conditions and to better support the families affected.
The Minister will have heard the excellent speech made by my hon. Friend the Member for South West Bedfordshire (Andrew Selous), who talked about taking it on himself to send leaflets to his GPs to raise awareness. Does the Department have a mechanism for alerting all GPs to these conditions, which seem to be relatively unknown? If so, could GPs be encouraged by her Department to consider prescribing amoxicillin or a similar antibiotic at a very early stage, because that seems to be an almost risk-free option?
The Department does not regularly write to GPs because the NHS is operationally independent, but NHS England does and we can certainly speak to NHS England colleagues. They send out regular bulletins on a range of issues to GPs, so I will speak to my primary care colleagues to see whether that is possible. We do not have enough information at the moment about how many children in the UK are affected by PANS and PANDAS. In the US, scientists have suggested that the prevalence there could be as high as one in 200 children.
We have specifically talked about the United Kingdom and England today. Although there is a classification now by the World Health Organisation, very few countries issue guidance on the diagnosis, treatment, assessment and management of PANS/PANDAS, because the scientific evidence is so sparse. When I met my hon. Friend the Member for Aberconwy, we talked about how we can get that evidence base so that we can issue guidance to primary and secondary care providers. We know that symptoms tend to come on suddenly.
We heard from my hon. Friend the Member for North Devon (Selaine Saxby) about the example of Jack and the difference that a diagnosis made. It is often following an infection that children who are healthy and developmentally on track suddenly start exhibiting OCD or other neuropsychiatric symptoms. The hon. Member for Brentford and Isleworth (Ruth Cadbury) is correct that very often a course of antibiotics can improve and tackle some of the symptoms that parents say can change a child overnight such that they can no longer attend school and are suddenly plagued by anxiety and other neurological symptoms.
PANS and PANDAS require a clinical diagnosis based on specific signs and symptoms observed by a clinician. There are currently no lab tests or biomarkers that specifically diagnose those conditions. There is also an element of excluding other diagnoses in the process of diagnosing PANS and PANDAS. That means other illnesses or diseases are considered first rather than assuming it could be PANS and PANDAS.
Although there are currently no national or European clinical guidelines on assessment, investigations or diagnosis, a multidisciplinary team referral often helps speed the process up. That is why we need our primary care colleagues to be aware that this could be the cause of symptoms and to get those referrals in as quickly as possible.
I thank the Minister for her response. She mentions the fact that there is no lab test that can diagnose PANS/PANDAS, but is that not true for other neurological conditions that I mentioned, such as ME and some of the ongoing conditions that people are experiencing from long covid? Sometimes a lab test does not exist because of the nature of what caused the symptoms. Perhaps the medical profession and NHS England need to think slightly outside the box in their search for answers.
I absolutely agree with the hon. Lady. NHS England has been happy to work on such issues with the working group. It is embarking on work to roll out a nationwide surveillance study designed to identify the signs and symptoms because, again, it is probably unlikely that we will reach a definitive test that will ever give us a diagnosis, and it is about matching symptoms with a diagnostic criteria. NHS England has committed to doing that, and the Department is happy to support it in its work.
There is the issue about how quickly antibiotics should be prescribed and dispensed, but while one antibiotic may work for one child, it may not work for another, and it is sometimes a case of trial and error before the appropriate treatment is found. Although there is an evidence base for the treatment of symptoms, such as obsessions, compulsions and tics, it is recommended that children and families affected should be offered evidence-based treatments. That is why we absolutely need to build that research base to provide evidence-based guidance to clinicians, whether they are in primary or secondary care. At the moment, NICE says that it does not have the evidence base to put that guidance together, whether that relates to psychological treatments or to medications such as antibiotics. The commitment I can give today is to push and work with the working group, organisations and Members in this place to try to develop that research base.
I have been struck by a couple of things in the debate—one is the cross-party consensus, but another is the uniform distress that Members have relayed. On the point the Minister just made about whether treatment is psychiatric or medical, one of the key points is that PANS/PANDAS is often confused as being psychiatric when it is an infection that has proven susceptible to treatment with antibiotics. That is the kind of basic step forward that we are hoping for today.
I absolutely agree. I acknowledge that while the symptoms mimic a mental illness, there is very often a physical cause for those developments. That is why we need to build that evidence base with research to back the guidance that we can give to clinicians who, as colleagues have said, may not be aware of the condition or how to manage it.
Training on PANS is now included in the Royal College of Paediatrics and Child Health curriculum. In April 2021, the British Paediatric Neurology Association issued a consensus statement with the faculty of child and adolescent psychiatry at the Royal College of Psychiatrists. Following concerns about variation in how it was being interpreted across the UK, the new PANS PANDAS working group, as we have heard today, which is being supported by NHS England, issued a statement recommending the development of appropriate service models and pathways back in February. I am keen that we support the working group in its important work bringing the key organisations together so that we can get that consensus out to clinicians in the field.
The work that the working group has done highlights that all children presenting with acute onset neuropsychiatric symptoms should receive a full medical evaluation and signposts clinicians to existing international peer review treatment guidelines. As I have said, while NICE currently has no plans to issue guidance, should the evidence base develop further, and should there be an opportunity to do that, we would look to update clinical policy. NHS England would then consider the development of care pathways for those living with PANS/PANDAS. The key is building that evidence research base.
We have the evidence to sufficiently demonstrate that PANS and PANDAS are discrete disease entities. I hope that answers the question by the hon. Member for North East Fife on whether we recognise that. We absolutely do, but we do not have the evidence and research base on assessment, diagnosis, treatment and management. However, the Department is funding research into rare diseases through the National Institute for Health and Care Research, which is spending over £1 billion a year every year on research particularly into rarer conditions. It welcomes funding applications for research into any aspect of human health, which would include PANS and PANDAS. Applications are subject to peer review and judged in open competition, with awards made on the basis of importance to the topics of patients, health and care services.
The National Institute for Health and Care Research does not just provide funding; it will also provide guidance, whether for academics, clinicians, researchers, the working group, charities or any other organisation. I am happy to organise introductory meetings with the National Institute for Health and Care Research. It has met other groups to explore the types of research it would support and that would build an evidence base. I strongly encourage researchers with an interest in this area to come forward with proposals so that we can develop that evidence base and make real inroads.
Other countries are not necessarily leading the way. Not many countries have international guidance on the issue. I cannot remember which hon. Member referred to this, but the UK and the devolved nations have an opportunity to take a lead, build that evidence base and develop guidance on that basis.
I assure colleagues that I am committed to ensuring that those with PANS and PANDAS get the care they need. We need more high-quality research into these conditions. That is the only way we can get better outcomes for patients. I am happy to meet both the APPG and the working group to take this forwards, because there is an opportunity to develop our knowledge, increase awareness and ultimately to have better outcomes for those children affected.
I echo the thanks given to all Members who have taken the time to attend. I do not want to suggest that the shadow Minister, the SNP spokesperson and the Minister did not want to attend, but it is striking that Back-Bench Members, including some who may not have been aware of the condition until recently, wanted to be here because, having been contacted by constituents, they now have a particular interest in the issue.
The hon. Member for Aberconwy (Robin Millar), who chairs the APPG—the hon. Member for Brentford and Isleworth (Ruth Cadbury) was the previous chair—talked strongly about how symptoms are misinterpreted, which results in misdiagnosis or lack of diagnosis. MPs found out about this due to constituents getting in touch because of the stigma. I have engaged with my constituent and we have spoken about potentially speaking to the local newspaper. Indeed, we had an approach from a local television news broadcaster who said that they would be desperate to speak to the family. However, the stigma of this condition and the need to protect the child, who is not getting the support they need from medical professionals, are so strong that they feel that they cannot speak out publicly. I am therefore very grateful to the Backbench Business Committee that we have had the opportunity to do that.
The Minister’s response has been encouraging. If there is anything that I as a Scottish MP can do in relation to the Scottish Government, I am keen to help. We have ICD-11 from the WHO, and now we need to move forward as quickly as possible to build that evidence so as to give us everything we need, including the NICE guidance.
I intend to do the same as the hon. Member for South West Bedfordshire (Andrew Selous). When the Minister writes to NHS England, I hope she will repeat her quote, which is in Hansard, that the Government recognise this condition. One of the challenges, certainly from the perspective of first-line practitioners, is that while people might get the support they need from their regular GP, another GP at the surgery might provide a completely different response. We should not need NICE guidance to address such inconsistency and lack of support—we should seek to address that now. I thank everyone again for their time.
Question put and agreed to.
That this House has considered PANS and PANDAS.
Offshore Wind: Public Ownership
I beg to move,
That this House has considered the level of public ownership in the offshore wind sector.
It is a pleasure to serve under your chairmanship, Mr Dowd. When a natural bounty is discovered, it is only right that a nation and its people should benefit from it, not simply corporations and investors. The fruits of land and sea should benefit all, not just the few. Scotland has been fortunate, blessed first with North sea oil and now renewable energy, in particular offshore wind, a further natural resource offering great opportunities and at such an extent that it should be transformative. A recent Prime Minister even used the phrase, the “Saudi Arabia of wind”.
Other nations have shown what can and should be done. Scotland discovered oil at the same time as Norway, but now Scots can look only with envy, not just at the standard of living of their Nordic counterparts but at the Norwegian oil fund. Now valued at $1.4 trillion, it is suggested that it owns, on average, 1.5% of every listed company in the world. The British National Oil Corporation was sold off, while Equinor, owned by the Norwegian state, goes from strength to strength. Funds that should have seen Scotland bloom were instead used by Thatcher to smash organised labour and by New Labour to wage illegal wars. That must not happen with offshore wind. The people of Scotland must benefit, not just multinationals.
Norway has shown what should be done with oil and gas. Denmark is showing what can be done with offshore wind by taking a 20% stake in every new offshore wind development—this is not North Korea, but a European democracy. It has not seen investors flee. This also shows that public ownership does not have to be just a state energy company operating sites, desirable as that is, but can include actions such as this, which ensure that people and their nation gain from their natural resources—benefits for the many, not exploitation by the few.
I thank the hon. Gentleman for securing the debate. The private sector will invest some £60.8 billion across the UK over the next five years in developing and operating offshore wind projects. Does the hon. Member agree—from the way he is talking, I think he does—that whether investment is public or private, all devolved nations of the United Kingdom of Great Britain and Northern Ireland must benefit from any potential funding and that that would ensure a boost in jobs and increased sustainability for the renewable energy sector?
Of course; this should benefit our people. As I said, it is not just down to state energy companies, desirable though that is. This has to be done through the private sector, but as Denmark and Norway have shown, the state can take a share and state companies can be involved. That should be happening here, but the UK Government remain wedded to a privatisation route that has created a dysfunctional energy sector that we are all now paying for.
A Scottish energy company was promised by the Scottish National party and then shamefully abandoned. It must be delivered. Publicly owned and state companies are operating in the UK and the Scottish offshore wind sector. The absurdity is that they are neither Scottish nor from the UK. They are foreign state firms operating in Scottish and UK waters, delivering profits not for Governments in Edinburgh or London, but furth of these shores and with the wealth benefiting lands far from here.
Let me narrate the situation at the Neart na Gaoithe offshore wind farm. Despite the Gaelic name, it is located in the firth of Forth, between my constituency and that of my hon. Friend the Member for Kirkcaldy and Cowdenbeath (Neale Hanvey). Pillars and turbines are now visible, and the energy is coming ashore at Innerwick, just along from where I reside in Dunbar. That is all good, we might think, but who owns it? It is operated by two state-owned companies. One is EDF Energy, the French state-owned energy company that also happens to own Torness nuclear power station just along the road and adjacent to where the energy comes ashore. State ownership is not opposed, it seems, so long as it is someone else’s.
The other organisation is the Electricity Supply Board, or ESB, which is the majority publicly owned energy company of the Republic of Ireland. The Irish consul general in Edinburgh tells me that ESB’s investment in the firth of Forth is that state company’s largest ever investment outwith Ireland. We have the perversity that the wealth and profits that are generated will not come to Edinburgh or London and will not benefit Scottish or UK citizens. Instead, they will flow to Paris and Dublin, and the citizens of Ireland and France will reap the benefit that nature bestowed upon us.
Of course, big energy multinationals are also involved: SSE, Scottish Power, which in fact is owned by Iberdrola from Spain, and BP, among many others. However, state-owned firms from other lands are also there and many of them are significantly bigger than the Irish Electricity Supply Board—I do not intend to denigrate ESB—which has done well to provide for Ireland’s people. It is a lesson that Scotland must learn. As in so many other aspects, our Irish cousins, although blessed with less, have delivered so much more.
Neart na Gaoithe is not alone in this charade, where a Government opposed to state-owned energy companies allows foreign state-owned energy companies to profit and perhaps even plunder with abandon. It is a dereliction of duty and the price is paid not just in the loss of profits, but in the scandalously high prices paid by struggling families who are trying to power their homes. Many of them live in places where they can see the turbines off their shores or where they are in the lea of those turbines that operate on the land—energy-rich Scotland, fuel-poor Scots, indeed.
It is not only France and Ireland that receive a warm welcome, despite the Government’s political antipathy towards a nationalised energy sector. Research by the House of Commons Library has disclosed that in UK offshore waters, the state-controlled Danish company Ørsted and the Norwegian state operator Equinor own the largest shares of UK offshore wind, at 20.4% and 9.2% respectively. UK public entities own 0.03%.
Okay. I will address the questions to the hon. Gentleman.
Hon. Members will agree that this debate is timely, following the confirmation last week that there were no bids for new offshore wind development in the latest auction round, which means that the Government are criminally behind the curve when it comes to reaching 50 GW of offshore wind power generation by 2023. That has resulted in delays for the Erebus wind farm in my country of Wales. First of all, does the hon. Gentleman agree that last week’s announcement demonstrated that—
Order. I am sorry—you will have to sit down, please. An intervention is made to ask a question of a Member; it should not be a small speech. It has to be very short, because the debate is only for half an hour. An intervention is not an alternative method of making a speech—it has to be a question.
Okay. In terms of the future of wind energy and renewable energy in my country of Wales, does the hon. Gentleman agree that now is the time that the Crown Estate and its administration is devolved to Wales, as it is in Scotland, so that we can disburse the moneys as we see fit?
I think that where Scotland goes, Wales should follow. It is remiss that Wales does not have control over the money coming from the Crown Estate, and I certainly hope that Wales follows Scotland in that regard, as indeed the UK should in the establishment of a state energy company. The hon. Lady’s point is well made and correct.
I am concentrating on Scottish waters, where the Scottish Government’s ScotWind auction sold offshore wind farms at absurdly low prices, compounding the perversity of failing to deliver a state energy company, yet Scotland’s offshore wind resource has six state companies operating within it.
Along the A1 from Innerwick in Cockenzie, in my East Lothian constituency, energy will land from the Inchcape wind farm, which, again, is in the firth of Forth. Inchcape is owned by Red Rock Power, which is a European subsidiary of SDIC Power from Beijing. SDIC Power Holdings Co. Ltd is a listed company on the Shanghai stock exchange, but it is a state-controlled enterprise, with the Chinese Government holding more than 49% of its shares. The UK Government frown not just on public ownership, but on communism, yet it is fine for a state-owned company from communist China to benefit from Scotland’s offshore resource. You couldn’t make it up!
There are three more. Further north, Aberdeen offshore windfarm, off the Aberdeenshire coast, has 58 turbines turning and is owned by Vattenfall, thus generating wealth for the Swedish people. Vattenfall is 100% owned by the Swedish state. That shows that not just communist countries, but even ones with conservative Governments benefit from state ownership.
Sited further north of Peterhead is Hywind, a development in which Masdar holds a 25% stake, with 75% held by Equinor. Equinor is a Norwegian state energy company that benefits its people through the gas and oil resources in Norwegian waters, but adds to that through expansion into Scotland’s offshore wind. Again, Hywind is a joint enterprise, with two state-owned companies co-operating to exploit Scotland’s natural resource. Masdar, also known as the Abu Dhabi Future Energy Company, is a UAE Government-owned company, which is securing Abu Dhabi’s future, not Scotland’s.
In those fields—some already operating and others being developed—we have the absurdity of foreign state ownership of Scotland’s natural resource, and it is costing us. The organisation Common Wealth, in its paper “Power to the People: The Case for a Publicly Owned Generation Company” noted in 2021 that
“our energy bills combined with Contracts for Difference payments contributed £2.56 billion in payments to offshore wind generators owned by foreign state entities.”
Meanwhile, we are told that ownership does not matter, although it matters to the Governments of Sweden, Norway, France, Ireland, China and the UAE. They seem to see the benefit of not just managing their but our natural resource. Why? Because it underpins energy security, provides affordable energy for households and businesses, supports a just transition from fossil fuel to renewables, and allows for investment in technologies. All that helps hard-pressed households, boosts indigenous business and creates a more vibrant and competitive economy. It need not be outright ownership, welcome though that would be; as Denmark shows, a stake can be taken, allowing the nation and its people to benefit and prosper from their natural bounty.
It is about not just slippage of profits and wealth to foreign shores, but loss of control and influence over our natural resource. The evidence shows that we are losing out in more ways than simply the profit. Scotland is losing the turbine manufacturing. A few turbines are to be built at Nigg, but meanwhile hundreds of commissioned orders are going elsewhere. Yards such as Arnish and BiFab lie empty, even when proximate to the site. Not one turbine for a Forth field will be constructed in Scotland. Assembly is a poor substitute for manufacture, seeing lower profit and requiring less skilled labour. Every firth in Scotland should be manufacturing turbines and expanding to meet growing need, yet other than at Nigg, they lie idle and our folk face unemployment and our land a loss of skills.
Benefits from the supply chain is a mantra from the UK Government, shamefully echoed by their Scottish counterparts, but it is not borne out in practice. In my constituency, where the turbines offshore are visible and the horizon will change irrevocably, no work is being generated. What should benefit current and future generations instead sees folk unable to heat their homes and youngsters struggling to access skilled employment. Local business have not benefited and new businesses in the sector are not being created, either to deal with the offshore work, or to provide onshore opportunities through long duration battery storage or hydrogen production.
Let us look one of the sites owned by foreign state companies to confirm that. Neart na Gaoithe, which is owned by EDF from France and ESB from Ireland, is seeing the work go elsewhere. The turbines are being produced at Siemens in Humberside, albeit assembled in Dundee, with the foundations laid by Saipem from Italy. They are being taken out to the field by Fred. Olsen Renewables, and the cabling is being done by DEME Offshore from Belgium. Where are the contracts for Scottish businesses and the work for local folk?
There should be a Scottish state energy company and it should operate and take a share in all the fields that are being developed. Other nations do it and, as I have shown, are doing it in our waters. Denmark, with both its company and its public stake, is showing what can be done, just as Norway showed what could be achieved with an oil and gas bounty. Scotland has lost out on the former but must not do so with the latter. The bounty from the energy off our shores must benefit our people, not just corporations or even state companies from other lands.
The great Scottish comedian Billy Connolly penned a song, “Sergeant, Where’s Mine?”, describing the plight of a soldier with life-changing wounds reflecting on the prospectus the recruiting sergeant had first given him. Lying in his hospital bed he says:
“Oh Sergeant, is this the adventure you meant
When I put my name down on the line
All that talk of computers and sunshine and skis
Oh, I’m askin’ you, Sergeant, where’s mine”.
Well, all I’m askin’ you Minister, where’s ours? All that talk of the “Saudi Arabia of wind” and the work and the jobs, where are they? And when other nations, whether they are Ireland or France, Denmark, Sweden, Norway or China, have a share of our natural bounty, oh Minister, where’s ours?
I conclude by asking the Minister to confirm that his Government will neither oppose a state energy company nor Scotland seeking to take a share in its natural wealth. The absurdity of an energy-rich Scotland yet fuel-poor Scots must end. We demand a share and a stake in our natural bounty.
It is a pleasure to serve under your—as ever—sartorially elegant chairmanship, Mr Dowd. I congratulate the hon. Member for East Lothian (Kenny MacAskill) on securing this important debate, and the hon. Members who have taken part in it.
The hon. Gentleman gave a well-constructed, well-researched and thoughtful speech from the particular political perspective from which he hails, and I thank him for it. He will be aware of the important role that offshore wind and other renewables play in delivering secure, domestically generated energy, and the boost that provides for economic growth across the UK. He is right that we must harness the opportunities of offshore wind for Scotland and maximise the benefits for our nations—whether that is Wales, Scotland, England or Northern Ireland.
Where the hon. Gentleman and I differ is on how best to exploit that opportunity from where we start. This Government believe that a state-owned model is not the best approach. I am sure that, if we had allowed some new state company to come in and dominate our offshore wind sector, we would never have seen the 70% reduction in the cost of offshore wind that we have seen over recent years. It was the contracts for difference framework that we created, which allowed companies from all over the world, state or non-state, to come in, that transformed the economics of offshore wind and opened up the potential for not only the UK but the whole world of this important technology in tackling net zero.
The UK market is open to offshore wind investment, whether from state-backed or privately owned developers, and it has been extremely effective. The success of CfD has been in leveraging private capital to support wider public benefits. Our market-friendly approach has transformed the economics, as I said.
The UK encouraged an estimated £50 billion of new investment in low-carbon sectors in 2021 and 2022 alone. We currently have 14.2 GW of installed offshore wind capacity, the most of any nation in Europe. The hon. Gentleman made many references to different countries, but we have more of it than anybody else, and we drove its changing economics by taking a competitive approach rather than a protectionist, state-run approach that would never have delivered such a transformation.
We are committed to our ambition of reaching 50 GW by 2030, including up to 5 GW of floating offshore wind. We have not only the world’s largest operational wind farm project—Hornsea 2 off the Yorkshire coast, which is named after a town in my constituency—but the second, third and fourth largest projects.
I will make a little more progress, if I may.
Properly regulated markets that incentivise private capital—or indeed state capital—to invest in the energy system provide the best outcomes for consumers. Market competition is the most effective driver of efficiency, innovation and value. Private ownership of energy assets improves performance and reliability, and offers consumers greater choice and higher standards of products and services.
Our free market approach means that we have a highly competitive offshore wind market, which benefits from the expertise and experience of developers from all over the globe. It has enabled significant decarbonisation of our energy system, with dramatic drops in the cost of renewables. In 2010, when Labour left power, this country had a paltry 6.7% of its electricity coming from renewables. That was shameful. In the first quarter of this year, nearly 48% of our electricity came from renewables. Ten or 11 years ago, nearly 40% of our electricity came from coal. Next year, that will be zero, again because of our market-friendly policies, which would be at risk were His Majesty’s Opposition to have their ideas for state-run energy companies wrecking one of the most successful markets in the world. All over the country people are benefiting from the growth of the sector, and the cheap, secure, low-carbon electricity it produces.
Scotland has already benefited from the opportunities in offshore wind. It is a shame the hon. Member for East Lothian could not bring himself to recognise any of that. With its strong winds and plentiful coastline, it has made a significant contribution towards our offshore wind ambitions: so far, 3 GW is operational or under construction, and more than 40 GW of capacity is in the pipeline. The opportunity is enormous. The Scottish taxpayer already benefits from the Crown Estate Scotland seabed leasing. All net profit from offshore wind leasing rounds and rent is passed on to the Scottish Government for public spending.
We welcomed the recent announcement of a potential £200 million investment in high-voltage direct current manufacturing in the highlands by Sumitomo of Japan, which could create up to 150 jobs. The offshore wind industry has also supported the revitalisation of ports from Wick to Dundee. A huge range of diverse companies in Scotland already benefit from the offshore wind industry’s growth: crane manufacturers, consultants, underwater operations experts, turbine maintenance specialists and more. We know that opportunity will only expand as we grow the industry further.
The UK, as I have said, leads the world in floating offshore wind, a new technology that opens up access to new, deeper areas of seabed. The Hywind Scotland project was the world’s first floating windfarm. Combined with the Kincardine project, also in Scotland, it has given the UK one of the largest amounts of operational floating capacity anywhere in the world, at 80 MW. The UK has the world’s largest floating wind pipeline, with around 25 GW already identified, including through the ScotWind leasing round and INTOG processes. That represents a huge opportunity for the Scottish economy, especially from installation and lifetime maintenance activities, which are best undertaken locally.
I suggest to the hon. Member for East Lothian that, if he is as passionately committed as he suggests to jobs and benefits for Scotland, he should not be sending a message that we want to deter foreign investment, but signalling that we welcome it.
I will in a moment, if time allows.
To achieve our deployment ambitions and secure high-quality local jobs, we must continue to build a robust and competitive UK offshore wind supply chain. We are focused on maximising the economic opportunity arising from our transition to clean energy. Our significant strengths, including in wind energy and innovation, mean we have an essential role in building those supply chains, as demonstrated by this Government’s investment to date.
Through the offshore wind manufacturing investment scheme, the UK Government have made available funding to support investment in major port and manufacturing infrastructure. We have seen more than £500 million invested by SeAH Wind and JDR Cable Systems in manufacturing facilities, which will create or safeguard up to 1,200 jobs. I want to see similar investments in Scotland. That is why we continue to work with industry as it develops a long-term industrial growth plan for the sector, following the publication of Tim Pick’s recommendations.
Government backing attracts the private investment needed to deliver net zero. That includes research and development, where we are supporting innovation in floating wind technology through the floating offshore wind demonstration programme. That uses £31 million of Government funding, alongside £30 million from industry, to keep the UK at the cutting edge of offshore wind innovation. We are not stopping there. Just two weeks ago, applications closed for the Government’s floating offshore wind manufacturing investment scheme, which will provide up to £160 million to kick-start investment in port infrastructure projects needed to deliver our floating offshore wind ambitions.
The hon. Member for East Lothian gave a passionate speech effectively opposing the world’s investing in our renewable energy, and in offshore wind in particular. I caution him to think again, send out a more positive line to the world and recognise the huge investment opportunities here.
Does the Minister recognise that everything that he has said about private sector investment can and does happen in Denmark, but Denmark has taken a 20% stake on behalf of the Danish people, as Norway has done for oil and gas? None of what the Minister has suggested is impossible in Denmark, and it is happening. Does he accept that?
Denmark’s situation, size and industrial history are very different from the UK’s. What I am saying is that the UK is a European and, indeed, a world leader. We have decarbonised more than any other major economy on earth, and we believe that it is making us the best possible investment environment. We do not see the advantages of taking the state stakes that the hon. Gentleman suggests.
It remains essential that communities most affected by offshore wind and its associated infrastructure can benefit from its deployment. We recognise, for example, that regional distribution charges particularly impact the north of Scotland. That is why our cross-subsidy scheme provides more than £100 million annually to protect electricity consumers in the far north. It is worth £60 a year to every household in the north of Scotland.
We also want communities and individual families that are not involved directly in the industry to see benefits. That is why we have recently consulted on proposals for community benefits for transmission network infrastructure, including in Scotland, because we are essentially rewiring the whole UK economy as we make this transition. We must do it at speed, but in a way that has community support and in which we recognise the impact on host communities. Developing transmission infrastructure, particularly between Scotland and England, will be key for unlocking the full potential of renewable energy, and offshore wind in particular. It will mean that we can get electricity from where it is generated to where it is needed.
Hon. Members will have seen that the first annual contracts for difference auction completed last week. I am delighted that it delivered a total of 3.7 GW of renewable electricity. Contracts have gone to geothermal projects for the first time. There are record numbers of tidal stream projects, in which Scotland is a major player; I was delighted to visit the European Marine Energy Centre in Orkney and see so much of the significant work going on there. We also saw a doubling of onshore wind from last year’s record auction, and new solar. We hoped that offshore wind would be successful in this round, but we recognise that the challenging macroeconomic pressures felt by the industry around the world impacted its ability to come through the round successfully.
We are reflecting carefully on the results of allocation round 5 so that we make appropriate adjustments for AR6. That is how it works: we get data by trying to understand supply chain costs and commissioning research, but the most valuable data of all is actual behaviour in real auctions. That information will come into adjustments for AR6 to ensure that our evidence base reflects the true market environment. At the same time, value for money for the consumer through a competitive process remains an important feature of the CfD scheme, and I make no apology for always prioritising protecting the consumer. With annual auctions now in place, the allocation round is due to open in about six months, meaning that there is an opportunity to gain a contract with minimal delay to deployment for projects that were not successful this time.
This Government have made real progress in delivering the ambitions set out in the British energy security strategy and our “Powering up Britain” plan. We are committed to achieving our ambition of 50 GW of offshore wind by 2030. It has a vital role to play in delivering a decarbonised power system by 2035, subject to security of supply, and achieving our legally binding 2050 net zero commitments. We need to celebrate what we have done to date and recognise that most of the growth is not in the past, but in the future. The opportunities for Scotland, Wales, Northern Ireland and England are immense, and we should work collectively to ensure that we attract investment and create as many jobs as possible in this country supporting the transformation of our energy system and our spearheading of the global move to net zero, which is so important to us and future generations.
Question put and agreed to.
[Sir Robert Syms in the Chair]
I beg to move,
That this House has considered flying schools.
It is a pleasure to serve under your chairmanship, Sir Robert. I am grateful to colleagues who have come along to contribute. On the face of it, this is quite a niche subject, but it has implications beyond constituencies, such as mine, that contain flying schools.
My interest is primarily because of Shoreham airport in my constituency—Shoreham airport, not Brighton City airport as it was somehow re-christened at some stage. It is the oldest commercial airport in the United Kingdom, founded in 1910, and the oldest purpose-built airport in the world still in operation. It mostly operates leisure flights. It has an art deco terminal building, often used for films and by air-related businesses. It encompasses helicopter training and fixed-wing pilot training.
Shoreham was known for its air show until the tragic air crash of 2015, in which 11 men sadly lost their lives and which I have raised before in the House. It was the end of what had been a very successful air show over the previous 28 years. Shoreham has had a flying school there since 1913, most recently operated by Flying Time Aviation Ltd, which was founded in 2006 but ceased trading in May this year. At its height, Shoreham was responsible for something like 6% or 7% of all the pilot licences granted in the United Kingdom. It was a very important place for people learning to fly.
As I said, my interest goes beyond Shoreham airport and my constituency. There are implications in what has happened there and elsewhere for the future of integrated flying schools across the country and the future capacity of the United Kingdom to train pilots sufficiently. No fewer than three major flying schools have gone bust in the last 10 months alone. The first, back in May, was the FTA flying school in Shoreham, which employed more than 12 instructors and had 160 students, typically paying up to £90,000 for a full pilot training course.
In November last year, Bournemouth Commercial Flight Training, the flying school at Bournemouth airport, founded in 2002, ceased trading. Tayside Aviation, based at Dundee airport—I am very pleased to see the hon. Member for Dundee West (Chris Law) here—founded in 1968, ceased trading in April 2023, just before Shoreham. It was a large training school, employing around 45 instructors, with 140 students. It offered pilot training for RAF pilots as well. This is a national issue. It is not just about Shoreham airport, which otherwise is a perfectly well-run airport.
Looking at the figures, we can see the looming problem. Back in 2015, around 2,500 commercial pilot licences were issued in this country. The prediction for this year is down to 500. We are losing a lot of capacity, and those three flying schools alone are responsible for a large chunk of that capacity. Hundreds of students are finding themselves seriously out of pocket because their flying school has gone down either before they started their course, having paid their fees up front, or mid-way through the course.
One of my constituents is affected by this issue. He paid significant fees up front for flight training, and that money has seemingly been lost. It is an issue that the Department for Transport needs to address. More broadly, as my hon. Friend rightly points out, the aviation industry, which is central to this country’s trade and connectivity, will start to suffer if the problem is not properly fixed.
I am grateful to my hon. Friend and near neighbour from Crawley who represents Gatwick airport. I know he can with us today only briefly due to a sitting of the Foreign Affairs Committee. One of his constituents contacted me, along with many other people from other constituencies who had relatives or were themselves being trained at Shoreham airport, then found themselves out of pocket with very serious financial implications. I will come on to what we need to do about that. It certainly has implications for capacity in the airline industry in the UK. If anybody knows about that issue, it is my hon. Friend, who represents one of the largest airports in the country. There is an angle whereby some of the commercial airlines may be able to help.
I am going to read out correspondence from some of those affected by Shoreham who contacted me. I invited a number of them to come and meet me in my constituency; we had a roundtable to hear some of their experiences and plan a way forward. It is my fault if Members have been contacted, because I encouraged people to contact their MPs to tell them about their experiences. That way we could get as many hon. Members as possible to put pressure on the transport authorities and others to look at the immediate problem, as well as address the longer-term implications and the weaknesses in the system.
I have also been working with the British Airline Pilots’ Association, which has been lobbying the Government for changes in the regulation of flight training schools, particularly to protect students who have made a big financial commitment and are, for all intents and purposes, completely unprotected. That is unlike the situation if they were at a university paying fees, or had other financial investments or obligations, which would be covered under Financial Conduct Authority provisions. The point I am making is that if someone is on a pilot training course, it is little different from any other form of tertiary education, yet it is treated completely differently from training on other expensive courses, such training courses for medics and lawyers. Pilot training is one of the most expensive training courses.
One potential protection that has been suggested, not least by the Minister and the Civil Aviation Authority, is that someone paying their fee could do so by credit card. The trouble is, many of the flying schools do not take credit cards. If someone has to pay £90,000 up front, not many people have got a limit on their credit cards that would allow them to pay it in one sum. That is not a facility that is open or practical for many potential students.
I wrote to the noble Baroness Vere in the Lords, who is the Minister responsible for aviation. I am grateful to the Minister of State, Department for Transport, my right hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman), for covering her position today. I am afraid that it took some months and a bit of chasing to secure a meeting, but I am glad to say we have now secured one for a few weeks’ time, and I will be taking a delegation along with representatives from BALPA to see Baroness Vere.
A statement from the BALPA interim general secretary, Miranda Rackley, rightly noted that there is no public funding for pilot training:
“Flight schools going bust is financially devastating to hard-working students who deserve to have their money better protected from flight school failures. Pilot training is amongst the most expensive training of all professions, and unlike other careers such as law and medicine, there is no student funding available…Many trainees resort to family support to fund their training, such as remortgaging family houses. Government needs to step up and protect students that are so vital to the future of the UK aviation industry.”
BALPA has given a number of examples, and I have some direct examples too. A couple from Worthing, in my constituency, had to raise £90,000 for their daughter to train as an airline pilot. The 19-year-old signed up with FTA at Shoreham, and had to make a downpayment of £10,000 and pay a further £4,500 each month. In late May the school went out of business, which left her parents with losses of £45,000. That is a lot of money.
I can give other examples. Somebody wrote to me to say that their son
“was extremely keen on training to work for an airline. Because of that I remortgaged my house to fund him and almost paid for entire lessons in advance. Now I have no money left to support him financially for his dream job, and I am stuck in a predicament in how to move forward with my son’s education”.
Somebody from East Sussex said:
“My son was a student pilot at FTA in Shoreham, which has gone into liquidation. We have lost over £80,000.”
Somebody from London said:
“I paid a deposit to start training with them”
—Flying Time Limited—
“due to Covid and the changing of the schools schedule they were not able to provide lessons. When I asked for a refund they said they will get back to me and a week later they sent an email informing me the school is closing. It’s extremely sad and I’m not sure what to do or where to start as I want to continue with lessons.”
A constituent said:
“I have now been offered a place at one of the big ATO’s to continue my flight training as the FTA Global syllabus has been approved by the CAA and my training records have been reviewed by the training team at the ATO. So I am now in a situation that I am out of pocket”
—but could be transferred elsewhere—
“and the only way to get back into training without significant time off (due to being recent on training) is by gaining some sort of financial assistance. There is also a time frame I would need to start the training hence why us students would really need assistance from the government.”
There is a particularly poignant one from a Newcastle resident, who said that
“we have lost £50,313 that we had paid into my son’s training. Since a very young age all my son wanted to do was to be a pilot. He is unable to go into the RAF as he has corrected vision…and so we focused on the commercial training route. I have worked for the NHS for the last 27 years and you can imagine we are not rich people. We are hardworking and will give anything we can to enable my son to become a pilot. My husband…used some of his pension money to help…pay the school fees…It is astounding to realise that someone can pay in so much money for their education only to lose it all and that there is no route for any recompense.”
“will no longer be able to become a pilot as we cannot financially afford to fund a full course again. The failure of FTA has devastated my son and he no longer knows how to move forward in any career path.”
Here is another one from Uxbridge:
“I am a pilot student who was learning an integrated course at Flying Time Aviation limited in Shoreham-by-Sea. The course cost around £78,140, excluding the accommodation and cost of living”
On top of the fees, students have to fund living away from home and their general living expenses as well, which are not taken into consideration. The letter continued:
“The payment was made in 12 monthly instalments after paying an initial deposit of £14,190. On May 22nd, I received an email from the director of FTA informing us about the closure of FTA. I had assumed that the company would have the decency to give back what they owed to the students... However, it was made clear that no refunds would be made at all at the meeting held the next day. This has not only left me but more than 170 students in debt…I received an email last week from the liquidation company, which shows that the company owes me £65,500…however, with the company being extremely in debt, the chances of me and the rest of the fellow students receiving their money back are slim to none…we were only informed about the severity of this situation on the day they ceased trading.”
Finally, somebody from Kent said:
“I am one of the many who have been affected by this closure and have lost considerable amount of money and time—roughly £16,000 and only up until June to finish my flight training”.
There is a time consideration as well. People have 18 months under CAA regulations from the start of their course to the end and the examinations to complete that course. If people have started the course and cannot find or fund an alternative, they are right back where they started and that money has gone completely to waste.
I have taken up the case with Baroness Vere and the CAA, and they have both written back to me. The problem is that the CAA has oversight only of safety considerations and the quality of pilot training for flying schools, and has nothing to do with the finances or their sustainability, but surely the two are linked. There is growing evidence that the cash-flow problems that flying schools have had were leading to corners being cut, which could lead to compromised levels of safety, so financial sustainability is an important consideration in ensuring that flying training schools offer the full, safe and regulated pilots course that those students pay for.
Why do flying schools find themselves in this parlous situation? There are a number of reasons. First, they were hit hard by the pandemic. There was some support for them from the Government, but clearly flying training was not a priority at that time; indeed, much of it stopped for quite a long period. Secondly, flying schools are very dependent on fuel prices, which have rocketed because of events in Ukraine. The third consideration is that, perhaps uniquely in Europe, flying training courses in this country are subject to VAT, which is a large premium on top of already large fees. That does not happen in most if not all other European countries, where flying training is quite rightly treated as being educational, so is not subject to VAT.
I would like the Minister to comment on that last point. Does he think that flying training is a form of education and training, which the Government quite rightly encourage? If so, can he say why it is being treated as just any other sort of consumer item on which people are liable to pay VAT? That does not seem right.
There is also a Brexit element, which I am sure will greatly encourage the hon. Member for Dundee West. That is because previously flying training schools would only pay regulation fees to the CAA, but now, in some cases, if students have European pilots’ licences they will also pay fees to the European Union Aviation Safety Agency, or EASA. However, there is a Brexit bonus for pilots, which you, Sir Robert, will be glad to hear. Now that the UK has left the European aviation system, pilots are able to hold both a UK licence and a European licence, which was not possible previously under European regulations.
As a result of all these factors, many flying schools have had cash-flow problems, leading to claims that they have been demanding money up-front from students in order to keep themselves afloat. In the case of the FTA at Shoreham, it is claimed that it now has debts in excess of £5.5 million, including a £1-million debt to His Majesty’s Revenue and Customs, much of which will be accounted for by VAT liability. However, the FTA’s planes are all mortgaged and it has precious few assets, so it is highly unlikely that there will be anything left for the students who paid up-front or who are partway through their course; they will have to find a new flying school to transfer to, if they can afford to raise the necessary funds to do so.
As I have said, there is the added complication that this issue is time-limited, which is where I think the CAA has a far greater role to play. There are concerns that the CAA has not been as proactive as it might have been in trying to find solutions for some of the students at FTA, including reconsidering the way that exams are held and considering whether there can be any flexibility in that regard, particularly for those people whose course was delayed because of the pandemic; earlier, I cited the case of one such student.
There are also serious questions to be asked of the owners of FTA, who apparently were in touch with the potential receivers back in January, and there was also a reorganisation of debt liabilities to a new company, even though FTA was still taking up-front fees from students virtually up to the day on which it went under. As I have said, those students are not covered by basic Financial Conduct Authority protections, and the advice from the CAA and Ministers has been that they should pay with a credit card which, as I have also said, is not very practical. Consequently, those students are not covered by the protections in section 75 of the Consumer Credit Act 1974 that other credit card purchases would attract. The FTA flying school in Shoreham was a key academy, offering a European flying licence, and it looked like one of the safer and more sustainable flying schools. Consequently, its closure has shocked the industry and clearly other flying schools remain vulnerable.
When I wrote to the Minister, Baroness Vere, her response, as I have said, was that
“the extent of the CAA’s regulatory oversight of flight training organisations is limited to ensuring each organisation complies with specified safety requirements, including suitable training to an agreed safety standard.
The CAA has no direct regulatory oversight of the financial health of a flight training organisation or of the individuals operating within that business, and any proposals to grant these powers to the CAA would first require the Department to consider amending existing legislation, through its rule-making programme, to introduce such powers. In this regard, any changes to the scope of the CAA’s role and functions would likely require a process of developing and consulting on new draft regulations, new regulatory guidance, training for CAA inspectors and the establishment of a framework for regulatory oversight and insurance of the initial and ongoing financial resilience of flight training organisations.”
Right—let’s do it, because, as I have said, all of that will be needed before long if we are still to have a flying school business left in this country in the future.
BALPA contends that the CAA has a statutory responsibility, under retained EU law, to operate an ongoing oversight programme for UK-approved flight schools, which includes requiring “evidence of sufficient funding”. BALPA does not believe that, to date, the CAA has discharged that responsibility diligently or at all, and I agree. There is a financial oversight aspect of the CAA’s regulatory role. Clearly, demanding fees up front to keep operations afloat does not smack of flying schools having sufficient funding. The CAA needs to step up and step in.
BALPA has been working with students to introduce protections to avoid some of the disastrous financial consequences that have befallen students at Bournemouth, Shoreham and Dundee. Specifically, it has brought in its finance fairness charter, under which it asks that, as dedicated approved training organisations, flight schools
“commit to a fundamental principle of not accepting advance payments or deposits from cadets that exceed”
a certain amount
“for training services. This financial limit aims to assure cadets while promoting fiscal responsibility.”
Additionally, it asks that ATOs
“pledge to furnish cadets with comprehensive information regarding payment alternatives if available, further underscoring transparency in line with these commitments”
“pledge to extend the convenience of payment by credit card without imposing any undue surcharge providing the cadet with additional consumer protection.”
The BALPA charter adds:
“Transparency is paramount. ATOs undertake the commitment to furnish cadets with accessible information pertaining to their training programs, associated costs, payment protocols, refund mechanisms, and all pertinent terms and conditions.”
That seems perfectly sensible to me, and I hope the Minister will consider taking it up with the CAA. One person who has been caught up in all this wrote to me, referring to the
“seemingly disinterested attitude the CAA has taken towards investigation of misuse of Student monies”,
with the CAA just rolling out the excuse that that does not come its remit, when many of us think that it does.
“For many pilot hopefuls,” BALPA says,
“the costs involved in attaining the necessary qualifications have meant going to extreme measures to secure the funding required, including re-mortgaging family homes”—
I have given examples of that—
“taking out multiple un-secured loans, maximising limits on credit cards and/or borrowing sums of money from family, far exceeding any normal student borrowing.”
“In the UK, a trainee professional pilot is not viewed in the same way as a student in any other field or profession. In 99% of cases in the UK, a trainee professional pilot does not even qualify for student status.
For too long, trainee pilots have been viewed and treated as customers. They are students in education, investing in their futures and they are the future of the UK’s aviation industry.”
I wholly agree.
There is another issue, which I referred to briefly: VAT. Interestingly, this point was raised by the now Defence Secretary in a question to the Chancellor of the Exchequer in June 2018, when he was on the Back Benches. He asked the Chancellor,
“with reference to Strategic Review of General Aviation, published by the Civil Aviation Authority in July 2006, whether his Department has conducted a review of whether the current VAT treatment applied to flight training places UK flying schools at a competitive disadvantage to those based in other countries; and if he will make a statement.”
The Treasury replied:
“The government does not hold information on tax revenues that can be broken down to assess the impact of tax on flight training.”
This is not a new issue and many senior colleagues have raised it in the past. I cannot stress enough the financial impact that these closures have had on students who have saved or begged families hard to train as pilots to fulfil their dreams. Why do we not treat flying schools like any other places teaching students in tertiary education, rather than treating students as consumers of a product that happens to be a training course? Why is flight training subject to VAT in this country, unlike anywhere else in Europe?
Having said that, the consequences of the recent closures go far beyond the implications for individual students who find themselves severely out of pocket and need protections. BALPA says that we also need new protections to help secure the training pipeline of commercial pilots to aid forward planning for airlines. We need those new protections to prevent the loss of foreign investment from airlines investing in the UK’s highly experienced flight training industry. We used to be the pride of the world and many foreign pilots would come here for their training. We need new protections to support smaller airfields across the country that support thousands of skilled jobs, including flight instructors, engineers and air traffic controllers.
Today, I received a note from Airlines UK, which makes some interesting observations. Of the 15,295 holders of CAA-issued commercial pilot licences aged between 18 and 64, only 2,954 are under 30, while 3,500 are between 51 and 64. We have an ageing population of pilots who are already trained and working. In the last decade, the total number of UK commercial pilot licence holders fell by 10% and the number under the age of 30 fell by 4%. Airlines UK therefore supports many of the proposals made by BALPA, including that we should remove
“VAT from pilot and air traffic control officer training”;
that we should
“enable student and/or other self-funded options to be used for courses to qualify as a pilot”;
and that there should be an update of the apprenticeship levy
“to enable employers to overcome existing barriers to use apprenticeship funding for pilot and ATCO training.”
We should bring together people from the Department for Education, the Department for Transport and the Treasury, BALPA, and the rest of the airline industry, which plays a role because it is the beneficiary of pilot training—the bigger airlines do not tend to pay for some of this training, but I think they have a role too—to find an immediate solution for those prospective pilots left severely out of pocket, and to introduce financial protections to ensure that that is highly unlikely to happen again, and to ensure that there is oversight of financial sustainability and that the CAA, or an alternative body, can regulate the future of flight training schools.
Without that, we will have an awful lot of students who find themselves at a loose end, unable to fulfil their dreams of becoming the pilots that this country desperately needs. There will also a big confidence issue for pilot training in the United Kingdom. Other countries send their students to this country to train, but people from our own country who want to train as pilots will not be able to do so in the United Kingdom, either because of a lack of capacity or because it is too risky, so they will go abroad and decide to stay and work there, and we will lose them.
There is a severe risk to the UK airline industry unless this situation is sorted out urgently, and that is my ask of the Minister and his colleagues. This issue has big implications for the flying industry in the United Kingdom and a big implication for a lot of the students represented by hon. Members here today. It cannot be ignored any more. I hope that in our forthcoming meeting with the Minister she will be able to progress some urgently needed solutions to the problem.
I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for raising this matter and putting on the record so skilfully the perplexing and, in many respects, heartbreaking saga that students are going through.
Although this is not a registered interest, I declare that my son is a trainee pilot. Thankfully he is not in one of the schools that have been mentioned in this debate. He has nearly completed his training. He is currently in the United States of America finishing his night school training for jet aircraft and hopes sometime next year to be a pilot flying the skies around the United Kingdom and Europe. I wish him all the best, because I am immensely proud of him for the job that he has done.
Considering the points that have been raised in the debate, I feel for the parents and the students. The sagas described by the hon. Member for East Worthing and Shoreham are personal lives; they are the stories of young kids who dared to dream, who wanted to get their jet licence, who wanted that as their career, and whose mothers and fathers sacrificed everything for them. We heard about parents putting houses on the line and remortgaging to facilitate that for their children, because they believed in them, and then that being cruelly snatched from them. There is no chance that they will get to start again, get a refund, or get picked up and taken on by another school. Their stories are heartbreaking.
I know that the Minister is a passionate man and that he will care about those individual stories. They are the lives of young people. They are the future of our nation’s aviation sector. If we do not put this right, we will suffer consequences down the line—and very quickly. One airline has something like 500 pilot vacancies over the next two years. Those must be filled. Anyone who has recently been at any of our local airports will know of the delays and the lack of crew availability, and the problems that those things cause. We need to fix that now, because we are an island nation that relies on aviation not just for passenger travel but for cargo travel and postal access. As a nation that relies on aviation, we will feel the consequences if the matter is not fixed immediately.
Pilots are necessary to our economy, and the training pipeline put in place by a number of these schools is crucial for economic growth and development. The smaller airfields across the United Kingdom where a number of these pilots initially trained will also feel the impact and could be damaged. A number of private and smaller airfields across Northern Ireland, which have been the incubator for young pilots, are at risk, and it is the same for smaller airlines and airfields across the rest of the United Kingdom.
A number of things need to be done, but it is important to reiterate this point. As a parent who had to pay the deposit for my kid’s training, I could not pay it on a credit card. There was zero protection. It was an eye-watering amount: the first deposit was just shy of £15,000, and in some instances deposits are not refundable. People are really staking a lot on these companies. I remember going around the banks with my son and saying, “Can this young lad get a loan? I believe in him.” No—he was not getting a loan for a pilot’s licence. I took him to inquire about whether he could get a student grant. He is a student—he is doing a degree alongside his pilot’s licence—but no, he could not have a student grant at all, for any part of it. Mummy and daddy would have to pay for that. It is a big decision when you put your house on the line and say, “I’ll remortgage the house to get that person the career that they need.”
As the hon. Member for East Worthing and Shoreham indicated, when training is cruelly snatched from kids in circumstances like this, it not only wrecks their lives, dreams, hopes and aspirations, but it devastates their parents. The fact that the money paid in for the student cannot be protected needs to be fixed. There are no refunds for an aviation course after the first £10,000. As I said, the initial payments are eye-watering—and those are just the fees. My son trained at Gatwick for the first nine months, so he had to live in London. He had to pay fees, living costs and all the rest of it. Other kids across the United Kingdom are faced with the same thing: they have to come down to Gatwick or one of the other big airports, live near it and pay their fees and living costs. They get zero support, whereas other students get reduced rates, railcards and all sorts of other things. Trainee pilots do not benefit from any of that, and they have to pay for food and board on top of all those fees. Banks will not give a loan without an asset being put up.
A number of asks have been outlined, but I want to ask the Government to look at incorporating trainee pilots into the student loan system, so that they can get a loan that is paid off more easily. They will move into a bracket whereby they are able to pay off such loans, so they should be regarded as worth backing. They will probably be able to pay off the loans more quickly than students who do an arts degree. Trainee pilots do a necessary qualification that takes them into a sector that the economy actually needs. Something should be put in place to allow the Government to say that the student loan system can be used for trainee pilots. That is a reasonable ask, and it is something the Government should look at.
I agree that the civil aviation sector must do much more. After all, all pilots are trained initially by civil aviation, and it is civil aviation that they benefit. Something must be done, not necessarily to step in and save flying schools that have become failed businesses, but to save the students, help them to progress in a much better way, and help them get what they are entitled to: a very expensive but very beneficial thing called a commercial pilot’s licence for jet aviation, which is essential for our economy. I appeal to the Minister to look at the points that were raised by the hon. Member for East Worthing and Shoreham, to see whether there is some way we can help students who are directly affected by the flying school closures, and to look at the wider picture for aviation students going forward.
It is a pleasure to speak in this debate. I congratulate the hon. Member for East Worthing and Shoreham (Tim Loughton) on leading it, setting the scene extremely well and outlining the issues.
I give special thanks to my hon. Friend the Member for North Antrim (Ian Paisley), whose son is training to be a pilot, and I hope that one day we will both be in a plane of which he is the pilot. We look forward to that accomplishment. My hon. Friend put forward our request that trainee pilots be part of the same system as students, because it is a simple system and easier to regulate. The wherewithal to do that is already there. Being a pilot seems to be a vocation. If we do not make preparations now, we could find ourselves in a position whereby we might not have the number of pilots we need.
As someone who flies twice a week to get to the House, I have the greatest respect for our pilots and airlines. It is important that we do more across the UK to better support and fund flying schools for trainee pilots, so today’s debate is very important. I want to make a case and give some specifics for Northern Ireland, as I always do.
My constituency, which is rich and diverse, has its own flying clubs to train pilots, and we are fortunate to have them training at this very moment. One of the flying schools in Strangford is called the Ulster Flying Club, located in Newtownards. I have had a relationship with it throughout the years I have been a councillor, a Member of the Legislative Assembly and an MP. The club holds open days every year and other events, and it is very much an integral part of the community. It trains trainee pilots to be pilots.
I know of one constituent who just completed 10 flying lessons when he was only 13. That was because a provisional pilot’s licence was available. It is often the first step in becoming a commercial airline pilot. It is just fantastic that so many training grounds offer an opportunity in aviation for those of all ages who are interested. My own son was interested at one time. It may have been a “flight of fancy”, if I can use that terminology, but at one time he wished to be a pilot. I think what put him off was the cost factor. Also, he met his future wife and she had different ideas. It was one or other of those things that changed his opinion, but the fact was that the opportunity to be a trainee pilot at Ulster Flying Club in Newtownards was one of the options considered.
Whether a provisional pilot’s licence or a pilot’s licence is purely for leisure and recreation or because of professional interest, it is great that such openings are available for our young people. I encourage them all to take up the opportunities. I congratulate the Ulster Flying Club in Newtownards on its clear commitment to try to make that happen for all—not just for the constituents of Strangford but for those further afield. I was in contact with the British Airline Pilots’ Association ahead of this debate, and it made me aware of its role in protecting young, aspiring pilots and supporting the aviation industry in general.
To be specific, I agree that we must have better financial protection for trainee pilots, as the hon. Member for East Worthing and Shoreham set out so well in his introduction. In 2023, three UK flying schools have collapsed, which is devastating not only for the aviation industry but for the trainee pilots, who in some cases have paid tens of thousands of pounds in advance fees. The hon. Gentleman gave a number of examples of that. One that I read about in the information I was sent was of a young girl who had paid some £90,000, which is an incredible loss. It is quite unsustainable for any young person and for the family—the bank of mum and dad—to stand over that. They then have to face the fact of the vocation they had chosen not being achievable.
There is absolutely no doubt that we as policymakers in this place have a responsibility to support young people in their career choices, especially one where the financial aspect is so huge. The smaller airfields—such as the one in my constituency of Strangford—support thousands of skilled jobs, including those of engineers, air traffic controllers and trainee instructors. All these things have to be paid for. I am very fortunate that the Ulster Flying Club has such member strength and is so strong. It has lots of adult pilots who have their licences and it has a strong youth section as well. But it takes money to keep it all going, so we must invest in these facilities and not risk their closure altogether.
BALPA has recommended that the Government regulate such that an ATO’s ongoing approval requires it to take advance payments or deposits from consumers in instalments no greater than £5,000, or perhaps 5% of the total course cost at a time. That is something to look at. I look to the Minister to consider these proposals and see whether something can be done. Can this be regulated? Can it be done in a different way? Clearly, if action is not taken, we have a severe problem. As stated by other Members, the financial burden is just huge, and to ask a young, aspiring pilot to risk that after the closure already of three schools is a massive ask for anyone and for their family.
I have always been a big supporter of encouraging young people to pursue their dreams in terms of their careers. We as parliamentarians in this House and also as parents—as a grandparent in my case—have a duty, I believe, to encourage our young people to do so. How many times have we been at a careers event, or how many times have we been speaking in a school, where we have encouraged young people to achieve their goals? If they have a dream—a goal that they wish to achieve—we encourage them to reach out and grasp it. If we say that, we have to mean it in this place as well, which is why we look to the Minister for help.
We have the second largest national aerospace industry in the world—after the United States—here in the United Kingdom of Great Britain and Northern Ireland. Whether our flying schools are teaching young people to fly purely as a hobby or preparing them for a life in which they are flying planes for some of the biggest airlines globally, this industry must be supported by the Government in order to ensure that young people—our future and, indeed, the Government’s future—are not let down but have the financial means to learn, without the worry of closure.
I very much support what has been put forward. I thank right hon. and hon. Members for their contributions and look forward to those of the shadow Ministers. We look to our Minister for a response that gives us the reassurance that we can then give to our constituents.
I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for securing this debate that allows us to discuss what is a wide-ranging and important topic, given the number of flying schools that have closed over the past 12 months and the impact that has had on those affected by the closures. Unfortunately, like others who have already spoken, my constituency of Dundee West has direct experience of that, and its situation has many parallels with what other Members have described.
With great sadness, Tayside Aviation in Dundee, one of Scotland’s leading flight schools for more than 50 years, went into administration and ceased trading in April. At the time of the school’s collapse, around 60 trainee pilots were either participating in or enrolled in training, with fees paid in advance. As we have heard, unlike for most other career paths, student loans cannot be used to fund flying training. The likelihood of the payback of student loans from a pilot career is arguably greater than many others, and that anomaly needs to be fixed.
Furthermore, pilot training is uniquely subject to VAT in the UK, whereas it is exempt in other countries. That is astonishing, because it is about education. We are taxing those who often take loans from their parents an extra 20%, on top of fees that could be upwards of £70,000 or £80,000. The Minister will surely agree that we need a level playing field. Charging VAT limits the number of people who can afford flying as a career path and increases the numbers who choose to train abroad, thus reducing the viability of training schools in the UK.
The costs associated with flight training are very significant and have to be wholly met by the trainee pilot. They encompass tuition fees, aircraft rental, exams and licences. For many aspiring pilots, realising their dream of taking to the skies comes with a hefty price tag. The closure of Tayside Aviation left numerous trainees in a dire situation after investing significant sums of money in their training, only to see their dreams shattered.
It has been reported that some students have lost upwards of £50,000, with no indication of whether they will receive any of it back and their future career ambitions now in jeopardy. In one instance, a trainee made a £6,000 payment to Tayside Aviation just five hours before the company went bust. Although some who paid using credit cards have been successful in clawing back some of their moneys, most will receive very little of what they paid. Many families were in contact with me about their individual cases, and I share deep concern and sympathy for those who, for instance, had to remortgage homes to fund their training and were subsequently affected by the business’s collapse.
The lack of financial regulation in the flying school industry exacerbates the financial risks. Unlike many other educational institutions, flying schools are not subject to the same level of oversight and financial protection measures, which begs the question: why? Trainee pilots are left without adequate safeguards to protect their investments when a flying school faces financial difficulties. In the case of Tayside Aviation, trainees are left with uncertainty, struggling to recover their investments and unsure of where to turn for support. In a recent letter to the Transport Secretary, it has been noted that the potential sum owed to the customers of now-defunct flying schools is estimated at around £4 million.
Furthermore, the schools often required advance payments because of the elevated risk of insolvency. Disturbingly, anecdotal reports suggest that certain flying schools refuse to accept credit card payments for such advances, as we have already heard, leaving consumers without the protection afforded by the Consumer Credit Act. This concerning situation underscores the need for greater financial safeguards and transparency in the aviation education sector to protect the rights and investments of aspiring pilots.
Although flight schools fall under the regulatory purview of the Civil Aviation Authority, it is crucial to note that that oversight primarily covers safety measures and the quality of pilot training. It does not extend to monitoring financial stability or providing protections for would-be pilots. To enhance consumer protection and financial transparency in the aviation education sector, it has been suggested by representatives of BALPA, Wings Alliance, Flyer magazine and Bristol Groundschool that the CAA should consider implementing specific requirements as part of a flying school’s approval process. Requirements could include limiting advance payments from consumers to a maximum of £5,000 and mandating the availability of credit card payment options without additional surcharges. Sounds perfectly reasonable, surely?
Additionally, the CAA should conduct a comprehensive review of its oversight procedures for flying schools, aiming to ensure full compliance with retained EU law. Furthermore, the establishment of a dedicated consumer protection scheme, akin to the ATOL—air travel organisers’ licence—scheme for package holiday customers, could be explored to safeguard the funds of student pilots and provide them and their families with greater financial security.
The demise of Tayside Aviation has been of detriment not only to its trainees but to the city and its wider economy. Tayside Aviation supported 22 full-time jobs and delivered the RAF air cadet pilot scheme. The collapse also threatens to undermine a key project in the Tay cities deal. Tayside Aviation played a pivotal role in the Tay cities initiative to establish an aviation academy for Scotland. The project aims to cultivate a proficient workforce comprising aircraft engineers, air traffic controllers and emerging pilots. With a budget of over £8 million, the initiative seeks to enhance infrastructure and foster the seamless integration of aviation education and training at local, regional and national scales.
The lion’s share of the investment is designated for Perth College and its subsidiary, Air Service Training Ltd. An allocation of £2 million was specifically earmarked for the Dundee campus of the aviation academy for Scotland, to be operated by Tayside Aviation. The Dundee campus would have a primary focus on delivering comprehensive training programmes for aspiring pilots and future air traffic management professionals. It is therefore imperative that a flight school at Dundee airport is re-established. I firmly believe that the facilities there remain an attractive proposition for any prospective buyer, including airlines looking to train their own pilots.
Moreover, the viability of the airport itself is dependent on its regular use, through flying clubs, education and training and the maintenance of commercial passenger routes. Bearing that in mind, the UK Government must recognise how vital it is that the public service obligation for flights between Dundee and London is renewed at the end of next month, when the current contract ends. Historically, the PSO has been funded by the UK Government, the Scottish Government and Dundee City Council. The case for the continuation of the PSO has been accepted, which has allowed the competitive tender process to commence. However, no confirmation has been given in respect of future funding for the PSO. The total tender amount is expected to increase, so it needs to be affordable for all parties.
The PSO underpins the wider activity at Dundee airport and is vital to its future success and connectivity. It makes the city and the region more attractive to investors, businesses and tourists. Analysis has shown that the economic benefit brought by the PSO has the potential to be six times the cost of the PSO contract. First, in principle, do the UK Government continue to support the Dundee-to-London PSO? If so, do they recognise the importance of the Tayside Aviation flying school, alongside the route, to the future of Dundee airport?
Secondly, subject to detailed assessment of tenders received, will UK Government funding for the PSO continue at the same level and increase if necessary? Given that it is a PSO route, what further steps can the UK Government take to support the viability of connectivity between Dundee, Scotland’s islands and the rest of the UK?
Furthermore, recognising the importance of the PSO to the operations at Dundee airport, is there scope to explore further revenue funding to support the PSO through the Tay cities deal, as part of a wider Dundee airport project, should there be a funding deficit? I have written to the Minister responsible for aviation to request an urgent meeting to discuss this issue and to look for a way forward for both the flight school and the PSO, so that they can secure a future at the airport. I would be grateful if the Minister could address those points.
Finally, with flying schools closing, airports and routes at risk, and the number of UK commercial pilot licence holders down 10%, we do not want to be in the same situation as the USA, where regional air services have been decimated by pilot shortages and more than 100 small communities have lost some or all of their air services in the last two years.
Our airports and airlines and the people who work for them are vital for domestic and international connectivity, which we value so highly. The loss of flight schools does not involve simple cases of enterprises going out of business. The closures are devastating to the careers of potential pilots, who have had to invest huge sums of money that are not expected of those in other professions. Flight schools are crucial to the aviation industry and, as outlined, critical to the success of smaller airports throughout the country. It is essential that would-be pilots are supported properly and that flights schools are regulated properly, enabling trainees and the industry to have the confidence and certainty to succeed.
It is a pleasure to serve under your chairmanship, Sir Robert.
I, too, congratulate the hon. Member for East Worthing and Shoreham (Tim Loughton) on the powerful personal testimony that he brought to us of constituents and others affected by the closure of flight schools. I also congratulate the hon. Members for North Antrim (Ian Paisley) and for Strangford (Jim Shannon) on their testimonies. For one moment, I thought the Democratic Unionist party was getting on a biblical stage—the tale of two sons, like Cain and Abel, one becoming a farmer and the other a shepherd. One will become a pilot and, on behalf of His Majesty’s official Opposition, I wish that son well in his endeavours.
We are in this debate because two flight schools have closed, one at Dundee airport and the other at Shoreham airport—I say that before I am admonished by the hon. Member for East Worthing and Shoreham, as my notes call it Brighton City airport—which is a sad loss of the jobs for trainers and staff. As the hon. Member for Strangford said, we have a world-class aviation sector in the UK, and we want to keep it that way.
The closure of those valuable facilities most severely impacted the aspiring student pilots who were just setting out on their careers. The closures left them and their families seriously out of pocket, as we have heard. Commercial pilot training can cost up to £150,000 and is not currently eligible for student funding, which is available for other professions such as law and medicine. With no mechanism for student finance, many aspiring pilots take extreme measures, such as multiple loans and—when they can—credit cards, borrowing from friends and families or, as Baroness Vere said as Aviation Minister back in 2019, relying on the bank of mum and dad to get through training.
In May this year, the Government published a report called, “Addressing the cost of pilot training”, which was a fascinating 62-page read in preparation for this debate—
I thank the Minister for his support on that.
The report highlights the fact that the lack of diversity and the barriers to access are something we all agree on. This is in no way data, but in my capacity as shadow Aviation Minister I attend many events and conferences, and I am still surprised at the lack of diversity in the industry. I get the irony of somebody who looks like me saying that.
To return to the collapse of the two flight schools, the amounts owed to the individual students affected is about £4 million, with an average individual loss per student of some £90,000. That money is unlikely ever to be recovered, as some flight schools do not take payment by credit card—as has been pointed out—so the consumer protections afforded by that method of payment have not been possible. In addition to that, the students are unsecured creditors, so there is no legal requirement for them to be repaid the money—morally, however, that is another issue.
In the decade since 2007, the average cost of initial pilot training in the UK increased by about 54%. Various academic and industry studies undertaken on pilot recruitment have noted that of the thousands of potential pilots who start flight training every year, about 80% leave. The failure to fund tuition fully is cited as a major reason for the drop-out rate.
Research commissioned by the Department for Transport showed that increasingly dynamic market conditions in the light of covid-19 meant:
“Training organisations and airlines suffered financially from lack of operation during the pandemic and lockdowns”.
There is little doubt that being unable to operate would impact on such businesses. For example, Lufthansa Aviation Training suspended its training from the beginning of the pandemic. Interestingly, Lufthansa was able to offer all its 850 students full refunds. I wonder whether the chaos in the sector and the refusal by the Government to offer a sector-specific deal might have added to the knock-on effects we see now.
The heavy reliance on self-funding creates barriers to entry to the pilot profession, disproportionately affecting some demographic groups more than others. Only 6% of pilots worldwide are women, and just 4% are from BAME communities. How can that be? I would be interested to find out the figures for children of a traditional working-class background who cannot rely on the bank of mum and dad. Kids like me ruled out ever becoming a pilot, because there was not, and clearly still is not, a route for working-class children and children with no access to credit who were unwilling or unable to go into debt to fund the training. If I may, I will quote Baroness Vere again: back in 2019, she said that
“social mobility is a fundamental right and it should not be that some people are blocked out of entire careers just because they don’t have the ‘Bank of Mum & Dad’”.
The cost of learning to fly not only plays a key role in limiting the pool of talent that the profession can draw on, but hampers the diversity of the pilot community. There was an attempt to address diversity in the pilot workforce with the creation of a first officer apprenticeship, which is a level 6 qualification that involves training as a co-pilot over a two-year period. Although the scheme is welcome, it is flawed by its very design. Industry sources have said that the £27,000 funding cap is not sufficient to cover flight training. Furthermore, apprentices cannot be asked to take on debt to supplement their training, which puts the onus on the airlines. There are restrictions on bonding apprentices to training providers, but airlines are likely to be unwilling to invest sufficient sums of money in a person who might leave immediately on qualifying. Almost by design, the scheme is flawed.
Moreover, there is a concern that the cost of training to secure a pilot’s licence in the UK may begin to put UK airlines at a competitive disadvantage relative to counterparts in the European Union, where pilot training is less expensive. Other changes have an impact on that situation: since the UK exited the EU, potential non-UK candidates now require settled status to live and work in the UK. In addition, those undergoing pilot training in the UK will be required to sit additional exams to get additional licence approval, which has additional cost and time implications for students. Taking those matters into consideration, there is a real concern that trainees will opt out of a UK licence and fly on an EU licence only, which will significantly reduce the pool of pilots available here. A 2020 study shows that the emerging shortage of qualified pilots is a high priority for airlines. Respondents to the flight operations survey noted upcoming pilot shortages as a top five focus, and 22% said it was their leading focus.
The collapse of the schools only serves to highlight a number of issues in flight schools and wider issues with pilot training: flight schools’ operating models, funding for aspiring pilots, lack of diversity in the workforce and the complexity of the first officer apprenticeship scheme, which by its own construction and in its current format is destined to fail. There is much to be done to ensure that the job of a pilot is open to all, not just to those with a well-resourced bank of mum and dad. I look forward to the Government’s acting on the recommendations of their own report, “Options for addressing the cost of pilot training”, and ensuring a pipeline of talent from all demographics.
It is a delight to see you in the Chair, Sir Robert. I thank everyone who has spoken in the debate, and I congratulate the hon. Member for Wythenshawe and Sale East (Mike Kane) on retaining his place in the shadow Transport team. It has been an interesting debate, and I am grateful to colleagues for their contributions. Aviation is a very important sector and is a matter of local importance in the constituencies involved.
Let me start by reiterating the apology that my noble Friend Baroness Vere gave to my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton). I know that she and he are to meet in a matter of days, and I look forward to that being a constructive and engaging conversation. I am delighted to respond to his concerns in this debate. As he will know, the Government regard the aviation sector as an important strategic asset. It contributes at least £14 billion to our GDP every year and supports some 230,000 jobs across all regions of the country. We recognise the sector’s importance both geographically and economically.
It is important to focus, as hon. Friends have done, on the dire impact of training operators’ failures on the students involved. There is a tremendous human cost, which has been brought out well during this debate. I have a particular sense of identification with it because I have a pilot’s licence myself, although tragically it has long since fallen out of use. It was paid for not by the bank of mum and dad but out of my own earnings, in case Opposition Members were wondering. I am the son of a pilot, the brother of pilots, the nephew of a pilot and the grandson of a pilot, so I have a very considerable personal understanding of the issues involved, as well as the ambition, inspiration and joy that flight gives young men and women across this country, as it has done for generations. I fully recognise the point that the hon. Member for Wythenshawe and Sale East made about the increasing importance of a relentless focus on improving diversity in the sector. He is absolutely right about that, in every dimension.
Having said that, what we have here, as far as I can tell, is the disorderly liquidation of three local aviation training operators. That carries with it tremendous disruption and difficulty, and it exacerbates the impact because an individual can literally turn up one day or—as colleagues’ constituents have done—receive an email saying that the institution to which they have confided their hopes, their dreams and a lot of money has gone, completely unexpectedly and without any notice, into liquidation. They may, and in many cases will, receive back none of the money that they have already contributed.
When we think about the wider picture, however, it is important to put things into perspective. May I offer the Chamber a correction to a number that has been used? In 2023—I am advised by civil servants that this is true—there were 11,675 applications for training across all licences in aviation. We are talking about terrible local impacts on a relatively small number of people so far and three failures of ATOs among some 270 registered flight schools across the UK. That is not to derogate for a second from the tremendous importance and extreme sadness and in some cases grief that has been inflicted; it is only to say that making general rules on the basis of a relatively small portion of the whole sector is something that one needs to bear in mind. When we think about the enormous sums that have been lost in some cases, we are talking about people who are in commercial licences at the very top of the pyramid and are therefore as close as one could be to potential long-term gainful employment.
I will come on later to what the CAA is doing and the suggestions that have been made, but let me just pick up on a couple of points that, rightly and importantly, have been made by my hon. Friend the Member for East Worthing and Shoreham. He is right that the pandemic had a difficult impact on the aviation industry generally and on the training sector. As he will recall, the Government made every effort, at considerable cost to the taxpayer, to support institutions, companies and individuals throughout the air transport sector. That amounted to something like £8 billion of pandemic-related support and included support through loan guarantees; support for exporters; the Bank of England’s covid corporate financing facility; the coronavirus job retention scheme, for which I was responsible; the Treasury’s furlough scheme; and the airport and ground operations support scheme. A tremendous amount of specific support for the sector was given during what was a completely unexpected and dramatic change in our business, social, personal and economic arrangements. My hon. Friend is absolutely right to focus on that; he is also right that fuel prices have gone up, which will have had the effect of driving prices upwards.
However, as a former Financial Secretary to the Treasury, I do not share my hon. Friend’s view that a cut to VAT would be the answer to the problem. There is a very simple reason for that. There are many cases of sectors in the UK economy that have called for VAT cuts. In a very small number of cases, because VAT is by design a broad-based tax, reductions have been made to levels of VAT. Very often, they have not been passed on as any kind of saving to the end user; they have gone to support the margins of the company. In the training operator business there may be some value in that, but it is the normal course of things that in a competitive private sector industry there will inevitably be organisations that for various reasons do not manage themselves effectively, or go bust for other reasons.
I am slightly disappointed by the Minister’s comment. This is not a huge mass industry; it is not beyond the wit of a regulator or of the Treasury to ensure that VAT savings are directly passed on, or else the companies would not be eligible. Even if the Minister will not consider this for the future, does he not think that there is a moral case for students who have lost their fees and are severely out of pocket at least to be refunded the VAT element that they paid, which has gone or may still go to the Treasury for a service that they have not received?
I am not making policy from where I stand; I was speaking as a former Treasury Minister about the general attitude towards VAT and the general problem that no Government of any stamp can compel a private company to pass a saving on to consumers. Indeed, whether or not savings are passed on is itself a function of the competitive conditions in the sector. I will come on to what the CAA can do later in my remarks, but although I understand my hon. Friend’s concern about the cost of VAT, let me remind him that the taxpayer will be a significant loser from the failure of these companies. I recognise a certain strength in his point about individual students being recognised; if he wishes to raise that point with the Treasury or with Baroness Vere, he is very welcome to do so. However, the general policy, as far as I am aware, is the one that I have enunciated for the Government.
I am trying to reflect on what the Minister has said about VAT, and specifically on one of the clear points that has been raised. We are at a competitive disadvantage because we charge but no other country in Europe is charging. If we look at the decline in flying schools and the issues with financing to go and study in the first place, and then someone is being asked to pay 20% on top, what is to stop any young aspiring pilot from saying, “Wait a minute, I’ll just go to Europe where I won’t have this extra 20% surcharge”?
Of course individuals are welcome—and will want—to consider all the options under all circumstances, but I have not accepted the hon. Member’s narrative that the sector is in decline. We have had three important local failures of flying schools, but in general the sector has rebounded remarkably well from the pandemic. I would not accept that it is in decline; in fact, in many ways it has made a robust recovery.
In his own remarks, the hon. Gentleman highlighted the failure of Tayside Aviation. As far as I understand it, however, it would absolutely have been within the power of the Scottish Government not to change VAT, but to provide some grant intervention to Tayside Aviation had they wished to do so, either as an education provider or under the heading of industrial strategy, both of which are devolved areas. I do not know whether the hon. Gentleman wants to comment on whether the Scottish Government had considered that, either as a matter of intervention at the time or now, in order to support Tayside Aviation if it wished to get back up as a trading entity.
The hon. Gentleman does not respond. Let me press on. The question is what we can do to support students under the very difficult circumstances in which they have found themselves. The CAA has responsibility for flight safety rather than for the financial wellbeing of the flight schools. Nevertheless, I think it has understood and recognised that there is every benefit to the UK in seeking to retain the value of students’ training so far. It has therefore enabled the transfer of training records to other ATOs so that, wherever possible, training is not lost. It also lies within the CAA’s power to extend the 18-month period in which students can restart their training; it can do so on a case-by-case basis for anyone caught out by exam timescales or other aspects.
The hon. Member for Wythenshawe and Sale East mentioned first officer apprenticeships. I do not share his rather negative approach. This is an important development, which can itself be further built on. It may not provide the full total towards the training, but it is a very substantial contribution. It remains available to sponsors of apprenticeships, beyond the individual students, to support—as they do in other industries—students who wish to complete the training under that framework.
It is also important to say that treating ATOs as higher education providers would carry costs to them. They would be required to register as higher education providers with the Office for Students. There would be a number of regulatory burdens that ATOs might wish to take on, but they might very well decide that they did not want to submit to them. Some of those would address the issue of concern here, for example through student protection plans, compliance with consumer protection laws, Ofsted inspections, quality and standards assessments and the like. My hon. Friend the Member for East Worthing and Shoreham may wish to pick up that point with my noble Friend Baroness Vere when he sees her. It is a matter of empirical investigation whether ATOs would be interested in registering as higher education providers with the Office for Students and whether they would treat it as a competitive trading advantage.
I understand and appreciate the Minister’s Treasury background. Does he accept that the student loans scheme is an investment in the value of what an educated person brings to society? We recognise the value of an arts degree, which we relate to salary, and that is very commendable. We recognise that for a pilot, it relates not the school they go to, but to the individual. A pilot will be in the higher echelons of earning, probably from day one, in a jet company. Surely the Government recognise that giving them a soft loan under the student loans scheme would be of great benefit to society, because society would get the money back more quickly. Is that not of value?
The hon. Gentleman is right to raise that interesting question. I have already talked about one scheme that has a similar approach—not a loan scheme, but an apprenticeship scheme. However, for a loan as he has described, the problem, which I have raised, would be the need to register with the Office for Students. As one goes up the flight training tree, one gets further away from basic education and closer and closer to a commercially valuable proposition that it is in the interest of companies in the aviation sector to support and finance. There may well be other things that can be done.
The hon. Gentleman raises an interesting and somewhat philosophical question. I do not intend to get enormously technical on this issue, but the reason why, in the case of doctors, for example, this support has been given is that historically these doctors then go and work for the majority—perhaps all—of their careers in the NHS, in the discharge of a public function. If doctors left immediately to go and join commercial medical organisations, which an increasing number are, it might well be that, in some cases, from a public sector perspective, the philosophical question whether or not they should be supported by the taxpayer would be raised. I think we are in the same space of discussion; that is interesting.
I will say a couple of other things, if I may. Of course, the Department is working with industry and the Education and Skills Funding Agency on the first officer apprenticeship, as I mentioned. That, I think, has an important role to play in this.
Let me just pick up one other little thing that was just raised by colleagues before I close. The hon. Member for Dundee West (Chris Law) raised the question of PSOs. Of course, that does not directly have anything to do with this debate, but it is important. Let me just say that the Government recognise that PSOs are important to meet regional connectivity and levelling-up objectives. As I understand it—and I think he said—Dundee City Council has recently undertaken a tender for a new contract on the route from the end of October, and the Department has said that it will consider the application. It is obviously not appropriate for me to prejudge that in a debate today in Parliament, but the Government are very much looking forward to seeing that application and will judge it, of course, on its merits, in the usual way, in due course. With that, I think I will sit down.
I will not take up too much more of the Chamber’s time, because I spoke fairly extensively to start with, but I would certainly like to thank hon. colleagues who have brought to bear their own experiences and those of their families, particularly from the Northern Ireland angle, and from Dundee and the large and important training school that the hon. Member for Dundee West (Chris Law) spoke about in detail.
As I started by saying, this is not a localised issue; it is a UK-wide issue, and we have had three parts of the United Kingdom represented in contributions today, for which I am grateful. But I must say that I am disappointed by the Minister’s response. I fear that he spoke rather more with a Treasury hat on than with his more recent Transport Minister’s hat on. He does seem to be in a state of denial about a very real and serious problem, which is recognised by the industry. He just does not seem to acknowledge that flying schools are in a state of decline and the number of pilots that they have the capacity to produce is substantially declining.
I quoted, again at the outset, that around 2,500 pilot licences were granted in 2015, whereas this year, they are anticipated to be one fifth of that, at 500. That is not a healthy, vibrant business as it stands.
Okay, well, those are the figures that have been provided by those in the industry. The three flying training schools that have gone under produced many hundreds of pilots a year. That represented a substantial part of the capacity within the United Kingdom. Therefore, I am afraid that this is not a localised problem, involving just a few individual schools. There are serious fears for the sustainability of many of the surviving large schools in particular.
I will not rerun all of the issues that we came up with earlier, but there are serious problems that I hope we will be able to air in more detail when we meet the Minister about the immediate problem of the hundreds of students who find themselves without a course, without the funds to find an alternative course, and without an awful lot from the CAA. I am afraid that that has been the experience, hence the request for the CAA to step up and step in rather more proactively than it has. We need an acknowledgment that students who pay fees up front are vulnerable to the flying schools going out of business, and are without the protections we take for granted when we buy goods and services or embark on educational courses elsewhere. Again, I take issue with the Minister’s challenging that this is some form of education. The clue is in the title: these are flying schools, which are training people, in the air rather than on the ground, to provide a vital public service on which this country relies.
It is not just the training schools and their immediate employees that will be suffering. It is the local economies—the economies of smaller regional airports that rely on the flying training schools for a great deal of their revenue, from touchdown fees or the purchase of kerosene. That is often the most profitable part of the business of those small airports and crucial to their survival, not least my own in Shoreham.
Contrary to what the Minister says, the implications go beyond just the three individual cases of flying training schools that have gone under in the last 10 months. I am grateful that we have had this airing of an issue that has not had a great deal of publicity but which has a great many implications, well beyond the constituencies represented today and the three specific training schools I have mentioned. I hope we can take those points further when we meet the noble Baroness, which I think is next week. I will be happy if any colleagues here wish to join me in that delegation along with BALPA. I am grateful for the time in the Chamber.
Question put and agreed to.
That this House has considered flying schools.
At-risk Academics: UK Support
I beg to move,
That this House has considered UK support for at-risk academics.
Yesterday evening, I was privileged to attend a remarkable 90th anniversary event hosted by the Royal Society and the British Academy. In 1933, the skies over Europe were darkening. The Nazis had come to power in Germany and were already making racial discrimination against non-Aryans, principally Jews, part of their state policy—the early steps on the road to the holocaust. One of the first such steps came on 7 April that year, with the passing of the so-called “law for the restoration of the professional civil service”. An innocuous title covered a grim reality. The law forced out of their posts civil servants of non-Aryan origin, primarily those of Jewish descent, together with members of political organisations that were deemed to be hostile. Jews, other non-Aryans and political opponents were also barred from holding positions as teachers, professors or judges.
Up until then, the German educational system, and especially its universities, had been among the best in the world. Leading German academics were outstanding in their fields and had many contacts and connections with their counterparts in the UK, yet the new law meant that many faced immediate dismissal with no prospect of further work in Germany. Happily, the reaction of their colleagues here in the UK was immediate and decisive. The prime mover was Sir William Beveridge, then the director of the London School of Economics, who happened to be in Vienna that April and was horrified to hear about the purge. Returning home, he immediately began to create an organisation to raise funds to help its victims.
The result, on 22 May 1933, from the rooms of the Royal Society at Burlington House the founding statement was launched of what was initially called the Academic Assistance Council, or AAC—a major initiative of which the UK can rightly be proud. In just a few weeks, 41 university chancellors and vice-chancellors, distinguished professors and other public figures had come together to pledge support for the planned rescue of their colleagues and counterparts in Germany. They included no fewer than nine members of the Order of Merit and, I am pleased to say, a serving Member of this House, the then Conservative MP for Hastings, Eustace Percy. They defined their mission as
“the relief of suffering and the defence of learning and science”.
It was a mission to save not just the individuals and their families, but also the hard-won knowledge and skills held within their heads.
The founders’ appeal for funds immediately bore fruit. Between May and August 1933, the AAC raised nearly £10,000 to get its work off the ground—about £900,000 in today’s values—and much of that came from UK academics. In the following six years until the outbreak of war, the AAC—later called the Society for the Protection of Science and Learning or SPSL—and its individual council members helped between 1,500 and 2,000 academics to escape from Germany and other countries under fascist influence or control. Their contribution to the arts and sciences here in the UK and elsewhere proved to be immense: 16 of those helped by the AAC/SPSL later won Nobel prizes, 18 were knighted and over 100 became fellows of the Royal Society or the British Academy.
Ninety years on, sadly, many academics around the world are again at risk. Some are caught up in conflict. Their universities may have been destroyed or left without power or water, making productive work impossible. Just getting to and from work may now mean running a gauntlet of rival militia gangs. Others face violence or persecution at the hands of repressive regimes or extremist groups, which see a free-thinking and free-speaking academic as an intolerable challenge to their authority.
As we know, women in Afghanistan can no longer go to university at all. In certain countries, academics are in serious danger because of their sexual orientation. Elsewhere, those who defend democracy and denounce state corruption are subjected to arbitrary arrest and physical violence, as happened as recently as July to Dr Gubad Ibadoghlu, a renowned senior visiting fellow at the London School of Economics, who was seized in Azerbaijan while visiting his mother and, disgracefully, is still incarcerated. It is therefore just as well that the organisation originally founded to rescue academics from the Nazis is still at work today. Now known as the Council for At-Risk Academics, or Cara, it is busier now than at any time since the 1930s, fielding hundreds of applications for support, especially from Afghanistan, Ukraine and the middle east, but also from many other countries around the world.
The right hon. Gentleman and I are well aware of the situation of Dr Gubad Ibadoghlu in Azerbaijan. He is a distinguished academic, proud of academic independence and the objectivity of his work and studies. He will not be intimidated by anybody regarding what he writes or how he writes it. He is in a difficult situation at the moment, and I would be grateful if the Minister could assure us that the British Government will do all they can to ensure that he gets the medical support and attention he needs, as well as to ensure his right to pursue his profession and live in peace.
I entirely agree with everything the right hon. Member says, and I told a special adviser before the debate that I would be mentioning this case. I understand that there has been a statement of concern from four countries—the US, the UK, France and Germany—about this case, and I hope that those in power in Azerbaijan will take the representations seriously.
My first contact with Cara came during the fall of Kabul in 2021, when a constituent sought my help to bring her sister-in-law, an academic opposed to the Taliban, to safety in the UK and to a Cara fellowship at the University of Southampton. The task was neither quick nor easy, but it ended successfully with Cara’s help. It is a pleasure to see the executive director of Cara, Stephen Wordsworth, present at the debate today. I am grateful to him and his organisation for all they did for my constituent’s sister-in-law.
Since then, I have drawn attention to Cara’s work several times and was pleased to table early-day motion 1188 in May, with the backing of 20 more MPs on both sides of the House, to mark the anniversary of its 1933 founding statement. That success for my constituent was just one of hundreds of cases with which Cara is dealing. The charity has steadily built up its support network of UK universities and research institutes, now numbering 135. Most of them host a Cara fellow, often several, and act as their visa sponsors.
The House should note that Cara fellows come on regular visas, not as asylum seekers, and, to their great credit, the supporting universities usually cover much or all of the cost of each placement. Thanks to that support, some 170 academics from all around the world are safe with their families on Cara fellowship placements in the UK. At any given time the Cara team are working to help place dozens more, while other new applications are being carefully sifted and assessed. Many of them will soon lead to successful placements. For each one who comes, however, another will apply and will deserve help.
We talk often about attracting the best and the brightest to this country. With the generous support of the UK’s universities and research institutes, Cara plays a crucial part in this endeavour—but with the important difference that were it not for Cara, these highly talented people would in many cases be destitute, locked up, badly injured or even dead. The work is painstaking and unrelenting, and it is carried out by just 14 people. The hope is always that Cara fellows will one day be able to go home safely, and some do, with individuals recently returning to Syria, Yemen, Ukraine, Turkey, Iraq, Palestine and Azerbaijan, which we just mentioned in another context. Others, however, must continue to wait. I could provide dozens of examples but shall limit myself to just a few. For their safety and that of their relatives and friends still in their home countries, some of the names are pseudonyms.
Naila was an accomplished academic in Yemen in the field of public health. When she first contacted Cara, she was living with her husband and a young child. They were under siege and fearing for their lives. With Cara’s support, she secured a placement at Cambridge University, where she now works on a global talent visa.
Nadiya, a Ukrainian academic with vast international experience in civic education and citizenship linguistics, was forced to flee Ukraine with her 12-year-old daughter after Russia’s invasion. Cara helped her to secure a visiting research fellowship at the department of education at Oxford, where she is now continuing her research.
Wynne was a renowned environmental researcher and activist in Myanmar with over 30 years’ experience, who sought Cara’s help after the 2021 military coup. He is now a visiting fellow at Oxford, researching drought and water insecurity.
Oleksandra was a professor of economics in Kyiv. She left with her daughter after Russia’s invasion and is now a visiting researcher at the London School of Economics.
I commend the right hon. Gentleman for bringing this issue forward. He always bring good things to Westminster Hall, but also to the main Chamber. Since 2022, over 100 Ukrainian academics have been supported to settle in the UK with British Academy and Cara at-risk fellowships. Does the right hon. Gentleman agree that we, as a compassionate and generous country, should continue to ensure that those academics from Ukraine are supported in their careers, and that this approach must also extend to the likes of women in Afghanistan, who deserve the very same treatment?
I could not agree more with the hon. Gentleman, who is another long-time friend from across the divide in the House of Commons Chamber. He is absolutely right, and I will refer in a little more detail to the Researchers at Risk programme very shortly.
I return to my list of examples of people who have been saved and are now doing well. Nooria, from Afghanistan, is a specialist in gynaecology and obstetrics, and was working as both a clinician and an associate professor at the Kabul University of Medical Sciences. After the Taliban takeover, she was trapped at home. With Cara’s support, she was offered a visiting research position at the University of Cambridge, where her work has now led to a fully funded PhD offer.
Hayat is a researcher from Afghanistan with a PhD and a master’s degree from the UK and the US respectively, but this previous international experience attracted reprisals from the Taliban. As a Cara fellow at the University of Nottingham, he is carrying out work in three research projects on the impact of conflict and natural disasters on households’ welfare and food security.
Huda was a radiology researcher in Syria when she contacted Cara. She experienced bombings throughout the conflict and was once shot at in her car. Cara helped her to secure a postdoctoral placement at the University of Cambridge, after which she was awarded a global talent visa.
Ayşe completed a visiting fellowship at Wolfson College, University of Oxford, and returned home to Turkey, where she continues to do research on gender violence.
Wiesam completed a visiting fellowship in the department of geography at the University of Manchester, and returned home to Gaza, where he is now working as a professor in thermal remote sensing at Al-Aqsa University.
Ahmed completed a visiting fellowship at University College London before returning to Iraq, where he is now a dean of college at a university.
In the past two years, Cara has also worked with the British Academy—the hon. Member for Strangford (Jim Shannon) referred to this—and other national academies, to deliver the largely Government-funded Researchers at Risk programme. Thanks to that, another 180 academics from Ukraine have received awards paid to them by Cara to allow them to continue their work here. Cara has also worked with the funding scheme in Germany for at-risk scholars, the Philipp Schwartz Initiative, since its launch in 2016.
Cara’s strong track record of supporting threatened scholars around the world is an important contribution to the fulfilment of the UK’s aim to promote a more effective international response to humanitarian crises. As an organisation, it remains unique in Europe, and we should celebrate its 90th anniversary and the difference it has made and continues to make to so many lives for
“the relief of suffering and the defence of learning and science”.
It requires little direct help from Government. but I have a couple of requests for the Minister. First, as already noted, Cara fellows come to the UK on regular visas. Thanks to the care that Cara and the host university visa sponsors take, Cara fellows have in recent years enjoyed a 100% visa application success rate. I hope that the Home Office and UK Visas and Immigration will keep looking positively on Cara-associated visa applications, and that the Department will continue to recognise the contribution that Cara fellows make during their stays in the UK and subsequently through active partnerships, if and when they can safely return home. I also hope that the Home Office and UKVI will, therefore, be ready to discuss with Cara ways in which the visa regime might be adapted to make their fellows’ time in this country even more productive.
Finally, the Researchers at Risk programme has shown how effective a Government-funded scheme can be when it works with and complements existing efforts by proven practitioners. The original funding for Researchers at Risk is now fully committed, but I hope that the Government will learn from the undoubted success and be prepared to consider a longer-term follow-on scheme, open to academics at risk around the world. That would, indeed, ensure that the United Kingdom remains a global leader in this admirable field, and worthy of the efforts—
I congratulate my right hon. Friend on a superb speech. We do have at-risk academics in this country, not from torture or persecution in the sense that he is talking about, but from the modern thought police. People’s livelihoods and mental health can be put on the line by unfair dismissals. Would it not be a huge irony if some of the Cara fellows had the same fate? Does he agree that to be that true beacon in our country, we need that freedom of expression in all our institutions of higher learning, especially our universities?
My hon. Friend tempts me to move into a wider area of controversy, but one thing that I would note, without crossing that line, is that very often the people in our university community in the United Kingdom who speak out most strongly in favour of freedom of speech and who insist that people should listen to views with which they might not necessarily agree, rather than shout them down, have often experienced repression in their own countries and come to the United Kingdom to escape that type of restriction.
I will leave that point there and resume what will be my final sentence by repeating the fact that building on the undoubted success of the Researchers at Risk scheme would ensure that we remain both a global leader in this admirable field and worthy of the efforts made by the eminent founders of Cara 90 years ago.
It is a pleasure to appear before you, Sir Robert, in this most important debate.
I am grateful to my right hon. Friend the Member for New Forest East (Sir Julian Lewis) for securing this debate. As was abundantly clear from his remarks, this topic is of long-standing interest to him and I am pleased to respond on behalf of the Government and my right hon. Friend the Immigration Minister, who unfortunately is not here today.
I pay tribute to my right hon. Friend the Member for New Forest East for his commitment to highlighting these issues and for championing such a commendable cause. As he pointed out, there are many examples of academics who have been able to continue their important work and studies here in the United Kingdom, whether that be through the global talent visa, the skilled worker visa or any other route for which they are eligible.
My right hon. Friend’s passion for and knowledge of this subject shone through his remarks today, particularly when he spoke about the work of the Council for At-Risk Academics. I have also heard him raise this issue in the main Chamber of the House of Commons itself, so dear does he hold this cause to his heart.
I think we all agree that academia, science and research have an enormously beneficial and enriching effect on our society and on our way of life in the United Kingdom. These activities drive progress in how we think and how we live. They foster collaboration and creativity. Whatever the discipline or the field, it is right that we do all we can to ensure that those working in it are supported and encouraged. Any threat against their freedom to carry out their work is totally unacceptable.
The impact of any attempt to impose restrictions on research in academia is profound; it is felt not only by the individuals involved but by the world as a whole, as we are denied the benefits of their knowledge and the advancements they could help forge.
For our part, the United Kingdom Government are committed to the cause of academic freedom globally and to ensuring that at-risk academics have a place of safety in which to study, teach and carry out research, including within the UK. Our work and study visa regime provides opportunities for such individuals to come to the United Kingdom and to continue their careers here, either on a permanent basis or until such time as it is safe for them to return to their own country. Such individuals can carry out their learning in peace and security, can forge a new and better life for themselves, and can contribute to the UK’s society and economy. That also demonstrates to those around the globe who seek to curtail knowledge and inquiry that the United Kingdom remains a beacon of academic freedom.
I am very grateful to the Minister for giving way and I apologise, Sir Robert, for missing the very start of the debate. I am also grateful to the right hon. Member for New Forest East (Sir Julian Lewis) for advising me of it.
The Minister is making a very good point about how the UK is seen globally. The point I want to make is the benefit that UK institutions receive from having these people here, who are right at the very top of their academic game. That is very true for the University of St Andrews, which is in my constituency and which is one of the Cara institutes. Does the Minister agree that we are getting the best of the best through this approach?
I agree with the hon. Lady that there is much we gain by way of academic research. Indeed, we enjoy the best not only of academia but of what the inquiring mind can bring to our institutions with a global feel. I agree with her wholeheartedly.
We thank Cara, similar organisations and the wider university sector, which create these opportunities and reach out to eligible individuals and groups. I also thank all those people who are here in Westminster Hall today. It is so nice to see the Public Gallery so very full. It includes Stephen Wordsworth, who is the director of Cara and who is here today with colleagues and friends. You are most welcome.
My right hon. Friend the Member for New Forest East is also the Chairman of the Intelligence and Security Committee. As I alluded to earlier, he has said on a number of occasions that some states will continue to project threats to individuals even when those individuals are in the UK, having sought safety here. We will seek to identify and mitigate those threats wherever they exist. If threats should follow any academics to the United Kingdom, our world-leading intelligence and security agencies would take a proactive and robust approach to identify those threats and, where they exist, to provide protective security in whatever form is necessary.
There have been various interventions in the debate. It is not right for me to talk about specific cases, but I will ask the Immigration Minister to write to the right hon. Member for Islington North (Jeremy Corbyn) to address the points that he raised. I am grateful, as always, for the intervention by the hon. Member for Strangford (Jim Shannon). I think he has just left, but he always brings great experience and wisdom to these debates, and he works collaboratively across parties.
I thank the Minister for the remarks she has just made, but would it be possible for the Government to put more direct pressure on Governments such as that of Azerbaijan about the treatment of academics, as well as about the individual cases that have been raised today?
As the right hon. Gentleman knows, the Government work very hard to promote the interests of academic and personal freedom across the globe. I cannot mention specific cases, but I will definitely get back to him through the Immigration Minister on the case that he mentioned. The Government will continue to seek academic freedom wherever they can throughout the world in cases of unjust and unfair incarceration.
My hon. Friend the Member for Woking (Mr Lord) was right in his intervention. Everybody who is here in this debate has the same heartfelt feelings about how we need to assist academia across the globe and provide, where appropriate, safety for academics to express their views.
It has been an interesting and informative debate. I hope I have left my right hon. Friend the Member for New Forest East and other Members in no doubt of the Government’s enduring commitment to protect, promote and support academia and research, which benefits so many of us. I offer my thanks again to my right hon. Friend for securing this important discussion.
Question put and agreed to.
LGBT+ People and Spouses: Social Care
I beg to move,
That this House has considered the treatment of LGBT+ people and their spouses in social care settings.
It is a pleasure to serve under your chairmanship, Sir Robert. I sought this debate because of the horrific experience of my constituent Ted Brown and his late partner, Noel Glynn. Ted is present in the Public Gallery this afternoon. Ted and Noel were together for almost 50 years. They met at the first Gay Pride event in 1972, which Ted helped to organise. They were civil partners; they were devoted to each other. Sadly, Noel developed dementia in older age and, in 2018, he was placed in Albany Lodge care home in Croydon after Lambeth Council was unable to find a place in a care home any closer to Ted in Brixton.
One day, Ted noticed that Noel had suffered bruising and a cigarette burn to the back of his hand, and two whistleblowers at Albany Lodge confirmed that Noel was being subjected to homophobic abuse from some of the staff. The whistleblowers recounted two staff members asking him, “Are you a gay man? Do you like gay men?” before dragging him to his room, where other residents heard a disturbance going on and Noel’s voice. In January 2019, Noel told a social worker, “I don’t like it here—they beat me up”. The social worker recommended moving Noel to another care home, but he remained at Albany Lodge for nine more months. Throughout that time, Ted was paying £1,400 a month to Albany Lodge for Noel’s care. Ted told me that staff at the care home refused to recognise his relationship with Noel, and that he was warned by two other LGBT residents in the home not to tell staff that they were a couple, because, “It won’t be good for either of you”.
Noel was a vulnerable man with dementia. He should have been safe in Albany Lodge. The abuse he suffered was horrific and inexcusable, and it was a clear breach of his human rights. That was recognised in a court judgment against Lambeth Council, which placed Noel in Albany Lodge, that awarded the couple £30,000 in compensation. Sadly, Noel died in 2021 before the compensation was paid.
Ted told me that when Noel was first placed in Albany Lodge, there was a delay in undertaking a necessary medical assessment. He contacted the care home to chase this on Noel’s behalf and received an email notifying him that an assessment would be done that day on his father. He was not invited to attend this appointment, which would usually be supported by a spouse or close family member since the aim of the assessment was to gather information about the person’s health history, including matters such as allergies and eating habits. Noel, by then, had dementia.
Ted went to the home anyway and was initially not allowed into the room with Noel, despite bringing documents demonstrating their civil partnership, his power of attorney for Noel and evidence that they had been partners for 49 years. As Ted waited outside the room, he could hear Noel calling out for him. This utterly distressing situation speaks to a total lack of dignity for LGBT+ couples in the care system that urgently needs to be addressed. Prior to being admitted to Albany Lodge, Noel initially received care at home. Ted believes that Noel was also subjected to homophobic abuse by one of the carers, who he observed treating him roughly. In an indication that these experiences are not at all uncommon, Ted also told me that prior to the carers coming in, he had been warned by a friend to remove all traces of his relationship with Noel as a couple from their home.
In a report titled “Stripped of all Pride”, Compassion in Care documented 486 reports of homophobic abuse in care settings and of LGBT+ staff who were afraid to disclose their sexuality. I strongly encourage the Minister to read the report, if he has not already done so; the testimonies are shocking and devastating. One whistleblower wrote:
“There was one gay resident in the home, staff were so cruel to them, some staff treated this poor man as if he had something catching. I saw one staff member spit on this man whilst telling him to repent as he was a filthy pervert. Another staff member slapped this man around the back of his head, really hard. I reported it, I was horrified. The staff started shouting at me are you a pervert lover? Are you gay? Nothing was done, I went to the authorities and left”.
That is hate crime, happening behind closed doors and being perpetrated against some of the most vulnerable people. There are many similarly shocking testimonies in the Compassion in Care report.
My hon. Friend is giving a powerful and emotional account of her constituents. I welcome Ted to the Chamber; I wish it was under happier circumstances. I want to raise something that happened in my constituency a few years ago. A gay couple were taunted with offensive and degrading questions about their sexuality on a bus in West Hampstead. They were then brutally attacked. It was in the news, so my hon. Friend might have heard about it. This year, Rainbow Europe announced that the UK has fallen to 17th place in terms of safety for LGBTQ people. Nine years ago, it was in first place. Does my hon. Friend agree that crimes that are targeted at someone’s LGBTQ identity should have tougher sentences?
I thank my hon. Friend for her intervention and for raising that shocking case, which I remember from media reports at the time. We cannot ever take progress on equality for granted, and it is vital that we take seriously that drop in protections for LGBTQ+ people and that the current increase in hate crime is met with the toughest possible sanctions that can be delivered.
Perhaps even more shocking than the testimonies in the Compassion in Care report is the fact that, of the 486 services involved in the testimonies, 481 were still rated as good by the Care Quality Commission. A 2016 CQC-commissioned report found that older people were hiding their sexual orientation and gender identity because of fears of discrimination. The abuse that Noel suffered and the abuse documented by Compassion in Care are utterly abhorrent, and there should be no place for them anywhere, still less in settings that are trusted to look after our most vulnerable loved ones—older people who are physically frail or suffering the disorientation of dementia.
For the current generation of older LGBTQ+ people, such abuse can also be a re-traumatisation. Those aged 75 and older were adults before homosexuality was decriminalised in 1967. They lived through the long years of section 28, have experienced life in a deeply homophobic society, are very likely to have spent a significant period of time concealing their sexuality, and have lived through the trauma of the HIV/AIDS epidemic—suffering the loss of much-loved partners, friends and community members while society stigmatised them. Older people who are LGBTQ+ are also disproportionately likely to have become estranged from family members and may lack people around them to advocate on their behalf in the care system.
I am particularly concerned about the poor response to Noel’s case. Once the horrific abuse he suffered was identified, it should have been the job of the care home, the local authority, the CQC and the Government to ensure that it could never happen again, but the reality was far from that. When Noel’s abuse was reported, staff were suspended, but Ted understands that they were allowed to return to work on a different floor of the same home. Following inspections in 2019 and again this year, the CQC continued to rate Albany Lodge as good. The fact that one local authority placed Noel in a care home in a different local authority has also presented problems in ensuring accountability.
No one should have to fear that they or a loved one will be abused in a place that has a responsibility to care for them. No one should have to fear that their sexuality or gender identity might result in such abuse. In 2016, the CQC recommended that commissioners, providers, and health and care staff should
“consider the needs of LGBT people in planning and delivering end of life care services”,
that health and care staff should
“communicate openly and sensitively about sexual orientation and gender identity as a routine part of their delivering good quality, personalised end of life care”
and that commissioners and providers should
“collect data on sexual orientation and gender identity as part of an equalities approach to monitoring end of life care outcomes.”
The Government also mentioned the need for improved monitoring in their 2018 LGBT action plan, but there is little evidence of progress. There are examples of good practice, both in the delivery of LGBT affirmative retirement housing, such as Tonic Housing in Lambeth, and in the Pride in Care quality standard championed by Care England, but it is unacceptable that monitoring the experiences of LGBT+ residents is not a mainstream part of CQC assessments. Albany Lodge should not have continued to be rated “good” while an LGBT resident was being abused under its roof, and it certainly should not have continued to be rated “good” after that abuse had come to light.
What progress does the Minister believe has been made following the publication of the Government’s LGBT action plan five years ago in 2018? What action is he taking to protect the rights of LGBTQ+ residents in adult social care? Will the Government ensure that gathering the experiences of LGBTQ+ residents and their spouses forms part of the CQC inspection framework for care homes? Will he take steps to ensure that no care home or care agency found to have allowed homophobic, biphobic or transphobic abuse can continue to be rated “good” by the CQC? Will he consider further support to roll out the Pride in Care quality standard to more care homes across the country?
When Ted spoke with me about Noel’s experience, he told me about the guilt he feels about being unable to protect the man he loved from abuse. I am sure all of us can understand that guilt, even though it is entirely misplaced. Ted should have been able to trust Albany Lodge to care for Noel and that trust was fundamentally broken. We cannot undo what happened to Noel, but we can work to ensure that it does not happen to anyone else. I hope that the Minister will set out the meaningful action that he will take to this end.
It is a pleasure to serve under you in the Chair, Sir Robert. I pay tribute to my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for her powerful advocacy for both Ted and Noel. It was shocking and very difficult listening, and she was eloquent and forceful in making the case to support LGBT people in social care.
I am grateful for the work of York LGBT Forum. It has tirelessly campaigned for the rights of LGBTQ people across the community. It engages with stakeholders to advance the rights of LGBT people across the city and the region. As part of its “Free to be Me” work in social care, the forum is hosting a seminar this coming Friday entitled “Don’t Leave Me in Silence” reflecting on the experiences of people in social care. I spoke to one member last weekend and she talked through the work she had engaged with, and it echoed the inquiry the all-party parliamentary group for ageing and older people, of which I am chair, undertook a few years ago, which recognised the importance of identifying the social care needs of LGBT+ people and their partners.
In the session, which was held in Parliament, we heard how partners were often ignored in social care settings, not least when determining the wishes of their loved ones in care. We heard how, on so many occasions, they were unable to communicate the needs of their relationships before they entered care—instead becoming a distant friend. People in care often felt that they could not even put a picture of their partner up in their room, almost eradicating the memory of their relationship. We heard the distress, the loss of identity and how they felt shame, not to mention their facing some pretty intrusive questioning, too.
With good social care, this should not be an issue. On entering a care setting, a relationship should be established that takes all the needs of individuals into account. It does not take much to ask what someone’s requirements are and who their family is, and to ensure that their family is honoured. It is a central part of care. It is what care is: recognising the human, not just the physical, needs that someone has. It does not take much to ask, and it does not cost much to train staff.
LGBT+ awareness training would significantly enhance the experience of LGBT people in care. The CQC should monitor the training that staff have, and the Skills for Care workforce, which has set out a learning framework, should review that framework, not least in the light of today’s debate, and ensure that it is rolled out to all care settings. It should be a marker that the CQC looks for when examining care settings.
Recently, I talked to a constituent who was still at home and seriously ill. She knew that in the not-too-distant future her time would come for more intense care. She asked that she would be in a setting that recognised her gender identity; she feared being placed in one that would recognise only her birth identity. Such dying wishes must be honoured. That is about respect for the individual and understanding their care needs. It is about ensuring that they are cared for holistically and that they and their families are given the time, care and support that they need. It is about listening; it is about acting. I heard one story about someone who started to be dressed in the clothing that represented their birth gender identity, because no one had taken the time to listen. That cannot be a matter for a care facility to determine; it is a matter for the individual and their family.
This debate has focused on the family, but it is worth remembering that many LGBT+ people may not have family. The chair of York’s Ageing Well Without Children, or AWOC, Sue Lister, has explored what it means for individuals who might not have family at all, or whose partner has passed. She wrote a poem, which I would like to close with today. It is called “Lesbian Loneliness”. It is written about a care setting:
“Magnolia walls house the non-absorbent thrones.
Dry voices whisper round the walls like leaves that fall unnoticed.
Uniformed bursts of energy swirl according to the clock
Bringing this, taking that.
Weathered skin, brittle bones, ghosts of the past
Gather on these barren shores.
My life, my love, has passed away, leaving me hung upon the thorns of grief in a waste of loneliness.
Unspoken. Living too long in the shadow of social shame
I dare not rock the boat and she is buried forever.
‘My love’ I cry in the dark hours and hold her in my heart
By day I pass as an ordinary old woman.”
It is a pleasure to serve under your chairmanship, Sir Robert, and to respond to the debate on behalf of the shadow Health and Social Care team in my first outing as the newly appointed shadow Minister of State for Social Care. It is always good to see the Minister for Public Health in his place.
I sincerely thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for securing the debate and for all her work on this important subject. Her contribution this afternoon was heartbreaking —the way in which her constituent was treated was utterly shameful. I also thank my hon. Friend the Member for York Central (Rachael Maskell) for her contribution. She ended on such a powerful poem, which speaks to so many who suffer in care home settings.
The Care Quality Commission guidance for all providers of adult social care clearly states that people using care services
“must not be discriminated against in any way and the provider must take account of protected characteristics, set out in the Equality Act 2010.”
As we have heard today and as we know from other studies, however, that is not always the case.
A survey conducted in 2017 found that 23% of open LGBT+ respondents who had been in a care home or other form of institutional care reported that being gay, trans, bisexual or lesbian, or having other protected characteristics, had a negative effect on the care that they received. Those examples are varied, but each and every one of them is concerning. Some respondents to the 2017 survey said that they felt invisible. Other responses related to use of language—for example the assumption that a partner or spouse is of the opposite sex, when that is not necessarily the case.
At their worst, the experiences of LGBT+ people in care home settings can be traumatic, as demonstrated by the story of Noel Glynn and his partner Ted Brown, who is a constituent of my hon. Friend the Member for Dulwich and West Norwood. Before he died, it is reported that Mr Glynn, who had dementia, suffered bruising across his body and had a cigarette burn on the back of his hand because of abuse from care staff. Other residents warned his partner Ted not to reveal to staff that he and Noel were a couple, saying, “That won’t be good for either of you”.
Mr Glynn and Mr Brown sued Lambeth Council, but Mr Glynn very sadly died before any compensatory payments were made. This case is beyond abhorrent. I hope the Minister will set out how it happened and what steps the Government are taking to ensure that it never happens again. The Minister will know that the Care Quality Commission does not currently consider the extent of homophobia or transphobia in inspections, despite its fundamental standards. Following this case, will the Minister look again at that guidance?
More generally, what this issue comes down to is the importance of personalised care. A report by the Women and Equalities Committee published in 2019 points to research showing that 72% of care workers do not consider sexual orientation to be relevant to one’s health needs. That same report states that
“most health and social care professionals feel under-equipped to deal with LGBT people’s needs rather than intentionally discriminating.”
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 are clear on this subject. Regulation 9 states that people using a service should have care or treatment that is personalised specifically for them. It is important that care providers respond to the serious concerns raised by LGBT+ people and ensure that those accessing services feel respected and safe, and benefit from care that is tailored to their needs.
My questions to the Minister are as follows. Given the extraordinary shortages in adult social care staff—sitting at around 165,000—what work are he and his Department doing to protect the principle of personalised care? Further, what steps is the Department taking to monitor the experiences of LGBT+ people in social care settings? In the 2018 LGBT action plan, the Government pledged to develop best-practice guidance for monitoring and to make this openly available to the public sector. Why were these pledges not implemented? Have they simply been abandoned alongside a plethora of other Government commitments, from banning conversion therapy to tackling waiting lists? Finally, LGBT+ organisations have called for better guidelines and staff training for those working in care settings. Can the Minister outline whether the Government support these calls?
The next Labour Government will address the vacancies in social care by delivering a new deal for care workers, guaranteeing fair pay, training, terms and conditions and career progression.
If the hon. Gentleman had been at the TUC conference today, he would have heard the shadow Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), outline precisely what Labour’s fair pay deal will be for the social care sector, but we need to go beyond that. We need to ensure that social care becomes a valued profession again, rather than just assuming that agency staff can fill the vacancies. We need to make sure that social care once again has parity with the rest of the healthcare system and that care workers want to work in the care sector not just because of pay, terms and conditions, but because it is a profession—which, sadly, many feel it no longer is.
We will work in partnership with users and families and develop a set of national standards based on existing minimum entitlements and legal rights, including legal rights that exist in the Equality Act 2010—a piece of legislation of which I am fiercely proud, and which the last Labour Government took through Parliament and put on the statute book. We need to make sure that all service delivery, particularly in social care, meets the ambitions and legal expectations of the Equality Act—sadly, that has let down so many LGBT+ people in the social care sector, as we have seen from the statistics in the surveys that I have cited this afternoon.
We would also ensure that our commitment to raise standards right across the sector is upheld by requiring all care providers to demonstrate financial sustainability and, crucially for this debate, to deliver high quality care for service users before they are allowed to receive contracts from local authorities, making sure that local authorities commission care providers who are capable of delivering the care that people need at the standard we should expect. That would result in more personalised and ultimately higher-quality care for all individuals.
In 2023 people who are lesbian, gay, bisexual, trans and others should not feel ostracised by a system that is there to support them. They should not feel ignored and that their personal needs are not being met. Ultimately, they should not feel the need to hide the fact that they are gay, lesbian, bisexual, trans or other. I hope that the Minister will agree with me that we can get to work on delivering that higher standard of care for all service users. The testimony that we have heard today from my hon. Friend the Member for Dulwich and West Norwood should stand as that end point. Never again should somebody from the LGBT+ community be treated as we have heard. “Never again” should be more than a slogan. It should be deeds.
It is a pleasure to serve under your chairmanship, Sir Robert. I apologise if this important debate is interrupted by a vote. I also apologise for the fact that my colleague the Minister for Social Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), has been in a car accident and cannot be here today.
I pay tribute to the hon. Member for Dulwich and West Norwood (Helen Hayes) for securing this debate on a hugely important issue, which is only likely to grow in importance over time. I express my sympathy to Ted for the appalling, abhorrent experience that he and Noel suffered. I am glad that compensation has been paid, although it is not enough, and I am happy to continue to discuss that case with the hon. Lady and her constituent after this debate.
People have a right to live in safety, free from abuse and neglect, and they should expect high-quality care and tailored support to meet their personal care needs. Nobody should be disadvantaged due to their background, sexual orientation, gender identity, culture or community.
The hon. Member for Denton and Reddish (Andrew Gwynne) has mentioned some of the guidance and the clear recent legislation we have passed to ensure that is the case. Care workers, social workers and everyone working in social care need to be sensitive to people’s individual needs and circumstances, including their sexual orientation and gender identity. It is vital they have the confidence to discuss individuals’ differences to find out how they can best provide care and meet individuals’ needs.
I want to thank our amazing social care workforce, who work tirelessly to deliver high-quality care to individuals. It is important to recognise the hard and brilliant work of the social care workforce, even though today we are talking about some horrendous failures in social care, where things have not gone right, as highlighted in a report by Compassion In Care that has been mentioned several times and which is called “Stripped of all Pride”. I read the report and found it absolutely harrowing. Some of the cases discussed are almost unbelievable. The report shines a spotlight on how LGBT people are subject to prejudices and biases, potentially from the workforce and, if they are in the workforce, from people receiving care. I want to pay tribute to the whistleblowers who spoke to that people working on that report for speaking out against the abuse and vulnerability they face, not just in the case of Ted and Noel but across the country. It is vital that LGBT people are free to live and work in care homes where the culture is inclusive and respectful.
Many people who require care and support may not have children; not just LGBT people but, as the hon. Member for York Central (Rachael Maskell) pointed out, other people too. It is essential that we have strong systems to protect them and we do not just rely on other friends and family members to pick up discrimination or abuse.
Care providers have a key role in safeguarding, and all the relevant care professions are subject to employer checks and controls. Guidance from the National Institute for Health and Care Excellence is clear that care homes must have a safeguarding lead and that they should make sure everyone knows who that is. As part of its inspection regime, the Care Quality Commission checks that care providers have effective systems to keep adults safe from abuse and neglect. I will set out some of those robust processes.
Local authorities have a duty to investigate safeguarding concerns under the Care Act 2014. Anyone who is concerned that an adult with care or support needs is at risk of or experiencing abuse or neglect should contact the provider and the adult safeguarding team in the relevant local authority. If someone is in immediate danger or it is believed that a crime, including hate crimes, has been committed people should contact the police too. Any form of abuse or neglect is unacceptable, and we need a focused and effective safeguarding system.
All social care providers already have a duty to be respectful of an individual’s protected characteristics, including their sexual orientation, and make sure that their staff have the appropriate training to cater for the individuals in their care. In its role, the CQC takes a preventive approach to people experiencing prejudice or abuse, and looking at the quality of care for LGBT people in adult social care has been one of its equality objectives over a number of years. It is important that those who may be more likely to experience discrimination are listened to and have their needs understood by the local authority. That is why, from now on, the CQC will assess equity in outcomes and consider how local authorities ensure that people with protected characteristics under the Equality Act 2010 are understood. The new duty we have created for the CQC to assess local authorities’ delivery of their Care Act duties went live in April 2023, and that will make a big difference in ensuring that those at the authority level are thinking actively and working on this vital issue.
CQC assessment of local authorities will increase transparency so that those who might be more likely to experience discrimination, such as LGBT people, are able to hold their local authority to account. It is not just about raising and enforcing standards; it is about having the resource to provide a good service. That is why I am making the record increase in social care funding that we have set out, with an extra £7.5 billion overall, including nearly £600 million for the workforce development plan, so that we have a high-quality social care workforce as well as strong rules.
Leadership is key to developing an inclusive culture. The funded delivery partner of the Department of Health and Social Care, Skills for Care, has produced resources for care providers to help to develop a stronger awareness of the importance of equality and diversity standards. That helps social care leaders and their teams develop an inclusive and confident approach to diversity. I am aware that there are some providers that cater specifically to the LGBT community, which I think is great, and I want to recognise their important work. The hon. Member for Dulwich and West Norwood mentioned Tonic and I pay tribute to it and others across the country for their work. However, it is not just about them; it is about making sure that social care settings are suitable for everyone, whatever the setting.
I thank the hon. Members who have taken part in this important debate today and for shining a light on this important issue.
I congratulate the hon. Member for Dulwich and West Norwood (Helen Hayes) on securing this debate, and on her moving and thoughtful speech. A lot has been said about driving such behaviour out of social care settings, but I wonder whether the Minister might say a little bit about the role that the police might have. We all want a fantastic ethos from social care settings, from local government and from national Government, but even with reasonable recruitment policies and so on, if there are bad apples in the sector, the damage they can do to vulnerable people over years or decades can be quite devastating. We need to make sure that those people are driven out if they get a police record, and are never able to enter that sector again.
Absolutely. The police take this issue more and more seriously, which is vital. Some of the things that we have been talking about today, including in the “Stripped of all Pride” report, are clearly criminal offences, and it is important that we bring to justice all the people who do them. There is always much more to do, but the Government take this matter deadly seriously; it is horrific and appalling to hear about some of the treatment that people have experienced, and we are determined to stop that, using every single tool we have.
Let me put on record a matter that I should have done at the beginning of my opening speech: I co-chair the all-party parliamentary group on adult social care—apologies for not mentioning that earlier.
I thank my hon. Friend the Member for York Central (Rachael Maskell) for her moving and powerful speech, particularly for the poem with which she finished; sometimes prose is not quite enough to convey the depth of emotion on such issues, but that poem did so very well. I thank my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), who was right to locate this issue within the wider pressures facing social care and to discuss the esteem within which the sector is held. There are many good people working extremely hard every single day to deliver high-quality care, but the pressures of social care, the difficulty local authorities have finding placements and the difficulty of recruitment and retention faced by many organisations certainly do not help with the issues of scrutiny and accountability that we are concerned with today.
Finally, I thank the Minister for the tone of his remarks and his commitment to address the issue. I urge him to look more at an issue that he did not mention in his response: the Pride in Care standard, which shows already what good can look like for LGBTQ+ people in care settings, and can give assurance to relatives looking for care placements for their loved ones that the setting understands and takes seriously the very specific personalisation needed, and the need to ensure absolutely that homophobia, transphobia, discrimination and abuse are eradicated from such settings.
Question put and agreed to.
That this House has considered the treatment of LGBT+ people and their spouses in social care settings.