Tuesday 25 June 2019
[Ian Paisley in the Chair]
Living with Dementia
It is very warm in the Chamber today. Hon. Members may want to remove their jackets: please feel free to do so—I would not want anyone parboiled. Before I call Debbie Abrahams, who will move the motion in her own time, I ask Members to prepare, because of the interest in the debate, to make speeches of about five minutes. We shall keep that informal, but hopefully we will be able to get everyone in.
It is lovely to see you in the Chair, Mr Paisley. I thank the Backbench Business Committee, which granted the debate, and I want to recognise my hon. Friend the Member for Cambridge (Daniel Zeichner) as its co-sponsor. I also thank the Alzheimer’s Society, which provides superb support to the all-party parliamentary group on dementia, and the parliamentary digital team for promoting the debate. We hope to hear the views of many people from across the country on the recommendations in the report we shall discuss.
The subject of dementia and people living with dementia is particularly close to my heart. As many Members will know, my mum was diagnosed with Alzheimer’s disease at 64 and I was one of her principal carers. Having had that caring experience and seen some of the issues my mum faced, I wanted to raise awareness about dementia and the many different brain diseases that cause it. As many will know, dementia is now the leading cause of death in the UK, having overtaken heart disease and cancer. It is estimated that 850,000 people in the UK have a dementia, and Alzheimer’s disease is the most common. That is expected to increase to 2 million by 2050. Globally, there will be 152 million people living with dementia by 2050—a 204% increase. If there is anyone who does not now know someone with dementia, they soon will.
There is already much work under way at the UK Dementia Research Institute, where there is a search for programmes to identify people at risk of different dementia types and prevent them from contracting the disease, as well as for treatments and cures. In spite of the commitment by the former Prime Minister, David Cameron, to invest in dementia research, it still receives only one tenth of the research funding that cancer receives. However, there is also a need to invest in dementia research that could improve the lives of people affected by dementia today. I have campaigned with many others to raise the issues affecting people living with dementia, including becoming the first MP to be a Dementia Friends champion, working with Oldham Dementia Action Alliance to develop a dementia-friendly Oldham and Saddleworth, and undertaking various all-party group inquiries on how to improve the quality of life of people living with dementia.
The report from our latest inquiry, on dementia and disability, was launched last week. More than 2,500 people affected by dementia responded to our call for evidence—one of the largest responses to any all-party group inquiry. What the respondents had to say is very important. According to the Equality Act 2010 and the United Nations convention on the rights of persons with disabilities, dementia is a disability. As one family carer put it:
“If this isn’t a disability then I don’t know what is.”
However, the all-party group was told that society is lagging behind in that understanding and failing to uphold the legal rights of people with dementia. Evidence presented to the inquiry revealed that, across the country, the disability rights of people with dementia are not being upheld. Shockingly, 98% of the survey respondents thought that people living with dementia are treated differently from people with other health conditions or disabilities. They believe that that is due to the hidden nature of dementia, and the stigma that surrounds the condition. That is simply not good enough, and we need to do more.
I congratulate my hon. Friend on obtaining the debate, and those who supported her. I hope she will touch on the cost of care. The cost of looking after people with dementia is astronomical, as it is with care generally. I hope she will also touch on progress with dementia research.
I thank my hon. Friend, who anticipates me. I shall certainly talk about social care in relation to people living with dementia and their carers. My speech is focused on our inquiry report, but other hon. Members may want to touch on progress being made in research.
A central finding of the inquiry is that the public, employers, organisations, Governments and public bodies need to do more, and need to recognise the rights of people with dementia. The inquiry also revealed that a range of societal barriers prevents people with dementia from living independently. Action needs to be taken across a number of key areas to ensure that people with dementia receive the protections and safeguards provided by legislation and convention. The key areas that were identified as having a direct impact on people’s daily lives include employment, social protection, which is also called social security or welfare benefits—I consider that a misnomer because most people who receive so-called welfare benefits have contributed, so they are an entitlement, not a benefit—social care, transport, housing and community life.
On employment, the importance of work in giving people a sense of purpose, self-esteem, status, companionship and income was raised. Work can also provide a routine. Without it, people can feel a loss of identity and sense of purpose. One person with young onset dementia told us:
“I applied for so many jobs and I just got rejections. I used to lecture at a university and now I can’t get a job collecting trolleys. Any job is worthwhile. Not having a job destroys self-esteem.”
At the launch of the inquiry report last week we heard of a woman who had worked in a Government Department and had been diagnosed with early onset dementia. She became ill because of the condition, was then disciplined about that and, ultimately, was forced to take ill-health redundancy. I know that the Minister will be as concerned as I am about that disgraceful position. If Departments are setting out how we should lead, we must make sure we have our own house in order.
There needs to be more awareness among both employers and employees of the employment rights of people with dementia. People need to feel empowered to tell their employers about their diagnosis and employers should feel supported in fulfilling their responsibility to make reasonable adjustments so that people with dementia can continue to make a meaningful contribution in the workplace. The Government have a hugely important role to play, by providing guidance and support for employers. The Access to Work programme could go some way to addressing the unmet needs of people with dementia in relation to employment. However, as I know the Minister recognises, that is a small pot of money, which currently supports only about 35,000 of the 4 million or so disabled people who are fit and able to work. We need to make sure that that is extended.
In relation to social protection, people raised issues about the extra costs associated with living with a disability. Access to extra financial support can provide a lifeline for people with dementia and help people to continue getting out and doing the things they enjoy. One of the key challenges for people affected by dementia is knowing what financial support is available to them. One family member told the all-party group that they felt that
“people with dementia are effectively ignored by the disability benefits system.”
People with dementia and their carers need access to more support to enable them to know what financial help they are entitled to and how to make a successful claim. The Minister knows my views on both the fit-for-work and personal independence payment assessments. Until those assessments are scrapped, people with dementia deserve to be assessed by professionals who understand the condition, and they should not have to undergo unnecessary reviews or reassessments, as currently happens.
Assessment processes need to be clear and appropriate for people with cognitive impairments. That is why we are calling for the Government to mandate the Department for Work and Pensions to convene an expert group to review access to social protection for people living with dementia and their carers, recognising their specific needs. This group must include those who are experts by virtue of their own lived experience. The Government should also mandate the DWP to exempt personal independence payment claimants below the state pension age and with a dementia diagnosis from reassessments, which are unnecessary and cause a lot of distress for people living with dementia and their families.
A further key issue was social care. The inquiry received considerable feedback about inadequate or inaccessible social care for people affected by dementia living in England. There are many ways to improve the lives of people with dementia, but it is difficult in the current context of the well-documented social care crisis across the country. It is now recognised that that social care crisis is a dementia crisis. We need to fix the broken care system, and I am proud to support the Alzheimer’s Society’s “Fix Dementia Care” campaign. I know the Minister is eager to publish the Green Paper as soon as possible, and I urge the Government to recognise that.
In the context of social care reform, I will mention the Alzheimer’s Society’s campaign for a dementia fund. The system of dementia care in this country is in urgent need of reform and extra investment. In May, I tabled early-day motion 2360 in support of the campaign, calling for a financial injection into the social care system in the short to medium term, allowing for greater provision of safe and quality care, longer visits and savings to the NHS. My EDM now has the backing of more than 100 MPs of all parties, and I know that thousands of Alzheimer’s Society campaigners have written to their own MPs as well. I would welcome a commitment from the Minister to look at the proposal, and her support in getting the Government to include a dementia fund in the forthcoming spending review, to end the unfairness for people with dementia.
Another key area is transport. Access to public transport can have a huge impact on the lives of people affected by dementia, helping to reduce loneliness and social isolation by linking someone to their community and friends, and providing links to essential services such as necessary respite care. Access to public transport is therefore critical to maintaining someone’s quality of life. However, accessing transport can be very challenging for people with dementia. We heard many stories of how poor or inaccessible transport is, preventing people with dementia from participating in society, despite rights to accessible transport being enshrined in the Equality Act 2010.
Our report stresses the importance of reviewing any changes to bus and community transport services in the context of the public sector equality duty, to ensure that reasonable adjustments are made to enable people with dementia to continue to use public transport. Local authorities have a huge role to play here, and I hope that they will take steps to support people living with dementia in their communities.
On housing, the inquiry found that people with dementia are frequently being denied their right to live independently in their own homes, where they are able to make their own choices. It is important that people with dementia are supported as much as possible to stay as long as possible in their own home or to access suitable supported housing. People with dementia have the right to personal choice over where and how they live. We believe that people living with dementia must have access to adaptable housing, trained home care staff, and specialised supported housing schemes.
The final area is community life. The evidence supplied to our inquiry reaffirmed the importance of supporting people with dementia to continue to lead full and independent lives. That means creating communities where no one is excluded or has to face dementia alone. The all-party parliamentary group praised the work of the Dementia Friends programme, which helps to raise awareness of the condition and has created almost 3 million Dementia Friends in England, Wales and Northern Ireland—5,000 of them in my constituency of Oldham East and Saddleworth, a fact that I am very proud of.
A particularly relevant recommendation of the report is for Westminster to become the world’s first dementia-friendly Parliament, including ensuring that the parliamentary estate is a safe and welcoming place for people affected by dementia to work and visit. I have met a number of people today who are visiting Parliament; I hope they will be able to report positively on how they have been received today.
Our report is wide-ranging and covers a number of different issues that need to be addressed if the disability rights of people living with dementia are to be realised. Over the coming months, the all-party parliamentary group on dementia will work with the Alzheimer’s Society and other partners to turn the report’s recommendations into reality. That has the potential to have a huge impact on the lives of people living with dementia and their carers, and I hope that everyone in the Chamber today and beyond will offer their support.
It is a pleasure to serve under your chairmanship, Mr Paisley. I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this important debate, in conjunction with the hon. Member for Cambridge (Daniel Zeichner) and the Backbench Business Committee.
Hon. Members should be dismayed to learn that, according to a recent survey, 98% of the 2,521 respondents felt that those with dementia were treated differently from people with other health conditions or disabilities. Some even found that employers would not make reasonable adjustments to the workplace. Those respondents believed that they were discriminated against, facing unnecessary stigma and often negative attitudes. It is a worrying statistic given that, apparently, 850,000 people in the UK live with dementia. Indeed, 70% of care home patients live with the condition.
Media coverage of the condition tends to occur only when it befalls a prominent person in public life, when relatives have the courage to publish their experiences, as the TV presenter Sally Magnusson in Scotland did in relation to her mother, or when a member of the public sadly goes missing and the police issue an urgent appeal for help in locating them. It is important that we raise wider and more regular awareness of a condition that appears to be on the increase throughout the United Kingdom.
I apologise for being late to this debate. Last November, my father passed away. He was a sufferer from dementia and, while he got fantastic care, we found as a family that there was a lack of staff with the experience to diagnose dementia, because there are different stages and diagnoses. Does the hon. Gentleman agree that one area that is forgotten about is young carers, who have to dedicate a lot of their time to looking after their parents while still keeping up their studies? We seem to forget about them.
The hon. Gentleman is right that we often seem to overlook the young carers. In my family, we have experience of hosting my mother-in-law. I was very fond of her, but we had two or three months of hosting her, and despite having two daughters who are nurses, what a challenge that was in my life and that of my wife. We thought we knew about dementia, but we knew nothing about it until we walked for several months with my mother-in-law, who I was very fond of.
When I served as a councillor in South Ayrshire, one of my colleagues, Councillor Hugh Hunter, and others were active in ensuring that the needs of dementia sufferers and their carers were to the fore. In his council area, in 2016, a dementia-friendly project was launched, with the laudable aim of building a community that supports people with dementia, enabling sufferers to remain in their community for as long as practicable and reducing the stigma. Indeed, in the constituency of the hon. Member for Central Ayrshire (Dr Whitford), which borders mine, is the Carlton Hotel, one of the first in Scotland to provide a dementia-friendly bedroom. I think she and I would both agree that that is delightful, and I give credit to that hotel and others that do the same.
In 2015, the UK Government launched the Dementia 2020 challenge, a vision for dementia care, support, awareness and research, which includes awareness training for NHS and care staff. I understand research spending is around £60 million a year to 2020, but not beyond. Four years on, I wonder whether the Minister might provide us with an update and an outline of what the future might hold for those with dementia and—equally importantly, as was said earlier—their carers.
In particular, I am sure sufferers and carers would be grateful for more detail on the proposed Green Paper on a new social care policy, especially the Alzheimer’s Society’s desire for a dementia fund to afford financial support for the very real additional costs associated with dementia treatment and care. An update on the Accelerated Access Collaborative introduced last year, which enables patients to benefit from rapid uptake products, breakthrough medicines and technologies with the greatest potential to change lives, would also be welcome. I know an update would be gratefully received by many of my constituents and others elsewhere in the United Kingdom.
I very much welcome the fact that mental capacity legislation should enhance safeguards against deprivation of liberty and ensure that those living with dementia have a person to advocate on their behalf. However, the Government could further assist by making form filling easier and considering whether there is truly a constant need for reassessment, given that dementia is sadly a progressive condition for which there is currently no effective cure.
All our Governments and other organisations must ensure that those living with dementia are able to do so with dignity, respect and, most importantly, compassionate care, to remain safely independent for as long as is reasonably practicable. The Alzheimer’s Society’s mantra that everyone affected by dementia should feel part of—not apart from—society sums the situation up. It is to be commended for encouraging more than 2 million people to sign up as Dementia Friends, and its informative website is truly well worth a visit.
During Dementia Action Week last month, I belatedly became aware that some stores in Ayr—a town in my constituency—such as Specsavers, have several Dementia Friends on their teams. Hopefully this small step will be a growing trend in retail, hospitality and, equally importantly, transport throughout the UK, to extend that hand to those living with dementia who need that wee bit of extra help.
It is a pleasure to serve under your chairmanship, Mr Paisley. I thank the Backbench Business Committee for granting this debate. It is an honour to follow my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), who so expertly laid out the issues. I will say a little bit about social care and then move on to research.
Some 1,179 people live with dementia in Cambridge—around 1% of the constituency population—meaning that thousands of my constituents care for or know a close friend or relative with dementia. My hon. Friend touched on some of the social care issues. It seems hard to deny that we have a crisis in social care. In March 2017, the Government said they would publish a Green Paper on ensuring that the system will be sustainable in the long term. However, two years on, and after many delays, Ministers have still not given a date for when it will be published.
I understand that 400,000 fewer older people receive publicly funded care than in 2010. With local authority budgets cut by 49.1% since 2010, including £7 billion lost from adult social care, and a further £1.3 billion to be cut in 2019-20, it is hard not to conclude that the situation for many of those living with dementia, and for their families, has been made much harsher and more difficult.
Alzheimer’s Research UK has campaigned for more money to be invested into research, so that with new treatments we can really change the lives of those who have dementia. As we all know, research has revolutionised the ways we treat, cure and prevent diseases such as cancer. There is no reason why that cannot be the same for brain diseases such as dementia. New treatments would also ease pressure on our healthcare and social care services, improving lives and saving public service resources. Public donations have allowed Alzheimer’s Research UK to invest £100 million over the last 20 years to drive forward its research, but that funding alone does not allow it to further explore emerging fields.
However, when we do invest in dementia research, look at what we can achieve. Alzheimer’s Research UK’s Drug Discovery Institute in Cambridge couples the deep disease knowledge and biology expertise of the academic community with high-quality, innovative drug discovery technologies. More than 100,000 combined hours have been committed to drug discovery by 30 new staff. The institute is currently investigating 10 new potential drug targets in its own work or through collaborations, has generated 12 new internal collaborations at the University of Cambridge and has attracted nine new partners from both the private and the academic sectors.
In addition to the institute, the Cambridge Network Centre, launched 20 years ago, has grown to include 2,200 dementia researchers across the UK. It has helped researchers to buy cutting-edge technology to carry out their research, supported grant applications and fellowship applications and enabled PhD students to buy equipment such as virtual reality technology to further their research. I suspect I am not the only one to have seen the virtual reality dementia simulation and met Helen Davies when Alzheimer’s Research UK was in Parliament. I—like others, I suspect—found it extremely interesting and slightly surreal, but also very impressive at explaining the effects of the disease.
While £269 million is invested in cancer research, only £83.1 million is invested in dementia research—just 0.3% of its total cost to society. Alzheimer’s Research UK is calling for the Government to increase that to just 1% of its total cost, which would unlock the resources needed to really cement the UK as the world leader in dementia research and to make real breakthroughs. I very much hope that the Minister will commit to discussing that with her colleagues in the Department for Business, Energy and Industrial Strategy and the Treasury—even possibly one or two Conservative party leadership candidates, for whom money suddenly seems to be no object—to ensure that we make the progress that we all need.
It is a pleasure to serve under your chairmanship, Mr Paisley. I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this important debate, and the Backbench Business Committee for granting it.
Both my grandmothers suffered with dementia, so like many here today I have seen at first hand how people slowly become a shadow of their former selves. We are all living longer than before, but with the gift of more time comes complex illness and disease. It is expected that, by 2020, more than 1 million people across the UK will have dementia, with one in five people aged over 90 suffering from it. Chichester has a significant elderly population, and we therefore have more sufferers than the national average.
We know that this area of health will only become more of an issue in the coming years, so policy around it needs to be robust, for both patients and their families. In 2015, the Challenge on Dementia 2020 was launched, setting out the vision for how dementia care support, awareness and research will be transformed by 2020. A big part of this is awareness raising, so people can spot the signs in loved ones. I and my team are registered to take part in Age UK’s dementia awareness training, and I am sure that many people across the country are doing the same. More people are receiving a dementia diagnosis than ever before, helped by the fact that more than 660,000 NHS staff have received dementia training. That is important, because the earlier the diagnosis, the more time patients and their families have to prepare for what is to come.
From my own experience, I know that dementia is a very changeable disease, with good days and bad. Sometimes I would sit with my nan and she would be as sharp as a pin. Sadly, on others, she would barely recognise me. However, there are some things that can beat dementia, and in her case it was politics. I will never forget visiting my nan, Joan Roberts, after she moved out of her council house and into a local care home in Huyton. I had just finished my first election campaign, contesting St Helens South and Whiston in 2015—as a Conservative—and wanted to show her my election leaflets. At the time, she was in the advanced stages of dementia. She looked at the photos and admired the different outfits I was wearing, but all of a sudden her face went as black as thunder when she realised I was standing as a Conservative. “That is not my party,” she exclaimed. I said, “Goodness, nan; you can’t remember what you had for breakfast but you still remember that you’re Labour.” I went on to reassure her that we had never agreed on politics, and she seemed happy enough with that reply.
Having seen how this disease impacted my family, I think it is crucial that we bolster support for family carers. My constituent, Wendy, cares for her husband Richard and has had her life turned upside down. Her husband was her main support through life, and they used to talk about everything, but now they cannot. In contrast to much of their marriage, she now cares for him. Wendy, like many others, receives support from Sage House, our local dementia hub. The services it offers sufferers and their carers are a vital lifeline.
My family were very lucky in that regard. Coming from a large Liverpudlian family, we have a home-made support network, but not everyone is so lucky or lives close enough to each other. When my other grandmother, Jessie Gibson, was diagnosed with Alzheimer’s, her 11 surviving children, including my dad, drew up a 24-hour rota so that someone was always there to care for her in her home in Huyton. However, having 11 children who live within a few miles of each other is quite an unusual care option, and not one that I guess many of us have.
Sage House is an amazing local service. It is there from the earliest stages of dementia to end-of-life care. It has group sessions, which are important to people with dementia because loneliness often becomes more of an issue. Similarly, Chichester Lunch Club offers a fantastic support service that helps people to build and maintain relationships. Anyone who has loved ones with dementia will know how important it is for their wider mental health that they keep up social interaction.
Like most issues of the 21st century, there is always a technological advancement that can help. Chichester Careline is the only monitoring service in West Sussex providing telecare equipment to the most vulnerable in our society. Its services are becoming ever more invaluable, because they are often used by people in the earlier stages of dementia. People with dementia often get confused, and on occasion get lost; they sometimes wander out of their house. My nan used to go out looking for her two daughters, who she thought had not come home for the evening, even though they were in their 60s and 70s. Careline operates a “Mindme” service. That means that if a person becomes lost or disorientated, they can be located through a website, which is monitored by their family, friends and carers as well as Chichester Careline. That service is available 24/7, 365 days a year. The technology can now go further for people who are prone to wandering off. An imaginary ring fence can be installed around a location, and that sets off an alert if a user crosses it.
Dementia is an illness that has touched my family and will affect more and more families up and down the country. A key concern of mine is social care—for those with dementia and for the elderly more generally. I believe that we need a transformative adjustment in policy that genuinely offers a sustainable, integrated model of care. At this point, I urge hon. Members here today who have not already done so to join the all-party parliamentary group on social care, which I set up with the hon. Member for Sheffield, Heeley (Louise Haigh) and in which we are working to be a voice for the industry and its professionals to improve the status of that vital work, on which many people up and down the country rely. It is our great responsibility to care for those who cared for us. We need to get this right. One day, and sooner than we think, we will be the ones in need of that care.
I am delighted to participate in this important debate on improving the lives of people with dementia. I begin by extending my thanks to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing the debate, and by applauding the excellent work in my constituency carried out by Quarriers dementia befriending service—I met people from the service only a few weeks ago—and its wonderful volunteers, who work so hard and do so much to improve the lives of those with dementia.
I must declare an interest in the debate, as my husband’s mother—my mother-in-law—is living with dementia. Watching an older person—I appreciate that we have heard about cases of younger people being diagnosed with this disease—make the descent from the person they used to be into someone who is so far removed from their former self is really distressing. My mother-in-law’s name is Iris Gibson, and before the illness took hold she was the longest-serving SNP councillor on Glasgow City Council at the time; she was a woman who was a keen runner, having participated in marathons all over the world; she was a woman who was never home but was always out at meetings or events in her council ward, or representing Glasgow City Council in her role as bailie at official functions; and she was a woman who was perfectly comfortable exploring foreign lands on her own when she took time for a holiday. Over an extremely short period of time, her children and I have watched her go from being all those things to being a woman who is easily confused, who is not always able to recognise her grown-up children and who has lost all sense of herself. If she could have seen, and if she had known, how her elderly years would play out, she would have been distressed beyond measure at the prospect. Her grown-up children, twins Kenneth and Janis, find her descent into dementia very distressing to see, as might be expected. This illness is cruel beyond words, and if anything can be done to improve the lives of those who are living with the disease and the lives of their families—we cannot forget their families—we need to do all in our power to deliver that.
Iris has had to surrender her own home and lives in a care home in Largs called Haylie House. She seems happy there, but the disease has robbed her of decades of memories. She appears to have forgotten so much of her life before dementia, which was a life she lived to the full. Sadly, that story of dementia can be told by every single person who has watched a precious family member fall victim to this disease, be robbed of the recollections of a life lived to the full in glorious colour and have that replaced by blank, empty spaces, where decades have simply vanished and are beyond the grasp of the person struck by the illness.
In the UK, 850,000 people are living with dementia. By 2025, which is not far away, that figure will rise to more than 1 million, and by 2050 it will rise to more than 2 million. I am concerned about how we protect those living in our communities who have this disease—they may not even have been diagnosed. Too often, as we have discussed in this place, such individuals are seen as rich pickings by those who seek to part them from their savings. As a society, we need to put structures in place to protect them, in every way. Some financial institutions have put measures in place to protect our older, vulnerable people. I am referring to measures such as monitoring their bank accounts and having a few days buffering the removal of unusually large amounts from their account to help to safeguard them against fraud.
What is really needed, as we have discussed in this Chamber before, is a legal duty of care from the business world and from the state towards older people—especially those with dementia—who need that extra layer of protection in a world where rogues and thieves are creative and cunning and older people, even those with dementia, are isolated in their own homes without sufficient support. That protection must be put in place. In my view, it should be a legal, statutory duty for all financial institutions to deliver that protection. Those living with dementia deserve nothing less.
As our population ages and people live longer, there are huge cost and care challenges to face in terms of how we look after our older people, and especially those who live with this cruel disease. Those challenges are faced by societies right across Europe and, indeed, the world, and we must do all we can to meet them, despite the difficulties. The Scottish Government are working hard to improve dementia care and have published a three-year dementia strategy, but one challenge, to which money is perhaps not the answer, is recruiting and retaining care staff, whether the care is carried out in an older person’s home or in a care home. Integration of health and social care services allows for more joined-up delivery of services, but the story cannot end there. It is the case that 43% of the Scottish Government’s entire budget—43%—is spent on health. That is before one penny is spent on schools, housing, roads, local authorities or anything else. The costs of social care can only grow and will continue to be hugely challenging, and we must continue to work to meet the challenges. The Scottish Government are looking very carefully at a report from Alzheimer Scotland called “Delivering Fair Dementia Care For People With Advanced Dementia” and some of the issues that it raises about continuing to work to improve the lives of those living with this condition.
I echo many of the comments that have been made today about the need for continuing and improved research into this condition. Given the numbers affected and the cruel erosion that this illness inflicts on those struck down by it, caring for those in our society who are living with dementia will never be easy. That will always be challenging, not least because of recruitment and retention challenges. We need to recruit and retain staff to carry out the caring that is required—that is very difficult—and we will need more people to carry out those caring roles. We can all agree that our older people must have the care and support that they need throughout this shocking illness. We must not lose sight of that. Our older people with this illness need us to get this right.
It is a great honour to serve under your chairmanship, Mr Paisley. Like other hon. Members, I thank the hon. Members for Oldham East and Saddleworth (Debbie Abrahams) and for Cambridge (Daniel Zeichner) for bringing this timely and critical debate to the Chamber. We all feel very strongly about the subject. Many hon. Members have experienced, and have spoken movingly about, the impact of dementia on their own family. I am one of those, too. I will always remember the effect that dementia had on my grandfather in his final years. “Strict but fair” is probably the phrase used to describe that generation—my grandfather was a Royal Air Force officer and a teacher. I therefore have had personal involvement and have a personal interest in this matter, as so many do, and it is of course an emotional matter for many of us.
I am also married, as I have told the House before, to a music therapist. Many of my wife’s clients live with dementia. Classically, one always thinks of such people as being over 65, but that is not always the case. Increasingly, as my wife tells me, people who are much younger are affected, and it is those people on whom I would like to focus my brief comments.
I am a Dementia Friends champion. Many hon. Members are Dementia Friends and I warmly encourage any who are not to become one because of the education that it provides. One of the key lines and key lessons that dementia friend champions ask people to take away is that not everybody who is old has dementia and not everybody who has dementia is old. Although it is rare for younger people to have dementia, it is not that rare. About 5% of people with dementia are under 65, which is about 42,000 people—a significant number. I always ask people to become Dementia Friends because of the extraordinarily positive message that comes from that programme.
We should say not that someone is suffering with dementia, but that they are living with dementia. I am glad to hear that everyone is using the correct phraseology today—I hope that I will continue to do so throughout my speech. Secondly, one can live well with dementia, and there are many things that we can do in our constituencies and public lives to ensure that everybody does so.
Young onset dementia—people under 65—is very difficult to diagnose. It is easily confused with stress or depression at that age, so the diagnosis is delayed. Even when someone is diagnosed, it is often hard to find care. Care is often fragmented and targeted at people who are over 65, which is welcome where it is but, as the Dementia Friends programme shows, it is important that care is targeted to the individual’s needs.
That is why we are grateful for the Alzheimer Society’s Side by Side programme. I am honoured that YoungDementia UK is based in Witney. Its director, Tessa Gutteridge, is my constituent. It is a wonderful programme that seeks to bring together appropriate care for people under 65 who are living with dementia. For example, a social event for people in their 70s or 80s is not ideal for someone in their 40s who is living with dementia. It is much better if they are with people of their own age. YoungDementia UK have joined Age UK Oxfordshire and Guideposts Trust to bring together that specialised expertise and provide appropriate care and a support service targeted towards those with young onset dementia across Oxfordshire. We would like to see that throughout the whole country, which I know the Minister will think about in due course.
I am grateful to the hon. Member for Oldham East and Saddleworth for mentioning the report we have launched. I will not go through it in detail because she has done so fully. I would like to deal with the issue of employment. Under the Equality Act 2010, dementia is a disability. That particularly impacts those 42,000 people under 65, who may well be working. Their challenge is unique because they may themselves be carers for parents or children, they may be holding down a full-time job and they may have a mortgage to pay. It is particularly difficult. There is a stigma, as we know, around telling an employer that one is living with dementia.
There are difficulties in ensuring that the reasonable adjustments that should be made are made. That may be due to a lack of awareness of rights—perhaps employers do not realise that they should be making those reasonable adjustments. However, they may not realise what adjustments can be made. That is why I will give another unashamed plug for the Dementia Friends programme, which explains to people how it feels to live with dementia and what reasonable adjustments can be made.
The Government have an important role to play, which is dealt with in the all-party parliamentary group on dementia report. I ask the Minister to consider asking the Department for Work and Pensions to revise its guidance to employers about their responsibilities to support people who are living with dementia. It can cover reasonable adjustments, information on the Access to Work programme, and how to support employees with dementia. There is much more to do before we can call ourselves a society that is truly dementia-friendly, but I know that together we can do it.
It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate my hon. Friends the Members for Oldham East and Saddleworth (Debbie Abrahams) and for Cambridge (Daniel Zeichner) on securing this important debate. I support their vision to make this Parliament the first dementia-friendly Parliament in the world. My staff and I have undertaken dementia-friendly training in my constituency office. It is important for us all to try to promote a more dementia-friendly society, sector by sector, institution by institution and, as mentioned previously, shop by shop.
It is great that so many Members want to participate in the debate—it shows how active this is in our personal lives and our communities. A wide range of issues has been covered so far. We have looked at the impact on loved ones who are living with dementia and their carers, financial assistance and protection for people living with dementia, research, social care costs, dementia-friendly shops and institutions, and therapies that can help people who are living with dementia, such as music therapy. I want to touch on the role that I think mindfulness can play in helping people who are living with dementia and their carers.
I co-chair the all-party parliamentary group on mindfulness with the hon. Member for East Worthing and Shoreham (Tim Loughton). On Tuesday 14 May, we held a conference in the Macmillan room on mindfulness in an ageing world, including those living with Alzheimer’s. We had 150 people attending, including 15 of the charities representing elderly people, including the Alzheimer’s Society.
We heard from experts from around the world and the UK who have been doing research on mindfulness, ageing and Alzheimer’s. Dr Antoine Lutz of the centre for medical research at the University of Lyon has won a €7 million grant for research into ageing well and Alzheimer’s. We also heard from Dr Lone Fjorback from Aarhus University in Denmark, where they have a week-long festival for mental health to look at the issues in a positive light. From the UK, we heard from Dr Trudi Eddington, who is a British research scientist at City University researching those currently suffering with dementia. We also heard from Dr Eric Loucks, the associate professor of epidemiology, and behaviour and social sciences at Brown University.
There is promising early research out there. We used to think of the brain as set at the age of 25 and declining after that age. Now they have discovered neuroplasticity: how our brain changes size, function and shape over the course of our lives. Actions we take can encourage and discourage that. I ask the Minister and her advisers to assess that research, and particularly the research from the University of Lyon, which will be published later in the summer, and to meet officers of our all-party parliamentary group on mindfulness. I also ask the all-party parliamentary group on dementia and the Alzheimer’s Society to do the same. I pay tribute to that APPG and the Alzheimer’s Society, and all of those who work to lessen the suffering of those living with dementia and their carers.
Thank you, Mr Paisley, for allowing me to speak in this important debate. It is a pleasure to serve under your chairmanship. I congratulate my hon. Friends the Members for Oldham East and Saddleworth (Debbie Abrahams) and for Cambridge (Daniel Zeichner) on securing this important debate, and commend their work on the all-party parliamentary group on dementia.
The scale of the challenge of dementia is well known, but it bears repeating. In the UK, some 850,000 people live with dementia. That is set to double by 2040. Of course, the figures do not capture the great many other people whose lives are touched by dementia, most obviously family, friends and carers. With so many people affected by dementia, we need a comprehensive and joined-up approach that supports people and their families as soon as they are diagnosed. This must involve health, social care, local government and voluntary organisations.
There is a great deal of innovation and good practice. We must do all we can to ensure that it is shared as widely as possible, which is why I entirely agree with the Alzheimer’s Society that we need a national strategy on dementia. Of course, it is hugely important that the strategy is fully funded. I urge the Government to consider that in the upcoming spending review.
When thinking about a joined-up approach, we should look at the lessons from the integrated personal commissioning pilots. IPC, a partnership between the Local Government Association and NHS England, aims to integrate healthcare and education services around people rather than organisations. It focuses on an individual’s needs, along with the available community and peer support, to build their confidence and skills for self-managing long-term conditions such as dementia. It seeks to offer choice and control to patients by widening access to integrated personal budgets and developing more options to help people to achieve their goals.
An important point that the Alzheimer’s Society has raised is the need to ensure that people with dementia understand the information that they receive. What is told to people with dementia is not always the same as what they receive and understand. Given the nature of the condition, it is vital that medical professionals and others continually ensure that people are empowered by what they are told.
That point leads me on to the need for improved education about Alzheimer’s and dementia. I pay tribute to the Alzheimer’s Society’s Dementia Friends initiative, which has spread awareness and has seen 2.75 million people—including me and others in my office—become Dementia Friends. However, there is still poor knowledge among much of the public and some medical and care professionals about Alzheimer’s, dementia and what can be done to help people with the disease.
The Department of Health and Social Care should consider implementing a dementia awareness campaign to increase understanding of the symptoms of dementia and the interventions and treatments that can slow the progress of the disease, and to support people with dementia and their carers to lead independent lives for as long as is appropriate. The Government must do more to improve standards within the social care workforce to meet the needs of people with dementia, including by funding training to tier 2 of the dementia training standards framework for everyone who works in adult social care or interacts with people with dementia.
Finally, I turn to the support that we must provide for carers. I pay heartfelt tribute to the many thousands in this country who care for people with dementia and a whole range of other conditions. Out of love, they provide selfless care and deserve our utmost respect. Much more help must be given to those who care for people living with dementia. Carers need a wide range of practical, emotional and financial support. For instance, in its recent report on dementia and disability, the APPG on dementia found that carers need more support to know exactly what financial help they are entitled to, as well as how to make a successful claim. Carers are also time-poor and have little energy and—dare I say it?—headspace left after meeting the demands of caring for someone 24/7. The agencies involved need to take a more proactive approach to ensure that carers can claim the financial help they need, because they are entitled to support for the care they give their loved ones.
As we have heard, the Government’s aspiration to make the UK the best country in the world for dementia care and support is welcome, but it must be met with action and funding to make it a reality. I hope the Minister makes those commitments today.
As always, Mr Paisley, it is a pleasure to serve under your chairmanship. I join colleagues in paying tribute to my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for her leadership and for the compassion she shows in everything she does. I am a Dementia Friend because of her, having attended one of her workshops here in Westminster in 2016. I have since become a dementia champion and was asked by the Alzheimer’s Society to run its workshop for Dementia Friends at the 2016 Labour party conference to 80 colleagues and members, which was quite a challenge for my first workshop. I am incredibly proud to have played a very small role in training some of the UK’s 2.8 million Dementia Friends and sending them out into their communities to make them that bit more dementia-friendly. Once again, I pay tribute to my hon. Friend for her role in that.
This debate gives us an opportunity to evaluate where we are against the aspirations set out in the Government’s Challenge on Dementia 2020, but also to shine a spotlight on some of the good work that is being done at a grassroots level—not least in Halifax, thanks to some truly inspirational and passionate volunteers. As we have heard time and again, 850,000 people are living with dementia in the UK, a figure that is expected to double by 2040. One in 14 over-65s is living with dementia. If that is not an incentive to us all to do everything we can while we are able and empowered to do so, I do not know what is.
I recently wrote to older people in the Sowerby Bridge area of Halifax on behalf of the campaign to make Sowerby Bridge a dementia-friendly town, and invited them to a day of action to learn more and see the support available in their area. That campaign is driven by Shabir Hussain of Bluebird Care in Calderdale, who is a thoroughly committed community activist, along with Chris and June Harvey, who are truly dementia champions, and who run the wonderful Memory Lane Café for people with dementia and their carers. With their trustees and volunteers, Chris and June run pop-up cafés in churches and community centres in Sowerby Bridge and Halifax, with a dementia-friendly programme of games and crafts, information and support, cakes, music and conversation. Some 540,000 people in England alone care for those with dementia, and estimates suggest that one in three of us will be involved in caring for someone with dementia at some time in our lives, so a dementia-friendly environment that offers a thoroughly positive experience for all those involved in living well with dementia makes a massive difference to the regular attenders.
We also have a young onset dementia and Alzheimer’s group, or YODA for short, which was set up by Julie Hayden and provides support for younger people with dementia and for their carers and families. As we have heard, it is often overlooked that 42,000 people of working age live with dementia. Their requirements can be quite different. People diagnosed with dementia at that time of life usually present between the ages of 30 and 65 and are most likely in work, potentially with dependent children, older parents to care for or financial commitments such as a mortgage to consider. For that group, as other hon. Members have said, living well requires a different support package from that required for over-65s.
I would be remiss not to highlight the work of Inspector Neil Taylor of West Yorkshire police, who is a dementia champion and the chair of Dementia Friendly Todmorden. He has gone over and above in promoting best practice within West Yorkshire police and his local community—all credit to him. West Yorkshire police have introduced the Herbert protocol, named after George Herbert, a veteran of the Normandy landings who lived with dementia. The police and other agencies encourage family and carers to complete a form with useful information that could be used in the event of a vulnerable person going missing. The form includes vital details such as medication required, mobile numbers and places previously located, along with a recent photograph. In the event of a loved one going missing, the form can be handed quickly to the police to speed up the search and assist in supporting that person, who may be lost and confused when they are located. I recommend that all forces adopt such a protocol as soon as possible.
We are blessed with dedicated volunteers who have made Calderdale a better place to live with dementia, but what if Shabir, Chris and June, Julie, Neil and others like them were not there? The environment might be quite different without their leadership. How can we ensure that such work is supported and replicated elsewhere?
I give credit where it is due. David Cameron’s Government launched the dementia challenge in 2012, which sought to create dementia-friendly communities, with work led by the Alzheimer’s Society; drive improvements in health and care; and improve research, with a commitment that funding for dementia research be doubled to more than £66 million by 2015. Under Dementia Challenge 2020, as the programme was called when it relaunched in 2015, the Government committed to investing more than £300 million in dementia research and medical innovation.
It has been estimated that dementia costs the UK economy £23 billion a year, which is more than the costs of cancer, heart disease or stroke. With the numbers of people living with dementia expected to double by 2040, predicted costs are expected to treble alongside that increase. For anyone not yet won over by the human arguments for committing to research for dementia, the economic arguments speak for themselves.
To be fair to David Cameron, I believe that he understood the issue. I hope the Minister can assure us that she will seek to make it a continuing priority for the incoming Prime Minister. However, there are still areas in which I would like to see things standardised across the UK to support people, particularly younger people, who live with dementia, as well as their families and carers. To have a dementia diagnosis in the workplace, with dependants or financial commitments, must be incredibly daunting, but with a renewed focus on that group, and with changes to our understanding of the support that those demographics need to live well, we can make a positive difference. I thank the APPG on dementia for its report “Hidden No More: Dementia and disability”, which calls, quite simply, for
“equality, non-discrimination, participation and inclusion.”
I wholeheartedly endorse those aims.
I, too, pay tribute to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this crucial debate.
As has been said, the number of people suffering dementia in the UK is 850,000—I apologise, because I have already said “suffering” instead of “living with”, but many people are suffering. We talk about what is being done in pockets and what is being done well, but that is not happening for all those 850,000 people. Some of them are stuck in their houses, some are tutted at by people behind them in supermarkets and some are made to feel unwelcome in certain places. Until we can say that all 850,000 of those people are living well with dementia, we have not done our jobs.
There are 90,000 people living with dementia in Scotland, and more than 3,000 of them are under 65. The impact on those people has been touched on. It is estimated that only two thirds of people with dementia have been diagnosed, and that means that we do not actually have a handle on the scale of the problem.
Alzheimer’s—a term that many people use interchangeably with dementia—is the commonest form of dementia, but there is also vascular dementia; in many patients, it is mixed. A rarer form of dementia, Lewy body dementia, causes a particular type of dementia, with less memory loss but big impacts on movement. In particular, it causes hallucinations, and our police and firefighters should know about that. If they have had 50 calls from the same patient, it may be not because there is a burglar, but because that person is having hallucinations of a burglar. That is why we need to integrate all our public services, so that they learn from each other. Other conditions, such as HIV and Parkinson’s, can also lead to dementia. Many people know about memory loss, but there is not so much awareness of the difficulties that dementia creates with making decisions, concentrating and spatial awareness. People with advanced dementia have real difficulty moving around in our environment, and the situation is even worse if certain parts of the brain are impacted.
Unfortunately, at the moment treatment is very limited; there have been no new drugs for dementia since 2002. The most commonly used drugs are those that stop the breakdown of acetylcholine, a neurotransmitter that sends messages from one brain cell to the next. Those drugs can improve concentration, but they do not work against the underlying causes of dementia, partly because we still do not understand all the underlying causes. We see the breakdown of proteins, we see bits of proteins appearing in the brain and we see brain cells getting tangled up, but what exactly is causing all that? We need to upscale research to a totally game-changing level to understand the cause so that we can try to prevent and treat dementia. In Scotland in 2013, the Scottish Dementia Research Consortium was set up as an umbrella organisation to try to bring all such projects together. As well as laboratory research into the cause and treatment of dementia, research into a human rights approach to those living with dementia is critical in improving support and care.
We are also looking at adapting our health and care systems. As my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) mentioned, two years ago Scotland published a national strategy for dementia, which is the country’s third such strategy; the first was in 2010. This one will focus on the whole pathway, from providing post-diagnostic support right through to end of life, and including community co-ordinators.
Dementia is the disease that our generation fears. My grandmother feared tuberculosis—people did not even name it; they called it “consumption”—and the people I looked after as a surgeon feared cancer. What many of us now fear is losing ourself, as we have heard described so graphically this morning, or losing the person we have loved all our adult life.
Providing social care is critical for those living with dementia and for their families. In Scotland, we have spent more on social care, which allows us to provide free personal care. That means that if someone can be supported at home to live with independence and dignity, it will not cost them or their family. Since Frank’s law came into effect in Scotland just two months ago, that has also applied to those under the age of 65. The care they receive is thus related to their illness and particular needs, without a bizarre cut-off at 65 that prevents a 64-year-old from receiving the care that they require.
The problem is that we are struggling to recruit people as carers, whether in care homes or in home care. Most people want to be cared for in their own home, but it is very labour-intensive. Some aspects of the situation are being made worse by Brexit. In parts of Scotland, such as the highlands, 30% of carers are from Europe, so there will be an existential problem for care services. We also need to turn caring into a proper professional career, with training, career development and a decent salary that rewards carers for the very difficult job that they do.
It is critical that we support a person with dementia along their entire journey. All we have to do is to sit in this Chamber and imagine ourselves in that clinic, getting that diagnosis, and then going home and finding that there is nothing—no information, no support and no one to answer questions. The integration agenda, which is further down the line in Scotland, is linking things up. We have linked our NHS back into integration since devolution, but integrating healthcare and social care is a lot harder; social care is much more fragmented, because it is provided by multiple private companies.
We have multiple projects going on in Scotland that are often recognised through Scotland’s dementia awards. My local health board has won one such award for its “Bridging the gap” project, which provides a dementia support adviser to liaise between hospital, community and family along the patient’s journey. In Wishaw, there is a theatre buddy scheme, so that if someone with dementia requires surgery, their buddy—they could be a worker or a relative—is there at the last moment before the operation and when the patient wakes up. One project that I particularly like is the provision of assistance dogs that have been trained by prisoners in Castle Huntly, which involves a double win: the prisoners are proud that they are helping someone in the community, and those living with dementia have assistance dogs.
However, for those who are living with dementia now, the most important thing is to make them feel welcome and included in the communities that we live in. In 2016, I was lucky enough to be invited to speak at the launch of Dementia Friendly Prestwick, which is led by a very impressive team, particularly Julie and Lorna, who are leading lights within it. I had not done any of the work required to set it up; I was just asked to give a speech at the launch. However, I was inspired by that launch to set up Dementia Friendly Troon and Villages, Troon being the community that I live in.
In Prestwick, a relaxed cinema has been running for three years. There are subtitles, the cinema is free, it is not as dark as most cinemas, they serve home-baked food and they have even had a local potter make double-handed cups. The baking is all done by Berelands House, one of our local nursing homes. The cinema was a finalist in the Scottish Dementia Awards, and the sound and screen are of really high quality; I went to watch one of the movies myself. That service is provided by Friends of the Broadway, the Broadway being an old cinema in Prestwick.
In Troon, we have relaxed golf and an allotment, which is supported by other gardeners. We started by asking, “Why do we love living in Ayrshire, and how do we help people to hang on to that for as long as possible?”
First, I apologise for not being here at the start of the debate; I had a meeting with the Turkish ambassador, so I just could not be here earlier. Does the hon. Lady agree that greater support should be provided for those living with dementia to enable family members and other close relatives to take care of their loved ones—that is really important—for as long as possible before putting them into care facilities?
I absolutely agree; care should be provided in the home, if at all possible. That is where we would all want to be. The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) mentioned the hotel room that uses colour as well as technology to make it easier for a person with dementia to stay in it, as well as making it easier for their carer to be there.
Guided walks are provided in Troon. Troon promenade is being redesigned to make it easier to move around on, and Troon is part of Cycling Without Age, which provides cycle rides along the promenade on trishaws every Sunday afternoon. Staff at our local airport, Prestwick, have received the training to make it a dementia-friendly airport. That all depends on Alzheimer Scotland, which provides training to staff at the airport and at other, smaller businesses, such as hairdressers and cafés.
We are the ones who have to make the change. All we are asked to do is be patient, rather than tutting behind someone in a supermarket. In our area, we have managed to get two supermarkets to provide relaxed lanes where people will not be rushed, but will be invited and chatted to as they come through. Let us all be less hectic, and let us make everyone feel welcome in our communities.
It is a pleasure to serve under your chairmanship, Mr Paisley. I thank my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for securing today’s debate and for her excellent work on the all-party parliamentary group on dementia, championing awareness of dementia and support for those affected. I also thank Members present, particularly the hon. Members for North Ayrshire and Arran (Patricia Gibson) and for Chichester (Gillian Keegan), who have shared very personal stories about how they and their families have been affected. I pay tribute to carers, both paid and unpaid, who do so much to make life bearable for those who are suffering—I apologise for saying “suffering”, but personal experience teaches me that that is the reality.
Dementia is a life-changing disability that affects millions of people in the UK. Some 850,000 people in the UK have been diagnosed with dementia, including more than 1,000 people in my constituency of Burnley. More than 24 million people have a friend or family member who lives with dementia, and that figure is increasing all the time. Alzheimer’s Research UK estimates that one in three people born in the UK this year will develop dementia in later life, and as the hon. Member for Witney (Robert Courts) has reminded us, this is not just a feature of old age; people of all ages can suffer.
Dementia has a huge human cost. My grandmother suffered with dementia—she did suffer—and, regrettably, the support that was needed was not available to my family. Dementia also has a huge impact on resources: each year, the total cost of dementia to the UK is £26 billion, and that cost is expected to more than double in the next 25 years. Given the scale of the issue, it is fitting that Members from all parts of the House have raised their voices today to call for action.
Members have made it abundantly clear that action is needed in three main areas. First, prevention is crucial: The Lancet reports that 30% of cases of dementia could be avoided through an increased understanding of risk factors and the implementation of basic lifestyle changes. It is imperative that the Government lead on enhancing awareness among the general public, and on celebrating dementia-friendly projects and looking at other processes. I am grateful to my hon. Friend the Member for Vale of Clwyd (Chris Ruane) for reminding us of the impact that mindfulness can have on preventing the development of dementia.
In the area of research, it is clear that dementia is the poor relation; as my hon. Friend the Member for Cambridge (Daniel Zeichner) has so expertly reminded us, dementia is decades behind other conditions. Alzheimer’s Research UK has asked, very reasonably, that the Government commit to investing an amount equal to just 1% of the total societal cost of dementia into research. After all, the UK has some of the best scientists in this field, although there are simply not enough of them; they are outnumbered four to one by cancer specialists. The 2015 challenge on dementia, which has been mentioned, was most welcome but does not go far enough, and I look forward to hearing how the Minister might take that forward.
While prevention measures and research to achieve early diagnosis and future treatment are still so inadequate, it is vital that those who are diagnosed with dementia are given access to a comprehensive package of support. That is not just a job for the authorities: we have heard many Members describe pockets of really good practice in their constituencies, and I pay tribute to those who are delivering on the ground. However, there is no doubt that Government cuts to social care funding amounting to £7 billion since 2010 have taken their toll—nowhere more so than in the area of social care for those who suffer with dementia.
We often hear talk of the so-called dementia penalty, which is not surprising, as those affected by dementia regularly pick up two thirds of all care costs. Dementia patients often require more specialised and more expensive care. The associated costs can be as high as £500,000, and they almost always exceed £100,000. It is clear that patients with dementia are treated differently from patients with other conditions and disabilities. The failure to fund care adequately is placing additional pressure on NHS resources: last year, there were 70,000 avoidable hospital admissions for people diagnosed with dementia. That causes unnecessary suffering for patients and their families and is hugely wasteful of NHS resources.
What can be done to right this wrong? The recommendations of the all-party group on dementia could be implemented without delay. Dementia must be fully recognised as a disability, with sufferers afforded the same rights, protections and dignities as any other disabled person. Local authorities and health providers need to collaborate to offer a package of support that is both comprehensive and accessible; as my hon. Friend the Member for Bradford South (Judith Cummins) has stressed, it is no good having help available if that help is difficult to access. The eagerly anticipated social care Green Paper must fully address the needs of those living with dementia. The UK Parliament must lead by example, becoming the first dementia-friendly Parliament and actively promoting and supporting dementia-friendly communities everywhere. All members of health and wellbeing boards should be obliged to become Dementia Friends. Most crucially, the Government’s plans for the NHS and care workforce must properly reflect the needs of people with dementia.
The situation is urgent, and now is the time for the Government to listen. As part of the comprehensive spending review, the Government must introduce a dedicated £2.4 billion dementia fund to cover the additional costs of delivering dementia specialist care, and end the inequity between dementia and other diseases that currently leaves affected families facing astronomical care costs. That fund would enable timely access to an integrated package of support and help to facilitate specialist training for all care workers, equipping them to deliver high-quality dementia care.
Will the Minister commit today to addressing the long-term needs of dementia sufferers in the social care Green Paper and in the NHS and social workforce strategy? Will she commit to increasing research into the development of new treatments? Will she go beyond warm words and ensure that those with dementia are not forgotten in the comprehensive spending review? Will she support the establishment of a dedicated dementia fund to give people the support they are desperately crying out for?
As ever, Mr Paisley, it is a great pleasure to serve under your stewardship. I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this important debate, the hon. Member for Cambridge (Daniel Zeichner) for supporting her in doing so, and the Backbench Business Committee for allowing time for it. I also thank all the other Members who have taken part in the debate, and in some cases shared very personal journeys and stories about their family’s experiences with dementia and, indeed, some interesting and inspiring best practice from their constituencies—things that other areas can learn from.
I also thank the hon. Member for Oldham East and Saddleworth for her personal commitment and dedication to people living with dementia, both through her work on the all-party parliamentary group on dementia and in her constituency. She is so committed to making Oldham East and Saddleworth a really dementia-friendly place to live; she sets an excellent example of what we as Members of Parliament can do in our own communities, and I welcome her vision of making Westminster the first dementia-friendly Parliament. I will do everything I can to support her in that endeavour, because I know that her passion is driven by her experience of having a close family member living with dementia.
Other Members have spoken about their own experiences, and I have also had two very close family members living with dementia: my grandmother and my uncle, who passed away just before Christmas. I have experienced at first hand the impact that dementia has, both on the person who is living with it and those who love and care for them. Hon. Members from across the House have spoken about the importance of carers, and I have seen at first hand the impact that caring for my grandmother had on my mum—on her relationships, her professional life and her health and wellbeing. Those carers’ commitment should never be taken lightly. A dementia diagnosis is more than a diagnosis for that individual: it is a diagnosis for the whole family, their loved ones, their community and their workplace.
In my constituency, 1,152 people live with dementia. As the Minister rightly said, it affects a lot of families as well as the wider family circle. Has she given any consideration to respite care for those families to give them a break from the physical, emotional and mental pressure that they are under?
Respite care was one of the themes of the carers action plan that we published last year. SCIE is putting together guidance for local authorities on how they can best provide that crucial respite moment for those brilliant carers. [Interruption.]
A diagnosis is very much for an individual, but also for their families and loved ones and for their communities and workplaces. When those come together, it is possible to live well with dementia, as my hon. Friend the Member for Witney (Robert Courts) said. Such personal experiences make me passionate about my responsibilities as a Minister. The hon. Member for Halifax (Holly Lynch) challenged me to continue to push the Government to keep dementia as a priority, and I always will. I am proud of the Government’s commitment to deliver on the dementia challenge 2020 in full to make this the best country in the world to live for anyone with a dementia diagnosis.
The challenge aims to transform the lives of people with dementia, as well as their carers and their families, through better awareness, care and research. We have made significant progress as part of the challenge, but we know, as we have heard today, that there is still much more to do. We have already started our work on our strategy for the period beyond 2020. This is not something that finishes in 2020. It is simply the start of the next phase and we will publish our thoughts on it early next year.
One of the key successes of the challenge has been improved diagnosis. We are meeting our ambition, and today two thirds of people living with dementia receive a diagnosis, but we clearly still have some way to go. Of course, not everybody wants a diagnosis, but we know that a timely diagnosis enables a person with dementia to access the advice, information, care and support that can help them to live well with the condition and remain independent for as long as possible.
We are focusing on reducing the variation in local dementia diagnosis rates. There is a real geographical variation, and targeted support to identify and engage the areas most in need of assistance will really help. Reducing the gap in diagnosis rates will ensure that people with dementia have consistent access to a diagnosis wherever they are in the country. We also know that receiving good quality care improves the lives of people with dementia. Equipping our health and social care workforce with the skills that they need is therefore crucial to the quality of care for those living with dementia.
Since 2012—the hon. Member for Bradford South (Judith Cummins) mentioned this—1 million episodes of the tier 1 dementia awareness training have been completed by NHS staff, and more than 1 million care workers completed the care certificate, or common induction standards. We continue to work to meet our commitment that staff have the training appropriate to their role. We want to see more people doing the tier 2 training, which is much more robust, so we are exploring options to see how we can increase take-up for anyone who needs it.
That is an interesting question. I do not know the answer, but I would be keen to look into it to find out. We are looking to explore ways to encourage the take-up of tier 2 dementia training. I recently co-signed a letter to health and care organisations with the chief executives of Skills for Care and Health Education England to highlight the importance of dementia training and education, which is a really important part of our discussions.
We are also meeting our commitment on Government funding for dementia research of £60 million or more each year, to reach at least £300 million invested over the five years up to 2020. The figure is actually more than £60 million this year—it is £83.5 million. In addition, we have the UK Dementia Research Institute, which is funded to the tune of £290 million: £190 million from Government and £50 million each from the Alzheimer’s Society and Alzheimer’s Research UK.
I thank the Minister for giving way and apologise for the earlier interruption; I am glad it did not put her off her stride.
Much of what we have discussed today—the issues around this illness—are devolved to Scotland, but I want to press her on an issue that is not devolved: legal protection for older people with dementia. What measures can be put in place for financial institutions to have a legal duty of care to look after those people? In the debate we have focused on the practicalities of care, which is important, but we have to think about how we protect people in law in financial terms.
I thank the hon. Lady for that intervention. I am sure the slight disturbance caused by her mobile created a welcome distraction for everybody from my speech. I took note of what she said in her speech and she makes an excellent point about protections.
To go back to research funding, the incredible dementia discovery fund, which other Members have mentioned, was launched by David Cameron in 2015. It is the world’s largest venture fund aimed at a single disease area that looks to develop novel pre-clinical therapies. Our continued commitment to support research has also seen increasing numbers of people involved in the joint dementia research programme, with 20,000 people taking part in dementia research studies. To answer the question asked by the hon. Member for Vale of Clwyd (Chris Ruane), I am happy to meet and discuss any other research that comes forward.
Ahead of developing new treatments, we need to be able to support people to live well with dementia in their communities. The Dementia Friends programme, which a lot of people have mentioned—I am also a Dementia Friends champion—is a great example of increasing public awareness. Through the dementia-friendly communities programme—365 so far this year in England— we are making society more inclusive. We are supporting the National Dementia Action Alliance’s work to promote dementia-friendly hospitals across England through its charter to improve the care that people receive.
My hon. Friend the Member for Witney asked me about writing to the Department for Work and Pensions about improving its guidance to employers, which I will commit to do. We know that careful reforms are required to ensure that the social care system is prepared for the challenges of an ageing society, including for those with dementia. Many Members, including the hon. Member for Cambridge, mentioned adult social care funding. Many Members also talked about cuts to local authorities, but over the past year we have given councils access to an additional £10 billion: an 8% real-terms increase.
However, the fact that we are still talking about the social care system being on the point of crisis, at a tipping point or under huge pressure, shows the scale of the problem. That is why we have committed to publishing the adult social care Green Paper at the earliest opportunity. I share everybody’s frustration about the delays, but it will set out ideas for an element of risk pooling to save individuals from catastrophic costs, which some have spoken about today. We are committed to ensuring that everybody has access to the care and support they need. More short-term social care funding will be agreed alongside the rest of the local government settlement in the forthcoming spending review.
The NHS long-term plan sets out a 10-year strategy, outlining how the NHS will spend the £33.9 billion cash terms annual increase that will go into the NHS budget. We now know that around a third of dementia cases are preventable. Since 2018, every person attending an NHS health check in England—the hon. Member for Burnley (Julie Cooper) mentioned prevention—receives information about how to reduce the risk of developing dementia. It includes advice on smoking, safe levels of alcohol and being physically active. Between 2013 and 2018, nearly 7 million people attended health checks.
My hon. Friend the Member for Chichester (Gillian Keegan) mentioned Careline in her constituency. There are lots of innovative ways that technology can improve the lives of people with dementia. Jelly Drops are an ingenious way to tackle dehydration using sweet-like capsules. My local county council in Hampshire uses existing technology such as Amazon and wearable technology to help people maintain their independence, stay safe and combat isolation. All those achievements, brought together in the dementia challenge 2020, help to improve the lives of people with dementia, but we know that more needs to be done. We are committed to continuing to improve the lives of people with dementia, and of their families and carers.
I thank everybody for their excellent contributions to a really important debate. I particularly thank those who shared their personal stories. Such empathy makes a difference to people who have dementia and to their carers, and I thank Members for that. There were examples of excellent practice. In different parts of the country, excellent work is going on, and we need to make sure that it goes beyond Members’ own constituencies. The key thing is national leadership. I know the Minister is committed. On the areas around housing, transport and social protection, which are not necessarily in her brief, I would be grateful if she made sure her colleagues are aware of the recommendations.
Motion lapsed (Standing Order No. 10(6)).
Gambling Levy: Online Gambling and Greyhound Racing
I beg to move,
That this House has considered the gambling levy from online gambling and racing greyhounds.
It is a pleasure to serve under your chairmanship, Mr Paisley, and to lead this debate. In 2016, as Chair of the Environment, Food and Rural Affairs Committee, I led an inquiry into greyhound welfare. At the time, we found that there was a distinct lack of data, the regulation was not strong enough, the inspection regimes were insufficient, and there was poor welfare in parts of the greyhound racing industry. We recommended improvements in each of those areas, but funding continues to hold the key to lasting improvements.
I compliment the industry on going forward in many ways. Today’s debate is not about finding fault with the industry; it is about concentrating on the betting industry and the £2,500 million a year that is bet on greyhound racing, and ensuring that enough of that gets to animal welfare charities and the industry in order to make the life of retired greyhounds so much better.
My grandfather kept greyhounds, so there is a particular interest in them in my family. I agree that these dogs are not simply assets; they are living and breathing, and deserve a minimum of care. A small statutory levy may well bring about that standard of care. Does the hon. Gentleman agree that a 1% levy will not break the bank for the bookies, but will help a poor animal to avoid a broken leg from inadequate nutrition and the strenuous nature of the races it is involved in?
My hon. Friend—I believe him to be my hon. Friend—raises a very good point. Not only would 1% not break the bank for the betting industry, but without greyhound racing the gambling industry would lose £2,500 million a year. I will be quite blunt: I think it is criminal that the industry does not pay 1% or more—1.5% or even 2% if necessary. There is no point in imposing a levy for the sheer sake of it, but we have to remember that back in 2008-09 we were on some £14 million. Since then, the amount has probably halved. We are building it back up to £10 million now, but I would like to see around £20 million going towards rehoming greyhounds.
The public demand good welfare—it is also in the interests of the industry—and for the betting industry to deliver that money. Otherwise, there will be huge pressure not to have greyhound racing at all. That is the point I stress. The amount of welfare funding at the moment is a voluntary 0.6%. I will talk about the good companies that come up with that. Previously, too few betting companies have coughed up the cash, and there are still a few more to go—especially online betting companies based overseas.
I congratulate the Minister, and her predecessor, my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), on getting the bookies around the table, and on getting them to contribute to the British Greyhound Racing Fund, which was set up to protect greyhound welfare. I also congratulate the betting companies themselves—Betfair, Betfred, Sky Bet and William Hill—that have committed to meet the 0.6% target in January in this year, raising a projected £3 million a year. That will take the total amount raised up from £7 million to £10 million.
However, too many companies still do not contribute. Many independent bookmakers, and a growing overseas betting presence, do not pay their fair share. Not only is it wrong from the point of view of the greyhounds’ welfare, but it is wrong for the rest of the betting industry, because if some companies are making that donation so should they all. Bookmakers profiting from greyhound racing have a responsibility to support it, whether they trade on the high street or online. Of course, high street bookmakers have contributed and still do.
When we consider that £2,500 million is staked annually on live greyhound racing in the UK, the welfare conditions of some of those animals remain shocking. They are improving, but with more money they could be much better. Greyhounds bred for racing are animals, not assets. They are gentle, athletic breeds. They feel pain, whether due to damaged limbs or dental problems, and they need love like any other dog. We must ensure that all kennels are up to scratch.
I thank the Greyhound Board of Great Britain for all the work that it does inspecting and helping to raise standards, and I thank the Kennel Club, the Greyhound Trust and other welfare charities for the great work that they do in rehoming greyhounds. An increase in cash for the British Greyhound Racing Fund would make a great difference to greyhound welfare. Even the commitment made in January for the betting companies to reach 0.6% merely reverses a decade-long trend of drastically declining income from the voluntary levy paid by bookmakers.
Income for the British Greyhound Racing Fund has fallen by half in the last 10 years, from £14 million in 2008-09 to just £7 million last year. While online betting continues to thrive, retail betting is suffering. Some 60% of BGRF funding currently comes from retail betting, but the introduction of the £2 maximum stake for fixed odds betting terminals which, by the way, I am very much in favour of, will result in a decline in the amount of money received. That is why we need to increase the percentage of the levy.
A statutory levy that targets greyhound betting equally, levied on all bets placed on UK greyhound racing, will be fair on betting companies and on greyhounds. A strong greyhound welfare system requires strong long-term financing. Take horse-racing as an example. The horse-racing betting levy covers the gross profits of all gambling operators offering bets on horse-racing in Great Britain. Last year alone, the 10% statutory levy on profits generated around £100 million to support infrastructure improvements, a reduction in injuries, better data and higher prize money.
A similar statutory levy on greyhound racing, but based on 1% of gross turnover, would generate £11.6 million for greyhound welfare. A levy of 1.5% would generate £17.5 million. That is where I would like it to be at the very least, because I do not believe that it would affect the industry very much at all. In fact, it would make for a stronger industry. Immediately, the money would provide a more stable income stream for animal welfare activists and charities that improve kennelling standards, pay for veterinary bills and rehome greyhounds. It would also create an even playing field between contributing bookies.
As the sixth most-watched sport in Britain, the welfare and care of all racing greyhounds, from registration to retirement, must be a fundamental part of its successful future. Last year, 4,963 injuries were sustained by dogs in the greyhound racing industry. We welcome the industry giving those figures, because that was something that we put in our report. Almost 1,000 died or were euthanised. I do not want greyhounds to be euthanised because it is not economic to keep them going. That simply should not happen. Enough money should come from the betting industry to rehabilitate those dogs and get them rehomed.
A campaign is under way to ban greyhound racing altogether. I believe a statutory levy will better protect welfare and the industry in the long run. The industry should embrace that—if it does not, greyhound racing will be under pressure in future. It is wrong of the companies not to embrace the levy and pay more. I congratulate the Minister and the gaming companies that have contributed a voluntary levy on their hard work, but I urge her to do more and greater things to get more money out of the gaming industry.
After Brexit, the Government should come forward at the earliest opportunity with primary legislation to introduce a statutory levy, to equalise welfare contributions and protect greyhound racing. Believe it or not, the statutory levy on horse-racing was introduced before we joined the EU, and it is quite difficult to introduce a levy under EU law. As we leave the EU, we can put a statutory levy on online gambling and racing greyhounds. I would very much welcome that, because putting it in place would bring into line a lot of the gambling companies that are not paying at the moment. We in this House, and people across the country, all want our greyhounds to have a good retirement. Let us ensure that those that can be rehabilitated after racing have a good life. We can then have a good industry that is well run with good welfare conditions that are well funded by the gaming industry.
I congratulate my hon. Friend the Member for Tiverton and Honiton (Neil Parish) on securing this debate and on giving us a chance to speak about the breadth of areas he mentioned. It is absolutely right that we do so, because greyhound racing employs over 7,000 people in the UK, with over 2 million people attending races each year. It contributes an estimated £55 million to the Exchequer.
I welcome the opportunity to discuss the Department’s positive work, including by my predecessor and my officials, to ensure that we have supported greyhound racing, that we increase bookmaker contributions and, vitally, that the welfare of our greyhounds is protected and indeed improved. We recognise the challenges that the sport has faced over the past few years. There has been a decline in racecourse attendance, and betting has progressively moved online, resulting in a drop in contributions from gambling operators to the British Greyhound Racing Fund.
The hon. Gentleman’s words are gratefully received, and in January we announced progress on additional voluntary funding—a commitment to the welfare of greyhounds. It is worth an estimated additional £3 million this year, increasing the expected income to around £10 million annually. This commitment will significantly improve the welfare of thousands of greyhounds, both on and off the track, and it will further support retired or injured greyhounds, ensuring they can enjoy a full and active life—as we heard—both inside the sport and in retirement. Although we recognise that it is a positive step in securing additional contributions from the five largest online betting operators, I am aware—the hon. Gentleman has also made the point—that we want more money for welfare. I therefore urge bookmakers that have not signed up to the agreement to do so to meet their welfare obligations to the sport and the animals.
The most difficult part is that, to a degree, we can name and shame companies that are not contributing, but those that are offshore and well away from the UK probably do not worry too much about their reputation. How do we get at them to ensure they contribute? More people are moving to offshore online betting.
On welfare and levies on gambling, my Department has to ensure that bookmakers are at the table. Where profits are in this country, we should seek to ensure that they go back for the good of the sport or to support other areas where there are vulnerabilities. I take his point and will write to him.
The Department has a responsibility to ensure that all bookmakers meet their obligation. I will be meeting the Remote Gambling Association next month, when this will be on our agenda. I also recently met the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Macclesfield (David Rutley), who has responsibility for animal welfare, to discuss our respective Departments’ funding and welfare concerns, and to ensure that it continues to be an important issue across Government. I also met the Greyhound Board of Great Britain, alongside the RSPCA and the Dogs Trust, to discuss everything the industry has to think about on greyhound welfare. I have made it clear that welfare should be at the heart of the sport, as my hon. Friend said, and that standards should be as good as they can be, so that the sport will remain an attractive spectacle and continue to thrive by having people enjoy it. I will continue that work with Department for Environment, Food and Rural Affairs, so that industry representatives and everyone involved ensure that greyhound welfare is absolutely safeguarded. Any greyhound put to sleep due to medical treatment being too expensive or a poor prognosis is one too many, and we must stop it.
The publication of GBGB’s “Greyhound Commitment” is welcome and marks a sea change for the greyhound racing industry. It is driving up welfare commitments and standards, which is what we want, and has led to an increase in voluntary funding. Alongside the publication of the injury and retirement figures in 2018, the “Greyhound Commitment” makes it clear that we are making progress on this journey. It also shows that there is much more to do, and I want to ensure that we continue our commitment to drive these changes.
Over the next three years, GBGB has committed to halving the number of greyhounds that are regrettably put to sleep due to their not having a home or for economic reasons. The ultimate aim is to bring the figure down to zero within five years, which is absolutely right and an expectation that I thoroughly support. Hon. Members all want greyhounds to find new homes and enjoy a healthy retirement when they leave the sport. There are positive signs of the industry stepping up to the challenge that my hon. Friend laid down in the 2016 Environment, Food and Rural Affairs Committee report on greyhound racing, to build capacity and strengthen welfare in the system rather than just waiting for legislation and indeed enforcement.
On the voluntary commitment, bookmakers and the industry can play an important part in ensuring that there is enough funding for the greyhounds and integrity in the sport. Of course, this is only one source of income for the sport. More than half of the industry’s income, totalling around £119 million, comes from existing commercial agreements and racegoers. It is important that the industry looks at ways of increasing commercial income, so that more support can be used to benefit welfare and raise standards. As my hon. Friend said, we cannot do that without greyhounds being at the heart of the matter. Putting the welfare of animals at the heart of the sport, and supporting that with funds from existing commercial income, can only sustain and support the industry further. Greyhound welfare is an objective that we must all share to guarantee the long-term future of the sport.
Online betting on greyhound racing has increased in recent years, and the industry should continue to seek opportunities to generate more commercial revenue through online streaming and media platforms. That is another avenue through which we can support the industry directly.
The Government do not currently plan to introduce a statutory levy. My hon. Friend mentioned that state aid is one reason why a levy is problematic. Things may change post-Brexit, but we expect progress even without introducing a levy.
I accept what the Minister says, but I am a great believer in needing quite a big stick to bring people into line now and again. I would have thought that the idea of bringing in a levy in future would concentrate minds in the industry. If it delivered the 1% to 1.5%, we would perhaps not need the statutory levy, but sometimes the stick needs to be available.
My hon. Friend tempts me. I have never said, for any other aspect of gambling, that levies are off the table. At this point, the Government do not currently have plans to introduce a levy but, as I said, that does not stop us from working with all available tools to ensure that the sport has a successful future.
The Department for Digital, Culture, Media and Sport has committed to securing new funding from online operators, which was worth around £3 million to the sport in January of this year. As I said, that raises the total income to around £10 million annually, which ensures that we can work with GBGB on its long-term strategy for welfare, and shows the cross-Government commitment to doing what we can with the tools that are currently on the table to ensure that the industry is up to scratch. I take this opportunity to remind all operators to ensure that they are contributing and that we maximise commercial income from the sport so that we can deliver on our welfare commitments.
I thank my hon. Friend for raising the issue of the welfare of greyhounds. We need to make sure that we have a stronger industry in which the greyhound is at the heart of the sport. As we heard from the hon. Member for Strangford (Jim Shannon), there is a passion for making sure that that is the case. I remain confident about the new funding commitment announced in January. We will help the sport to ensure that welfare standards are met and maintained.
Like my hon. Friend, I urge all non-paying bookmakers to contribute to the fund so that we can sustain the sport’s future. I commit to working with DEFRA and with bookmakers to make welfare the priority, and to keeping everything under review, making clear that bookmakers should continue to meet their obligations to the sport. I have been delighted to speak about the progress that we have made so far this year. We will always keep everything under review.
Question put and agreed to.
[Stewart Hosie in the Chair]
I beg to move,
That this House has considered abolishing child imprisonment.
It is a pleasure to serve under your chairmanship, Mr Hosie.
For decades, what has been happening to the forgotten children imprisoned across England and Wales is state-supported and state-sanctioned child abuse. Worse still, those in this place who have the power to stop it have not done so.
At present, 727 children are in prison: 81% in youth offenders institutions and 19% in secure training centres. The lives of many of those children before prison were marked by significant harm and suffering. Up to 92% of children in custody have suffered prior physical or sexual abuse, or neglect, and nearly half have been in the care system. Children in custody are three times more likely than their peers to have suffered the death of a parent or sibling, and three times more likely to have unmet mental health needs. A quarter of them identify themselves as disabled, with one in five having special educational needs. Children who identify as black, Asian or minority ethnic are disproportionately overrepresented. When there is a reduction in the size of the overall youth custody system but a rise in the number of BAME people represented in it, my right hon. Friend the Member for Tottenham (Mr Lammy) put it well when he said that there is discriminatory practice and institutional racism in the prison system and that something is just not working.
Children in such institutions have significant needs, which would be better met in a nurturing, specialised and therapeutic system modelled on the secure children’s homes ethos in which child welfare is the overriding concern, as recommended by the End Child Imprisonment coalition. At present, 65% of children go on to reoffend within a year of release. A child-focused environment, with an end to the slash and burn of austerity stripping away support and mental health services, is likely not only to reduce reoffending but to stop reoffending in the first place.
In 2016, the Government committed to closing youth offenders institutions and secure training centres for good. They know that the findings of the Youth Custody Improvement Board, the Youth Justice Board and Her Majesty’s chief inspector of prisons—that those institutions are not fit for purpose and not safe for children or young people—were right.
I am grateful to my hon. Friend for securing this important debate. Successive reports and inquiries have found that children’s prisons are unsafe and unable to meet even basic needs. The Howard League for Penal Reform reported that a child in Feltham spent 23.5 hours a day in a cell for 55 days in a row. Does she agree that we need to invest urgently in children’s centres so that children are not kept in such awful conditions?
I thank my hon. Friend for her intervention. She cites one of the examples that I will consider.
Three years after that 2016 announcement, those institutions remain. Only this year, the chair of the independent inquiry into child sexual abuse stated that she was
“deeply disturbed by the continuing problem of child sexual abuse in these institutions over the last decade.”
Report after report shows that life for children in prison consists of systematic denial of basic physical needs such as nutritious food, fresh air, exercise, and warm and comfortable shelter. Children live in environments permeated with violence, uncertainty and fear, where meaningful adult contact and education are limited or non-existent.
Adults living in such an environment would struggle. For any child, living with those heightened levels of anxiety and fear, with no trusted adult to confide in or to seek help from, will surely result in trauma and mental health difficulties. It is therefore perhaps not surprising that incidents of self-harm increased by 159% between 2014 and 2017, or that the Royal College of Psychiatrists reported that up to three quarters of doctors specialising in mental health in prisons do not think that it is possible for them to provide adequate care because of the conditions in which they are working.
When children react negatively to such an environment, they are punished with segregation—solitary confinement, which the United Nations defines as being locked indoors for 22 hours per day—or pain-inducing restraint. Recently, my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) led a debate on youth solitary confinement in which the Minister, as he may recall, said that
“children are never, and should never be, subject to solitary confinement in the UK.”—[Official Report, 2 April 2019; Vol. 657, c. 339WH.]
Instead, he said, they are “segregated” or “removed from association”.
Such statements are repeated in ongoing and lengthy correspondence that I have had with various Ministers from the Ministry of Justice and the Department for Education. As they tie themselves into semantic knots, the repetition of statements to the effect that solitary confinement is not used is simply at odds with the facts. In 2017, the Howard League advocated on behalf of that young boy who had spent 23.5 hours per day in his cell for 55 days in a row. Last year, an investigation by the “Victoria Derbyshire” show found that in the previous year, at least 40 children had been held in their cells for at least 22 hours per day.
Just this week, the children’s rights charity Article 39 informed me about two boys, one aged 15 and one 17. They both have serious mental health issues. They are waiting for medical care and are stuck in solitary confinement for between 22 and 23 hours per day. As they are confined to their cells, prison officers observe them in shifts through a perspex door. When the boys are allowed out of their cells, they are not permitted meaningful contact with their peers. Planned health appointments are missed due to staff shortages and doctors who do visit them can talk to and observe them only through a hatch. Reportedly, that level of confinement would be enough to induce a mental breakdown and possibly psychotic mental states. Article 39 told me about another young boy who was subject to solitary confinement. He was acutely psychotic and in need of urgent in-patient care and treatment, but he sat in his cell for more than four weeks until a suitable hospital placement was secured and he was transferred out of prison.
This year, the Joint Committee on Human Rights published a report stating that
“pain inducing techniques and solitary confinement…are…not compliant with human rights standards”.
The Committee called for such techniques to be banned. The report also states:
“Data…shows that children are restrained too often, with…thousands of unjustified restraints each year, and that separation is also used too often”,
adding that staff are too quick to use restraint or separation.
The permitted use of pain-inducing restraint is beyond comprehension. Prisons are the only institutions in which staff are trained and permitted to inflict pain deliberately on children. Adult staff are given a green light to cause significant harm to a child in their care. If a parent, foster carer or anyone else behaved in that manner, they would be deemed to be breaking the law and would be dealt with appropriately. In the stark and unforgiving world of children’s prisons, however, apparently it is okay for adults to cause significant harm to vulnerable and frightened children. In the past, I have worked with incredibly distressed and—some would say—violent children who have lashed out. I know that is difficult, but staff in those institutions are put in impossible situations. Their training and the option that they are given is always about restraint. Better training and support are needed for those staff as a matter of urgency.
The techniques referred to as minimising and managing physical restraint are put into four categories: low, medium, high level and pain inducing. The exact details of those techniques are kept hidden from the public, as the Government state that they reflect those used in adult prisons. We do know that sometimes children are kept in holds on the floor for more than 15 minutes, on their front or back. There are reports of children losing consciousness, with blue lips, fingernails and earlobes, having difficulty breathing and vomiting. One boy’s wrist was described as “snapping like a pencil.” Despite the screams, the restraint continued.
Data for the last year from the Ministry shows that medical attention was required in 668 use-of-force incidents. Of those, 30 were so serious that the young people had to be admitted to hospital. In the past, some incidents have even resulted in death, either directly or afterwards when children, unable to take any more, have taken their own lives. I know the Minister will be familiar with the cases of Gareth Myatt and Adam Rickwood. Their deaths led to MMPR, which we know is comparable to restraint used in adult prisons but, as I said, we cannot see. We do not really know the true extent of the pain being inflicted on those children.
The children who have been significantly harmed and are no longer with us deserve to have their stories told. Their lives mattered. For children who are in prison now and future generations, a whole new approach is needed. I respectfully say to the Minister that secure schools are not the answer. After all, 20 years ago that was what secure training centres were supposed to be but, as today’s debate shows, they have evolved into something far uglier than their remit of excellence in care and education. Furthermore, having Medway as the experimental site for this new model is not only grossly misguided, but smacks of a lack of understanding of how culture, custom and practice infect an institution and never leave. Rebranding while the centre is still classed as requiring improvement for child safety will not lead to the improvements for which the Minister hopes.
The campaign to end child imprisonment, of which I am sure the Minister is aware, is formed by a coalition of groups with a deep understanding of children’s prisons, child development and children’s rights. Those groups are campaigning not just for the closure of those prisons and a more child-welfare-based model, but for a move from responsibility for children’s detention towards children’s services. They want a change in the law so that deprivation of liberty is always an absolute last resort, and to remove punishment and deterrence as reasons for imprisoning children. I would like the Minister to respond to the campaign’s asks, and to outline the Ministry’s timetable for phasing out those institutions. I would appreciate it if he could tell us when we can expect the findings and recommendations of the review of pain-inducing techniques that began more than a year ago.
We are debating the harrowing and frightening lives that some children have to endure day in, day out. Those are children for whom the state has sole responsibility. I urge the Minister to take serious action: abolish child prisons before more harm is done. It is not only his professional duty but his moral duty to do so.
I congratulate the hon. Member for South Shields (Mrs Lewell-Buck) on securing this debate and on the conviction and professional knowledge she brought to bear on it.
I am afraid I do not have much knowledge of the prison estate; I am speaking for the specific reason that shortly after I become an MP, around the turn of the century, there was an upsurge of interest in precisely this problem and a great flurry of official and ministerial attention. As far as I can see, absolutely nothing was learnt from that time. The events centred on Feltham young offenders institution, which is close to my constituency. There were disturbances; there was a suicide caused by racially aggravated bullying, and many of the things we just heard about were reported in the press. I went there several times with other MPs, and there was an investigation and a report.
Seemingly, the problems had been solved, because the Government at the time and the prison authorities put in more staff; overcrowding among 16 to 18-year-olds was greatly reduced and we were told that the problem had gone away. But it is clear from reports from the same institution and others that many of those problems are still with us in exactly the same form or are considerably worse. It is worth rehearsing some of the main findings from that time, many of which seem highly relevant today. I want to test the Minister’s institutional memory, to know whether he is even aware that we are going round the same cycle as before.
One of the first major conclusions was the neglect of mental health. We heard from the hon. Lady how the dissatisfaction of professionals and the Royal College of Psychiatrists is a problem, as it was then. A second problem was the complete lack, or very flimsy provision, of education facilities, partly because prisoners were being constantly recycled through the prison estate—they had very short stays and there was no time to acquire qualifications. Those who were doing vocational training in workshops were denied access to equipment because of the fear of harm and self-harm. As a result, most young people were going out on to the streets functionally illiterate and without any practical qualifications, perpetuating their problems.
The third problem, which I think is exactly the same today, was a phase of extreme overcrowding. Professional staff were not there for a very long period and, as a consequence, young prisoners were “banged up” for 23 hours a day. They were also put together in very unsuitable pairings; I went into a cell where a young offender who was there because he had been found using cannabis during his first experience of it was put with a very violent rapist, and was clearly traumatised by the contact with his cellmate. It was patently obvious even to a visitor that it was inappropriate. It perpetuated the problem to have remand prisoners and sentenced prisoners mingling together and learning from each other in a bad way.
The situation then, which I think is now significantly worse, was that there was a disproportionate number of BAME prisoners—then overwhelmingly black, and now black and Asian in greater numbers. I think the Asian population has been affected by extreme religious tendencies that have got into the prison system. We have all those ills, which were supposed to have been cured but appear to be back again in force. The simple question I ask is: why have the lessons not been learned? Why do we not progress from one generation to another? As was very eloquently described, the young people concerned reoffend, and their children will in turn reoffend, unless we learn the lessons of the past.
Sitting suspended for a Division in the House.
It is a pleasure to serve under your chairpersonship, Mr Hosie. I congratulate the hon. Member for South Shields (Mrs Lewell-Buck) on securing this debate.
As a member of the Joint Committee on Human Rights, I am acutely aware of the issues the hon. Lady raised, as a result of our recent investigation into youth detention, solitary confinement and restraint. She also raised wider issues pertaining to the current provision of youth custody, including concerns about not only safety and the use of restraint and force, but segregation of children away from others, the lack of purposeful activity for children in custody, the lack of time out of their cells, the disproportionate number of black and minority ethnic children in custody—the right hon. Member for Twickenham (Sir Vince Cable) referred to that—and the distance from home at which children are sometimes held.
Social work statistics in Scotland in 2017-18 showed an increase of 89% in the average number of residents from outwith Scotland in secure accommodation. That is a form of restriction of liberty, because placing children so far from their family reduces family contact and is clearly detrimental to their wellbeing. I very much endorse the call by the hon. Member for South Shields for children to be placed as close as possible to where they come from.
I have been assisted in preparing for this debate by a helpful briefing from the Howard League for Penal Reform, which historically has had a great deal of involvement in this matter. It was very useful to hear from the right hon. Member for Twickenham how far back these problems go, and how very often the attempts at reform have failed, so that we face the same problems today as we did 10, 20 or more years ago. The Howard League has highlighted the number of children from black, Asian and ethnic minority backgrounds who have histories of care and high levels of health problems. We have children with disabilities held in the sorts of conditions that I have described, and it is simply not acceptable.
It is particularly depressing that the 2017 report by the right hon. Member for Tottenham (Mr Lammy) found that more than 40% of children in prison in England and Wales were from black and minority ethnic backgrounds and that, despite the concerns he raised, that figure has now risen to 51%. That is something that we should all be ashamed of.
As I said, the Joint Committee on Human Rights carried out an investigation into youth detention, solitary confinement and restraint. I will say a little bit about our findings in a moment, but most important for the purposes of this debate is our overall finding that the UK Government must increase its
“efforts to coordinate and reconfigure resources, to ensure that there are enough specialised placements…so that each child can be placed in the most appropriate setting and as near as possible to home.”
We were really advocating for recognition of the fact that these offenders are children, and for a more holistic approach. That is what we have attempted in Scotland, as I will come on to in a moment, and with some success—although I will not pretend that some of the problems we are talking about today do not also occur within the Scottish system.
The focus of the report by the Joint Committee on Human Rights was on solitary confinement and restraint. I must confess that we were greatly assisted by evidence from the Minister responding to today’s debate, who was admirably frank about matters, but some serious questions remain to be answered. Our report found
“substantial medical evidence”
of the significant
“physical and psychological impacts of restraint, particularly when used upon children.”
We were quite clear in our findings that restraint harms children, but it also harms the staff who are trained to inflict it; it undermines rehabilitation, which is the objective of detention; and it contributes to a vicious circle of problems that figure in continued offending by such children.
The Committee found that
“rates of restraint of children…are unacceptably high,”
and that those children’s rights were being routinely breached. We were very clear that the deliberate infliction of pain is
“unacceptable under any circumstances under rights legislation”.
We also stated:
“The use of restraint for maintaining ‘good order and discipline’ must be prohibited in all but the most exceptional of circumstances.”
We recognised that sometimes the behaviour even of children can be extremely challenging for staff, and we recognised the right of staff to act in self-defence when necessary, but we were quite clear that the deliberate infliction of pain on children was unacceptable.
In its report, the Joint Committee also looked at solitary confinement and made it clear that
“the use of separation from human contact is harmful to children if used for more than a few hours at a time and, beyond that,”—
as the hon. Member for South Shields said—
“it can amount to inhuman or degrading treatment that is a breach of children’s rights.”
The evidence we heard showed that incidents of separation—separating a child out from other children where there has been trouble or difficulty—can “drift” so that they end up in what amounts to solitary confinement, which can, in practice, be prolonged.
We were using the term “solitary confinement” to refer to
“isolation from normal human contact”
exceeding 22 hours per day, and “prolonged solitary confinement” where it lasts for more than 15 days.
We noted that many commentators, including all the witnesses that gave us evidence on the issue, disagreed with the Government’s assertion that solitary confinement is not used for children. We agreed with the Government that the guidelines do not permit solitary confinement, but we stated that although Ministers should not allow children to be intentionally placed in solitary confinement, that was, in effect, what was happening: incidents of separating a child out can drift and become severe isolation amounting to solitary confinement. In fairness to the Government, we said that the breach of children’s rights was not a policy decision of the Government, but it was within the Government’s power to prevent it by having closer oversight.
We made various calls, of which the Minister is well aware, on the Government to take immediate steps to ensure that the separation of children from human contact never becomes solitary confinement, and that every decision or review of a decision to extend a period of separation beyond 72 hours should be reported to the Minister, who should lay such information before each House. That might seem an extreme recommendation, but it was in recognition of the fact that we are talking about children and the long-lasting damage that can be done if they are placed in solitary confinement.
Depriving a child of their liberty is one of the most serious actions that the state can take. It must always be used as a last resort, and for the shortest possible time. As I have said, my colleagues in the Scottish Government are committed to reducing the number of young people in custody, and they have had some success in doing so. In Scotland, there has been progress on this issue over a long period of time. In the 1960s, after the Kilbrandon report, Scotland moved to a holistic system of justice for children, and the children’s hearing system was set up for all children under 16. The key difference was a move from an adversarial system to an inquisitorial approach, whereby children’s offending is dealt with by a lay panel, with the idea that we should look to the causes of children’s offending rather than subjecting them to the same criminal justice process as adults.
Many years later, the Taylor report made a recommendation for similar reforms to process in England and Wales. It recommended that all children who plead guilty should be diverted from court to a panel that would investigate
“the causes of the child’s behaviour, including any health, welfare and education issues, and put in place a rigorous Plan that will tackle the factors associated with the offending and give victims and communities assurance that the behaviour is being addressed.”
It is a matter of regret that that recommendation has not been taken up by the United Kingdom Government. Ministers in the Home Office and Ministry of Justice have frequently said that there are aspects of criminal justice policy in Scotland that are useful for the Government of England and Wales to look at in relation to good practice. If we go back to the process by which we deal with children who offend, it might be possible to reduce the number of children who need to be held in a secure setting and therefore reduce the sorts of problems that we are discussing. I ask the Minister to address that issue as well as the questions that have been specifically addressed to him by the hon. Member for South Shields.
Will the Minister explain to us why the Government are prepared to look at only some parts of the Taylor report, and why the UK Government are not looking at a system for England and Wales similar to Scotland’s children’s panel? I also want an assurance from the Minister that the Government—not just him—will take very seriously the recommendations of the Joint Committee on Human Rights. I am sure, given his evidence to the Committee, that such an assurance will be forthcoming. The recommendations were agreed unanimously among Members of both Houses, across all parties, and focused on restraint and solitary confinement.
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friend the Member for South Shields (Mrs Lewell-Buck) for securing this important debate. She is a passionate campaigner for the rights and fair treatment of children, and the serious and substantial work she does is a credit to her. She made a brilliant speech and, along with the spokesperson for the Scottish National party, the hon. and learned Member for Edinburgh South West (Joanna Cherry), covered most of the pertinent points, including on solitary confinement and segregation, which was the subject of a lengthy debate in this place not long ago. I will come to that later in my speech.
Another pertinent point made by my hon. Friend the Member for South Shields and the hon. and learned Member for Edinburgh South West was on the blurring of the lines. The Government are adamant that no child is subject to solitary confinement, but the line between segregation and solitary confinement is blurred. Although the Minister’s intentions are not to be doubted, we need further clarification. The other pertinent point made by all who have spoken was on the sheer disproportionality in BAME representation in our youth estate: more than 50% is the current figure, which is shocking and cause for concern.
It is widely recognised by innumerable studies, reports and testimonies that child and young offenders are some of the most troubled and challenged groups of people in our society. Although they face many of the same issues that all young people do, they also face challenges and have needs of a far more extreme and pressing nature, and their experiences are far from typical of those faced by other children. When compared with the general population and their peers, children in custody are far more likely to experience mental health issues. Figures published by the prisons inspectorate and information collated by the MOJ both state that around 1 in 3 children in custody suffered from emotional or mental health issues. That is worrying enough on its own but, from what we know about mental health issues in the adult estate and wider society, the figure is expected to be much larger in reality. In many cases, mental health issues are aggravated by substance misuse, with nearly half of children assessed as having a substance misuse issue on entering custody—that figure too will no doubt be higher in reality.
Children who have spent time in care, with all the emotional distress, the huge disruptions to their lives and schooling, and likely prior abuse and trauma that life in care brings, are also much more likely to end up involved in criminal activity, and they are disproportionately represented to a significant degree in custody as a result. Less than one in every 100 children in England are in care, but they account for around two in every five children held in secure training centres and young offender institutions.
The Government’s review of youth custody—the Taylor review, to which hon. Members have referred—found that around nine in 10 children held in custody had been excluded from school at some point. Forty per cent. of the under-18s surveyed reported that they had not been to school since they were 14 years old. Many young people in custody are also further hampered by a range of additional mental health challenges that affect their education and learning, with 30% of 10 to 17-year olds suffering from ADHD, more than 50% from dyslexia, and 20% from another learning disability. It is therefore no surprise that their educational attainment is much lower than the national average. The Taylor review further points out that half of 15 to 17-year-olds entering young offender institutions have the literacy or numeracy levels expected of a seven to 11-year-old.
Such a cocktail of challenges and disadvantages are at the core of the drivers of offending for many children and young people. However, despite the challenges, the youth custodial system is fit to neither hold them nor care for them. It is plagued by serious problems that the Opposition have repeatedly warned of, and it is incapable of both ensuring the safety of vulnerable young people and effectively rehabilitating them for life after their release.
We agree that all children should be safe, including those in custody, but on this Government’s watch we have witnessed a marked increase in violence. The Taylor review points out that the number of assaults each month per 100 young people in custody rose dramatically from nine in 2009-10 to 16.2 in 2014-15. Indeed, so bad is the level of violence that the chief inspector of prisons not only described worrying rates of violence and a staggering decline in safety in the youth custodial estate in his 2017 and 2018 annual reports, but was forced to declare that no young offender institution or secure training centre is safe to hold children and young people.
Just today the inspectorate published a report into Her Majesty’s Young Offender Institution Werrington that found that violence remains far too high. That follows a report into the notorious Feltham prison, referred to by a number of Members, which also saw a significant increase in violence. The Government like to praise the reduction in the number of children and young people in custody yet, as a result of their cuts to staff and budgets, those still imprisoned are in much greater danger. They have, like with the adult estate, pushed the youth custodial estate into a spiral of violence, where neither children nor staff are safe.
Children and young people imprisoned in the youth estate are also significantly more likely to carry out acts of self-harm as the vital support once available to vulnerable individuals is eroded and becomes yet another victim of cuts. Self-harm rates in youth custody have soared in a matter of just a few years, almost doubling from 5.1 incidents per 100 children in the year to March 2012 to nine incidents per 100 children in the year to March 2017.
Earlier this month, we saw that the rate of self-harm had doubled at Feltham, some cases of which were extremely serious and involved ligatures or significant cuts. The chief inspector of prisons warned that the
“care for children in crisis was inconsistent”
and that there was no action plan to address the rise in incidents. That is not helped by the fact that more than one in five children feel that it is easy to get illegal drugs into their young offender institution that are proven to aggravate mental health conditions and contribute to rates of self-harm. Nor is it helped by the excessive lock-up of children and young people inside their cells for much of the day—they are often allowed out for as little as 30 minutes for showers, telephone calls and exercise outside.
Thirteen years on from the independent Carlile inquiry into the use of restraint and solitary confinement, children and young people are still being subjected to those degrading and downright dangerous conditions. The internationally recognised Mandela rules state that solitary confinement—I make the point again that the Government call it segregation, and perhaps the Minister in responding could be clearer on what he sees as not the textbook differences but the practical differences between the two—has a devastating effect on physical and mental health, particularly among groups with mental health issues. Despite that, and even its acceptance in the Prison Service rules, in October last year the Children’s Commissioner found that the number of episodes of segregation in youth custody in England and Wales has increased in the past four years, even as the overall number of children detained has fallen.
Her Majesty’s inspectorate of prisons has also raised worrying concerns that the use of force in the youth estate remains too high, with disproportionate force employed against children. So widespread is the use of force and restraint that the UN Committee against Torture took the step of asking the Government to ban all forms of restraint that inflict deliberate pain on children. Perhaps the Minister could enlighten us on the Government’s response.
Finally, to a topical issue—the failures in the youth justice system and youth custodial estate are having a particular impact on BAME children. The failure to tackle needs, the drivers of offending and deep mistrust of the justice system among young people—particularly BAME children—are entrenching disproportionality in the system. Two years ago, my right hon. Friend the Member for Tottenham (Mr Lammy) published his landmark review on the treatment and outcome of those from a BAME background in the justice system. He found that, within the youth justice system, the proportion of those from BAME backgrounds rose from 25% to 41% in the decade from 2006 to 2016. That is a worrying American level of disproportionality that, as he says, leaves the UK sitting at
“the extreme end of the developed world in relation to disproportionality.”
We have heard today that the figure now is higher than 41%. That disproportionality should worry us all, particularly as a greater number of BAME children in the youth justice system live in poor housing, are disengaged from education and are more likely to suffer from mental health issues than their non-BAME counterparts.
The evidence we have heard is clear: the youth custodial estate is in dire crisis, the victim of years of underfunding and neglect by the Government. The Minister faces serious questions over the failure of the youth estate and the Ministry of Justice to keep children safe, treat them humanely, and properly prepare them for release. He must answer our questions and answer for the Government’s failure. He must also set out, as a matter of urgency, a plan to ensure that all children in the youth custodial estate are safe from violence and self-harm; a commitment to end the use of painful restraint techniques and solitary confinement; an explanation of the difference as he sees it between solitary confinement and segregation; and what the Government will do to reduce the unwarranted disproportionality of outcomes for BAME children. We have heard much about that in the last two years, but we have seen little in practice.
I thank the hon. Member for South Shields (Mrs Lewell-Buck) for securing a debate on this important subject. I know of her commitment to pursuing the subject and ensuring that it continues to be spoken about in this House, and rightly so.
Depriving a child of their liberty is an action that should be undertaken only as a last resort. It is not a responsibility that any state ever takes lightly. All parties would accept their responsibility for our youth justice system and this area, having served in government. I draw a slight distinction for the hon. and learned Member for Edinburgh South West (Joanna Cherry), although one place I hope to visit—I am always happy to learn from the Scottish experience where possible—is HMYOI Polmont, which would be interesting as a comparator for how the English and Welsh system operates.
I am deeply committed to improving outcomes for children who offend. As all speakers have set out, children who enter the youth justice system are some of the most vulnerable in our society and are disproportionately represented in other at-risk groups with multiple and complex needs. It will not surprise my shadow, the hon. Member for Bradford East (Imran Hussain), to know that I take issue with a number of his points, but I share his view. He set out eloquently the characteristics and context for that cohort of young people who end up in custody. For instance, of 555 children surveyed in YOIs in 2017-18, 16% considered themselves to have a disability, 30% reported emotional or mental health problems, and 45% had been, at some point, in local authority care. It is a key priority for me and this Government to ensure that such children receive the support and interventions they need to fulfil their potential and live a crime-free and constructive life.
The principal aim of our youth justice system, and indeed our justice system, must be to protect society. I argue that we do that most effectively by breaking the cycle of reoffending and enabling effective rehabilitation. To deliver a youth justice system that understands and addresses the underlying causes of offending—a range of bases and other factors, and past trauma buried somewhere in that young person, which the shadow Minister was right to allude to—must be key. We can then ensure that every child has the opportunity to turn their life around and move on from their previous offending behaviour.
I am grateful to the right hon. Member for Twickenham (Sir Vince Cable). It is always a pleasure to hear the leader of the Liberal Democrats speak in Westminster Hall, and although I am not sure that my institutional memory is as long as his, he rightly highlighted the context and stated where we have come from. Colleagues who are Members of the House for long enough so often see the same initiatives and ideas come round for a second time—I am not suggesting that the right hon. Gentleman has been here for that long, but he makes a valid point.
We have seen considerable successes in the youth justice system over the past decade and, as has been said, there has been a reduction of nearly 90% in children entering the system for the first time, from just under 100,000 in 2007-08 to around 14,400 in 2017-18. The total number of children receiving a caution or sentence has decreased by 82% from around 146,500 in 2007-08, to around 26,700 in 2017-18. Importantly, we have seen an unprecedented reduction in the number of children in custody, which has reduced by nearly 70% from a monthly average of around 2,900 in 2007-08, to just under 900—it is often lower—in 2017-18.
I will return to those statistics, but one issue raised by a number of right hon. and hon. Members was disproportionality. The justice system must uphold the principles of equality and fairness for all, and in 2017-18 BAME children made up 45% of the youth custody population on average. I am committed to reducing disproportionate outcomes for BAME children in the system, and I share the concerns voiced by the right hon. Member for Tottenham (Mr Lammy) in his 2017 report. Since my appointment almost exactly a year ago, I have worked closely with him. He has been constructive and has welcomed the significant progress in implementing his reforms. It will not surprise hon. Members, however, to hear that he is always clear that he thinks we need to do more and do it faster, but I put on record my gratitude to him for his engagement.
We recognise the need for systemic change, and the principle underpinning that approach is the “explain or change” system. On occasions, there may be a rational and reasonable explanation for something, and we can furnish that where appropriate. If we cannot explain, we should look to make changes that address disproportionate outcomes for BAME children in the justice system. The shadow Minister may be aware that I met his colleague, the hon. Member for Bolton South East (Yasmin Qureshi), to discuss that and the work being done on it, and I am grateful to her for the constructive nature of those discussions.
When a crime has been committed, we have a duty to consider the needs and background of the perpetrator, but also those of the victim and wider community. As such, it is right that courts have the powers they need to sentence children appropriately. With the exception of the hon. Member for South Shields, I note that no one called for the abolition of imprisonment in this context, and I will come on to speak about what should be defined as an appropriate custodial setting. As is her wont as Queen’s Counsel, the hon. and learned Member for Edinburgh South West chose her words exceptionally carefully when referring to custodial settings, and it is an important point.
Does the Minister think that it would be beneficial for the system in England and Wales to follow the lead of Scotland in limiting and doing away with short-term sentences as far as possible? That has worked for adults across the system in Scotland, and reduced reoffending. I know it has been looked at by the Government, but does the Minister accept it is a good idea?
The hon. and learned Lady gently tempts me. She will be aware of the clear statement that I, the Secretary of State and others have made about the effectiveness or otherwise of short sentences. I have often said that a short sentence can be long enough to disrupt family life, education, relationships and home, but too short for any meaningful attempt to grapple with the underlying problems and needs of an offender. There is a particular challenge for young people under 18, because there is already a significant presumption against custody, which must be a last resort.
The offences that attract a custodial sentence—I leave this as a reflection on the nature of the cohort of young people who are in prison—include the possession of an article with a blade or point, common assault and battery, possession of other weapons, robbery, burglary in a dwelling, assault, and actual bodily harm. Those offenders make up the bulk of those sentenced to custody, including with short sentences, and I think that many in this House and beyond would still consider such offences very serious. The hon. and learned Lady will be aware that the Secretary of State set out his intention to bring forward proposals for discussion and consultation on how we approach short sentences, and I suspect that if she is patient, she may see that develop further in the coming weeks.
Is the Minister aware of the success of the violence reduction unit in Scotland, and the diversionary schemes that take a holistic approach to knife crime? Those have succeeded in hugely reducing knife crime in Scotland, particularly among young men, not by locking them away but by taking a holistic approach to the problem. Surely that approach should also be followed south of the border.
I enjoy taking interventions from the hon. and learned Lady, and although I am always somewhat nervous about what may be coming in my direction, she was kind in that last intervention. She rightly highlights the experience in Scotland. We are aware of that, and I take a close interest in it. The debate on the efficacy and future of short sentences is alive, and I am sure that she and other hon. Members will participate in it.
The youth justice system offers courts and other decision makers a range of flexible sentences that can be used to address a child’s behaviour and offending. Those range from informal diversions to cautions, community sentences and custody for the most serious offences. The Government believe that there will always be some children for whom custody may be the appropriate and necessary sentence, but we are equally clear that it should always be a last resort, and for a period of time in line with the seriousness of the offence.
In 2018, 26 sentences were given to children for murder—by “children”, I mean those under 18 who fall into the care of the youth justice system, for which I am responsible—and 44 for wounding with intent to cause grievous bodily harm. In 2017-18, 32% of custodial sentences given to children were for violence against the person and possession of weapons—that goes back to the offences I mentioned earlier. Notwithstanding the point made by the hon. and learned Lady, we believe that those offences involve significant public protection concerns that must also be carefully considered in any future approach.
The age of criminal responsibility in England and Wales is 10. Custodial sentences are available for children from that age, although their use is restricted, and the courts have a statutory duty to consider a child’s welfare during sentencing. Children under 12 will only ever receive a custodial sentence for the most serious offences where neither a community sentence or fine can be justified. Furthermore, we recognise that needs can differ among different age groups, and the sentencing guidelines reflect that. For example, detention and training orders are not available for under-12s, and can only be given to children aged 12 to 14 if they are considered to be persistent offenders. Returning to the definition of “child”, about 95% of those who receive a custodial sentence are 16 and 17-year-olds.[Official Report, 11 July 2019, Vol. 663, c. 3MC.] That is still a small number. I take the underlying point that the hon. Member for South Shields is making, but we should be clear about the age that is predominantly reflected in those who receive custodial sentences.
It is also clear that custody is used sparingly. Although proportions of sentence types have remained stable, the overall numbers are much lower than they were 10 years ago. For example, in 2017-18, just under 1,600 immediate custodial sentences were given to children, in comparison with about 15,500 community sentences. The proportions were 7% and 68%. In 2007-08, there were nearly 5,800 immediate custodial sentences, but the proportions were 6% and 68%, so they have been relatively consistent.
I am clear that custody needs to be in the right environment to rehabilitate children, which goes to the shadow Minister’s point. I have never shied away from the fact that, as I said in my evidence to the Joint Committee on Human Rights, in many cases we are not delivering the best outcomes for children. That is why we are committed to reforming youth custody and ensuring it is a place of safety and learning that is able to rehabilitate the young people who need to be there.
As the hon. Lady and the shadow Minister said, HMIP inspections of YOIs have identified safety and purposeful activity as key areas for improvement. The shadow Minister referred to what the chief inspector of prisons said in 2017-18. He is a decent chap, and I know that he would want to be clear for the record that the Chief Inspector of Prisons subsequently moved away from that and does not maintain that there are no safe institutions. However, he was right to highlight what was said at the time. We have taken several steps to address these issues and in 2017, following that, we began a comprehensive reform programme to ensure that the services provided in custody are aligned with the increasingly complex needs of the children in our care.
Since 2017, the number of operational frontline staff in the YCS has increased by almost 40%. We have recruited more psychologists, healthcare staff and frontline officers, who are being appropriately trained in mental health and trauma-informed approaches. Earlier this year, the YCS began implementing a new evidence-based behaviour management strategy and integrated care framework, and we have built two new enhanced support units for those with the most challenging needs. We are also working with education providers and devolving additional funding to commission more educational, vocational and enrichment activities.
The ability to work with children displaying complex needs requires a very specific, very important set of skills. We are therefore also investing to improve the quality of our staff training. We have introduced a new youth justice specialist role tied to a foundation degree in youth justice to teach the latest in effective practice in youth work and rehabilitation. More than 400 staff have enrolled so far, and we are aiming for every prison officer in the YCS to have undertaken that training by 2023.
There will always be a need for a degree of security and a form of custodial setting. Alongside improving the existing estate, we are changing the fundamental approach. Last year, we announced the creation of the country’s first secure school, to be developed in Medway in Kent, which the hon. Member for South Shields referred to. I have huge respect for her, but respectfully disagree. I believe that secure schools are the right way to proceed to ensure we move away from the concept of a prison with education to that of a school—an educational setting—with a degree of security. I believe that that strikes the right balance.
I would argue that secure schools are not a rerun of secure training centres. The Government recognise that there is a need for a secure custodial setting as part of the youth justice system, but we believe that education should be to the fore. The hon. Lady will have seen that, unlike for secure training centres, we are looking to education providers, rather than to established organisations dealing with custody and security, to run secure schools. We are very clear that, with the investment we are proposing, we can redesign and improve the Medway facility, achieving value for money for the taxpayer and adopting a different culture and approach in that setting.
We have made it clear that we will open Medway as the first secure school, with a second one to follow. However, we wish to assess at each stage how well the system is working, how effective it is, and whether any improvements are needed along the way, so it would be wrong to set a date for a full and complete replacement and roll-out. The hon. Lady would not expect me to do that without testing the new model to ensure it adapts to reflect the experience, as it is completely different from the secure training centres. As I said earlier, all Governments must accept their share of responsibility for the system today. In a moment, I will address the questions that the shadow Minister asked.
We will give the leaders of secure schools freedom and autonomy, similar to the freedom enjoyed by headteachers, to create relationships, care and practice centred around the needs of the children. This new model of youth custody draws on the ethos and practice of schools, with the structure and support of the secure children’s home model. I look forward to announcing the provider of the first one at Medway very shortly.
Despite the successes, children leaving custody are the most likely to reoffend in the whole criminal justice system. Reoffending rates are far too high for children sentenced to custody for six months or less. That relates to the points made by the hon. and learned Member for Edinburgh South West. We believe that short periods in custody can have a negative impact on a child’s rehabilitation. It can disrupt family relationships which, as the second Farmer review showed, can be fundamental to supporting rehabilitation and reducing future offending.
The Secretary of State for Justice set out in oral questions earlier this month the persuasive evidence that short custodial sentences do not work, and that community sentences can be more effective in reducing reoffending and keeping the public safe. I know that Members of all parties share that view, and I hope we will continue to see progress.
Let me turn to some of the questions that hon. Members asked. The hon. and learned Member for Edinburgh South West talked about the need for young people entering custody to be placed as near to their home as possible. She is right that, occasionally, there are needs that mean that that cannot happen. In cases where there has been gang-related violence or serious youth violence, there may be a genuine need to separate some young people in the custodial estate. She is right that that goes to the heart of maintaining family and other relationships.
It is always a pleasure to be cross-examined by the hon. and learned Lady and, indeed, by the whole of the Joint Committee on Human Rights. I have read its report carefully, and I will be responding to it on behalf of Her Majesty’s Government very shortly. I can speak only for this Government. I do not know whether I will still be a Minister in five weeks’ time, but I can speak as one today. We will be responding very shortly.
The hon. and learned Lady mentioned the Taylor review recommendation about children’s panels. That is certainly an interesting idea. The principles underpinning it—understanding and addressing the root causes of offending—are absolutely valid and the right ones to look at in the context of the youth justice system. However, to implement the idea exactly as suggested would, to my mind, represent a significant change to the approach in this country, which still puts a judge, or a sentencer, at the heart of sentencing. As she will have seen from our response, we did not accept that recommendation, because we recognised the broader impact it would have on how our justice system operates.
The shadow Minister, and possibly also the hon. Member for South Shields, mentioned doctors’ access to patients. Doctors can always access patients directly where there is a medical need and the doctor makes that medical judgment.
The hon. Lady and the shadow Minister mentioned restraint. The training around restraint is very clear: it points to de-escalation, and the non-use of restraint is the priority. The training is there to provide officers with the skills to use. On pain-inducing techniques and restraint more broadly, as both hon. Members alluded to, the Taylor review has been under way for a while. One hon. Member—I think it was the shadow Minister, but it may have been the hon. Lady—asked when we can expect that review to be published. I will not comment before it is published, but we have said that we anticipate it will be published by the summer. I look forward to being able to do that and respond in due course, if I am still in this post.
The Minister is being generous with his time. He seemed to indicate that pain-inducing restraint was used only for de-escalation. He will have heard from my opening comments that there is testimony from children saying quite the opposite. This is causing children pain. Has he seen the MMPR? Is he confident that it is not causing children harm? Would he want it used on any of the children he knows?
The point I was making—forgive me if I was unclear—is that the training given to officers emphasises de-escalation as the key and the first step to be taken. It is only when there is no alternative that there is escalating use of different techniques. However, the hon. Lady made her point very clearly. As I said, I will wait until I have seen the Taylor review and we are able to publish it. I suspect that this issue will return to the Chamber in some form at that point.
A number of right hon. and hon. Members, particularly the shadow Minister, raised removal from association. We are clear that that would not be defined as isolation, not least because there is meaningful human contact with officers, medical professionals and, indeed, education professionals, who throughout any period of removal from association bring learning activities to an individual’s cell and work with them. There is no removal of meaningful human contact for the entirety of that period. There is human contact, but the shadow Minister is right that there is a definitional point to be considered. We discussed legal definitions and their different interpretations at length in the Joint Committee on Human Rights. He understandably elevated his point by saying that although we can argue about definitions, he has concerns about numbers and the operation of removal from association.
The shadow Minister also mentioned the assault rate, the segregation rate and a whole range of other factors. I urge a degree of caution with respect to statistics expressed as numbers per 100. I mentioned in my testimony to the Joint Committee that, as the numbers go down, it is largely only those who have committed very serious, often violent offences who are sentenced to custody. They are a very concentrated cohort. As the shadow Minister alluded to, they are challenging and challenged individuals in terms of their backgrounds and experiences, but they are a much more concentrated group who are much more prone to violent offences than previously. That is a challenge. It does not necessarily negate his point, but I wanted to put a bit of context around the statistics and how they are interpreted.
The shadow Minister mentioned budgets and funding. He is a fair and decent man, so I know he would recognise the role played in the financial situation by the previous Labour Government’s mismanagement of the national finances.
This has been a very important debate. We need to think differently about how we deal with children who offend. We must ensure that we place at the heart of the system the need to break the cycle of reoffending before those young people become adults, and we must understand the trauma they have often experienced, which may well be a driving factor in their offending behaviour. The courts should have available to them a wide range of sentencing options for all those who are at the age of criminal responsibility, to ensure that we adequately address children’s offending behaviour. Sometimes, as a last resort, that may warrant a custodial sentence.
I am clear that the term “under 18” encompasses children at many different stages of development, so a different type of sentence, cognisant of the individual circumstances of the person, will be necessary in each case. However, I am also clear that custody should be available as a sentencing option in only the most serious cases. The youth secure estate requires real reform to ensure that custody, where it is used, is used effectively. I will bear very much in mind the comment by the right hon. Member for Twickenham about remembering my history and where we have been before in seeking to ensure that any future change is meaningful and achieves the results we would all wish for.
Let me conclude by thanking you, Mr Hosie, for your chairmanship. I thank all those who contributed, and I thank the hon. Member for South Shields for bringing this important debate to the Chamber.
I thank all right hon. and hon. Members who took part in the debate. In the early stages of the Minister’s response, he seemed to suggest that I did not feel there should be consequences for crimes committed. Let me clarify that that is not my position at all. He seemed either not to have heard me or to have misunderstood the points I was making. Just to clarify, I advocated abolishing child imprisonment and putting in its place secure children’s homes, because that option is in keeping with all the knowledge and understanding we now have about children’s development.
It is disappointing that the Minister’s views on restraint and solitary confinement differ so vastly and wildly from the testimonies of children themselves and of those who work in this environment day in, day out. It is safe to say that I am happy that this House has considered abolishing child imprisonment, but I am not happy that we are not moving forward with it. It is something I shall be revisiting with the Minister imminently.
Question put and agreed to.
That this House has considered abolishing child imprisonment.
Beer Duty Rates
[Mr Philip Hollobone in the Chair]
I beg to move,
That this House has considered differential rates of beer duty.
It is an honour to serve under your chairmanship, Mr Hollobone. I am extremely grateful for the opportunity to raise, again, the importance of beer duty, and pleased to represent all the constituents who have contacted me to ask that we cut beer duty. It is a campaign I am delighted to support. Although I am certainly a keen supporter, I do not believe that an across-the-board cut in beer duty is the best option, as I shall argue in this speech. That is where a differential rate of beer duty is to be much desired. Simply put, it would differentiate between the duty rates for on-trade sales of beer in pubs and the rates for off-trade sales. I am keen for that proposal to be implemented, so I have written to the Chancellor to seek his support—as the Minister will know, having responded to my letter of 23 April. That was my second letter to the Treasury on the intriguing proposal, in which I carefully responded to the points that the Minister had raised in his reply to my first letter in November 2018.
I point out that my hon. Friend wrote to my predecessor, and it was my predecessor, my right hon. Friend the Member for Central Devon (Mel Stride), who responded to him, rather than the present incumbent of this illustrious slot.
I thank the Minister for pointing that out. I am well aware that it was his predecessor; it was the Minister incumbent at the time.
I sent a long and detailed reply to the letter, but the response was almost word for word the same as the first. Four words at the start of one sentence had been removed, and one word and one number—the date—had been changed. I am sure that that was just an oversight in the machinery of the Government; I hope it is not an indication of how much the Treasury wants to debate the matter. We must do more to protect our pubs.
The Minister will tell me that the Government have supported pubs in many ways, notably through the beer duty freeze, which means that beer duty is 18% lower than it was in 2012—hurrah! No doubt that is an impressive achievement, but if we have done so much, why have 11,000 pubs closed in the last decade and why does one pub still close every 12 hours?
I celebrate that positive action; it is great that the duty is 18% lower than in 2012.
The Alcohol Health Alliance concludes that previous across-the-board cuts in beer duty have helped supermarkets to continue to undermine on-trade sales, while failing to slow the rate of pub closures. Despite the Government’s valiant efforts, therefore, the important contributions that our pubs make to the economy and to community life by providing a place to socialise and encouraging responsible drinking remain at risk.
Most concerningly, analysis shows that it is small independent pubs that are disappearing as the big pub chains consolidate their businesses around larger bars, usually in town centres. Eventually, that will allow those big pub chains to monopolise the on-trade marketplace. That will give them a stranglehold over pricing and is unlikely to result in a cheaper pint for the consumer.
Moreover, the closure of any pub, especially a small community asset, endangers work on loneliness and social cohesion. Researchers have found that people who have a local pub are happier, have more friends and feel more engaged with their local communities, but closures are depriving some people of those benefits. That can be particularly acute in rural areas. The pub is a famous and traditional part of the British way of life. It is an essential part of the community. It deals with loneliness and is a form of social care. The traditional landlord knows his clientele. He knows who needs help, who is in trouble and what resources are available, and he is a friendly ear.
As a touring actor many years ago, I stayed in a small village on the outskirts of Stratford-upon-Avon that had a pub, a church and a community centre, and a pub landlord, a vicar and a policeman. Twenty years later, I went back and those three pillars of the community had gone, along with the pub. It was a sad reflection of that wonderful little community that I knew so well, where people talked over the garden fence, talked to one another in the pub, looked after each other and looked out for one another. Instead, the people of that little local community had disappeared into their silos. They went to the local town to work as commuters and came back to their houses to drink cheap supermarket booze in front of their widescreen televisions. The community had broken down. The loss of that community is a great shame, and I want to prevent that from happening elsewhere. We must do all we can to prevent the closure of any pub.
I worked in the pub trade for 10 years. One of my first and most enjoyable jobs was working at the Windmill Tavern and the Gates Bar in my constituency. That was a long time ago, but those pubs survive. Sadly, I know a lot of landlords who knew then, and know now, that business rates and the price of a pint are far too high. We are losing places to socialise and we are losing communities. Communities need pubs, so I strongly support the hon. Gentleman.
I ran a pub with my wife—the Kings Head on Kings Head Hill, Chingford—in one of those moments when my acting career was not going too well.
Pubs are also positive for our high streets. They attract visitors, so closures are counterproductive to the Government’s efforts to revitalise our urban centres. Let us not forget the general economic impact of the beer and pub industries, which contribute £23 billion to GDP every year and support more than 900,000 jobs. Crucially, 44% of those jobs are held by 16 to 24-year-olds.
All that is at risk, however, because of beer duty rates. Even after the Government’s reductions, we still have one of the highest rates in Europe and pay 40% of all beer duty in the EU while consuming only 12% of the beer—despite my best efforts. That has contributed to the fact that, according to the Campaign for Real Ale, 56% of drinkers believe that the price of a pint of beer in a pub has become unaffordable.
Drinkaware notes the shifting preference of the consumer, who now purchases alcohol in the off-trade marketplace to consume at home, as per my example of the little village near Stratford-upon-Avon. When people can buy a pint of beer for less than £1 in some supermarkets, it is hardly surprising that many choose that option, especially when pubs simply cannot get near those rock-bottom prices. I believe that the average pint of beer is between £3.50 and £4, which is three or four times the amount.
The data supports that shifting preference and demonstrates that while high rates of beer duty have been pricing people out of drinking in pubs, off-trade sales have been thriving. Figures from the British Beer and Pub Association show that since 2000, on-trade consumption has fallen by a massive 47.2%, but off-trade consumption has risen by 29.3%. That is clearly inequitable and stems from the disparity in cost between the two. The Government’s across-the-board beer duty reductions have not addressed that disparity, given that they also benefit off-trade sales. Because pub closures largely derive from the surge in the sale of cheap alcohol, the disparity needs to be addressed.
An underlying potential public health concern could result from inaction, because people who drink at home without a responsible landlord to keep an eye on them are at risk of alcohol abuse. Today, the number of hospital admissions related to alcohol remains high at one million annually, and that places a strain on our precious resources. Most worryingly, the number of admissions has risen as a pint has become more expensive. Even if there is not a direct correlation, 73% of publicans think that increasing the price of off-trade alcohol is crucial to tackling alcohol problems.
We can do that with a differential rate of beer duty that skews the odds back in our pubs’ favour by cutting the on-trade beer duty rate to benefit those sales over off-trade sales. The Exchequer Secretary to the Treasury said recently:
“I can see the strong argument for that, but it is unfortunately not possible under EU law. Duty is levied on production, not on the place of consumption. However, we might be able to turn to that should we have sufficient flexibility.”—[Official Report, 28 March 2019; Vol. 657, c. 635.]
We are shortly going to get that flexibility, and there must be a technological mechanism that we can use to track the destination of beer products when they leave the producer, and then add the tax accordingly. Such an approach would mean cutting the on-trade duty rate, before adding a stipend for beer products destined for the off-trade marketplace. It would also mean that the cut for on-trade sales would offset the increase in off-trade duty. I accept that such a change could impact all off-trade retailers, and therefore any such adjustment should be narrowed to large retailers only. For large retailers, sales of beer form only part of their turnover, whereas for small off-trade retailers, alcohol sales can be everything. That important point must be considered during any discussion of the proposal so that we do not damage our very valuable small businesses.
We must differentiate and cut beer duty for on-trade sales, because doing so will truly benefit our pubs. However, although I might be considered an expert on beer, I am not an expert on tax law. I hope that we can have a pledge from the Minister today that the Treasury will investigate this matter, so we can see whether such differential rates could hypothetically be used to support our pubs when we leave the EU. Moreover, when we investigate, we must find a way to ensure that producers pass on savings to the consumer. Many in the industry allege that previous savings have been retained by brewers, and that undermines efforts to save our pubs.
If I have convinced the Minister that there is still a strong argument for differential rates of beer duty—I am sure I have—I hope that one day he will join me for a drink in my local in Frinton to celebrate the introduction of this important change.
Yes, I do. Thank you, Mr Hollobone, for allowing me to take part in this debate at the very last minute. I wholeheartedly congratulate my hon. Friend the Member for Clacton (Giles Watling) on his tour de force in defence of the great British beer industry and on the importance of the British pint. I only wish there were more Members of Parliament who spoke with such passion about what is a great British industry. Although the Americans or the Germans or the Belgians might claim it, I have no doubt that we produce the best beer in the world here in Britain and we should support the industry.
I will reiterate a few of the points that my hon. Friend made so well. First, there are the costs incurred in the on-trade and the off-trade. It is more cost-effective and cost-efficient to sell trays of lager or six-packs of beer from a supermarket, for them to go down the aisle, be beeped through by the assistant in the supermarket of one’s choice and for someone to take them home. There is clearly a much higher cost involved in delivering a wonderful pint of British cask ale. For a start, there is a great deal more work in keeping it, and there is the customer service that is needed in its delivery. There is a lot more science and work in delivering great customer service and a great pint of beer than one may imagine, and that costs the publican. It also, of course, provides excellent jobs, with good training, in the pub industry, which we should support and encourage.
My father said that there was no such thing as bad beer. My hon. Friend is articulating that there is—there is a skill; it is a profession. One of the things we have lost over many years is the landlord as a profession, but with the rise of cask ale, it is beginning to come back. The landlord was well respected in our communities. He was a pillar of the community. He knew his job and he knew his cellar. The more we can support the great British pub, the more those skills can be retained and will flourish.
Secondly, on public safety, we all suffer on our high streets occasionally from what we call preloading or binge drinking, particularly among younger people who might buy some alcohol from the supermarket, or who may get it from their parents or whatever, who then go and drink in the park or in the town centre. There is a cost involved for the police and the wider community in managing that, but there is no cost to the supermarket. However, publicans are required to keep their house in order. They are required to have door staff who treat people with respect and with care, and who make sure that the licensed premises is safe and that people who turn up who may have had too much to drink are refused so that everybody else in the establishment is kept safe. None of those costs are on a supermarket, but they are on the British landlord. It is important to recognise that and to represent it in the taxation regime.
There is also the extra cost of delivering cask ale or draught ale. This may be one way in which the Minister can think about being creative when he looks at a replacement for EU duty on alcohol as we come out of the European Union. The duty is on production and it may be difficult to differentiate the duty on a bottle of beer sold from a supermarket and the beer sold in a pub, but we could differentiate a bottle of beer sold in a supermarket and a pint of draught ale, because it is in a different container and is served in a different way. That may be one clever way—I know the Minister is extremely clever—in which he can crack this nut of supporting our pubs, which offer an asset to the community, keep us safe and are the great introduction to responsible drinking. I am sure hon. Members remember when someone went down to the pub where the landlord would keep an eye on them; he knows the family; if someone gets into trouble, he says, “You’ve had a few too many—go home.” We risk losing that if we lose the great British pub.
I am a non-alcoholic. I do not drink. I have done the pub trade for 10 years and I have never drank. I enjoy the social side of going to a pub and meeting people. Where publicans are really struggling now is with business rates. Pubs are community hubs, and we really need to look at business rates.
I could not agree with the hon. Gentleman more. As the ex-chairman of the all-party parliamentary beer group, I decided to challenge myself to have 12 months off alcohol. That runs out in July. I have been alcohol-free for 12 months, but that does not mean that I do not continue to support the British brewing industry and the British pub. It is absolutely at the centre of our community. The hon. Gentleman is exactly right.
The hon. Gentleman mentioned business rates and it is absolutely right that pubs are treated in a unique way on business rates. I use an old phrase: we have an analogue taxation system in a digital world. I am not saying that Amazon will be delivering my pint of cask ale to me via Amazon Prime, but businesses more generally, particularly small businesses, are having to compete with sales on the internet and the brave new world of retailing. I am absolutely sure that doing something about business rates will help our high streets.
I have one other matter to take up with the Minister, which I hope he will find interesting. One of the objectives behind all Government policy is responsible drinking. We want people to enjoy a pint of great British beer, but we want them to do it responsibly. A great thing we have seen because of responsible actions by brewers is a reduction in the alcohol by volume in drinks, and in beer in particular. Beer is a particularly good way for us to take units out of consumption, because of its high volume and relatively low strength.
The Government introduced a lower rate of duty on beer less than 2.8% ABV. Brewers have done a really good job and have tried to embrace that, but it is difficult for a brewer to produce a tasty beer at less than 2.8%. It is the alcohol that gives it the bite, but it is also the alcohol that helps to preserve it and keep it drinkable in the pipes for longer. With the best of intentions, landlords wanted to provide a lower-alcohol beer on cask, but they could not because it was not economically viable because the beer went off. It was 2.8% because of the EU directive, which prevented us from doing anything else. As we Brexit and come out of the European Union, we have the opportunity of a differential rate—maybe 3% or 3.5%—at which brewers could produce a great, tasty beer while taking units out of consumption. For those of us who enjoy a pint, but not a stronger pint, all those things would work well together.
I thank you very much for allowing me to take part in the debate, Mr Hollobone. In conclusion, I am absolutely heartened to hear that we have such beer champions. As the MP representing the heart of British brewing—Burton upon Trent, with its history and future in brewing—I hope the Minister will think about using Brexit to deliver cheaper beer for Britons across the country as we leave the European Union.
It is a great pleasure to serve under your chairmanship, Mr Hollobone. This is an important topic, as hon. Members from across the House have rightly said, which commands widespread interest across not merely the House but the country. In that context, if I may make a small but telling party political point, I wish that the Opposition had been able to field a spokesman to express their view on the matter.
I am grateful to the previous speakers for giving me that opportunity. I intend to take full advantage of it. I stand corrected on the point about the Opposition, for which I am grateful.
I thank my hon. Friend the Member for Clacton (Giles Watling) not merely for his ingenuity and brilliance in securing the debate and raising this topic, but for the vigour and energy that he has shown in pressing this issue over the several years he has been in the House. In doing so, although he may not realise it, he takes up a beacon that was held for many years in this House by my great friend, my hon. Friend the Member for Burton (Andrew Griffiths), who I am delighted had the chance to speak. I have no doubt that, in due course, the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) will himself carry that beacon, or if not, will play an important role in making this argument, because it is an important one to advance. I thank all Members who have spoken for their contributions.
As my hon. Friend the Member for Clacton rightly said, and as colleagues from across the House know, beer and breweries are an important part of our national life, and the same is of course true for that essential accompaniment, the great British pub. As a Herefordshire man, I ought to point out that pubs do not merely serve beer. In my constituency we have Bulmers, while in Herefordshire we have Westons, Tom Oliver and Denis Gwatkin; we have a host of fantastic cider producers. Tragically, they are not the subject of this discussion; our attention must focus exclusively on beer and the beer duty. However, they contribute to the important presence of pubs in our national life.
That will certainly be of great interest to my constituents, both as consumers and producers. As my hon. Friend knows, there has been a tremendous reinvigoration of the brewing industry over the last nine years. The number of brewers has this year risen dramatically to more than 2,200. The rise of craft beer has seen breweries grow and flourish in every part of this country, including microbreweries, and exports have reached more than £500 million a year.
Again, it would be wrong of me not to mention a personal interest in this context. Certainly, my county of Herefordshire is as amply endowed with fabulous breweries and pubs as any part of the country. It would be wrong not to mention Wye Valley Brewery, Golden Valley Brewery and Hereford Brewery—I have pulled a pint of its Hereford Best in the Strangers Bar. Notable pubs in Hereford are the Barrels, where I held an informal surgery last Friday afternoon for a considerable period; the Volunteer Inn, known as the Volly; the Lichfield Vaults, known as the Lich; the Grapes; and the Britannia. However, I also pay attention to the specialists that have come into the market in my constituency over the last few years, which picks out this wider process of economic and social change, including Beer in Hand and the Hereford Beer House—part of a panoply of pubs across the entire county, including the King’s Head Hotel, the Man of Ross, the Mill Race in Ross and many other fine houses.
It would also be wrong of me not to touch on the excellent work in the community of the local Campaign for Real Ale team, with my support, in saving, for the second time, the Broadleys pub in south Hereford from being turned into a Co-op. It sheds a very bad light on the Co-op, which is in many ways a fine institution that I otherwise rather admire, even if I did have the crystal Methodist in front of me at one point when I was on the Treasury Committee, if hon. Members remember him. It should not sponsor the closure of pubs in order to open new Co-ops merely a few hundred yards away from ones that already exist. I single it out personally, not as a matter of Government policy, for its misbehaviour in that regard.
I agree with my hon. Friend, because I have seen that in action. Does he agree that one great way to support the great British pub is by doing something on beer duty? Seven out of 10 alcoholic drinks purchased in a pub are beer, so if we want to help pubs, doing something specifically on beer is the way to do it.
I will come on to a point my hon. Friend raised, and with great eloquence, on the vigorous role that the Government have taken in cutting beer duty and supporting the industry. However, I point out that this great change over the last few years has not been the result merely of enlightened tax policy but of an outbreak of entrepreneurialism and energy in the sector as a whole. It is important to realise that the Government cannot reverse the laws of economic gravity or changing tastes and habits, but they can help at the margin, and have tried to.
As my hon. Friend will know, in 2013 the Government took the decision to end the beer duty escalator. Since then, they have cut or frozen beer duty several times, including at the last Budget, with the effect that a typical pint of beer is 14p cheaper than it would otherwise be. The Government will of course continue to look for ways to support the brewing industry, and I absolutely look forward to further engagement with my hon. Friends and Members from across the House.
However, it is important to try to strike a responsible and sustainable balance with wider public spending commitments. It is worth noting that the Exchequer has forgone more than £5.2 billion in revenue due to cuts and freezes to all alcohol duties since 2013. That is £5 billion that has to be made up by taxpayers by other means if we are to be able to spend as we would wish on our public services. [Interruption.] Hon. Members who have recently arrived for the next debate will not be aware that we have a few more minutes, because of the kind courtesy of the Chair, and can run the debate until 4.45 pm.
My hon. Friend the Member for Clacton is absolutely right to emphasise the social importance of pubs, which are central places in the community. They are mixing places and meeting places for people from every walk of life. My hon. Friend the Member for Burton also made the point that pubs are a place of supervised, safe drinking, where publicans—male or female—know their customers, pulling pints and pulling people together in a social environment. That of course raises the stakes from a Government standpoint.
When considering whether to introduce differential beer duty, we and Governments before us have had to acknowledge that the UK is currently bound by EU laws that harmonise excise duties applicable to alcohol products. We can only introduce reliefs or different rates of duty for beer that are compatible with the EU directive on alcohol excise duty structures. My hon. Friend the Member for Burton made the point that, once the UK has left the EU, the Government and Parliament will no longer be bound by this directive, so there should be much greater opportunity to explore creative proposals to redress that balance. But until then, there are limits laid down in statute as to what can be introduced. However, even within that context—this point has been touched on—we have been able to make progress and exploit some existing differentials, which have benefited pubs and breweries. Those include the small brewers relief, which allows the smallest breweries to receive up to 50% off their duty bill in the start-up and growth phase. As hon. Members will know, the Treasury announced a review of that relief in the Budget. My officials are now working to take the results of the survey further to address the issues raised, and the Government hope to make further announcements in due course.
Of course, as I have said, we also recognise the importance of responsible drinking. That is why there are already differential rates of duty on lower-strength and alcohol-free beers. On beers of less than 1.2% ABV, no duty is paid at all, and on beers between 1.2% and 2.8%, the reduced rate is less than half the standard beer duty rate. My hon. Friend the Member for Burton is absolutely right. It is hard to produce a beer of, I would say, less than 2.3% that maintains its taste, but at between 2.3% and 2.8%, one can have a delicious pint and benefit from the duty differential. Conversely, higher-strength beers over 7.5% ABV pay a higher duty rate of roughly 30% more, in part to send a fiscal signal about the importance of responsible drinking.
The Minister is absolutely right in what he says about lower-strength beers and the potential that that has, but may I share with him what brewers across the country have said to me? If they got the opportunity, through the duty regime, to promote beers at 3% or up to 3.5%, they would do that wholeheartedly. That would not only create a new category, but help to take alcohol units out and therefore help responsible drinking at the same time.
I am grateful for that intervention. There may be scope to contemplate an uplift in relation to the higher level of lower-strength beer. It would be interesting to discuss that further.
Let me turn to some of the points that my hon. Friend the Member for Clacton raised. I intervened only to provide the point of information to him, because of course I did not see the correspondence that he had received and therefore could not respond to it in those terms. I apologise if he was disappointed by the response that was given. It is always the Treasury’s policy to try to give informative and full as well as, of course, accurate responses.
Let me pick up a couple of the points that were raised in my hon. Friend’s speech and that reiterate some of the wider issues. Of course, there are public health outcomes that need to be met. The closure of pubs potentially affects some of those, particularly in a world that has seen, in this country at least, something of an epidemic of loneliness, so my hon. Friend was absolutely right to pick up on that. He is also right to say that there is evidence that responsible drinking and better public health outcomes can be due to differential rates of duty. I understand that point. It is important, though, to remind ourselves of the practical difficulties that need to be overcome. It is not merely the EU law issue. It is also important that whatever the regimen may be, it is not subject to legal challenge for breaching state aid or competition rules. And we may wish to remain aligned with the EU even post Brexit, from a competition or state aid perspective, in part to prevent mercantilism from breaking out between EU businesses and our own.
Of course, there is an issue about enforcement. Her Majesty’s Revenue and Customs taxes beer at the point at which it moves into general distribution, rather than monitoring the wider beer supply chain. The concern is obviously about the potential to repackage beer that had the lower rate of duty paid on it and then to sell it and trouser the difference.
I absolutely understand the point that the Minister makes about the grey market and the potential for fraud; the all-party parliamentary beer group did an investigation into that. I therefore point him back to my previous remarks on draught beer. It is very easy to understand draught beer. It cannot be repackaged; it cannot be put in a different container; it is draught beer. We could have a differential on draught beer that I think would solve my hon. Friend’s problem.
I am delighted to have taken that final point of information. It may be the case that when we come to reconsider it, the draught beer distinction that my hon. Friend draws gives us a workable legal and practical basis on which to proceed. My point is a much simpler one: it is important to bear in mind the potential grey market impacts, as well as the competition, state aid and legal points that I raised earlier. Having said that, I am enormously grateful to my hon. Friend the Member for Clacton for initiating the debate and for making a case of great passion and urgency with his usual oratorical flourish. Even if I cannot join him in his own Kings Head where he was a publican, I very much hope to be able to join him in the future at some point.
Question put and agreed to.
That this House has considered differential rates of beer duty.
Electromagnetic Fields: Health Effects
I beg to move,
That this House has considered the health-related effects of electromagnetic fields.
I am honoured to serve under your chairmanship, Mr Hollobone. This Westminster Hall debate is timely. It comes on the back of an historic decision by Glastonbury Town Council to oppose the roll-out of 5G because of a severe lack of evidence about its effect on the health of those living and working around 5G sites. In the words of Martin Pall, emeritus professor of biochemistry at Washington State University:
“Putting in tens of millions of 5G antennae without a single biological test of safety has got to be about the stupidest idea anyone has had in the history of the world.”
We saw the roll-out of 5G postponed in Brussels when Céline Fremault, Environment and Energy Minister, identified that it was not compatible with Belgian radiation safety standards; and a planned upgrade to 5G in Geneva has been stopped, through application of the precautionary principle, until independent findings on possible health damage become available.
I was approached by an old friend who is now a constituent about how a sensitivity to electromagnetic fields seriously affects her health and the way she lives her life. Annelie lives in France for part of the year and has to return to Wales as her health deteriorates while working as a university lecturer. I was intrigued by the effects and wanted to know more, so I have been in contact with a number of people who either have concerns about the health-related effects or are suffering at first hand. Following discussions with others, I was keen to secure a debate on the subject, because the Government are sweeping the health concerns under the carpet and there appears to be an absolute refusal to acknowledge that the health-related effects even exist.
Initiating a conversation about electromagnetic sensitivity has had members of my own team and family telling me that it is all made up. That in itself motivated me to keep reading and to speak to as many people as I could in Wales and beyond who were suffering. What shocked me was the number of people who have ES but are too afraid to talk publicly about their illness, because they are really wary of being humiliated and ostracised.
Electrosensitivity is the symptomatic sensitivity to electric or magnetic fields of any frequency, including radio frequency transmissions. The condition was first described in 1932. It is when a person’s physiology is affected by external electromagnetic fields, giving rise to a spectrum of symptoms, which are often neurological. It is therefore an illness caused by environmental agents—essentially, an environmental toxic pollutant. The condition can arise because of continued exposure to an environment polluted by man-made EM and RF wireless signals at levels at orders of magnitude below those that produce heating effects, and it is well understood in many other countries. Symptoms include headaches, fatigue, disturbed sleep, tingling, pains in limbs, head or face, stabbing pains, brain fog and impaired cognitive function, dizziness, tinnitus, nosebleeds and palpitations. As we saw with chronic fatigue syndrome, however, there was disbelief about those presenting with symptoms of this condition. Indeed, it was construed by others, through a lack of knowledge and difficulty in diagnosis, as a psychological illness. I believe that electrosensitivity will be recognised in years to come—sooner than that, I hope—and that the Government will have to own up to their part in it.
To be honest, this is not a subject that I ever thought I would stand here and talk about, even though as a mother, I have always been keen to charge my son’s phone outside his bedroom but have never applied the same rule to myself. Parents seem to care about this in relation to their children, and we hear that masts—one was recently fitted to a school in Haringey—are no longer being put up on primary schools. There is something in this.
I also worry about the impact of social media on mental health, and about the smartphones’ increasingly addictive nature, which is impacting on the lives of the youngest of children. There is some evidence about the effects of radio frequency signals on mental health and behaviour in children and young people, but those effects are not considered in current attempts to address the increase in mental health and behavioural problems in the UK. I ask the Minister to include the effects of wireless signals when considering solutions for such problems in children and young people. The recent advice from the UK chief medical officers on screen time and wellbeing in young people has ignored evidence for the adverse effects of wireless signals.
I want to ask about the wider environmental impact. My hon. Friend will know that 4G has the same carbon footprint as all of aviation, and 5G will be a lot more. What is more, we are now hearing that 5G will have a detrimental impact on insect life, which is decreasing globally at 2.5% per year. Given that insects are essential to humanity because they are required to pollinate all fruits and vegetables, does she agree that before hurtling ahead for commercial reasons, we should apply the precautionary principle until we know precisely what the impact will be on insects and our carbon footprint?
We do need to take climate change and insect life into consideration when we discuss the impact of electromagnetic fields.
As MPs, we have a duty of care to our constituents. There is no escaping the fact that when MPs, schools, local authorities and others ask questions about the safety of new technologies, Government’s give a standard reply. People who question the health-related effects of electromagnetic fields come up against a brick wall, and today I want to break through that brick wall and ask the Minister several questions. I like to think that the smart way to move forward is to consider safety and sustainability when developing products.
Many years ago, the Trade and Industry Committee investigated the matter with all sorts of experts, but nobody could come to a conclusion. That is not to say that my hon. Friend is wrong, but it was looked at about 20 years ago. Is there any evidence that electromagnetic fields can affect the behaviour of animals?
There is evidence about the effects on animals. I cannot quote from it now, but I have read about it. We must remember that animals do not use screens, but there is evidence of the impact on them of electromagnetic fields from things such as smartphones and 5G. I would have to find that evidence and send it on to my hon. Friend.
On that point, there is clear evidence that with high-frequency 5G—there is some denial about the idea that the frequency may be so high—there will be an enormous loss of insect life. To get the necessary coverage we need to place masts every 150 metres. The coverage will be enormous, and there is an incredible risk of substantial damage. Surely we should apply the precautionary principle, even if all sorts of commercial threats are being made to the Government behind closed doors about what will happen if they do not go ahead.
We need to apply the precautionary principle when we look at anything. Many councils and the Government have embraced 5G, which has come up on us so quickly, as a solution to connectivity. To be honest, given the potential impact, I would rather see fibre broadband—fixed, wired broadband—in all the houses in my constituency and across Wales, rather than having masts put up everywhere just because that seems to be a cheaper solution.
I will not accept the response that electrosensitivity does not exist; studies show that it does. It has many effects that are not at all subjective, including effects on proteins and DNA, cell death, altered brain activity and effects in animals, as my hon. Friends have mentioned. Those effects can be measured, and they cannot be dismissed as being all in the mind.
We all know that decisions relating to technology can have unintended consequences. We are discussing one such consequence: the impact on our health. Similarly, it could be argued that the effects on our mental health are being caused by online contact or screen time, but in combination with studies about animals, we can see that the signals themselves have effects. Animals do not look at screens or use social media.
In the past, no matter what questions, evidence or concerns have been put to Public Health England or the Department of Health and Social Care, they have responded with their standard reply, which includes them saying that they have thoroughly assessed the evidence in the 2012 report by the independent Advisory Group on Non-ionising Radiation. The World Health Organisation International Agency for Research on Cancer classified all radio-frequency signals as possible human carcinogens in 2011, based on significant increased risks of gliomas and acoustic neuromas associated with mobile or cordless phone use in humans, as well as animal and mechanistic studies. Subsequent studies have strengthened the evidence in humans and provided clear evidence of tumours in animals. Some scientists are even calling for the classification to be upgraded to a definite carcinogen.
Why, then, has Public Health England removed all mention of the IARC classification of radio-frequency signals from its website? It informs people about other possible carcinogens. People cannot make informed decisions or protect those they are responsible for if the information is withheld. Will the Minister commit to ensuring that Public Health England informs people on its website and in leaflets, communications and presentations that all radio-frequency signals are a possible human carcinogen?
Following the publication of a paper on the AGNIR 2012 report in Reviews on Environment Health, the AGNIR was quietly disbanded. However, the inaccurate report is still on its website and is used to justify its advice to MPs and the public. When will the 2012 report be retracted because it is scientifically inaccurate and out of date?
The Department for Education in England and the Department of Education in Northern Ireland have said that it is the responsibility of schools to carry out risk assessments before technologies are introduced and used. However, schools cannot safeguard pupils or staff through a risk assessment if they have been given inaccurate information. Can schools be accurately informed about the risks, so that they can fulfil their responsibilities to safeguard children?
Schools and parents could have been informed that wireless signals are a possible human carcinogen; that there is evidence of damage to fertility; and that there are adverse effects on brain development. Schools could have been advised to use wired technologies to prevent possible harm to children’s health and development. The EU has sent a cautionary message about wi-fi in relation to schoolchildren, but only France has removed wi-fi from its primary schools.
The Cyprus Government have produced short, practical videos warning teenagers and pregnant women about the risks of radio frequency signals and offering simple actions. When will children, young people, parents and pregnant women in the UK be offered similar advice so that they can take steps to stay safer?
By denying the existence of adverse effects and providing inaccurate information, Public Health England and the Department of Health and Social Care have prevented the UK public from living and working in safe environments. When will the Government listen to the warnings from scientists and doctors to help MPs to better protect their constituents?
If we are to develop safer technologies in the future, we need to be honest about the risks. We must not ignore the fact that people have ES; those people exist, and their lives are being ruined. Others without ES also have genuine concerns about the roll-out of 5G. People do not need to suffer to be concerned, because the name 5G is deceptive: it implies a simple upgrade from the current 4G, or fourth generation, wireless, but it is so much more than that. It is a massive experiment, and the consequences of our actions are largely unknown.
One thing I feel very strongly about is that for people with ES there is literally no escape—they will have nowhere to go. Can we create safe public spaces and living and working environments so that everyone has somewhere to exist? That is extremely urgent, particularly with the introduction of 5G smart cities, smart roads, the internet of things and thousands of 5G satellites.
I would like the Government to give a commitment to creating white zones, where people can have respite when they need it; to pledge to provide up-to-date, transparent and independent research on the impact of electromagnetic fields; and to replace the 2012 AGNIR report. The science needs to be reviewed—no one can disagree that the technology moves on so quickly that there is even more need to keep up to date with the science.
Finally, I recently received a letter with a heartfelt request from a mum in west Wales:
“I’m told you think the only way forward is a white zone, I agree but also to get ES recognised as a disability. I have spoken with my MP and he agreed that if ES could be recognised as a disability, other things such as access to education would fall into place.”
I agree with Sarah. Her struggle is real, and so are the lives of many people who are largely ignored and belittled. Electromagnetic fields have had a dramatic impact on the life and health of my old classmate Annelie over the past 10 years. We can no longer hide and pretend that this is not happening. It cannot be swept under the carpet, especially in the light of the future impact of technological advances at the expense of people and our environment.
In conclusion, it is evident that the Government need to ensure that the research is independent. They need to recognise electrohypersensitivity as an occupational disease, as a French court did earlier this year, and put guidelines in place for employers to make reasonable adjustments so that their employees can continue to work in a healthy environment. I remember the days when we made plans to meet without mobile phones to say that we were running late or could not make it. Advances in technology have swept through our lives. Before I am accused of being a luddite, I stress that I think the technology is wonderful and offers a great many benefits to all, but we cannot continue to deny that there is an impact on some people’s health and wellbeing. This is not about stopping progress; it is about making sure that there are no health concerns about the technology, and about doing what is best for our constituents.
I am delighted to serve under your chairmanship, Mr Hollobone. My hon. Friend the Member for Gower (Tonia Antoniazzi) has done an admirable job in at least raising the issue that the precautionary principle should be paramount before we take on any new technology. As someone who represents a semi-rural area, let me say at the outset: please give me 3G. I am not worried about 4G or 5G; I just want 3G, with all the consequences it brings. My constituency still has at least one market town that cannot even get that. That was just a little plug for getting the existing technology in place.
What my hon. Friend says is worthy of debate. It should be taken seriously by the Government and should help the public to understand that their representatives are listening. Stroud being Stroud, an active campaign is already under way on 5G. People are saying, “We don’t want it and we’ll do anything to stop it, so please listen to those who have already raised concerns.”
Like my hon. Friend, I have met people who are incredibly affected by electromagnetic sensitivity—to the extent that, when they moved into their house, they had to have the smart meter taken out, and even asked their neighbour to take out theirs. Once that happened, their health dramatically improved. People say that electromagnetic sensitivity is all psychosomatic, but I have seen the evidence of people’s sensitivity to electromagnetic waves. If we ignore it, there will certainly be health and biological consequences, and there may be many more problems. Since my hon. Friend has done a valuable job of explaining the possible health and biological impacts, I will say more about planning.
It is only fair to ask the Government to at least respond to the growing evidence from the International Electromagnetic Field Scientist Appeal, PHIRE— the Physicians’ Health Initiative for Radiation and Environment—and other reputed scientists in the field, as well as from communities. Brussels has now stopped the roll-out, and so have a number of cities in California. There is growing concern, and it needs to be recognised and answered. It is a shame that we seem to be in complete ignorance of some of the effects of 5G. I have not seen proper medical studies that deal with people’s susceptibility to it. It would be right and proper for us to see those studies.
I apologise that I will have to leave before the end, Mr Hollobone.
Is my hon. Friend aware of the veracity of reports that 5G companies, which have enormous commercial power, have put pressure on the Government to move ahead quickly and are making threats similar to those made about the Transatlantic Trade and Investment Partnership? It may be that we have signed up already, and if we pull back on the basis of the precautionary principle and risks to human and wildlife health, the Government may end up being sued by big commercial interests. We should resist that in the interests of the public.
I agree. My hon. Friend’s work on air quality is very important. Politicians in general are at last beginning to take note of the threats. It seems lamentable that, now that we understand the threats to air quality through pollution from cars, incineration and other things, another technology is coming in that could be as damaging. Maybe we will not see its effects for years, but will in decades unless we understand what it can do to people. It may not affect everybody—it may be down to genetic susceptibility—but we ought to listen to what is happening to those people.
It would be useful for the Government to put the studies, and their responses to them, on the record. As my hon. Friend the Member for Gower says, one problem is that, now we are into 5G, there is a view that existing masts can be added to or that additional technology can be used. I put it to the Minister that the biggest worry is that there is a view, certainly in Stroud, that lamp posts will be seen as a perfectly acceptable substitute and that, instead of putting up new masts, the technology could be added to existing infrastructure.
It would be useful to know what powers exist, because I understand that the electronic communications code has granted virtually unlimited powers to companies to construct, maintain or develop the current infrastructure without any planning permission. It is all done under delegated responsibility, which means that the general public do not even know what is going on, because normally these things are not publicised. There is little recourse unless the public take court action to stop it, but the means of doing so are limited. Even a private landowner has little authority to stop it. The matter needs to be looked into and properly investigated.
I ask the Government to look at how they can consult the public, because the public are getting worried. The scare stories may not have the full scientific rigour that they should have, but the public know no more than what they have been told by various experts in the field, and there are always experts on either side of the argument. Our case is that, at the very least, there should be an open, honest and transparent investigation of the health and biological impact of the new technology.
Driving forward 5G is about financial interests. It is not being done for altruistic reasons, but because an awful lot of money stands to be made out of it in a very short period. We need to look at that. It exacerbates the digital divide. As I have said, I would be satisfied with 3G my constituency.
Having listened to my hon. Friend the Member for Gower, I hope the Minister will be able to say what plans the Government have to investigate the impact on the ecosystem, which is as important as human beings. We need to keep our bugs, birds and other fauna in the state they are in, given that they are under enormous attack. We talked about that yesterday in relation to the climate change statutory instrument that we passed. We are not just talking about our own survival but the survival of other species. It would be a tragedy if we have done things to protect them and yet we let 5G come in. There are allegations that 5G has an impact on other species, particularly in rural areas where we see many living creatures.
My final point is that part of the problem is that the new technology is coming through without much questioning, or even recourse for people to question it. The biggest problem is the speed at which it is being introduced. There is no way that communities that are at best uncertain about the impact of that technology on their children, their schools and their wider community can do anything.
I ask the Government to look at this carefully, as my hon. Friend the Member for Gower said, so that we consider the implications both for individuals’ health and the wider ecosystem, and that we also take time and recognise that the precautionary principle is as important in this area as it is in general about air quality.
It is a pleasure to serve under your chairmanship, Mr Hollobone.
I thank the hon. Member for Gower (Tonia Antoniazzi) for securing this debate and for the interesting comments she made about electrosensitivity, highlighting the issue of the 5G roll-out, in particular with relation to electromagnetic fields. As she pointed out, 5G operates on different frequencies and with much higher ranges than those we have seen before with previous roll-outs.
Of course, exposure to electromagnetic fields is not new, but due to technological advances it is now far more common for people to be exposed to man-made electromagnetic fields than it ever was in our parents’ or our grandparents’ time. In recent decades, we have seen the public becoming concerned about potential health issues involving numerous electromagnetic field sources, ranging from overhead power lines to computer or TV screens in the home, as well as from radars, microwave ovens and mobile phones, to name just a few other sources.
Of course there are some significant differences between these sources. With some of them, people can self-select to take a precautionary effect: we do not need to have a microwave in our home; we can limit our mobile use; and we do not need to have a TV screen in our bedroom. With other sources, such as overhead power lines or telephone masts, people are pretty much stuck with them if they are outside their home. It is different with those sources.
The evidence so far seems to show that electromagnetic fields do not have detrimental health impacts. However, more research is always being undertaken, which is especially important as the technology changes and the frequencies involved change—that point has been made by a number of hon. Members. There is current research on the effects of the long-term use of mobile phones. The World Health Organisation has said that, as yet:
“No obvious adverse effect of exposure to low level radiofrequency fields has been discovered.”
However, as has been pointed out, the frequencies of the new 5G technology are significantly higher than those used before, and therefore the research into that new technology is somewhat different than earlier research.
Over the years, the WHO has identified some “25,000 articles” on electromagnetic fields that
“have been published over the past 30 years.”
The WHO says of that body of scientific knowledge—indeed, it is undoubtedly the case—that
“scientific knowledge in this area is now more extensive than for most chemicals.”
However, the WHO also says that there are still
“some gaps in knowledge about biological effects”
and so there is a need for “further research”.
The European Union Scientific Committee on Emerging and Newly Identified Health Risks published a lengthy report in 2015—that is not so long ago in terms of years, but in terms of technology it is almost a generation ago. That committee’s final opinion was:
“The results of current scientific research show that there are no evident adverse health effects if exposure remains below the levels recommended by the EU legislation. Overall, the epidemiological studies on radiofrequency EMF exposure do not show an increased risk of brain tumours. Furthermore, they do not indicate an increased risk for other cancers of the head and neck region.
Previous studies also suggested an association of EMF with an increased risk of Alzheimer’s disease. New studies on that subject did not confirm this link.
Epidemiological studies associate exposure to Extremely Low Frequency (ELF) fields, from long-term living in close proximity to power lines to a higher rate of childhood leukaemia. No mechanisms have been identified and no support from experimental studies could explain these findings, which, together with shortcomings of the epidemiological studies, prevent a causal interpretation.
Concerning EMF hypersensitivity…research consistently shows that there is no causal link between self-reported symptoms and EMF exposure.”
The evidence is a little conflicted, but we would definitely benefit from having further evidence.
The role of the Government when it comes to the effects of electromagnetic fields is to ensure that policy is supported by the latest scientific research, so I do not envy the Government in considering the opposing research that has been published. According to the WHO, the heating effect of electromagnetic fields is the current focus of guidelines and regulation. The WHO has said that, to date, no adverse health effect from low-level, long-term exposure to radio frequency or power frequency fields has been confirmed. However, that is not to say that research into the effects of prolonged low-level exposure to these fields should not continue. We must always make sure that the policy is expertise-led.
With the seemingly exponential increase in the rate of technological innovation, the regulation and monitoring of the effects of these technologies on our health needs to continue. However, we must bear in mind not only the physiological impact of technology but the psychological impact of huge amounts of screen time, which can affect mood and sleep, which in turn can have an impact on mental health. This psychological impact must also continue to be monitored.
In conclusion, I concur with the hon. Member for Gower on the need for independent research into the 5G technology, because without public confidence in and understanding of that technology, we will all be faced with many people campaigning against it when it comes into their areas, and we need to know the answers now, before the technology is rolled out.
It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone.
I start by thanking my hon. Friend the Member for Gower (Tonia Antoniazzi) for securing this debate and for her excellent speech, which set the scene and informed us all about this issue. Earlier this year, I met her to discuss it, so I am pleased that she was able to secure the debate on it.
I also thank my hon. Friend the Member for Stroud (Dr Drew) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the Scottish National party, for their thoughtful contributions to this debate. There were also excellent interventions by my hon. Friend the Member for Swansea West (Geraint Davies); I am pleased that he is still with us in Westminster Hall, as he had said that he had to leave early.
As we have heard, the World Health Organisation has concluded that current evidence does not confirm the existence of any health consequences from exposure to low-level electromagnetic fields. I know that the Government have followed a similar line, with the independent Advisory Group on Non-Ionising Radiation concluding that although a substantial amount of research has been conducted in this area, there is no convincing evidence that electromagnetic field exposures below guideline levels cause health effects in either adults or children. However, as we have heard, concerns exist about the long-term impact of electromagnetic fields, and although my hon. Friends did not go into great detail about individual cases, I have read of such cases and I am sure that all hon. Members have also read some of the details about them. As we become ever more reliant upon modern technology, such concerns will only increase.
On a more light-hearted note, those people who have Netflix might have seen the impact of electromagnetic fields being played out, albeit in a fictional sense, in a programme called “Better Call Saul”, in which the brother of the main character is terribly affected—indeed, he is housebound—by EMF. It is often said with these types of issues that Hollywood leads the way in bringing them to the public’s attention, and this example is definitely a case in point.
International studies, such as the cohort study of mobile phone use and health, or COSMOS, and national studies, such as the study of cognition, adolescents and mobile phones, or SCAMP, exist to continue research into any possible impacts. It is important that such studies continue, so that the public can be aware of all the current advice about electromagnetic fields. As we have heard, as technology develops there will be concerns—new and old—about the impact that it could have on our health. What assessment has the Minister made of all those studies, specifically those that conclude that radio waves are carcinogenic? As we have heard, Cyprus and Austria advise children and teenagers how to limit their exposure to radio waves. Will the UK Government consider doing that, too?
Some of my constituents have written to me with concerns about the new 5G network, as also reported by other hon. Members, and I am grateful for the Minister’s response on that. I know that my hon. Friend the Member for Gower has had conversations with her constituents, who are concerned about the new technology being rolled out across the country. As she said, she would like white zones to be considered and protected. White zones give people who are sensitive to electromagnetic fields, or are concerned about their impact, somewhere to live without interference from radio waves, and that is why it is important that the matter is looked at cross-departmentally.
Is my hon. Friend aware of the concern that 5G cannot penetrate trees and that, as a result, we are looking at the destruction of thousands and thousands of trees? That destruction has already started around Swindon. How can we possibly be serious about our ambitions for zero carbon if we are destroying the trees and have this huge carbon footprint? It does not add up and is clearly environmentally ridiculous.
I was not aware of that, but my hon. Friend has put it out there on the record. I had heard, though, that 5G can go through us, where other things go around us, so it cannot go through trees but it can go through humans. There is a lot more we need to know about the technology.
As I was saying, anything that looks at this must be cross-departmental because of the impact on health, business, digital and the environment. Each of the Departments responsible for those areas should consider the health implications of electromagnetic fields, whether it is for a small minority of the population or the majority. Is that something the Minister has considered?
As we roll out digital technology, particularly in rural areas, the protection of white zones should be considered. We can be world leaders in digital, but that must not be at the expense of health and wellbeing. I therefore urge the Minister to ensure that all the information about the health and wellbeing impacts of electromagnetic fields is made available to the public, and kept under constant review as we find out more. I also urge her to work with her colleagues, across several Departments, to ensure that health and wellbeing is prioritised throughout the digital roll-out.
It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Gower (Tonia Antoniazzi) for securing the debate and giving us the opportunity to discuss this important subject.
People are exposed to radio waves in the home, at work and throughout their daily lives. As the hon. Member for Gower mentioned, people have been talking about the issues for about 100 years, since early in the last century, but the numbers of devices and transmitters have increased rapidly, and the pace of change in how this technology becomes part of our lives can be very unsettling to some. People ask whether radio wave exposure levels are increasing and whether there could be health consequences, and I want to put on record right at the beginning that, very importantly, radio waves are non-ionising radiation. That means that the packets of energy that form the radiation are too small to break chemical bonds: the radiation cannot damage cells and cause cancer in the same way as ionising radiation. Even so, there are concerns that this type of radiation could have health effects, and a great deal of research has been done in the United Kingdom and around the world to clarify the matter, which is something the Government take very seriously.
A number of issues, both for my Department and for colleagues in others, have been raised during the debate, and I will try to address them. I will also pass them on to colleagues.
Health concerns about electromagnetic fields have been raised in relation to each successive wave of new communications services, from 2G to 3G and 4G mobile phone networks, and with wi-fi, smart meters and now 5G. I have certainly noticed the growing number of letters I have received from parliamentary colleagues, passing on their constituents’ concerns, and I am grateful for the opportunity to address some of them today.
Concerns about telecommunications networks first came to the fore in the late 1990s. A report containing an evidence review and recommendations was prepared for Government by the independent expert group on mobile phones, under the chairmanship of Sir William Stewart. A major research programme was undertaken and the international exposure guidelines were adopted, with a commitment from industry that they would be followed. Although many new services and technologies have been launched, the basic way they are delivered—by radio—has not changed, and the science of how radio waves affect the body does not change when a new technology is launched. However, the Government take people’s health concerns about electromagnetic fields very seriously. They have committed, and continue to commit, significant resources to supporting research and analysis on the topic, and policies are in place to ensure the exposure guidelines are followed.
Public Health England monitors the health-related evidence and collaborates internationally to ensure that any important new evidence is identified and responded to.
I think the hon. Lady talked about accurate information, and about honesty concerning the information put out by Public Health England. Public Health England conducts extremely rigorous research, all based on the best available international evidence and on monitoring assessments of expert reviews. Some of those things will, of course, be in the public domain, and others will not. I will happily write to the hon. Lady with all the evidence that is available in the public domain.
The Committee on Medical Aspects of Radiation in the Environment has a watching brief on non-ionising radiation. It assesses all the available data to give health advice. Many scientific studies have been done over several decades, and a wide range of health topics have been investigated, including cancer, reproduction, cognitive effects and electrical hypersensitivity.
The Minister referred to the frequency range. It is true that we are talking about lower frequencies than the ionising radiation that would be beyond the visible spectrum. However, it is not true to say that all low frequencies are not harmful. Looking at microwave radiation, for example, if we get a high enough intensity of non-ionising radiation we can still cause harm. I would not want to be in a microwave oven and I am sure the Minister would not either. So it is not just about frequency; it is about the intensity of the radiation.
The hon. Lady is talking about risks and hazards. [Interruption.] Yes, we are talking about two different sorts of radio wave, but she said that I would not want to go in a microwave oven. I am not suggesting that I would put myself or anyone else in a microwave oven, so we are talking about hazards and risks. The best scientific evidence given to Government is that the radiation is safe, and I was going to go on to talk about the evidence that Government have used before addressing some of the points that the hon. Member for Gower raised. I apologise if I have not quite understood the point made by the hon. Member for Glasgow North West (Carol Monaghan); I will happily discuss it with her later.
Expert groups in the UK and around the world have examined the evidence and published many comprehensive reports. In the UK, the Advisory Group on Non-ionising Radiation produced reports in 2003 and 2012. The Government have played their role in the international effort to learn more about the health effects of radio- wave exposure. They supported the dedicated mobile telecommunications and health research programme that ran from 2001 to 2012 and they continue to fund research.
A challenge in understanding the evidence is that some studies report effects, while others do not. Sophisticated analyses are needed to draw studies together, considering their strengths and weaknesses and working out what they mean collectively, which is the role of expert groups. Simply counting or listing studies that have found effects is not an adequate way of assessing where the overall evidence lies.
An expert group reporting to the European Commission delivered a review in 2015, and the World Health Organisation is currently carrying out a major review on radio waves and health, which will include studies performed over the past 25 years. Overall, those expert groups have not found any clear evidence of adverse health effects occurring if the International Commission on Non-Ionizing Radiation Protection exposure guidelines are followed. The ICNIRP exposure restrictions have been incorporated into a 1999 European Council recommendation on limiting public exposures to electromagnetic fields. The United Kingdom and Public Health England support that recommendation.
Since 1996, the World Health Organisation has been running an international electromagnetic field project that provides a forum for countries to gather together, discuss and share knowledge on this topic. The WHO’s main conclusion is that electromagnetic field exposures below the limits recommended in the International Commission on Non-Ionizing Radiation Protection guidelines do not appear to have any known consequence for health. However, as the hon. Member for Gower and other Members have mentioned, that does not mean that people who have electrical hypersensitivity do not have symptoms. Those symptoms are real and can be very debilitating, and the Department’s guidance is that those people should seek medical advice, so that their personal situation can be taken into account and the best possible treatments found.
I will also address the points raised by many hon. Members about the effects of screen time on the mental health of children; as any parent can attest, there are some effects. The shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), referred to SCAMP, and the Government conduct research that looks at the effects of technologies on schoolchildren.
Exposure levels reduce very rapidly with increasing distance from transmitting antennae, which means that being in immediate proximity to the transmitting antenna of a mobile phone handset held next to the head is different from living near a base station. There is long-standing precautionary advice from Public Health England and the NHS for mobile phone users, and research is continuing. We are continually looking at the evidence and updating our advice.
Public Health England takes its role very seriously, and is always monitoring the evidence. Since perhaps 10 years ago, there has been a lot of research into having mobile phones next to one’s ear. Of course, the way we use our phones is changing, but Public Health England is always looking at this issue and reviewing the best available evidence.
There has been a general trend from 2G through to 5G for transmitters to become smaller, to be mounted nearer to the ground, and to use less transmitted power. The hon. Member for Stroud (Dr Drew) raised a point about the electronic communications code, which I think is a matter for colleagues in the Ministry of Housing, Communities and Local Government. The hon. Member for Swansea West (Geraint Davies) has left, but I do not think we are cutting down trees; in fact, I am sure that the Government have committed to planting more trees. I know that the Secretary of State is very keen on them, so I will write to him on that issue.
To answer the questions that were asked about radio frequency fields and cancer, a working group of the International Agency for Research on Cancer reviewed the health effects of exposure to RF fields and concluded that such exposures are possibly carcinogenic to humans—group 2B, based on IARC’s classification scheme. There was a minority opinion in the working group that current evidence for humans was inadequate, and therefore there was no conclusion about a causal association. In terms of the different classes of carcinogens, there is a statement on the PHE website that responds to the IARC classification. PHE has summary advice statements that it sends to inquirers with a full explanation of different carcinogens; there is a broad spectrum, including petrol engine exhausts, bracken fern and talc-based body powder.
Since 2001, the Office of Communications has been carrying out an audit of the emissions from mobile phone base stations. The Advisory Group on Non-Ionising Radiation’s 2012 report contained a summary of over 3,000 measurements made at over 500 sites by Ofcom. The maximum exposure found at any location was hundreds of times below the international guideline levels, and typical exposures were much lower still. Public Health England advises that there may be a small increase in overall exposure to radio waves when 5G is added to an existing network or a new area, but that is expected to remain low relative to guidelines.
I hope I have demonstrated that the Government take seriously the potential health effects of the introduction of 5G, and that Public Health England is well placed to identify and respond to any important new evidence that may emerge. I reiterate that the public’s levels of exposure to electromagnetic fields from telecommunications networks are currently very low in relation to the international guideline levels, and are expected to stay that way after the deployment of 5G.
I thank the Minister for her response and Members from all parties who have taken part in the debate.
I have concerns about the international guidelines, and I think that the effect of exposure to electromagnetic fields should not be underestimated. When my hon. Friend the Member for Stroud (Dr Drew) asked the Department for Digital, Culture, Media and Sport a written question, a Minister replied that her belief was that the next-generation network would not endanger the public, and added that Public Health England had found no evidence of any significant risk and that the Government
“anticipate no negative effects on public health.”
I am afraid that those statements are far from reassuring. Belief and anticipation are insufficient grounds for making such statements; we have to think about the precautionary principle. To state that there is no evidence of significant risk prompts the questions of what level of risk is acceptable, and at what stage an unknown risk moves from being acceptable to significant.
Question put and agreed to.
That this House has considered the health-related effects of electromagnetic fields.