Skip to main content

Westminster Hall

Volume 707: debated on Tuesday 25 January 2022

Westminster Hall

Tuesday 25 January 2022

[Judith Cummins in the Chair]

Cost of Living

Before we begin, I remind hon. Members that they are expected to wear face coverings when they are not speaking in the debate. This is in line with current Government guidance and that of the House of Commons Commission. Please also give one another and members of staff space when seated and when entering and leaving the room.

I beg to move,

That this House has considered the cost of living in the UK.

I am delighted to have secured this debate today. It is very timely, and I honestly do not think that anything occupies the minds of constituents in North Ayrshire and Arran or indeed any other constituency more than this issue. It affects everyone. Everyone has noticed that their monthly outgoings are rising. Energy costs are up. Food prices are up. Fuel prices are up. Clothes prices are up. In that context, it is no surprise that consumer borrowing is also up, which will throw many into unsustainable debt as they struggle to keep up with essential bills. There can be no doubt that we are caught up in a genuine, biting cost of living crisis. It is simply not good enough that while our families, our communities and our pensioners are suffering, the Government are eating themselves alive over whether the Prime Minister knew he was actually at a party when he attended a party at the address where he lives.

I want to begin by saying a few words about the cost of energy. Gas and electricity bills are expected to rise significantly in April, when the energy price cap is predicted to reach £2,000 a year or £165 a month. That represents a 45% increase, although there are reports of even steeper rises. It is no wonder that National Energy Action believes that 6 million households will be in fuel poverty by April. That is a 50% increase from last year and it will hit hardest the poorest families, who spend most on energy as a proportion of their income. The reality is that wages are simply not keeping pace with the rise in the cost of living, as the Office for National Statistics has highlighted, with the Office for Budget Responsibility indicating that average real wages will be lower in 2026 than they were in 2008. Instead of a rising price cap, an emergency financial package must be introduced to support the most vulnerable and help families to cope during this crisis. The cost of living crisis is real and will only worsen as energy bills rise, alongside regressive tax hikes and inflation, pushing more and more people into poverty.

In addition the ending of the uplift to universal credit and working tax credit is imposing the biggest overnight cut to welfare in 70 years. The situation for too many of our constituents is critical. The changes to the universal credit taper rate are welcome, but they are not enough to help those who are struggling with this perfect storm of financial pressures. Let us not forget that apart from the suffering that the cut in universal credit will cause for those on low incomes, it will take £460 million out of Scotland’s economy. That money would be spent in local shops, stimulating local economies in communities in each and every town and city.

I thank the hon. Member for securing this vital debate. Behind those headline figures is a 30-year high in inflation. As she rightly stated, that disproportionately affects the poorest in our communities. Jack Monroe, known on Twitter as BootstrapCook, has written for The Guardian and referred to those real-life experiences. For example, a 500-gram bag of pasta that was 29p is 70p today. That is a 141% price increase. And it goes on and on and on. The hon. Member is right to point out that people on universal credit have had that massive cut of £1,000 a year or £20 a week. That money must be restored.

I absolutely agree with the hon. Gentleman that the cut to universal credit is beyond words in its cruelty and its insensitivity to the struggles that real people face every day. It is a cruel irony that, just as the Scottish Government introduced the Scottish child payment, the UK Government chose to remove the £20 universal credit uplift across the UK—pulling the rug away from struggling households in Scotland. That example really crystallises a tale of two Governments.

Yesterday, I heard hon. Members in the main Chamber say, “If the SNP is so concerned about the cost of living crisis, it should do more in Scotland to support people who are suffering.” I say to the Minister that in Scotland the hated Tory bedroom tax—a tax, incidentally, that hits the disabled hardest—has been fully mitigated by the Scottish Government. I do not have time to mention all the support that the Scottish Government have brought in, using their own fixed budget, to support those who are suffering. It is deeply ironic that Members in this House talk about how the Scottish Government could do more when they are the very people who imposed the constraints that limit the Scottish Government’s powers to do just that. Give us the powers; if we have the powers, we will do more. The irony of calling for the Scottish Government to do more while tying their hands behind their back is well noted in Scotland.

However, the UK Government have a rich array of powers with which they could help to tackle this cost of living crisis—if the political will existed. They could introduce a real living wage. A real living wage would, as it says on the tin, relate to the cost of living—unlike the current, pretendy living wage. They could increase statutory sick pay, which is among the lowest in Europe. Unless the real living wage replaces the pretendy living wage, more and more people will find that they have less to live on as their pay is eroded by the rising cost of living.

The sad fact is that, shamefully, the UK has the highest poverty rate and the worst levels of inequality in all of north-west Europe, with 11.7% living in relative poverty. Around two thirds—68%—of working-age adults in poverty in the UK live in households with at least one adult working. That figure is at an all-time high. Poverty is driving unsustainable debt, with around 3.8 million households carrying an estimated £5.2 billion of arrears in household bills—a figure that has tripled since the start of the pandemic. People are borrowing more to pay for basics and essential bills.

Further, the Chancellor could cut VAT on energy bills and provide emergency loans to energy companies that are teetering on the brink. He could rule out a rise in the energy price cap and reintroduce the £20 per week uplift in universal credit. If the political will existed—and I fear that it does not—the UK Government could replicate the Scottish Government’s child payment across the UK.

As household energy bills soar, fuel costs are rising too. That does not just hit motorists hard; it also has a wider impact on industry because it pushes up the price of food, goods and services. Amid all the pain being suffered by our constituents and communities, we are approaching the highest tax burden since the early 1950s because of the national insurance hike. The consequences for our poorest could not be more stark; they could barely be more harsh. The national insurance hike means that workers earning as little as £10,000 will soon pay a national insurance rate of 14.25%, regardless of income. If student loan repayments are included, graduates earning just over £27,000 will pay a marginal tax rate of 42.25%—and the Tories call themselves the party of low taxation! All of that will act as a drag on recovery. UK consumer confidence is at its lowest level for 11 months, as people understandably worry about surging inflation, which is expected to rise to a staggering 7% by the spring.

It looks much bleaker when we factor in the Brexit effect, which I know the Government do not like to talk about, but let us do so for a minute. The Office for Budget Responsibility—the UK Government’s own forecaster—suggests that the worst is yet to come. Make UK is an organisation representing 20,000 manufacturers, and it has said that Brexit will undoubtedly add to soaring consumer costs this year. Squeezed supply chains are under pressure, with customs delays, border red tape and labour shortages, and additional costs ultimately borne by consumers.

Last month, as the hon. Member for Weaver Vale (Mike Amesbury) indicated in his intervention, we saw £15 added to the average price of groceries. The rate of food price increases is set to increase further this year, just as the national insurance hike is set to bite into pay packets in April.

Let us not forget the promises that were made—the pictures that were painted of the sunny uplands—as we approached Brexit. We were told that VAT on energy bills would be scrapped. Now we are told we cannot do that because it would be a “blunt instrument”. We were told that the price of food would go down. In the wake of Brexit, this message slightly changed to there will be “adequate food”, but we see the price of food rising fast.

It seems that there is one rule for one and one rule for another. As the Minister will stand up and tell us, there are lots of reasons why he cannot do more, there are lots of reasons why the Government cannot do more and hard choices have to be made. In that context, I cannot help but remember the words of Lord Agnew yesterday when he talked about the £4.3 billion of covid loans conveniently written off by the Treasury. He said “arrogance, indolence and ignorance” were at the heart of Government and were freezing “the Government machine”. He said:

“Schoolboy errors…allowing more than 1,000 companies”

that were

“not even trading when Covid struck”—[Official Report, House of Lords, 24 January 2022; Vol. 818, c. 20.]

to have loans could not be justified. I wonder how much pain people like the ordinary man in the street would have been saved by a cash injection from the Treasury of £4.3 billion.

We cannot forget the poor deal for pensioners in this crisis. The WASPI women—the Women Against State Pension Inequality Campaign—have already been left high and dry as their pension age was increased with little or no notice, throwing their retirement plans into chaos. I want to head off once again the allegation that if the SNP Government are so concerned, they can help the WASPI women. I simply quote that section 28 of the Scotland Act 2016 prevents the Scottish Government from providing support on reserved areas, including pensions assistance or assistance by reason of old age. Once again, we need to burst the myth that the Scottish Government can solve the WASPI problem. It is a problem of the Government’s own making and it is down to them to fix it. If the Scottish Government had the powers, we would be happy to do so with all the levers of an independent country.

Those who have finally reached state pension age now find they are being clobbered again as the triple lock has been abandoned—right in the middle of a cost of living crisis. State pensions have to keep pace with the cost of living, otherwise, we will see older people languishing in poverty as the threat of a rise in morbidity from the cold looms large this winter. I will say that again, because it is outrageous: there is an expectation this winter that the death from the cold among older people will rise. I do not even know what to say about that, it is so appalling.

Pensioner poverty has risen to a 15-year high under this Government’s watch as 985,065 pensioners have been directly impacted by the breaking of the triple lock, despite the fact that UK pensions are the least generous in north-west Europe. Not only are they the least generous but they have been clobbered by this Government in the middle of a cost of living crisis. It is simply not good enough for the Government to fiddle while households, pensioners and one in four children in the UK suffer poverty as a result of the choices the Government are making—and it is a result of the choices they are making. The cost of living crisis is not inevitable, although of course there are factors at play such as global energy challenges and the all-too-predictable consequences of Brexit driving up prices due to supply issues.

I am grateful that my hon. Friend mentioned energy prices. Does she agree that the UK Government’s penchant for reducing investment in onshore wind farms, as well as removing subsidies for offshore specifically in Scotland, undermines not only renewable energy but the production of the cheapest energy that this United Kingdom of Great Britain and Northern Ireland can provide, which would otherwise lower energy costs for our constituents?

Absolutely. That is yet another example of this Government’s skewed priorities—no joined-up thinking, no strategic thinking. Of course, at the moment, they are a Government who are not focused on governing, but are tearing themselves apart with their own internal struggles.

However, there is action that the Government can, and should, take to see people through this perfect storm of rising costs. To stand by and do nothing to alleviate this very real crisis while so many of our constituents across the UK suffer—including the Minister’s constituents—is not acceptable and, as I said, shows skewed priorities. It punishes those on low pay. It punishes those seeking work and pushes them further away from the job market, because poverty creates barriers to work that need not be there. Perhaps worst of all, it punishes those whose health prevents them from working. Among all that, it punishes the children in all the households that are struggling during these difficult times, because it blights their childhood with poverty. I can tell the Minister that the scars of childhood poverty do not easily heal and are never forgotten. If this Government wanted to, they could do more. They could use their powers for good, to protect and support those they are supposed to serve. I urge the Minister to make the case to his Government to do so.

I am grateful for the opportunity to take part in this worthwhile and timely debate. I apologise for not being able to take part in yesterday’s debate, but it is really important that we talk about how we can help households and families in our constituencies that are facing the real pressure of increased house prices, and all the anxiety and difficulties that go with that. I agree that the Government must do what they can to mitigate increasing living costs, particularly for low and fixed-income families.

I regularly host drop-ins across west Cornwall, where people can come along and raise whatever issue they like. I try to do so in every part of my constituency: like many Members present, I represent a large rural area, and it is important that I get to where people are. Many people, pensioners in particular, have come to me in recent months. Those households have worked hard to plan for their retirement, but find that their pension has become less able to meet their basic living costs—a position that they never expected to be in. These are not just pensioners on the state pension who might be getting pension credit: there are those who have a small pension in addition, but are finding that costs are outrunning their income.

I have also come across several families whose rent costs have rocketed over the past couple of years—an issue that I raised in this Chamber last month. It is really important that the Government look at how we can manage and protect housing supply, particularly in places such as Cornwall, which is a very attractive place to visit and possibly an attractive place to buy a second home or bolthole. That forces up the price of homes for the people living there, and that is true for lots of other constituencies, particularly coastal ones. The Government must look more earnestly at increasing the availability of rental properties and homes to buy by protecting them for permanent residents. When we build new homes, it is important that they meet a local need, as is the case in St Ives, which is part of my constituency. This is about the cost of housing and rent.

Would not part of the solution be to build homes for social rent, allocated to local residents? Fewer than 6,000 of those homes were built last year. Would the hon. Member agree that homes for social rent must certainly be a big part of the solution?

I completely would, and I welcome that intervention. However, in parts of the country, including my constituency, families with fairly decent incomes who would never qualify for that list are also seeing their rents rocketing. We are talking about the nurses, teachers and police officers we need to come to take jobs in Cornwall, or stay in the county, and who cannot afford the rents they are expected to pay.

I absolutely agree with the hon. Gentleman’s point. Cornwall County Council, now under a Conservative administration, is ramping up the provision of social rental properties. That meets the needs of a particular group of constituents, but does not reach or solve the whole problem.

In view of the rising costs of housing, Cornish MPs are arguing in favour of protecting new buildings for permanent residents only, which will help to protect those homes for local need. I agree that we need to look at every tool available to ensure that people have secure homes for life that they can feel safe in. Those homes should be built efficiently, so that rising energy costs, which I will address in a minute, can be managed, so that we are not just heating up the planet when we are trying to heat our homes.

I want to touch briefly on energy costs. My understanding at the moment is that the cost of production of energy has not risen. Companies that are producing it, not all of them based in the UK, are making colossal sums of money due to demand. I am interested to hear from the Minister what the Government are looking to do to bring the cost that suppliers pay for energy closer to the cost of production.

Another area to look at is the feed-in tariff. For example, customers are seeing energy prices increase and that is expected to carry on this year, but those who are feeding into the energy supply, through solar panels or wind turbines they have invested in, are not seeing any change in the money they receive for that energy. It seems sensible for the Minister to look at whether the feed-in tariff should be tracked against the energy costs people pay.

There is no doubt that the energy market needs reform, but right now urgent help is needed for households most hit by energy prices. I heard the calls for a cut in VAT, but householders concerned about energy costs have already worked extremely hard to reduce the amount of energy they use, sometimes choosing not to heat their homes in order to feed their families. The VAT element of the bill for those families will be tiny: they might save £20 or £30, perhaps a little more, a year in VAT. If I owned several electric cars, a couple of hot tubs, maybe a swimming pool, and a massive house with lights on all the time, the savings I would make from the VAT cut would be significant. We are not helping the households that most need it with the headline-grabbing promise to cut VAT on energy.

There must be targeted and effective help for the families I have referred to, the pensioners, people on fixed incomes and low-income households. There should be cash to help with energy bills and, at the same time, an effective way to improve people’s homes. We have had lots of schemes recently where large amounts of money have been made available for people to retrofit their homes. In Cornwall, builders—people involved in construction—were already run off their feet with building homes and looking after Cornwall’s homes and did not choose to take up those offers. People came in from different parts of the country to retrofit homes, not doing it properly or effectively, and often going bust before they got found out.

Lots of Government money was wasted while the homes were not actually improved. The Government need to look carefully at how we retrofit homes, probably through local authorities, where that can be targeted and effective. Ultimately, not now but in the near future, the Government with their sizeable majority could properly reform the energy market so that the poorest families paid hardly anything—if anything—for energy, and those more demanding homes paid more.

Does the hon. Gentleman agree that energy market reform also requires a reform of transmission charges? While in most parts of England a subsidy will be given to provide energy, north of a certain line north of London people have to charge to produce energy to put it on to the national grid, and that reduces the ability of renewables to lower energy costs.

I agree that there is a need for a time out to properly look at the energy market and how it works. The price cap we introduced a few years back was helpful and certainly it is helping right now; my understanding is that the variable tariff is the best to be on. However, I met policy advisers some years ago to discuss some sort of block tier energy price, where the first units paid are extremely cheap or free and the more units someone uses, the more they have to pay. We have to retrofit the poorer homes to make sure that does not penalise them, but there is a need in the energy market to make those who can afford it contribute to the cost of energy for those who cannot. It is not a luxury; it is something that we need to care about. We do care about it, and we need to do something.

Order. I remind hon. Members that I will be starting speeches from Front-Bench spokespersons at 10.28 am and no later than that. Can hon. Members adjust their times accordingly?

Thank you, Mrs Cummins. It is a pleasure to serve under your chairship. I congratulate my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) on facilitating the debate. It is such an important one at this time and I am pleased to contribute.

The cost of living crisis being experienced around the UK has been created and compounded by a series of UK Government failures, all reaching an awful crescendo, it seems, at the same time—a decade of austerity, savage cuts to welfare, chaos and shortages brought by Brexit, inept handling of the pandemic and Ministers’ shameful failure to mitigate and anticipate against rising energy prices. As is so often the case under the Government, it is those with the least who will suffer the most from the price cap increase.

The Joseph Rowntree Foundation finds that households on low incomes will spend a staggering average 18% of their income, after housing costs, on their energy bills from April. For single adult households on low incomes that rises to an extraordinary 54%: an increase of 21 percentage points since 2019-20. The climate deniers among the Tories—one in 15 of them according to a recent survey by The Independent, although I will point out that the hon. Member for St Ives (Derek Thomas) is not among their number—like to peddle a narrative that environmental levies are to blame for high energy costs. However, analysis by Carbon Brief has found that energy bills in the UK are nearly £2.5 billion higher than they would have been if climate policies had not been scrapped over the past decade.

Those cuts included gutting energy-efficiency subsidies, effectively banning onshore wind in England, as my hon. Friend the Member for West Dunbartonshire (Martin Docherty-Hughes) mentioned, and scrapping the zero carbon homes standard. The latter move, as Lord Deben, the Chair of the Committee on Climate Change has pointed out, has resulted in hundreds of thousands of insufficiently insulated homes continuing to be built in the years since, effectively pushing the costs for bringing their insulation and energy systems up to scratch on to homeowners and off housing developers’ balance sheets. Those cuts were made after a front page by The Sun in November 2013 reported that the then Prime Minister David Cameron’s answer to rising energy bills was to get rid of “all the green crap”.

The hikes in energy prices, along with the cuts to universal credit and increasing national insurance contributions, are forcing local and national Governments to take even more action to protect our citizens. In the past eight years, the Scottish Government have spent £1 billion tackling fuel poverty and improving energy efficiency in homes and created a £10 million fuel and security fund, which gives direct help to those who might otherwise have been forced to ration or disconnect altogether from their energy supply. The Scottish Parliament also passed the Fuel Poverty (Targets, Definition and Strategy) (Scotland) Act 2019, which commits to drastically reducing the number of households living in fuel poverty in Scotland by 2040. Even before the expected energy price cap rise in April, one in three Scots is struggling to cover their energy bills—a Citizens Advice Scotland survey found that 36% of people in Scotland say their energy bills are unaffordable.

I know how hard this is hitting many people in my constituency of Edinburgh North and Leith. For example, my constituent Imogen lives with her husband, two teenage children and very elderly parents, who live above her in a self-contained flat. Over the past two years, their heating bills have increased because Imogen’s husband is now working at home full time due to covid, she works part time at home, and her parents need the heating on a lot as they are in their late 80s to 90s and are now not very mobile.

After the family’s energy supplier went bust, they were shunted on to another one. The first direct debit was not taken, leaving the family in a state of uncertainty about how much they were paying. Eventually, Imogen was able to set up another direct debit, but only after numerous stressful attempts to contact the new energy provider, as the company did not attempt to contact them. The family’s current energy bills are approximately £3,000 a year, and that looks likely to increase to £4,500 after the rise in the energy price cap. As you can imagine, Mrs Cummins, she and her husband are extremely concerned about how they will cover such a hike. Many more of my constituents will be facing anxieties similar to those that Imogen and her family are dealing with, with many further facing that dreadful choice to heat or eat in coming months.

Citizens Advice Scotland says that of those struggling to cover their energy bills, 40% cite low incomes as a reason, while 12% say that inconsistent incomes make it difficult to afford to pay for their utilities. That is why the Scottish Government’s promotion of the real living wage across all sectors is so important, helping to ensure that Scotland has the lowest percentage of earners earning below that living wage in the UK.

Our Scottish Government public sector pay policy underlines our commitment to tackle poverty by introducing a public sector wage floor of £10.50 per hour from April 2022, with additional funding for local government to ensure that that applies to adult social care workers in commissioned services. The UK Government must act to make work pay by increasing minimum wage rates and the totally inadequate statutory sick pay, in line with the real living wage.

The Conservative Government’s contemptuous treatment of those on low pay is also reflected, of course, in their latest attack on lifeline welfare payments, with the enormous cuts in the incomes of families on universal credit and working tax credit. In Edinburgh North and Leith, 13% of working age households were impacted, with 34% of that number being working-age families with children.

It all comes on top of more than a decade of Tory Government austerity, which the SNP Scottish Government are having to work very hard to mitigate. The fixed Scottish budget funds the Scottish Government’s priorities of tackling child poverty and inequality by targeting over £4 billion in social security payments. That includes the doubling of the game-changing Scottish child payment to £20 a week from April 2022. The Child Poverty Action Group welcomed that, calling it a

“lifeline for…families across Scotland”.

Consumer prices were 5.4% higher in December 2021 than a year before. That is the highest inflation rate recorded in 30 years. However, as we have heard already, food campaigner Jack Monroe’s excellent Twitter thread, which highlights huge price hikes for basics such as pasta, baked beans and rice, shows how that figure grossly underestimates the real cost of inflation for families on minimum wages, zero-hours contracts, and those forced to food banks. She also highlighted the manufacturers’ sneaky practice of making products smaller while keeping the same price—known as “shrinkflation”.

This Tory Government might be able to ignore Brexit chaos and the rampant cronyism, dark money and corruption in British politics, but they cannot keep ignoring poverty and people on low incomes any longer. As we have heard from my hon. Friend the Member for North Ayrshire and Arran, the UK has the highest poverty rate of any country in north-west Europe, and the worst inequality for every year of this century.

We call on the UK Government to urgently tackle the cost of living crisis by cutting VAT on energy bills and categorically ruling out a rise in the energy price cap. We must also see an emergency financial package to help families by reversing cuts to universal credit, delivering a low-income energy payment, matching the Scottish child payment UK-wide, introducing a real living wage, and increasing statutory sick pay in line with that real living wage. The UK Government could also choose to act now by providing everyone eligible for cold weather payment with a one-off payment to help those on lowest incomes with fuel bills. That would mirror what the Scottish Government will do when they take on responsibility for cold weather payments from next winter.

We must never forget that Governments, particularly those with all the economic levers of a normal country at their command, have choices. They can choose either to support, and treat with respect and dignity, those among us who need a helping hand, or to scorn their vulnerability and do everything possible to put obstacles in their way while sneering that they do not deserve our help. I know which Government I prefer.

The question must be asked: why is Scotland having to protect its citizens from the right-wing policies and vicious ideologies of successive Tory Governments when Scotland did not vote for those Governments? It is time for our independence and a fairer Scotland that does everything in its power to protect and support its citizens.

It is a pleasure to serve under your chairship, Mrs Cummins. I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on securing today’s important debate, which keeps a spotlight on an issue that impacts every person across the UK—including in my constituency. The current rate of inflation is 5.4%, which is the highest it has been in three decades. The Bank of England expects the consumer prices index to peak at around 6% in April, but others have a grimmer forecast—Goldman Sachs expects it to hit around 6.9%.

The cost of living crisis must not be underestimated; every essential will cost more and every penny must stretch ever further. In-work poverty has become more common, which is ironic under the leadership of a Government who claim to incentivise work. In April, benefits will be uplifted in line with inflation, but as inflation stood in September; inflation was only at 3.1% then, so this will represent around a 3% real-terms cut in 2022. In October, the Government chose to remove the £20 universal credit uplift, which is needed now more than ever. That was before inflation hit its current high.

There are some obvious areas that we can immediately recognise as stressors, such as energy prices and the cost of food, but there are other problems that we might not see so suddenly. Social housing, one of the UK’s greatest supports for low-income families, is in short supply; demand simply cannot be met, so we see people forced towards an unaffordable rental market. In the year until September 2021, rent across the UK had already risen an average of 8.6%. If Greater London is excluded, that figure lessens, but only to 6.6%. Private properties, for the vast majority, require a hefty deposit, which is a huge upfront cost. We know that it is often cheaper in the long run to spend more in the short term, but that is not an option for those on lower incomes. Homeowners face anxieties too, as the interest rates on mortgages increase; they may struggle to keep up and there is a possibility that some may lose their homes—the roof over their families’ heads.

Another worry is car insurance. It is cheaper to pay it annually in a lump sum than monthly, the cost of which has just hit a 12-month high. A car might seem like a luxury, but for so many it is a necessity; it is how people commute in rural areas or in areas where there are poor transport links, and how people undertake caring responsibilities for family members. Those on low incomes are also more likely to have a poor credit rating and less likely to recover from debt—they may need to access short-term, high-interest payday loans. Previously, these loans may have been used to cover unexpected large expenses, such as a car breaking down or to replace white goods. However, there is a real risk that these loans are now going to be taken, out of necessity, to cover basic living expenses.

Credit cards pose the same risk; what happens when next month rolls around and people have the same expenses to cover but a couple of hundred pounds less in the bank to cover last month’s lending? It is a dangerous cycle and one that the Government must do everything in their power to prevent—these are not options that people should have to consider.

What if someone becomes sick? Statutory sick pay in the UK is the worst in Europe, at £96.35 per week. From April, a full-time job earning the national living wage is over £230 per week. I had a constituent contact me last week because she had missed the deadline for the warm home discount. She has no frequent internet access, a pay-as-you-go SIM card and she did not have the money to top up and call her supplier in time, so she lost out.

The Government cannot rest on their laurels any longer. Their own Back Benchers are calling for the national insurance hike to be scrapped; even the Chancellor is seeking to distance himself from it. It is clear that there is a need for action. I plead with the Minister and his colleagues: please, do not leave it until it is too late. Let us help our constituents through this difficult time.

It is an absolute pleasure to speak with you in the Chair, Mrs Cummins. I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on leading the debate and on her important contribution; she knows about this subject, and speaks with real passion and belief. I am always encouraged whenever I hear her speak and, like other hon. Members present, I wholeheartedly support her on this issue. I could not attend a debate on this subject in the Chamber yesterday, because I was speaking here in a different debate—much as I may try, I cannot be in two places at once—so it is great to be present to endorse what the hon. Lady has said and support her fully.

This is a topic that applies to the whole United Kingdom. Although some housing matters are devolved, the issue remains the same across all of this United Kingdom of Great Britain and Northern Ireland. The cost of living has been rising since early 2021, but in December 2021—just a few weeks ago—inflation reached its highest recorded level in decades, affecting the ability of households to afford goods and services. That is what this debate is about: affording the basics of life. The hon. Member for Weaver Vale (Mike Amesbury) gave a couple of examples that illustrate the issue of food prices. Consumer prices were 5.4% higher in December 2021 than the year before—just 12 months earlier—making it the highest inflation rate recorded since 1992.

The cost of living combines the prices of housing, fuel, electricity, food and domestic services. First, I will speak about the issue of house prices. The hon. Member for St Ives (Derek Thomas) referred to house prices in his area. Prices in Northern Ireland, including in my constituency and the constituency of my hon. Friend the Member for East Londonderry (Mr Campbell), are the highest they have been for ages. It is putting people in real debt. I want to explain that, if I can, in the short time I have.

House prices increased by 10% in November 2021. The average property has risen by £20,000 in the last year—the fastest pace of increase in 15 years. That gives us an idea of how quickly this is galloping forward. Wages are not keeping track. I have been contacted by multiple constituents—young people, in particular—who simply cannot get on the property ladder because of those prices.

There has been a 25% drop in those aged 25 to 29 who have a mortgage because they feel that rent is a better option financially. The thing is, it is not a better option, because their rental prices are going through the roof as well. Houses that could previously have been rented for perhaps £375 to £400 a month now cost £550 to £600 a month. That is an extra £150 that they have to find, which they just do not have. The press has described the housing situation in Northern Ireland as a survival of the richest, as the majority of people simply cannot afford the rising price of houses. That is not the society I want; I want a society where we all have an equal opportunity to acquire a house.

Does my hon. Friend agree that the picture that he is outlining—of escalating house prices, the inflation rate going through the roof and energy prices rocketing—sends a message to the Government that there need to be urgent solutions? We all understand that it is difficult because of the times that we are living in, but those solutions are needed now, not in six months’ or two years’ time. A crisis is emerging that all families, and particularly working families, are going to be hit with.

I absolutely agree and I thank my hon. Friend for his intervention. We look to the Minister to give us some encouragement. It is about now, not in six months’ time; it is about getting over this mountain that our constituents are dealing with because of the rise in prices. My hon. Friend is right.

We can argue that a wage increase could assist with those payments, but in reality the added finance that people are earning is going straight to paying for the cost of living. Two hon. Members who have spoken today, including the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), have referred to the issue of national insurance contributions. Today, it is being reported in the press that national insurance contributions may not actually be going up in April. I am not sure if that is true, but we cannot ignore the fact that there is no smoke without fire. Whether that is down to the Chancellor or the Prime Minister, I am not sure, but if that is the case, at least it would be something that we could take as help for our constituents—things we can do now, not later, as everyone is referring to.

Last week, I spoke about the rising prices of fuel. The fact that the Government and, back home, the Northern Ireland Assembly are having to provide additional schemes for people to avail themselves of shows that people are struggling to cope. The Communities Minister brought a scheme to the Northern Ireland Executive and Assembly to be endorsed: a £200 payment right away for those who are financially squeezed at this moment, and for those on benefits. We are doing it in Northern Ireland and I am sure that others are doing it elsewhere. Energy bills have already risen by a considerable amount and are set to rise to £2,000 per year from this April.

On my way to work each morning, I pass one of the oil companies in Newtownards, and they have prices up on the wall. Only about three months ago, the price of 900 litres of oil was £370—I remember, because I bought it at the time—but now it is £510. That is in a matter of months—my goodness! Those figures cannot be ignored. That is the reality right now. Such price rises will be detrimental to those already in fuel poverty. Recent statistics from National Energy Action estimate that between 1.2 million and 1.5 million households across the United Kingdom of Great Britain and Northern Ireland will struggle to pay their electricity or gas bills, adding to the cost of living in the UK.

On pension increases, a wee lady came to me to say, “Jim, tell me this: how will I spend the extra 25p I have in my pension?” What can I say to that honourable lady, who is a very good supporter of our party and of me individually? Twenty-five pence, my goodness! I have mentioned the price of oil and the price of food—as the hon. Member for Weaver Vale did, and as we all have. Twenty-five pence would not buy a loaf, a pint of milk—not even half a pint of milk—or a bar of chocolate. Twenty-five pence is a drop in the ocean, a ping on the ground; it is really nothing. I plead with the Minister for our pensioners. He is not ultimately responsible for this, but we need to have the discussions about what we need to do going forward.

The rising cost of food prices are contributing to the added cost of living. Food and non-alcoholic drink prices went up by 4.2% in the year to December 2021, on the official consumer price index measure of inflation. They may—they will—rise further in the coming months, and that contributes massively to the increase in families availing themselves of food banks. The Trussell Trust, which is in my constituency, delivered 2.5 million three-day packages over 2021. That was one of the highest figures in recent years.

In my constituency, the Trussell Trust in Newtownards indicated that it has done a third more food bank referrals. I know that we did it through our office by massive amounts on a year ago. That tells a story. People’s generosity to the food banks, with churches and individuals coming together, is massive, and we thank everyone who made contributions. However, we need to address the issues now.

At a time when many are struggling, I urge the Government to step in—because that is what we do. We do not always have the begging bowl out; it is about helping our people right now. I wish I had more time, but I do not, to go into detail about how badly the rise in the cost of living is impacting people. All too often, families struggle to make ends meet and the rise in prices for the most basic of daily needs is disheartening for so many. It depresses us no end.

To look towards the future, I also urge the Government and the Minister to remember that there will be a rise in national insurance, although I hope that today we will get an indication that that may not happen. We need such steps taken to help our people. The great thing about today is that all of us—all parties—are here together, but now we look to the Minister. His fellow Conservative, the hon. Member for St Ives, spoke convincingly about the issue. I think we have consensus across the Chamber on it, and we look to the Minister for encouragement to our constituents, and to ensure that the help that comes will come now and not later.

It is a pleasure to serve under your chairship, Mrs Cummins. I thank the hon. Member for North Ayrshire and Arran (Patricia Gibson) for securing this important debate. She made an excellent contribution, setting the scene. I also refer to my entry in the Register of Members’ Financial Interests.

I will talk first about just one of my thousands of constituents who are suffering so terribly as a result of the Tory cost-of-living crisis. In 1944, he fought to defeat fascism on the beaches of Normandy. At the end of the war, he returned home to the promise of a land fit for heroes. But now, in his late 90s and living alone, he is terrified by the prospect that one day very soon his modest pension will not stretch to cover the costs of soaring energy bills and food prices. He is not alone: all across the country, millions of people are living in freezing houses, too afraid to turn the heating on, while others are going hungry so that their kids get a half decent meal.

Meanwhile, with energy prices set to soar by a further 45% by spring, and households bracing themselves for a national insurance tax bombshell, this Government seem far more concerned with their own internal turmoil than with finally getting to grips with this crisis. I put one very simple question to the Minister today: how on earth can he justify letting a man who risked his life to defend our freedoms worry about the cost of turning his heating on in the middle of winter?

Last autumn, I warned Ministers that the impact of rising energy costs and the cut to universal credit risked plunging thousands of people on the Wirral into poverty. At the time, Ministers lazily dismissed my concerns out of hand, and the Prime Minister himself called fears about inflation “unfounded”. My God! Even now, when confronted with the reality of the situation, this Government refuse to act.

My party has set out a credible plan to address the scourge of rising energy costs. I urge Ministers to finally put the interests of our country above those of the Conservative party, and to set about removing VAT from domestic energy bills and implementing a windfall tax on North sea gas and oil to support those most in need. But we must go further still. We must bring the energy sector back into public hands, so we can begin to slash bills for UK consumers and build a greener energy sector that is less dependent on foreign energy supplies. We must also acknowledge that energy is only one part of a much wider problem. For more than a decade, UK workers have seen their wages stagnate as prices have soared. Even our healthcare heroes, who have done so much to save lives and stop the spread of the terrible virus over the last two years, have not been spared, with last year’s measly 3% pay rise amounting to a pay cut in real terms.

The Government must act now. That means abandoning their plan for a national insurance hike, which threatens to hit low-income workers and small businesses hardest of all, and committing themselves to a £15 minimum wage, as called for by my hon. Friend the Member for Middlesbrough (Andy McDonald).

It is a pleasure to serve under your chairmanship for the very first time, Mrs Cummins. I congratulate my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) on securing this timely and important debate, and thank all Members who have taken part. We have had a wide range of contributions, highlighting various factors concerning the cost of living these days.

This Tory Government are proud of their success in getting people into work—it is trumpeted at every turn. However, what is the point of getting people into work if doing so does not help them to support their families to get the basics in life? A pretendy living wage just does not do that; it does not help them when they become sick and have to rely on an absolutely ludicrous statutory sick pay, and it does not help if they are a pensioner on the most meagre pension in the western world, or a WAPSI woman waiting and waiting for her pension to arrive.

The UK is one of the richest countries in the world, but the gap between the richest and poorest in our society continues to grow. Many of my constituents in Motherwell and Wishaw suffer under this Government. Energy bills will rise by 45% from April. “That is a worldwide issue,” say this Government. That is true, but what makes the difference is what a Government do to mitigate poverty. What do this Tory Government do? Very, very little. As my hon. Friend the Member for North Ayrshire and Arran said, National Energy Action estimates that 6 million UK households will be living in fuel poverty by April—a 50% increase from April last year. I ask the Minister: what will be done about that? Inflation is rising, but the headline figures of predicted rises do not give the full picture. The think-tank Reform has said that inflation is hitting poorest families hardest.

Lorna Cooper from Paisley, the author of “Feed Your Family For £20 A Week”, prepared a shopping list and meal plan for January 2021 and then made a comparison this month. In 2021, the shopping list for the meal plan cost £20.21. This year, the cost is £25.88, which is a 23% increase. As we all know, many supermarket basic ranges no longer exist, and there cannot be many of us who have not already heard of the 141% rise in the cost of basic pasta.

This UK Tory Government have failed to address a cost of living crisis that will disproportionately affect disabled people. The Joseph Rowntree Foundation found that 49% of those living in poverty in the UK are either disabled people, or live in a household containing a disabled person. The Disability Benefits Consortium estimated that 2 million eligible claimants have missed out on support due to the decision to exclude legacy benefits claimants from the £20 uplift—a decision that now faces legal challenges. It also found that even if disabled people had received the £20 uplift that they were denied, it would still not be enough to meet the real needs of disabled people who rely on benefits.

Research by Scope says that life already costs those who are disabled £583 more a month on average, and that families of disabled children

“On average, face extra costs of £581 a month”.

It adds that

“For…24%...of families with disabled children, extra costs amount to over £1,000 a month.”

Disabled people have been disproportionately impacted by the pandemic and the covid restrictions, from rising food and energy prices to the emotional toll of shielding, but disabled people have been forgotten about in this Tory covid recovery plan.

Providing unpaid care is pushing thousands of families into poverty, and will have a lasting impact on their finances and quality of life. That was the case before covid-19, but the situation has now been exacerbated by the pandemic. Now such families face a cost of living crisis.

The Family Fund found that in 2021, 75% of families with disabled children reported that the overall support available to them had decreased since the beginning of the pandemic, and 76% reported that their overall financial situation had become worse as a result of the pandemic—and now the cost of living is increasing daily.

Carers UK has found that carers are using their own income or savings to cover the cost of care, equipment or products for the person they care for. On average, carers spend an estimated £1,370 a year on services or equipment for the person they care for. It also found that 35% of carers who provide 35 or more hours of care a week have been or are in debt. These are the words of a carer:

“I don’t have luxuries, can’t afford life insurance, car insurance or house insurance. At 60 I shouldn’t be using food banks and made to feel inadequate because I can’t afford petrol.”

Another carer has said:

“Crippled further by heating/electric going up even further to £177 a month. We have managed without heating in the past, I suspect we will again now”

Think about that—it is 2022. This situation is appalling.

What can be done about all this? The UK Government must introduce an emergency financial package to support the most vulnerable and to help families to cope with the Tory cost of living crisis. Here are some suggestions, based on what the SNP Scottish Government are doing, using their devolved powers to support disabled people—and, as my hon. Friend the Member for North Ayrshire and Arran has said, they are doing so on their fixed budget.

The Scottish Government have extended child winter heating assistance to include young people aged 16 to 18. In total, they will support severely disabled children, and young people and their families, through a £202 payment to help with heating bills. This benefit is unique in the UK.

The Scottish Government’s child disability payment opened for new applications in November last year. It is the first of three complex disability benefits to be introduced nationwide by the Scottish Government; the adult disability payment will be introduced at the end of this year. This new payment replaces the UK Government’s disability living allowance for children and provides money to help with the extra care and mobility costs that children and young people with a disability may have. The Scottish Government will provide disabled people with a fundamentally different experience, based on dignity and respect. They will also ensure that individuals who face the greatest inequalities and risk of long-term unemployment are at the forefront of those benefiting from support.

What will this UK Tory Government do to help those most in need? Will they roll back the benefits cap, the two-child limit and the cut to universal credit of £20 per week—removed as the cost of living rises and never given to those on legacy benefits? Will they cut back on the rise in national insurance contributions from April, which will affect the lowest paid, but not those living off dividends and property rentals? Will they provide real help with energy costs and housing costs, which have been mentioned a lot in this debate? I should like to think that they will, but I doubt it.

As a bonny lass from Ayr, it would be remiss of me to let today go without a bit of Burns, so here is the “Selkirk Grace”:

“Some hae meat an canna eat,

And some wad eat that want it;

But we hae meat, and we can eat,

And sae the Lord be thankit.”

It was true in Burns’ day that there were haves and have-nots; it is a disgrace that this state of affairs still exists in the UK in 2022. People and organisations across Motherwell and Wishaw, and the whole UK, are fighting the effects of poverty day and daily. It is time for this UK Government to step up and do the same.

It is a pleasure to serve under your chairship in this important debate, Mrs Cummins, and I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on having secured it. It is a fairly obvious truth that there are things that really matter to our country, and the subject of today’s debate is one of them. There are also things that are embarrassing and we wish we did not have to talk about, and frankly the sorry state of Downing Street is one of those, so I am glad to be here in this debate, talking about something that really matters.

The cost of living crisis that we are facing is going to come to a crunch this year, but let us be honest: it has been a problem for the past decade. When a country has had slow or no growth for a decade, and when wages are held down while prices rise, that will cause a problem for the vast majority of families in that country. Those who are in the worst financial situations face the indignity of having a food bank parcel where their shopping should be, unlike every other normal family in this country. It is outrageous that 2.5 million of our fellow citizens, including half a million children, are in that position. That is not the product of events that have happened in the global markets in recent times; it is the product of 10 years of lost economic growth, and 10 years of lost progress on tackling poverty in this country. That is why we are here today.

As we look at the rise of referrals to food banks, it is important to note that a different category is increasing: those in the middle class are also squeezed now. We are finding that more and more people are under the cosh of prices. We all know how important the role of food banks is, but the Government have to recognise that this crisis is greater than it ever was before.

I thank the hon. Member for his intervention, and to a degree, I agree with him: any of us could end up needing to go to a food bank. This can happen to any of us, but important though food banks have become, I want a Government that seek to end the need for them. Is that too much to ask? Do we just have to accept food banks as a permanent feature of our country now, or might we one day have a Government that set out to end the need for them?

As much as I agree with some of the points made by colleagues from the SNP, I have to challenge them. How are they going to meet their own goal set in 2017 of child poverty reduction? It was made without qualification. We all want to see an end to child poverty and therefore it is important that that goal is met. I feel strongly that the Tories in Westminster made the wrong choice in getting rid of Labour’s national goal to end child poverty and wiping the Child Poverty Act 2010 from the statute book. It is equally important that those who have made commitments to the people of Scotland stick to them.

The way the Scottish Government will do this is through independence and the control of our own economic levers—it is as simple as that. We make commitments and we hope to be able to achieve them, because then we can do things the way they should be done and in the way that is best for people in Scotland.

I look forward to hearing how that is going to work. I think the way to tackle poverty everywhere in the United Kingdom is through co-operation and the use of the redistributive force of the United Kingdom Treasury. Members rightly mention the bad impact of the botched Brexit deal on our country’s economic fortunes. I would hate to see any part of our country go through the same thing with the loss of access to the United Kingdom single market, so I look forward to hearing more in future debates about how that will work.

I turn to the UK Government and the issue of inflation. Members have mentioned that the headline inflation rate in no way represents the specific forces of inflation that are faced by those with the least. I think people who suffer poverty must be some of the finest economists in the country, because they are able to monitor prices and make every penny they have stretch further when they need to. The Government should take some responsibility here. What has the Minister asked of the Office for National Statistics, in respect of its measuring and reporting, so that we can know exactly what situation is faced by the people who have the least in this country?

I point the Minister to the comments of the chief executive of Iceland, who says that he is losing customers not to his competitors but to food banks. That should tell the Minister that we really do have a problem with prices in this country that cannot simply be understood from the headline rate of inflation.

Secondly, on work, does the Minister accept that whatever the intention of a jobs plan that set aside £9 billion for a job retention grant that was then cancelled; whatever the intention of a jobs plan that had a kickstart programme that was supposed to get jobs for 250,000 of our young people but failed to do so; and whatever the intention of a jobs plan that was supposed to bring older people back to the workforce, given the level of vacancies in our country now, that jobs plan was a failure?

Does he further accept that when it comes to people’s wages—the other side of the cost of living crisis—a crucial part of the problem is that people have too little choice about the job they do? The OBR says that one in five people is working below their skill level. They could get a better job, but they have not. The Government have much more to do to improve people’s prospects at work. I would bet the Minister agrees that the best route out of poverty is work. Why do we have a Tory Government that are failing to get people jobs that can pay for their bills and shopping? It is an outrageous situation.

Finally, I turn to some of the other ways in which people need help. If we think about people’s ability to earn more, some of the things that are holding them back are those facts about our economy that we have known about for far too long. The childcare system in this country is expensive and complicated. What steps has the Minister taken to simplify it? People trying to make ends meet on a lone parent’s income, for example, are limited by the cost of childcare and whether it is available at all. I think again of the one in five people who work below their skill level. A lot of them have caring responsibilities for children or older relatives and cannot work longer hours in their jobs because they do not have care support. What conversations has the Minister had about solving that?

I also want to mention the simple fact that in too many parts of our country it is hard to get around on public transport. The price of buses has gone through the roof in recent years, and in some parts of the country people cannot travel to a job because there is no public transport. Yes, the price of motoring has gone up, but it is hard to get a better job if someone relies on public transport in areas that have too little.

It would be remiss of me not to mention the fact that too few people are members of trade unions in this country, and that limits their ability to bargain for better wages.

The Labour party has put forward some simple, compelling and obvious ways in which the Government could take steps today to tackle the cost of living crisis. Whether it is cutting VAT on fuel or extending the warm home grant through a windfall tax on oil and gas, we know there are steps that we can take now. However, I want to hear from the Minister about the bigger structural changes that we need to fundamentally shift our economy so that every family in this country can truly make ends meet.

It is a pleasure to serve under your chairmanship today, Mrs Cummins, and to see your wonderful smiling face. I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on securing the debate. It has been a lively one on important issues, but it was brightened up by the wonderful tie of my hon. Friend the Member for St Ives (Derek Thomas).

The Government are taking the present challenges of those on low incomes very seriously. The pandemic has been challenging for many people. We acted quickly to put in place unprecedented levels of support during this period, as has been highlighted by some Members today. After yesterday’s debate, it feels a little like groundhog day discussing these issues today, but they are important. As was highlighted yesterday, given the current cost-of-living challenges, we in the Government are actively working on the best way to build on the existing support that is available. I hope that will reassure the hon. Members for Strangford (Jim Shannon) and for East Londonderry (Mr Campbell), who raised points on this, as well as my hon. Friend the Member for St Ives.

Since the pandemic started, we have spent more than £400 billion on protecting people’s jobs and livelihoods and supporting businesses and public services. There has been unprecedented welfare support. Universal credit has stood up to the challenge of covid-19, providing a vital safety net for 6 million people. We must thank the hard-working staff at the Department for Work and Pensions, including the thousands of work coaches across all our constituencies, who worked tirelessly to ensure that the benefits system did its job. Many of them are the pandemic’s unsung heroes. I hope that we make an extra effort to thank them when we perform our constituency duties over the weeks ahead, if we have not done so already.

I just want to add that whatever the policy disagreements between our parties, I agree wholeheartedly that those who work for the DWP, particularly on the frontline, deserve all our thanks.

I am grateful for that comment. The hon. Lady did not have to say that; I know her well enough to know that she feels that way. We have differences over policy, but we know we have very dedicated public servants in the UK and Scottish Governments who are committed to addressing the issues, and we are grateful for their work.

It is also important to highlight the fact that our successful vaccine programme is providing us with the protection to fight the virus in all its forms. Although we need to remain cautious, the latest labour market statistics show that time and again we have made positive decisions during the pandemic. As we have shown throughout the pandemic, the Government will do what it takes to support people who are struggling financially. Supporting vulnerable people in our society is of paramount importance to me, our Secretary of State and the Government.

The proportion of Government spending that goes on welfare reflects a strong commitment to the poorest in society. This year, we will invest more than £250 billion through the welfare system, including £110 billion on people of working age. That rightly provides an important safety net. We also take notice of the clear evidence that work, particularly where it is full time, plays an essential role in reducing the risk of poverty. With our economic recovery continuing, it is right to focus our attention on getting people back into work.

The latest job figures tell a positive story. A record number of people are now in payroll employment in the UK, with 23,000 people added to the payroll in Scotland in December alone. The UK has a buoyant labour market, with 1.25 million vacancies. That figure is has increased by 33,000, or 2.7%, on the month, and by 462,000, or 58.9%, since the start of the pandemic, offering people opportunities to secure a job, progress in work and increase their earnings. Current estimates show that the number of online job adverts in Scotland alone has risen by 13.3% since the start of the pandemic. To help people take advantage of those vacancies, our extended multibillion-pound plan for jobs will help people across the UK find work and boost their wages and prospects.

The hon. Member for Wirral South (Alison McGovern) will probably shake her head at this point, but we are making real progress. We have opened 150 temporary job centres; I had the honour of opening the most recent one in Macclesfield last Friday. We have recruited 13,500 work coaches. They make a difference because they care about individuals, often meeting them face-to-face—increasingly so as we come out of the pandemic. There are 1,200 extra work coaches in Scotland, helping with this vital task.

We are also investing in our young people through the kickstart scheme: 112,000 young people have started a life-changing six-month work placement, and 10,000 of those starts were in Scotland.[Official Report, 9 February 2022; Vol. 708, c. 12MC.]

It was supposed to be 250,000 by now. Given what the Minister just said, what accounts for the gap?

There are more vacancies available, and we are encouraging people to take them up across the country, in Scotland as well. The scheme has seen real success in turning people’s lives around. There are further opportunities in the months ahead for people to get involved with that important programme.

It does not stop there, because we want to ensure that we help address some of the gaps in the workforce that were highlighted yesterday: in hospitality, health and social care, and technology. Sector-based work academies help people to get new skills and a guaranteed job interview at the end of their placement.

I also recognise, along with many others here, the immense value that older workers bring to the workforce. That is why the DWP is providing specific funding for that cohort. There is funding available for the over-50s to get tailored Jobcentre Plus support, to help them find work and build on skills to get into the workforce.

In addition, to support those jobseekers who are out of work for 12 months or more, our Restart scheme provides intensive support to help claimants in England and Wales find jobs in their local area, which I am sure will be welcomed across the Chamber today. Through regular contact with all participants, providers will develop a strong understanding of the individual’s employment history, skills, aspirations and support needs to help each one succeed. That will break down the employment barriers holding claimants back from finding work.

I remind hon. Members that the DWP is focused on helping people to increase their income by progressing in work. We often talk about the importance of getting people into work, but we are equally committed to helping people progress in work and move ahead with their career aspirations. We will shortly respond to Baroness McGregor-Smith’s report on in-work progression and set out our approach. I hope that will be welcomed by the hon. Member for Motherwell and Wishaw (Marion Fellows), who was concerned about that issue.

Universal credit incentivises work as part of its design. With that in mind, we have gone further to make work pay, as has been referred to, by cutting universal credit taper rates from 63% to 55%, and increasing universal credit work allowances by £500 a year. That is essentially a tax cut for the lowest paid in society, worth around £2.2 billion in 2022-23. That means that 1.9 million households will keep, on average, around an extra £1,000 a year. In addition, from April 2022, we will boost the national living wage by 6.6% to £9.50, which is ahead of inflation and worth another £1,000 each year to workers on the lowest pay.

A number of Members have asked for confirmation that the national insurance contributions planned for April will be deferred, adjusted or done away with. I know the Minister cannot answer that question, because it is not his responsibility, but can he take it to the Chancellor for his consideration? That would be an excellent step in the right direction to help those who are under financial pressure.

The hon. Gentleman makes his point with characteristic commitment and compassion. We on the Treasury Bench note that and will make sure that it gets through. The particular levy he talks about is to tackle the impact of the pandemic on the NHS and to face a challenge that has not been faced adequately across many decades—to tackle social care—but the points he makes have been noted.

Coming back to the national living wage, the hon. Member for Edinburgh North and Leith (Deidre Brock) made some points about how we can move forward. Let me reassure her that the Low Pay Commission forecasts that the national living wage will reach £10 next year. That is consistent with the target for the national living wage to reach two thirds of median earnings by 2024. We will not stop at the 6.6% increase.

I note the interesting comments from the Minister about the national living wage and the planned increases, which I am sure will be welcome, so far as they go. Do his Government have any plans to deal with the age discrimination that is baked into the national living wage, which is not really a living wage?

I know where the hon. Lady is coming from. The issue is that younger people typically and often do not face the same cost challenges as other older people, because they are able to share accommodation costs with others. I do not regard it as discrimination, but I acknowledge the different costs that people face.

Further support for working parents has been put in place, doubling free childcare for working parents to 30 hours and increasing the value of healthy start vouchers by over a third, to boost the long-term health of young children. We are investing over £200 million a year from this year to continue the holiday activities and food programme, which provides enriching activities and healthy meals to children in all English local authorities.

I have noted discussion, not just today but yesterday, on concerns about the cost of living. We recognise that those exist, particularly in the case of energy costs. However, let me remind hon. Members of the measures we have in place to combat the adverse effects of the increase in worldwide oil and gas prices, which is a reaction to demand surging after the pandemic and the effect that has had on the global economy and our own economy. The energy price cap will remain in place at least until the end of 2022, to protect millions of customers and ensure they pay a fair price for their energy. Despite the rising costs for said energy, Ofgem has confirmed that the cap will stay at the current level this winter.

Secondly, winter fuel payments will be made to over 11 million pensioners this winter, ensuring that older people have the security and dignity they deserve. Households with someone of state pension age will receive £200, and households with someone over 80 will receive £300. Thirdly, cold weather payments help vulnerable people in receipt of certain income-related benefits to meet the additional costs of heating during periods of unseasonably severe cold weather. That includes older people receiving pension credit and those receiving an income-based benefit with a disability component or where the household includes a child under five. In 2020-21, just over 4 million payments were made, at a cost of just over £100 million.[Official Report, 9 February 2022; Vol. 708, c. 12MC.]

Finally, this Government are supporting 2.2 million low-income households by issuing a £140 rebate on their energy bills through the warm home discount, which is worth £354 million. From this year, proposed changes will increase the scheme by £121 million, to be worth £475 million a year, with nearly 3 million households receiving a £150 rebate. As I said at the start, we are working across Government—I reiterated this yesterday, as did my right hon. Friend the Chief Secretary to the Treasury—to determine the appropriate response to assist vulnerable people facing rising energy costs. We recognise that people will be facing unexpected challenges with essential household costs. That is why in October we introduced a £500 million support fund to assist vulnerable households across the country this winter. The £421 million household support fund in England has enabled local authorities to provide targeted support to households in need of help with the cost of food, utilities and wider essentials; and the devolved Administrations received a total of almost £80 million through the Barnett formula, with Scotland receiving £41 million of that. I am pleased to see that they have all used the money to help households this winter.

Beyond this package of support, some people are struggling with debt pressures. The Government work closely with the Money and Pensions Service, and the wider free-to-client debt advice sector, to provide access to high-quality debt advice. The service remains the biggest funder of free debt advice in England. The DWP also uses appropriate touchpoints to ensure that those in receipt of benefits are signposted quickly and directly to expert financial help. To help those people, the debt respite scheme, also known as Breathing Space, came into effect in England and Wales on 4 May 2021. That gives someone in problem debt the right to legal protections from creditor action.

It is important to place the cost of living challenges in context. Prices are rising in countries around the world. As the global economy recovers from the pandemic, consumer demand is surging at the same time as global supply chains are being disrupted. We recognise and understand the pressures that this is exerting on people’s wallets, and their worries as they see the cost of food, energy and other essentials increase. My right hon. Friends the Prime Minister, the Chancellor of the Exchequer and the Secretary of State for Work and Pensions—indeed, all of us in government—are listening to those concerns and watching what is happening in the markets. As has been shown during the pandemic, this Government will do what it takes to support those most in need. I can assure hon. Members that we are continuing to actively work across Government to build on the existing support, already available, and to determine the appropriate response to assist vulnerable people facing rising energy costs.

Could the Minister tell me how it is that 27 energy firms have gone bankrupt? There is something wrong. Could he explain to the Chamber why?

The hon. Gentleman got in quickly there; I was about to end my remarks. This is a complex challenge. We know that there has been a real surge, and the Department for Business, Energy and Industrial Strategy is working actively to address these challenges. As I have said here, we are not concerned only about what has happened at the customer-facing end of the supply chain and the challenges that that has given to customers. The issue is the rising prices as well, and that is what we are focusing on.

I did not expect a dramatic policy announcement from the Minister today, but I was hoping, and I think we were all hoping, for a change of tone to signify that more would be done. I was hoping that, even if the Minister could not be specific, he would make a commitment that more would be done; that this Government would look more carefully at what could be done for those at the sharp end of the cost of living crisis. We in Scotland understand that, to truly tackle the cost of living crisis, we need all the powers over tax and welfare. That is what is needed to properly address those challenges in order to build a fairer and more just society. For Scotland, it is clear from the Minister’s answer and from yesterday that we must take our future into our own hands and build the just, fairer and more equal society that people in Scotland actually want.

Question put and agreed to.


That this House has considered the cost of living in the UK.

Tourette’s syndrome

[Relevant document: e-petition 575370, Increase funding to provide support and research into Tourette’s Syndrome.]

Before we begin, I remind Members that they are expected to wear face coverings when they are not speaking in the debate. This is in line with current Government guidance and that of the House of Commons Commission. I will call Conor McGinn to move the motion and then I will call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

I beg to move,

That this House has considered the treatment and study of Tourette’s syndrome.

It is a pleasure to serve under your chairmanship, Ms Cummins. I am delighted to have secured this debate on Tourette’s syndrome and how a lack of provision for research, diagnosis and treatment is impacting on individuals and families across the United Kingdom.

First, it is worth explaining what Tourette’s syndrome is. In short, it is an inherited neurological condition that causes involuntary and uncontrollable motor and vocal tics. Tics usually start in childhood, around the age of six or seven, and can fluctuate in severity and frequency, potentially occurring in nearly any part of the body and in any muscle. This can be painful, as one might imagine, and of course very debilitating, even disabling. Tourette’s is not often experienced in isolation. Up to 85% of those with Tourette’s syndrome will also experience co-occurring conditions and features, which might include attention deficit hyperactivity disorder, ADHD, or obsessive compulsive disorder, OCD, and indeed anxiety. These can be equally challenging, if not in some cases more challenging to manage than tics.

By far the biggest misconception about Tourette’s is that it is a condition that simply makes people swear or say socially inappropriate things. Involuntary swearing is a symptom of Tourette’s syndrome, but it affects only a minority. Ninety per cent. of people with Tourette’s do not have this symptom. However, having secured this debate, in my experience it is the single factor that those I have spoken to—colleagues in this place and others—commonly think of as the defining characteristic of Tourette’s. That goes to the heart of the challenge that we have in addressing some of the misconceptions about this condition.

Despite Tourette’s syndrome affecting the quality of life of over 300,000 people here in the UK—including, figures indicate, approximately one school-age child in every 100, most of whom are undiagnosed—this is a condition that, although relatively prevalent, remains widely misunderstood. Indeed, it is often deeply stigmatised and mocked throughout society. The stigma cannot be overstated, and the impact of it is very real. A recent study published in the Journal of Developmental and Physical Disabilities in 2021 outlined just how many participants faced discrimination in numerous aspects of life: 75% in education, 71% in their social lives, 61% on public transport and 54% in employment. A 2017 study concluded that people with Tourette’s are over four times more likely than the general population to take their own lives.

The reason I applied for and am leading today’s debate is to support my constituent Emma McNally, a St Helens mum who first wrote to me in July 2020. Her son was diagnosed with Tourette’s syndrome aged nine and could access regular appointments under the care of an excellent neurologist at Liverpool’s Alder Hey Hospital, which I know is familiar to the Minister. The retirement of the specialist in March 2020 left a gaping hole in provision locally and Emma’s son was discharged, with no one able to take him on. Unacceptably, to this day he has been left without the care he needs.

Emma’s journey—from local St Helens mum, living in Parr in my constituency, who contacted her local MP—to national campaigner and now the chief executive of the national charity for Tourette’s has done a great deal to highlight and raise awareness of this condition. Her e-petition on Tourette’s, submitted through the mechanism we have in this House, secured 71,000 signatures, which reflects the clear strength of feeling across the country for better care and services. She is fighting tenaciously on behalf of families around the country. Although her petition sadly fell just short of the threshold required for automatic discussion in this House, I am glad that we are having today’s debate, which goes some way to doing justice to her brilliant work and the importance of this issue. I have been contacted by more than 30 colleagues from all parties across the House, from all parts of the United Kingdom, who have expressed their support. I want especially to mention the Minister’s colleague and the erstwhile Parliamentary Private Secretary at the Department of Health and Social Care, the hon. Member for St Austell and Newquay (Steve Double), who has worked with me over the last year on this issue. He is prohibited from actively participating in this debate because he is now in the Government Whips Office.

The debate is long overdue. The last time the House met to debate Tourette’s syndrome was in 2010. Back then, the charity Tourettes Action held a list of 44 consultants in the UK with a special interest in Tourette’s syndrome. Now, there are only 17 who provide care in the NHS and will see children, and there are none in the north-west. I am sad to say that the picture for those living with this condition and their families has got worse over the last decade, and it should be getting better. We need to change this.

Families tell me that there is a significant and urgent need for specialist services and clinicians to bolster early diagnosis and rapid treatment. Early intervention in Tourette’s cases could reduce the more pernicious, longer-term strains on an individual’s mental and physical health and wellbeing, as well as on that of their friends, families, colleagues and teachers, by giving them a clear diagnosis and an idea of who to turn to.

I congratulate the hon. Member on securing the debate. On the issue that he has explained—the much-misunderstood aspects of Tourette’s—would he agree with me that we need not only more finance and more professionals involved in treatment but a greater degree of research into the development of Tourette’s, to assure present and future generations that it can be seriously tackled?

I thank the hon. Gentleman for his support and his intervention. I will come to research; it is an absolutely critical part of a holistic approach that understands more about the condition, intervenes early and provides ongoing care. I thank him for his support for his constituents affected by Tourette’s.

I am sure that the Minister will agree that it is unacceptable that Emma McNally’s son has to travel to London from St Helens to have treatment for this condition. That is something that we need to change. Although there are specialist centres for Tourette’s, the problem for families is that many centres accept only local referrals, or those from local child and adolescent mental health services. If there is no Tourette’s specialist at a local CAMHS, or indeed in the clinical commissioning group area—and the CCG considers this outside its remit—the result is that care is inevitably denied. That produces a Catch-22 situation: care is not available locally at CCG level or further afield regionally—and only sparingly nationally.

Families want clearer referral pathways to help those with Tourette’s, as well as clearer referral guidelines for professionals. Despite their best efforts, many GPs simply do not know where to refer children or adults with tic disorders. Currently, many patients are experiencing long waiting times and the ping-pong of being referred back and forth from one service to another, which, as well as being incredibly frustrating for patients, wastes the time and resources of our professionals in the NHS.

Even clinicians in CAMHS and paediatrics lack clarity on how to treat tics. That needs fundamental improvement. A clearer process, with clearer guidelines, along with more professionals with a specialist interest in treating Tourette’s, would also go some way to reducing the number of patients who are diagnosed and discharged at the same appointment. For them, follow-up care is not a possibility. They then find themselves trapped in a spiral of referral and rejection.

As the hon. Member for East Londonderry (Mr Campbell) has already alluded to, research is key for clinical and public understanding. The Government’s response to Emma McNally’s petition said:

“Funding has been committed to support research into Tourette’s syndrome.”

Research investment into this condition through the National Institute for Health Research plummeted by almost 50% between 2019-20 and 2020-21, from just under £670,000 to just over £362,000. I repeat:

“Funding has been committed to support research into Tourette’s syndrome.”

The Government also referenced a renewed focus on expanding Health Education England’s clinical psychology training intake to help adopt and develop services and respond to patients’ needs. When I asked Ministers what proportion of the wider clinical psychology intake had taken a specialist or, indeed, any interest in a Tourette’s placement, the Department said it did not possess that information. That will not provide much assurance to families listening today. I know the Minister is sympathetic, which is why I have deliberately made this debate about the issue and the policy, because it is one that we can work on together. Will she provide some clarity on that now, or if that is not possible today, can she take it away and write to me?

It is a question of fairness. Tourette’s has similar levels of prevalence in our society as autism and epilepsy, but where diagnosis and support, along with public awareness, for those conditions has improved in recent years, understanding and support for Tourette’s remains much more limited. Indeed, it is hard to imagine where many individuals and families would be without the fantastic work of charity and support groups in this area, such as Tourettes Action, The Brain Charity, the ADHD Foundation and others who do so much to support people.

In conclusion, I hope today’s debate will play a role in raising awareness of Tourette’s syndrome and the wider struggle that so many families across the country face in getting the support and treatment to which they should be entitled. The Minister has heard what I have had to say. Will she meet Emma and some of the other families to hear directly from them, if the opportunity arises? I know her intentions are good and I am sure that she will pledge to do her bit to work with me and others in this House who take an interest in this, as well as with the people who are directly affected. That way, we can try to transform the experience of those living with Tourette’s syndrome so they can get the support they need to live the happy and fulfilled lives that they very much deserve.

It is a pleasure to serve under your chairmanship, Mrs Cummins. I thank the hon. Member for St Helens North (Conor McGinn) for securing the debate on this important issue. I have been listening and have heard his impassioned case for better support for children and young people with Tourette’s syndrome. In particular, I was touched by the story of one of his constituents, Emma McNally, and the difficulties that she and her son face in accessing the care and support that he needs. I want to extend my personal thanks to Emma, whose tireless campaigning, along with that of other parents of children with Tourette’s, has helped emphasise the importance of children with Tourette’s getting the help they need and the difficulties that they are facing getting that help, particularly in the north-west of England.

I know that for many patients and families, Tourette’s can be an extremely debilitating condition to live with. I regularly receive correspondence on this issue. I was particularly moved by the case of Jay Mangan from Sefton Central and his two children, Rebecca and Jack, both of whom have Tourette’s. Having watched the video that Mr Mangan shared, I was struck by the severity of the tic episodes that both Rebecca and Jack routinely suffer. As the hon. Member for St Helens North flagged in his speech, Tourette’s syndrome can be misunderstood. There is not much awareness of it, so videos such as Mr Mangan’s are helpful.

It is also important that Mr Mangan and families such as his get the support that they need. We know that with the right care and support, someone living with Tourette’s syndrome can lead a fulfilling life, which is why the Government are determined to ensure that all those with the condition have access to the appropriate services.

The majority of services are commissioned by clinical commissioning groups, which are best placed to understand the needs of their local area. Services are commissioned through local community paediatric services or child and adolescent mental health services. Such services will be appropriate for the majority of children and young people with Tourette’s syndrome, and the teams involved will refer them to multidisciplinary teams, including clinical psychologists where necessary, to help with the management of their conditions.

Clinicians are supported in that work through the BMJ Best Practice guidance on Tourette’s, which covers both diagnosis and management. For children who require more specialist support, there are currently three recognised specialist centres in the UK—one in Sheffield, and two in London. These centres have internationally recognised expertise in the assessment and management of Tourette’s syndrome.

Following the retirement of a consultant at Alder Hey Children’s Hospital who had developed a special interest in Tourette’s, I understand that the current level of support available in the area is different—we heard how that impacted on Emma’s son. Local CCGs have acknowledged the impact on families and are considering options to address the matter. We understand that Alder Hey Children’s Hospital has developed a proposal for a local tertiary service for Tourette’s, which is currently under review. Discussions with the nine Cheshire and Merseyside CCGs are being led by the NHS Liverpool CCG, with a meeting planned for later this month in order to scrutinise the proposed clinical model. I have asked to be personally apprised of the situation, and I want to take this opportunity to extend an invitation to the hon. Member for St Helens North to meet me and discuss the local situation further. Of course, I would also be very happy to meet the families and learn as much as I can from lived experience.

To support patients across the country, it is vital that we have sufficient numbers of trained healthcare professionals, as the hon. Gentleman said. There were more doctors and consultants working in the specialism of neurology in NHS trusts and CCGs in September 2021 than there were 12 months earlier. Furthermore, Health Education England has supported a 60% expansion in the clinical psychology training intake over the past two years, which is expected to achieve a growth of 2,520 additional psychologists in the NHS workforce by 2025. Clinical psychologists are well placed to develop new services and undertake further bespoke development to respond to the needs of patients with Tourette’s syndrome.

To support the provision of services that can help children and young people with Tourette’s, we are increasing funding to child and adolescent mental health services. In March 2021, we announced an additional £79 million of funding, which will be used to significantly expand children’s mental health services. That will allow around 22,500 more children and young people to access community health services, and it will provide a faster increase in the coverage of mental health support teams in schools and colleges. The Department for Education has also announced more than £17 million to improve mental health and wellbeing in schools and colleges, including new funding to train thousands of senior mental health leads.

However, we acknowledge that support must be provided to unpaid carers of children and young people with Tourette’s, whose lives are significantly impacted on by the responsibility of providing around-the-clock care and support. We will invest up to £25 million to work with the sector to kick-start a change in the services provided, to support unpaid carers. We know what vital role they play and the sacrifices that they make for their families. We expect that the funding will identify and test a range of new and existing interventions, which could include respite breaks and peer group and wellbeing support.

The hon. Member for East Londonderry (Mr Campbell) mentioned research, which is very important. As we look forward, we recognise the value of funding and supporting research into Tourette’s. We are currently funding a number of studies, including a study on deep brain stimulation in people with Tourette’s and a digital behavioural intervention for tics in children and adolescents.

The hon. Member for St Helens North mentioned the variability in funding: some £2.1 million was spent on Tourette’s research between 2018 and 2020, but that figure depends on applications to the fund, which are not always linear. However, we very much welcome applications to that fund in order to understand Tourette’s and its underlying conditions, in addition to those studies that we are undertaking.

I close by once again thanking the hon. Member for St Helens North for securing this important debate. It is important in raising awareness, and it is important to families in the north-west, in the Merseyside area—an area that I am familiar with, as the hon. Gentleman said, because it is where I am from. It is important that families get the support they need, because the condition is difficult for some families to overcome. I thank those parents and families as well for all their work on raising the profile of this condition and the understanding that, with the right care and support, people can go on to live fulfilling and happy lives. I look forward to meeting with the hon. Gentleman and some of the campaigners to discuss this issue further, and to focus on securing the support that many families in the north-west need.

Question put and agreed to.

Sitting suspended.

Early Years Educators

[James Gray in the Chair]

Before we start this afternoon’s proceedings, I remind Members that Mr Speaker enjoins us to wear our masks when we are not speaking, to maintain social distancing and to do all of those things that I know Members want to do anyhow.

I beg to move,

That this House has considered the role of early years educators.

It is a pleasure to see you in the Chair, Mr Gray. Looking around me, I also see many friends and supporters of our early years sector. I thank them for taking time out of their schedules to come to debate this issue; I know that there are a lot of important competing issues in Parliament today.

I start with two declarations of interest. First, I am married to a hard-working early years educator, who will be arriving home very shortly to pick up the school run and then juggle all the different things that working mums do while working dads are in Parliament—or vice versa. Secondly, for the last couple of years it has been my pleasure to chair the all-party parliamentary group on childcare and early education; we held our annual general meeting in the last hour, actually. I want to extend my thanks to parliamentary colleagues who have supported our work over the last year and have committed to do so for the year ahead. I was somehow re-elected chairman of the group for the next year. I also thank many colleagues old and new who have agreed to serve as officers for the coming year: we have much to do.

This afternoon’s debate is timely. It rather wonderfully coincides with the all-party group’s annual childcare and early education week, which celebrates and promotes the hard work of our early years educators and sector. Our theme for this year is celebrating the role of the early years workforce as educators, which is what I wanted to place at the heart of my chairmanship of the group, and seeking to explore the challenges that the workforce faces and celebrate the good work that it does.

Last week, the all-party group held a forum for parents to share their experiences of early years educators and settings. It was chaired by the brilliant Professor Kathy Sylva of Oxford University. Professor Sylva is at this very moment providing an update to the meeting of our all-party group, which is being chaired in my absence by the Father of the House, my hon. Friend the Member for Worthing West (Sir Peter Bottomley). The session is being recorded, and I urge any colleagues who would like to catch up on it to follow our social media channels. Parents provided some incredible examples. I see this as an example of the very best work that we can do in Westminster, and I am sure that Professor Sylva will not mind me touching on some of the things that were said. One parent spoke about the empathy, patience and humour an early years educator shows when working with both her and her child, who has significant special educational needs. Another reminded us of the little freedoms that early years settings empower families to have. One lady said she occasionally has lunch with her partner; that may sound frivolous, but one the best things that we can do for our children is provide them with a loving, secure home environment—and making sure that mum and dad stay mum and dad is rather important, too. One phrase that touched me was from a parent discussing the key worker in their child’s early years setting, who said:

“Simply, we would be lost without these people. They are truly amazing.”

Of course, there are areas for development in the early years workforce as we strive for its continued betterment. At our forum, parents raised the issues of settings’ opening hours and, overwhelmingly, the need to ensure that early years educators are properly paid, a subject to which I will return.

I commend the Government for acting on this issue in the spending review. Following a meeting that my hon. Friend the Member for Bury North (James Daly) and I had with the Chancellor of the Exchequer, my right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak), he placed early years at the centre of some of his announcements in this area in the Budget. He quadrupled the funding for early years settings over the next three years. That was most welcome, and an important step towards shoring up a sector that has been heavily hit, it is fair to say, during the pandemic.

However, as I have said before, this is not just about money. The early years sector faces an existential crisis as settings are being forced to close, and the valued early years educators that we are talking about are then lost to other lines of work, often due to remuneration. Most worryingly of all, bright young prospects are put off a career as an early years educator. At a meeting of our all-party group in December, two apprentices spoke compellingly about their work with children under five. However, those brilliant talents were pursuing careers in social care and not in early years. Social care is an important vocation, but they are a great loss to the potential early years workforce of tomorrow, and we need them. So more must be done to draw the early years educators of tomorrow towards the profession, and not push them away.

I know the hon. Member is a doughty champion for the early years sector. I have heard him mention his wife on several occasions and admire the work that she does. In an ideal world I would stay and make a speech in this debate, but I have to leave because I have moved to the shadow Treasury team and I have a commitment.

I wanted to come and pay tribute to the early years educators, and I am pleased the hon. Member still uses the term “educators”, because they are educators. They are not just key workers. They are the unsung heroes of our nation who make a massive difference to our children’s life chances. I do not think he mentioned how much they are paid, but on average, as he knows, it is only £7.42 an hour, which is dismal compared with how much it costs to live.

I wonder whether the hon. Member will comment on the fact that we need a cultural change in how we value and talk about early years practitioners and educators. Instead of just referring to the early years sector as childcare, we should also refer to early years educators and talk about early education. I could go on about this for ever.

It is funny how often, in my almost 12 years in this House, people say, “That is amazing; I was just about to come on to that in my speech”, and funnily enough, I was. The hon. Lady led on this subject when she led the all-party group, and she is absolutely right. Far too often we have seen early years practitioners presented as well-meaning amateurs who are good at changing and plasticine. They are good at those, but they are also educators, so she is absolutely right. Following on from what she said, I think a major contributing factor to the fact that we are losing people from the profession and not attracting them into it is that early years educators have been subject to so many misconceptions about their role that it has affected how their profession is viewed and then how it can attract people.

First and most commonly is the notion that early years educators somehow do not hold the same status as those who work in the subsequent parts of the education profession. That could not be further from the truth. The first few years of early education is the foundation on which lifelong learning, health and wellbeing are built. Handling this phase of a child’s life requires specialist knowledge and specialist approaches from trained, qualified practitioners. Early years educators are highly trained professionals and they hold specialist qualifications accordingly. Despite that, many settings are struggling to pay competitive salaries, and providers have therefore reported that staff are increasingly moving into sectors such as retail.

I congratulate the hon. Gentleman on securing this important debate. I apologise because I cannot stay for the full debate, either. On the point about pay, is it not linked to the fact that so many providers simply cannot cover the cost of their staff and their settings with the amount that they get from the Government for the so-called free hours of childcare—the 15 hours that is universal for three and four-year-olds and the 15 hours additional? We could have a whole debate on whether somebody like me should be entitled to those hours, which is a separate point, but I speak from experience as the mother of a three-year-old who gets only 27 hours of childcare a week, yet I still pay half of what I paid before he turned three. The providers simply cannot make ends meet, and that is why they cannot pay the staff properly and cannot train them well enough.

The hon. Lady is right. The early years settings that we hear from in the group report that funding for the hours offered under the flagship 30-hours entitlement, which of course I support, has not kept pace with the rise in minimum wage and all the other costs, so the gap between the cost of providing each hour versus what comes in has narrowed and narrowed, and the lines have crossed. That is why we are seeing a squeeze and settings closing. I thank her for that point.

Competitive pay is the least that any qualified professional should expect. I hope the funding announcement in the spending review, as I mentioned, will help to address that. However, the pandemic has added stress for everyone. It has added to the stress of skilled staff, including with the increased risk of exposure to infection that our early years professionals face. A loss of skilled staff means that the early years sector cannot deliver high-quality early education, which will especially affect the most deprived areas and the most disadvantaged children. I want to stress that point to the Minister; I know that he is acutely aware of it, and I hope he can address it in his closing remarks.

The early years workforce needs a step change in wages. The Government have gone far, but they need to go further. The Minister has my full support to take up our cause inside Government; we will back him all the way. Being a former junior Minister in the Department of Health and Social Care, I know that Under-Secretaries of State do not always have the swing vote on decisions in Her Majesty’s Treasury, which is why the Minister will need all the ballast we can provide. I think that I speak for all of us present in saying that we are there to provide it.

Urgency in addressing this area is underlined by my next point. Most early years places are delivered through private, voluntary or independent childcare settings. Maintained nurseries, such as Lanterns Nursery School in my constituency, play a vital role as well, but PVI providers deliver more than 80% of childcare places. PVI providers have a consistently good reputation across the board; like their maintained counterparts, PVI settings are overseen by Ofsted, which is good. In 2020, Ofsted ranked 96% of PVI providers as good or outstanding—up from 72% in 2012.

Most PVI providers—about 57%—have only one site. Only 9% of PVI providers are what we would call a chain, with 20 or more sites. Most of those settings are hard-working small businesses that employ people exclusively from the local community. They invest any surplus they have into upgrading the nursery environment and, crucially, developing their most important asset—their staff. We are not talking about people lining their pockets with those ever-dwindling surpluses. They are simply seeking to make a fair living while pursuing the brilliant vocation of shaping young lives, which brings me to my next point.

Earlier, hon. Members heard the story of how one parent and their child benefited from the support and inspiration offered by their early years educator, which is a tale that is replicated time and again across the country; I suspect other hon. Members will refer to it. Early years educators provide support, advice and guidance to parents, caregivers and families, including on nutrition, play, schooling and health. They are educators in the widest possible sense of the word. They often form great teams with parents and provide families with valuable insights into their child’s development. We know children form multiple attachments at an early stage, and one of those can be with those working with them in a nursery setting.

Crucially, as policymakers, we all understand the importance of early intervention in making a difference to life chances. For every £1 invested in early education, about £7 would be required to have the same impact in adolescence. Every £1 spent in early years saves about £13 in later interventions.

One parent and NHS worker captured it best when they said that, while

“nurses, doctors and other healthcare staff got most of the accolades,”

and rightly so, early years settings and their workers

“selflessly continued to open to look after keyworker children such as ours, even though it potentially put them at risk so we could continue to work.”

At the end of last year, there were press reports of adjusting staffing ratios in early years settings as part of an aim to lower the cost for parents, which I would gently caution the Minister against. Safe, secure and necessary monitoring in early years settings requires a higher staffing ratio than in schools. Leading voices from across the early years sector, including the Early Years Alliance and the National Day Nurseries Association, have warned against it.

I believe that early years professionals deserve pension contributions and pay increases that can keep in line with increases in the cost of living—a very hot political subject at the moment—which must be delivered through more investment and better recognition of the work of the early years workforce. We are in a position where the Government require early years settings to be open in order to deliver the 30-hour funding entitlement, but, as I have said, there is a shortfall in funding, and that situation can only go on for so long. The result of that shortfall is that many early years settings run at a loss and even face closure, especially those in disadvantaged areas. As a Conservative, I of course want small businesses—I mentioned how many of these early years providers are small businesses—to thrive: indeed, I believe that all Members in the House, from all parties, would want that. As a parent, I want all children to have access to the very best early education, wherever they live.

In the case of PVI early years settings, those two things are not mutually exclusive. Those who pursue a career in early years education do so because, above all else, they believe passionately in making a difference in children’s lives, and that is because early years education is vital in tackling inequalities. We know that the first five years of a child’s life are the most formative. However, when providers in the most deprived areas report themselves as being twice as likely to close as those in more affluent areas, we must acknowledge that something is going seriously wrong in the sector.

The Early Years Alliance has said that poorer families are more likely to lose access to early years settings because of what I have described as a market failure. I am sure that colleagues will speak about other experiences from their own area, but it is important to set the context. If we are to deliver on our promises and level up all parts of the country that have been left behind, the early years workforce is a vital tool in that project.

So what can we do? We can begin squaring the circle here today by supporting the APPG and our call for the early years workforce to take their rightful place as educators. I encourage colleagues to take advantage of the relaxation of covid restrictions to meet local early education providers in their area; I am sure that everybody who is participating in this debate already does so. We can all show our support for the work of those providers by thanking them during this debate.

However, it is to the Minister I look. I have sat in his seat many times. He is most welcome to his post, which I know he is still relatively new in, and I hope that he can find time to come and speak to us on the APPG in short time. We know that there is a lot in his in-tray, but we also know that he is a parent and no doubt a lot of what I have said today will resonate with him.

Before coming to my conclusion, I just need to qualify one point that I made earlier when I said that this issue is not all about money. I meant that, but so many of the challenges facing early years educators can be addressed by more targeted investment. We must address the workforce challenge that our early years sector faces. In my opinion, that can only be done by paying our early years educators the same amount as those working with the reception year group. The present system is inequitable and unfair. That change would be transformative for our valued early years workers. It is the cornerstone of what the Government can do to deliver for our early years professionals and the families they support.

Extra cash will be meaningless, however, unless it is accompanied by the wider transformation that I have spoken about, regarding how we view the early years workforce. It is a problem best encapsulated by the fact that they are highly skilled but low-paid professionals. We trust them with our most precious resource—our children—in the very early years of their lives, when so much attachment is formed. It is only right that we view them for what they are, which is educators.

Thank you, Mr Chairman, for calling me to speak.

It is, as always, a pleasure to speak in a Westminster Hall debate, but it is also a pleasure to follow the hon. Member for Winchester (Steve Brine). I will put on the record, as others have, my thanks to him for all he does in relation to early years education. There is absolutely no doubt in my mind—I suspect that there is no doubt in the minds of any of us here today—that he has a deep passion and interest in this subject matter. That was illustrated in his speech today. He often raises crucial issues that impact our early years educators and I value—to be fair, I think we all value—his continued efforts in that regard.

I appreciate that, as the Minister will know, the early years system in England is different to that in Northern Ireland. Regardless, it is great to be here in Westminster Hall and to hear the view of others, and perhaps I can compare some of the things that happen here with what happens back home.

Particularly during the pandemic, our early years educators have had to deal with an unprecedented number of stresses, staffing being one of them; the hon. Gentleman referred to that in his contribution, as others did in their interventions on him. In a survey conducted by the Early Years Alliance in the autumn of 2021, 84% of respondents said that they were finding it difficult to recruit suitable new staff. No big surprise there, really; it is the same in Northern Ireland. Early Years has stated that

“Before Covid-19, Northern Ireland’s childcare sector worked hard but was under-resourced. Now it faces huge challenges, and shortages could hamstring our economic and social recovery from coronavirus.”

Thankfully, there is some hope and we in Northern Ireland have taken some action, including financially. The Health and Education Ministers have issued a £12 million support package for childcare providers. The two Ministers responsible in Northern Ireland have recognised the issue and responded in a constructive and physical way, to ensure that finances are there.

There were long-term issues prior to the pandemic, including the retention of staff, especially those who are highly qualified. The hon. Member for Hampstead and Kilburn (Tulip Siddiq) referred to the wage structure, as did the hon. Member for Winchester. There is a need to have a wage structure in place, so that people involved in early years education can feel they are being reimbursed accordingly for all their hard efforts.

There are also ongoing issues relating to provision for special educational needs. SEN children rely heavily on routine and consistency; without it they risk a major hindrance in their development. I have regular contact on that in my constituency; I am sure others have the same. The role of early years is crucial for young children’s development. Positive benefits are dependent on several factors, including the quality of care, the nature of activities, relationships that children develop in their settings, group size, child-to-teacher ratios, staff retention, and teachers’ training and professional development. All those things collectively are critically important.

Does the hon. Gentleman agree that it is concerning that a report by the Education Policy Institute found that more than 40% of staff working in early years settings did not have access to training for speech and language? That is a growing area of concern, particularly as a result of the pandemic, and exacerbates the attainment gap for those from disadvantaged backgrounds. I am sure the Minister will say that the Government are putting money into early years training but, when that is worked out, it is about £460 per head of those working in the sector, and it will not cover the amount of need if we want to professionalise the workforce.

The Minister heard that request from the hon. Lady. I know the Minister is very interested in the subject and, when it comes to answering the requests from the hon. Lady, others and myself, he will be able to say what the Government are doing, with time to put that in place.

Most early years settings are private, run through unions and independent organisations. It is essential that they are given sustainable funding to carry out their role to the best of their ability. I am sure the Minister has engaged, as he always does, with his counterparts in the devolved nations, to ensure that the correct funding is going to the correct sectors of early years. When the Minister has responded in previous debates, I have always been very impressed by his interaction with the Northern Ireland Assembly. The Minister has been very up to speed on the matter. I am sure when he replies he will be able to confirm again that that is the case. I thank him in advance for his answer, ever conscious that it will be positive.

In relation to back home specifically, there are 1,200 local early care and education providers, 30,000 parents and a workforce of more than 10,000. The past year has demonstrated how essential high-quality education and childcare provision is for families and children in Northern Ireland, and that has been echoed in this debate today. Addressing childcare must be a key priority. If parents cannot access the childcare they need in order to work, we will not be able to rebuild fully our economy. The Minister responsible for that task is not here, but the work of Government to address and rejuvenate the economy is self-evident in the unemployment rates and job opportunities that we have heard about in the past few days. There is some good stuff being done there.

All discussion in relation to childcare and education starts with early years, and the importance of early learning for young children. Childcare settings have closed due to the pandemic and other factors, which may be purely financial, but Ofsted data show that there has been an ongoing decline in the number of childcare settings since 2015, due to the lack of childminders. From August 2015 to 2021, the decline levelled at 17%.

I will conclude with this comment, because I know a number of others wish to speak, and the Minister will be keen to have time to respond. I also look forward to the contribution from the shadow Minister, the hon. Member for Dulwich and West Norwood (Helen Hayes). I would like to thank each and every early years employer who goes above and beyond to help the development of our young people. I have met some of them, and I am greatly impressed by them and their vocational commitment to their jobs. Their role in society is admirable, but they undoubtedly face struggles, especially with staffing, with closures and sometimes with their wage structure, so we must do more. As I have said, I hope that further discussions between the Minister and his counterparts across the UK will enable us to exchange ideas and thoughts on how we can do better. We can all learn; we can learn from the Minister and, I hope, the Minister can learn from us.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend the Member for Winchester (Steve Brine) on securing the debate during Childcare and Early Education Week. Like him, I pass on my thanks to all nursery and early years workers, who have done such a fantastic job over the last two difficult years, particularly those working in Cornwall.

A child’s early education is key to their future success, so it is essential that every child has the best start in life, which means giving them the best possible support between the ages of nought and five. That is a critical stage in someone’s life, and it is essential that the early years programme is properly effective. That is why the issues in the sector need to be urgently addressed. Statistics show that 28% of four and five-year-olds finish their reception year at school without the early communication, language and literacy skills that they need to thrive.

Early years educators are crucial. It is harder to produce a curriculum in which children learn and get to the stage that they need for reception year while they think they are only playing—that takes quite a skillset. The quality of teaching is just as important to outcomes in the early years as it is in other stages of education. Quality is key for pre-schools to have the biggest impact on children’s life chances. In my opinion, early years educators should enjoy the same status as those in other teaching roles: they should be included in the same teacher training schemes and have the same bursaries and salaries as in primary teaching.

I come at the subject as someone who took full advantage of the Government’s 30 hours scheme. In 2015, when my daughter was nine months old, I had to go back to work part-time. I got to work for my hon. Friend the Member for North Cornwall (Scott Mann), who is a very flexible employer, but not everyone is as lucky as me. Having said that, even though I was working part-time, I had help from grandparents until my daughter was old enough for me to take advantage of the Government’s scheme. I was very grateful for all that help.

Now that I have become an MP, I find myself on the other side of the fence, hearing from early years providers how difficult it is to work in that sector. There are problems in recruitment and retention. Nurseries in my constituency are struggling to retain well-qualified staff, while recent research found that many early years practitioners have left for better-paid jobs. In Cornwall, people probably earn more in hospitality than in an early years setting.

Many people in the sector are pushed out of the job that they love because of a combination of low pay, low status and increasing workload. Some workers in the profession said that the challenges of supporting their own families on the salary of a childcare worker were too great and that staying in the sector was no longer a career option.

Furthermore, the early years sector is reliant on a largely female workforce. At a time when families are generally reliant on two incomes, with greater pressure on single parents always to be in work, I am sorry to say that working in the early years sector is increasingly unviable. There is evidence of increasing paperwork and demands from parents and employers, so it is of little surprise that the workforce is such an unstable one.

Compared with some Scandinavian countries, where jobs working with babies are highly sought after and most staff are graduates with higher degrees in child psychology, qualification levels for nursery workers in the UK remain low, and access to ongoing training is very limited. Investment in training is important because replacing staff is costly in both money and time. In an industry where word of mouth matters, good staff are key to occupancy. Providers should explain to staff why training is good for them, but when will they find the time to do it?

Pay is also important. It may not necessarily be possible for employers to pay for all study time, but if people are forced to work outside work hours, they will be overworked and burnt out, and they may choose to take their expertise elsewhere. That is not good when teaching children.

With my other hat on as a member of the APPG on baby loss, one of the things I am campaigning for is continuity of care for pregnant women, which I feel should go on into the early years sector. It is important to have a stable workforce while the children are developing attachments, knowing that they are going to see the same person every time they go to that setting.

As mentioned previously, staff feel a lack of status in their roles. Pay is very difficult in the sector, but being open about it offers the opportunity to explain why things are the way they are. Providers need to show staff that they are in line with market rates and what staff can do to get increased wages; clear structures and career paths give early educators better prospects and make the sector more attractive to school leavers. I look forward to hearing from the Minster how the Government seek to address this.

More positively, I should add that I sit on the Early Years Taskforce with my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). I have had feedback from Cornwall Council and met with providers and the children and families sector in the council. We were both pleased to hear that Cornwall is already doing a lot for what we want to achieve in the sector.

I would particularly like to pay tribute to Meredith Teasdale and the excellent Together for Families team at Cornwall Council. Cornwall Council has a strong partnership with two things of particular note. It gave welcome support and advice to its early years providers during the lockdown, which was pleasing to hear, and the support has also seen an increase in the take-up of early years education places for Cornwall’s two-year-olds.

Cornwall has also maintained a network of family hubs in difficult times, which supports multidisciplinary working to support families, introducing the Best Start for Life apprentices, who provide direct support to families that need it for the first 1,001 days of a child’s life. Those are both excellent examples of where we can continue to innovate in this important area. With that in mind, I am hopeful of and want to put out another call for any pilot schemes or funding schemes that are going to be running in the early years sectors; Cornwall, with its clean boundaries and co-operative team of MPs, councillors and brilliant council officers, will always put itself forward for them.

It is a pleasure to serve under your chairmanship, Mr Gray. I would like to add my congratulations to my hon. Friend the Member for Winchester (Steve Brine) for securing today’s debate.

We know from all the research that attention from adults is a crucial factor in the earliest part of a child’s life. That fact has a long history in public policy, dating in the modern era back to the Plowden Report of 1967 and reflected in decisions taken by Governments ever since, in respect of both primary education and the provision of initiatives such as the neighbourhood nurseries, children’s centres, early years centres, and now family hubs.

It seems to be a point that underpins the issue highlighted by my hon. Friend the Member for Winchester in respect of ratios: the need to ensure that we have sufficient adults in any particular setting to have an effective relationship and to give sufficient attention to the children. However, it is also incredibly important as we consider the future role and shape of our early years education. As has been highlighted today, we see a mixed economy of provision in which there are examples of outstandingly good practice that make a fundamental, evidence-based difference to the lives of children.

The nursery schools we see around the country and the excellent childminders, many of whom I see in my own constituency of Ruislip, Northwood and Pinner, are part of a bigger picture, where research done in the world of academia drawing on the experience of other countries—the United States, for example—in developing new initiatives designed specifically to tackle disadvantage and drive social mobility has been applied here, in the UK. I would like to focus my contribution primarily on the considerations that that brings forward for public policy as we begin to shape it for the coming years.

When we consider the shape of the system we have today, we see that our earliest educators are operating in a system of funding that is very much dominated by the needs and demands of our big secondary schools. It is a common piece of feedback from early years practitioners and those who own early years businesses—those who lead in this area—that the allocation of resources to early year settings in any given area tends to be an afterthought. It comes after the distribution of funding: first, to secondary schools; secondly, to primary schools; thirdly, to further education settings; and, finally, early years settings are thought of just before the tea break. We need to change that. Research that has come from the What Works Network, funded by the Department for Education and done over many years, shows that the funding that we allocate to the early years of a child’s life has the biggest impact on social mobility and in challenging disadvantage. It is very telling that Leon Feinstein, formerly head of evidence at the Early Intervention Foundation, where I served as a trustee, now with the Children’s Commissioner, has highlighted that the indicators from the early years foundation stage outcomes for children are extremely good predictors of how a child will do in their A-levels. We can tell pretty accurately from how a child is developing academically in their nursery school how they will do in their A-levels as they leave school at 18. We know there is very good evidence of the difference that it makes when we get this right.

In the past we have seen the Government beginning to look at not just the professionalisation of early years educators but the greater professionalisation of the workforce as a whole, for example, with the Children’s Workforce Development Council. A number of Members have referred to early years education becoming more of a graduate profession. We have seen, in respect of the teaching profession, consistency brought in to ensure that teachers are educated to master’s degree level, as a minimum. That is all part of an agenda that is about raising the attainment level of the people who are undertaking this crucial work. Clearly, the cross-party points that have been made about funding and what that means for rates of pay are also significant.

It seems to me that, as we survey the scene within the context of Government levelling-up policy, investment in doing the right things in the early years educator workforce is something that will pay dividends. It is unlikely, perhaps, to pay dividends in the short term—in two or three years—but we can see the contribution that this will make, especially to economic opportunity, in parts of our country that currently fall behind.

We have an opportunity to build on some real strengths within this overall workforce. One of the striking things is that in most parts of the country there is a significant local authority-run early years service. I am aware that in the London borough of Hillingdon, which covers about two thirds of my constituency, it is conspicuous that staff who work in that environment tend to be people who have 30 or 40 years’ experience and the highest levels of training and development. We need to make sure that, where we have access to that kind of resource, the benefits are spread so that those smaller, private voluntary providers—new entrants to the market—can learn from people who have been providing child care to a very high standard for 30 or 40 years. These are the people who have seen different trends come in and out and who know how to support parents who may be struggling with the challenges of bringing up extremely young children. It is an opportunity to connect what happens in the early years education workforce with our family hubs, our children’s centres, our nursery schools and into primary education and childminding. It would mean the skills and insights that we see in some settings are able to be shared effectively.

It is worth recognising that as we face this future we know—there is a cross-party acknowledgment—that this is not just about freeing parents to be more economically active. We have gone through periods in the past when the primary purpose of Government intervention in this area was intended, in particular, to make it possible for mums to return to work or to increase their working hours. That is important; we know that the mother’s level of both education and income is very important to a child’s life chances—to a greater degree than is the case with fathers. We also know that all this research demonstrates that the quality of early education really can drive a child’s opportunity later on.

As we see more Government interventions, such as the growth of tax-free childcare—something that I personally benefit from, having two young children—there is a need to ensure that ratios continue to support a high-quality offer. There is also a need to ensure that childcare is not something that arises as a consideration in a parent’s life only once the child is born and they need to think about going back to work. As my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) said, it should instead be something that is considered during antenatal care. That way, parents will know what to expect and how to make sure they are getting the right support for their child. All those things are incredibly important.

If I may offer a final suggestion to the Minister as a way of beginning to join some of these ideas up, we know that all local authorities have a sufficiency duty around childcare, which was introduced by the last Labour Government. That duty is often misunderstood. It is not about ensuring a sufficient supply; it is about having a plan to reflect the needs of the local population. How that happens varies quite a lot around the country, according to local demographics and local resources. However, there is an opportunity to use that sufficiency duty as a vehicle to bring together so many of these issues that affect not just the workforce but the future of children. We should consider how it can become more of a driver to share good practice and ways of addressing some of the financial challenges that individual settings of different kinds may face. It can be used to ensure that the research funded by the Department for Education and the research taking place in universities is brought together in a way that supports the agenda that we all share.

I hope that my contribution has been useful, and in particular that it has highlighted my experience in a local authority. I will finish by welcoming the continued focus that my hon. Friend the Member for Winchester brings to this issue. Often, the Government are rightly accused of thinking only about things that will make a difference in the next two or three years, but if we get early years right, it will make a difference to the lives of children and to their future as adults for decades ahead.

I thank my hon. Friend the Member for Winchester (Steve Brine) for securing this important debate. Sensible contributions have already been made about the need for investment in the early years workforce, the development and retention of staff, and the impact of early years education, especially for the most disadvantaged children in our constituencies—an issue in which I have held a long-term interest since my local government days and via my mother, Mrs Sandra Lewer, who was a nursery nurse and infant teacher.

The many challenges facing early learning providers have been exacerbated by the pandemic but also, importantly, by changes in funding from central Government and local authorities and the impact that they could have on post-covid recovery. That is what I will focus my contribution on.

Last week, I met Lyndsey Barnett, the CEO of Camrose early years centre, which is based in one of the most deprived areas in my constituency of Northampton South. The centre is a maintained nursery school and day care provider. It offers a fantastic quality of service from 8 am to 6 pm, including during school holidays. That is hugely important, because it means that working parents can drop their children off before work and collect them after the working day. Camrose is a benchmark for the excellent service that can be provided across my constituency and beyond to families from low-income areas who want to do all they can to work, and it is therefore crucial to the economy’s post-covid recovery. With the proposed restructuring of funding from the local authority as a result of central Government funding changes, the centre may have to cut back the services it offers.

That centre already faces many challenges in looking after vulnerable children, but it goes well beyond the remit of just a day care provider, not only supporting and educating young children—I reflect on the comments with which my hon. Friend the Member for Winchester set the scene for the debate—but offering support to their families. It is that complete child approach, acknowledging the crucial nature of the first 1,001 days—a frequent and key concern of my constituency neighbour, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom)—that makes recent Government announcements about family hubs so welcome. As a county council leader from 2009 to 2013, I must say that this renewed focus seems very like the children’s centre network that I promoted at that time, although I understand that Ministers will wish to stress that this time, it is different.

As Confucius said:

“By three methods we may learn wisdom: first, by reflection, which is noblest; second, by imitation, which is easiest; and third by experience, which is the bitterest.”

I apologise, Mr Gray, for appearing a couple of minutes late; I sprinted across the courtyard to try to get here to speak in this important debate. I am grateful to my hon. Friend the Member for Winchester (Steve Brine) for bringing it forward.

Early years education is vital to the development of our children—our future adults—and to our levelling-up agenda. Education and early years are key when we talk about what that means, what we are going to do, and how we tie together a coherent package around the phrase “levelling up”. Education is absolutely at the heart of that.

Just a week or so ago, I was lucky enough to visit Kangaroo Teacher Led Childcare in my constituency, where I met Alison, the owner and manager of the centre. She was adamant—my hon. Friend made this argument too—about the importance of the education element of early years settings. They do not just provide childcare—particularly not her setting, as she is a qualified teacher and a former deputy head of a primary school.

Alison explained how important her setting and others are to everything we understand about development in those preschool years—everything from nutrition to brain development, and the social, language and communication skills that are important. Even in that setting, I could see the difference between those children who had had many hours of early years education throughout their childhood and those who had not been socialising in the same way in their early years. The difference in speech and communication between those children was profound. We know that there is a huge correlation between children’s communication skills, in particular—their ability to express themselves and how they feel about things—and negative outcomes such as being expelled, being unemployed or even going to prison in later life, so this is hugely important from that perspective.

As someone who believes in small government and low taxes, I have always felt that if there is one area of life or society that the Government absolutely should invest and intervene in, it is education, because that is what sets people up to be independent adults who can make their own decisions in later life, and who hopefully will not need the Government to intervene.

From that perspective, I welcomed the Chancellor’s Budget last year, which put more money into the sector, with funding for workforce development in particular. We have already touched on how important that is for the sector. All of us in the room, who run what are effectively very small businesses, will recognise the challenge of having a very shallow structure where the most junior person in the office might only be one or two layers below us. There are very few places for people to go in that hierarchy, and often, after not many years, it is difficult to continue to progress and develop people, so they leave. We often find that in early years settings.

To retain staff, we need to help them and continue to develop and train them throughout their careers; those careers will be short if we do not do that. I would love to see a joined-up workforce strategy across early years, as was mentioned earlier, but also into other education and care pathways, such as primary schools and children’s services. People could then start—yes, perhaps on low wages—in an early years setting, but clearly see and understand the many varied, positive routes to all sorts of different careers. I think we need to do the same for social care and health; if people starting as care workers could see the massive range of opportunities that exist within the NHS, that would change our ability to recruit and retain people in social care. That is hugely important.

There was also £500 million in the Budget for family hubs and the Start4Life advice service. All that will be beneficial to our wider set of children’s services, and to those interventions in support of the most disadvantaged children.

My hon. Friend the Member for Winchester used the phrase “market failure” to describe early years. I hear that phrase a lot around children’s services and early years settings. I think it has also been used by Josh MacAlister when talking about the wider children’s services sector—about foster care and looked-after children. All these areas are hugely important to our ability to support the most disadvantaged kids and to churn out—for want of a better phrase—adults who can live productive and happy lives. I know that my hon. Friend the Minister feels strongly about this, too. There is so much to grasp, and trying to fix the market failure will be a huge challenge, but it is such an important challenge for him to focus on.

I will make two practical suggestions before concluding. They are only simple, and they are perhaps not the answer to all these problems, which will take much wider and more challenging work. First, a couple of Members have already touched on the fact that they access free childcare. I access free childcare—30 hours—for both my children. I waited with bated breath for the day when my bills would be halved, when my elder son turned three, and we took advantage of that great benefit. We did not need it; I was on an MP’s wage and my wife worked part time. People on up to £100,000 a year can access that taxpayer-funded benefit. I am all for extending the benefits system—the universal credit system—into the workplace slightly if that helps to encourage people to be in work rather than getting trapped on benefits, but a hundred grand a year is kind of pushing it. I am not sure that that is entirely necessary. I think we could redistribute that money in a way that helps more of the most disadvantaged children, where we see a particularly acute issue. I think that more children accessing free childcare would get much more bang for the buck.

Secondly, one way to use that might be to offer the early years experience to more looked-after children. I raised this with the Minister informally last week. It is really important to recognise that not every child in the care system, even, is able to access early years education in the same way or in the same amount. A child in foster care does not have the same right to 30 hours as other children in the care system do. There is no reason why they should not, other than an arbitrary line that has been drawn in the sand. For those children who have either lost parents or been taken away from their parents and had very traumatic experiences in their early lives, consistency and support from an early years provider could be hugely beneficial. It could be life-changing for those children. There is no reason why a child should not be able to get that if they are living with their nan or auntie rather than in children’s residential care. We could make a very simple change there, and I think it would also help us to incentivise people to begin to be foster carers or to take on their nieces and nephews in those circumstances. I think that would happen if there were the offer of a bit of respite and some incentive for people to join and help in those services.

Those are some small examples of areas where I think we could make an early change that would benefit a lot of young people. As many Members have said, this is a hugely important sector, and the Minister has a huge task on his hands to try to fix just some of it, but I know that he feels very strongly about it, as we all do. There is a real opportunity, through the MacAlister review and these kinds of conversations about early years and additional changes in funding, to make a real difference to the most disadvantaged children. That needs to be at the heart of our levelling-up agenda, and I trust that it will be when we see the work from the Government on this over the next months and years.

I thank my hon. Friend the Member for Winchester (Steve Brine) for initiating this debate today. To be debating this issue in Childcare and Early Education Week is really important, but it is even more important that every single person in the House is constantly celebrating the role of early years providers and the workforce, and recognising them as educators. My hon. Friend is absolutely right: we could not do without these people.

My husband and I work full time. We work incredibly long hours. It is definitely not a nine-to-five existence, and I need a real muddle of support to get me out of the house dressed, on time and able to string sentences together, which I probably will not be able to do brilliantly today. The childcare costs and pressures on families around the country are acute. I urge hon. Members to have a look at Instagram and to google the hashtags #parenting, #children and #childcare. Some of the statistics and information that come out are quite worrying. People are incredibly stretched.

I have said this before, but the juggle is real. It does not matter what someone does as a job or if they are not working at all; if mums and dads have little people running around with seemingly infinite energy each day, that means that every day is stretched even before they find out that their early years provider, nursery or childcare person cannot be helpful that day because they are stuck at home in isolation—they are perfectly well, but they have had a positive covid test—or that the nursery has had to close down because it just cannot make the numbers work on the business case. Military planning goes into all my friends’ days to get children to the right place at the right time. Families just cannot cope with these sudden shocks. It is for us in this place to try to find ways of smoothing out those shocks, or at least lessening their impact.

If anyone has the chance, I encourage them to listen the podcast “Parenting Hell” by the comedians and dads Josh Widdicombe—I can’t say his name; they get kids to try to say “Josh Widdicombe”, and they say it better than I can—and Rob Beckett. It is a brilliant look at an entertaining version of all the chaos that comes from real-life parenting. It is a nice bit of my week to know that I am part of a big club that is very dysfunctional.

We know that the transition to parenthood is one of the greatest pressures on a relationship or a marriage, so we have to do better at stopping these sudden shocks and problems. The system is quite literally causing family breakdowns, and we know the impact of family breakdowns on the country, on relationships, on families and on finances.

As we heard from a number of Members, the Prime Minister and the Chancellor of the Exchequer are incredibly committed to this issue. They have recognised the early years workforce and are very respectful of them. The new Secretary of State for Education, upon being appointed, included the word “families” in his strapline and mission statement, alongside “education” and “skills”. That shows a real commitment to the cause. All that has led to the Treasury quadrupling the money going into early years education, and millions of pounds to support family hubs, which will be transformational in our local areas where we can get them off the ground. The “Best Start for Life” programme is transformational and will provide a focus for families and our little people. However, we have to go further.

Let me make a couple of points that have already been touched on. In 2019, the staff turnover rate in the early years workforce—I am thinking only about nursery staff at the moment, excluding childminders—was 24%, compared with the UK average of 15% to 18% in other sectors. The cost of that turnover in 2019 alone was calculated as £879 million.

The Social Mobility Commission, in its report “The stability of the early years workforce in England”, found that the six most salient barriers to a stable early years workforce were low income; high workload and responsibilities; over-reliance on female practitioners; insufficient training and opportunities for progression; low status and reputation, and negative organisational culture. That is a pretty stark list. This is a workforce who feel they have low status, and they are the people we trust with our most precious charges—we send our little people into their care. They are people who are incredibly skilled and have solid qualifications—it is often a vocational passion to work in the profession—and they have reserves of patience that I certainly do not have when I am trying to feed my toddler vegetables, which she will not eat.

The other point is about the low public funding in comparison with other levels of education. The public subsidy for early years is about £3,000 per pupil, compared with £5,000 in primary, £6,600 in secondary and £6,500 for university students. That is incredibly frustrating given that it is now accepted that the first 1,001 days of a child’s life are the most important. We have heard that early intervention can change not only the life of the child and their family early on, but the path of their life; it will probably change the type of state services that the child—and then the adult—uses. Why are we not investing more up front and upstream?

I want to thank the early years providers in Stroud and around the country. They are levelling up on a daily basis. They were levelling up even before it was a thing with a title. There is a small but perfectly formed gang of MPs and peers, and a very dedicated ministerial team, who really believe in the early years workforce and the value that they all bring to future generations. I am working with the think-tank Onward to investigate and research many of the childcare issues, including costs, that we have heard about today. I also sit on the Work and Pensions Committee. The Chair and the Committee have kindly agreed to investigate the childcare element of universal credit, with the cap and the up-front payments. We will be doing work on that this year, and I hope it will be helpful to the ministerial team who are thinking about this.

I am grateful for this debate. I am sure that all of us could talk about this subject all day long. I look forward to hearing the outcome and the views of the Minister.

It is a pleasure to serve under your chairmanship, Mr Gray, and to follow all my hon. Friends. As one of the final speakers, I could simply say that I agree with everything that has been said and then sit down, but I will try a little harder than that. There have been excellent contributions, all of them articulate and passionate, because we all know the importance of the sector.

I should start by saying that I am the chair of—I have to check this because it has a long title—the APPG on nursery schools, nursery and reception classes, which essentially covers the grant-maintained sector. I am passionate about that, as was somebody else, and I wish he were here today. I spent many hours with the late and much-missed Member for Birmingham, Erdington, who was a passionate vice-chairman of the APPG for many years before I became chair. I will always be grateful for the insights that he gave me. We were both driven by the same thing.

When looking at this sector, we have to ask whether we just talk about money or whether we say, “Let us put a little bit here and a little bit there.” This debate is fundamental to why we are all MPs. If we are MPs or politicians because we want to get the fabled equality of opportunity for everyone, we must recognise that unless we get this right, there is no equality of opportunity. All the academic evidence in the world shows that the most important developmental stage for a child is, as has been stated, between zero and five. If they are behind academically and socially during that period, they do not catch up.

I am also chair of the APPG on youth employment. We do a lot of work on training and skills at age 16 and the choices that young people make at that stage. My hon. Friend the Member for Winchester (Steve Brine) talked about the impact of skilled workers. I talk repeatedly about how that decides—it cannot be any stronger than that—their ability to make the correct choice as to where they want to go with their career, what skills they want to have and where they want to be in their life.

I see that time is ticking on, Mr Gray, but I want to talk about my own experiences, if I may. I have been a governor at Hoyle Nursery School in Bury for the best part of 10 years. When I went there, we had a budget of about £500,000. There is a fundamental difficulty because the business model for the grant-maintained sector is very different from the business model in the private, voluntary and independent sectors. We certainly do not have time for a debate on how to equalise that, but it is an important factor.

We had no money. I remember that on the first day I went to the school, I looked around and I said, “Where is the investment? I know a lot of investment has gone into this school over the years. Under the Labour Government, lots of money was put into nursery schools.” The headteacher said to me, “Nothing has really changed. If you had been here five, six or seven years ago, you would probably have seen the same thing.” What we did do was put the money into training highly motivated staff to get the outcomes that were necessary for the young people who were there.

There were some challenges. We were a failing school when I first went there and we changed a few things. I became chair of governors, and in four years we got two outstanding Ofsted reports. In that school, 17 different languages are spoken.

One thing that has not been talked about today is the impact of intensive work at a nursery level on children with special educational needs. The SEN unit in the school that I am a governor of, and have been for a decade, literally changes lives. I want to pay tribute to the late, great Val Kay. Sadly, she passed away, but I worked with her for many years. Rachel O’Neil, who is the headteacher now, is driving forward a facility that does not differentiate between kids. It has an all-inclusive, progressive provision that gives SEN children the same ability to progress as it does children from any other background.

We have many children who have English as a second language and many children from dysfunctional families. The challenges are overcome. I do not have time to put into words the work, skill and love that are put into those children to ensure that when they leave that school, they have the best chance not only to progress emotionally, academically and socially, but to go on to the next stage of their education and take that further. I believe that in the sector I am talking about, the Government provided three years of supplementary funding, which was much to be welcomed.

I will make a few brief points to the Minister. He will know, because he is not only a good man but very much on top of his brief, that in the grant-maintained sector the costs of covid are mounting. There is also an argument for a consultation, or at least an interaction, regarding fair funding for the grant-maintained sector, so that funding is in the places where it is most needed, where this provision can make a difference. What does this sector do? It transforms lives, not just for the next five minutes, but throughout life. It improves relationships and gives people opportunity.

Returning to the start of my speech, when I went into that school, I looked at the young kids around that table and wondered what I wanted for them, if I were to be chair of governors. If I wanted them to have the chance to be astronauts, bus drivers, doctors or whatever they wanted to be, the only way to do that would be with investment and highly motivated, skilled educators who would put that provision in place.

As ever in this place, we talk a lot in general about putting in money, but unless there are bespoke leaders at a local level, it will not work. We are lucky in my area that we have fantastic teachers; I am sure that is so in Cornwall and everywhere else. This has been a brilliant debate and I thank my hon. Friend the Member for Winchester. To call him a doughty campaigner does not do him justice. I was pleased to be under his wing at the meeting with the Chancellor. I know that the Minister will do what he can to ensure that this sector thrives and flourishes.

It is a pleasure to see you in the Chair, Mr Gray. I congratulate the hon. Member for Winchester (Steve Brine) on securing this important debate to mark Childcare and Early Education Week, and on his work with the APPG on childcare and early education to establish and promote this important week to acknowledge, celebrate and reflect on the vital role of the early years sector.

I pay tribute to everyone who works in early years education and childcare. There are few more important tasks than ensuring that every child has the best possible start in life. We owe a huge debt of gratitude to everyone who dedicates their working time to looking after and supporting very young children to grow, develop and thrive, whether as childminders or in nursery settings. It is a vocation to work with children. Across the country, as we speak, hundreds of thousands of early years professionals, the vast majority of them women, are nurturing and caring for children, and supporting them to develop and grow.

The theme for this year’s Childcare and Early Education Week is, “We are educators”. Under-fives learn in different ways from older children, but they are learning voraciously every single day. The best early years provision is underpinned by an understanding of child development and a richness of curriculum, every bit as complex as that found in our formal school system. Early years educators have the capacity to have a dramatic and lifelong impact on a child’s life, protecting against the effects of poverty and disadvantage, and reducing inequality. They can literally alter the foundations. “We are educators” is an important statement of fact, but it is also a challenge, particularly to the Government, to give early years professionals the status they deserve as a vital part of our education system that has parity with post-five provision.

I thank all hon. Members who have spoken this afternoon. We are in danger of an outbreak of consensus on the importance of improvements in the status and pay of early years professionals, of staffing ratios and of good SEND provision and support for kinship carers. I would like to pay tribute in her absence to my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq), who was my predecessor in this role and who for six years tirelessly showed her dedication to the early years sector. I join the hon. Member for Bury North (James Daly) in paying tribute to Jack Dromey, who was a dedicated champion of early years education and who I know is very much missed by Members from all parties in the House.

Today, we are celebrating the early years and childcare sector, but the speeches we have heard are in stark contrast to the woeful neglect of the sector that we have seen during the past two years of the coronavirus pandemic. Time after time, early years provision has been an afterthought for this Government, considered and treated differently from the rest of the education system, and too often early years providers are left to fend for themselves.

I congratulate my hon. Friend on her powerful speech. Does she agree that the situation she just described is reflected in the Government’s decision to cut over 1,300 Sure Start centres in the last decade? In one year alone in Barnsley, nine were shut and we have a quarter of our kids growing up in poverty. Although family hubs are welcome, does she share my disappointment that we could have prevented there being a need for them by not shutting Sure Start centres in the first place?

I agree entirely with my hon. Friend. We had that infrastructure in Sure Start centres across the country, but 1,000 of them have closed, which is a shameful part of this Government’s record. Although it is welcome that they have recognised that terrible mistake with the introduction of family hubs, 150 family hubs across the country are no substitute for the 1,000 Sure Start centres that have closed their doors for good.

Early years settings have been open to all children since July 2020, without access to lateral flow tests or to additional funds for enhanced cleaning or personal protective equipment, despite the obvious inability of staff working with very small children to socially distance. Staff have been left vulnerable to infection and anxious about their own health and that of their families. I have been contacted by many providers in recent weeks who are struggling to stay open because of exceptionally high levels of sickness absence, as omicron has whipped through early years settings. With that coming on top of two years of stress and uncertainty, many who work in early years settings are exhausted and burnt out, and they are quite simply bewildered that the Government have not had their back.

Even before the pandemic, there were deep structural problems in the early years sector. The way in which the Government’s 30-hour entitlement is implemented does not work for providers and it certainly does not work for parents. A freedom of information request by the Early Years Alliance revealed that the cost of “fully funding” the entitlement would reach £7.49 an hour by 2020-21. Knowing that, the Government contribute average hourly funding of just £4.89 for a place for a three or four-year-old. Is it any wonder that the cost of childcare for working parents is spiralling up and up, while thousands of providers have closed and child-adult ratios are increasing in many settings?

The UK is among the most expensive places in the OECD for childcare, despite spending more than £4 billion of public money on it a year. The cost of childcare is a huge pressure on household finances at the best of times, but in the context of the current cost of living crisis, the pressure is unbearable for many families. High costs also deepen disadvantage, creating a system in which wealthier families can afford the highest quality provision, while families on lower incomes all too often have to settle for less.

As we begin to emerge from the pandemic, dealing with the devastating impact that it has had on our children should be a top priority for the Government. The youngest children are suffering the consequences of lockdown in their speech and language development, gross motor skills and social skills, and they have been denied many vital, indeed formative, experiences. In contrast to our Prime Minister, most of our youngest children will not have had a birthday party in the past two years—a contrast that shames him.

As a result of all that has been sacrificed, primary schools are reporting higher numbers of children who are not school-ready when they arrive in reception, and the impacts are worst for the poorest children. There is a gaping disadvantage gap that must be addressed urgently.

However, while the Government are mired in defending an indefensible Prime Minister, they have no vision or plan for the early years sector. There was no plan to support the sector through the pandemic; providers felt, in the words of the Early Years Alliance, as if they were “the forgotten sector”. There is no plan to support families with young children who are struggling with exorbitant childcare costs and who now also face a biting cost of living crisis. Most importantly, there is no plan for children, to provide the additional input that the youngest children need to catch up on all that they have lost during the pandemic.

Labour fully recognise the vital role of early years educators, who deserve recognition, gratitude and support, as well as a plan from this Government. I pay tribute to them today and I hope that this afternoon the Minister will provide the plan that is so desperately needed.

It is a pleasure to serve under your chairmanship, Mr Gray.

I congratulate my hon. Friend the Member for Winchester (Steve Brine) on securing this important debate, which comes during the APPG’s Childcare and Early Education Week. I know—I can get the sense from Westminster Hall today—how passionately all Members care about this issue. Given the importance of this sector, I welcome the awareness of it that this week will rightly bring. I am very keen to meet the APPG; I am sorry that we could not make that happen today, due to pre-existing commitments. Nevertheless, I am very keen to meet the members of the APPG and to work with them in the future.

I thank all hon. Members for their contributions to the debate, which have been constructive and thoughtful, and for the points they have made. I will endeavour to respond to as many as I can during the course of my response, conscious that we will have a Division in about 10 or 15 minutes.

I put on the record my and the Government’s sincere thanks and appreciation for the hard work, dedication and compassion that early years educators show every day. Despite the turbulence over the course of the pandemic, they have continued to keep our children safe and learning.

The early years experience is a vital part of a child’s education, as so many Members have set out today, that develops cognitive, social and emotional skills that set them up for life. Those who work in the sector are rightly passionate about those issues, and I have seen that at first hand. I have only been in my role as Minister for Children and Families since September, but I have visited numerous early years settings, and it is one of the best bits of the job. Every single one is a truly uplifting and inspirational experience, and I look forward to many more. A visit is always full of laughter, because the children come out with the funniest things—I forget, because mine are a little older now. We also see the passion and dedication of the staff, as well as their love, care and compassion—it is overwhelming.

Evidence shows that high-quality childcare supports children’s development, prepares children for school and, of course, allows parents to balance work and family life. We are doing more than any previous Government to ensure that as many families as possible can access high-quality and affordable childcare. I am proud of the progress that the early years sector has made in recent years. In 2019, nearly three out of four children achieved a good level of development, compared to around one out of two in 2013. In 2021, 97% of providers were rated good or outstanding by Ofsted, which was up from 85% in 2015. I am sure that Members will welcome that considerable progress.

It is important not to be complacent, and I will certainly not be. We must build on that excellent performance by the sector, particularly in the current tough circumstances. The question is, how can we do better, because we can do better? In my opinion, and my hon. Friend the Member for Winchester set this out elegantly and articulately, the answer is people. It is all about people who are educators. As of spring 2021, there were 62,000 providers offering 1.5 million Ofsted-registered childcare places in England, with almost 330,000 educators in those settings. The majority of educators work in group-based settings, or for such providers, with 16% in school-based settings—as my hon. Friend the Member for Bury South said—

North, I apologise to my hon. Friend the Member for Bury North (James Daly)—I should not have got that one wrong! I will address his point later.

A further 12% are childminders and assistants. The expertise of those educators is our greatest asset in ensuring that early years provision is of the highest quality. We must invest in the workforce, and that is exactly what the Government are doing. I will set out how in more detail later.

I now turn to some of the specific points made in the debate, before going on to some of the broader themes. My hon. Friend the Member for Winchester, in his constructive contribution, had a quote—

“we would be lost without these people. They are truly amazing”—

and I could not agree more. I have—from next week—a 10-year-old and a six-year-old. Recently, they have been through numerous childcare settings. I understand the importance of the settings and how vital they are not only to the parents, but to the children. They love—I use that word deliberately—the people who look after them in the day, those educators in the early years settings.

We have to address how the profession is viewed and valued—as educators and more than just childcare. My hon. Friend was absolutely right about that, and I will come on to it. He started and finished his speech with how early years staff are educators; early years is far more than just childcare. I totally agree, and I look forward to working with him and the APPG to see what more we can do in that area.

The hon. Member for Strangford (Jim Shannon) talked about the work we do with the devolved Administrations. A huge amount of work goes on at the level of officials. I have to confess, I have not yet met my counterpart to discuss this issue, but I very much look forward to doing so.

The hon. Member for Twickenham (Munira Wilson), who is not in her place but to whom I will respond none the less, raised the vital issue of speech and language. We have created the professional development programme and we have put a lot of emphasis on speech and language, because of its importance. We invested an extra £27 million, as part of the £180 million recovery programme. We also have the SEND review and, as part of that, it is vital that we have early identification and early intervention. It is important that that happens in early years settings wherever possible.

On the point about SEN provision, I have been contacted by a nursery in Barnsley which provides support—one-to-one support, in many cases—for children with SEN. It is worried that a number of nurseries are having to turn away children because there simply is not the funding. My local council has a deficit of £11 million, which is set to double in the coming years. What are the Government doing on SEN generally, and more specifically on funding?

The hon. Lady is right that there are significant issues within the SEND system, which is why we have the SEND review. There are local authorities with significant pressure on their budgets. We are putting more money into the high-needs budget—about 10%, year on year—but we are conscious that money alone will not solve the issue. That is why we have the SEND review. I am working at pace on that as we speak. The SEND review will conclude and we will launch a Green Paper and a consultation by the end of March, so within the first quarter of the year. The hon. Lady’s point is well made.

My hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) mentioned people leaving the profession. I will come back to that point, because it is really important. Recruitment and retention are key. I hear her call about the pilots in Cornwall and I will certainly look into that; I am always keen to visit Cornwall, whenever possible, so I will bear that in mind.

My hon. Friend also mentioned a largely female workforce, which is something I want to address. I want to see more men working in early years settings. It is really important. As my hon. Friend the Member for Winchester referenced, the Government want families to stay together wherever possible. Where they do not, there is not necessarily a male role model in the household, so it is really important in education settings that there are good male role models for children to look up to. We have the Pulse survey, which monitors the private, voluntary and independent sector. We meet with the sector regularly to keep on top of these issues.

My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) mentioned ratios, which I will come on to very briefly. I assure him that local authorities can retain only 5% of the funding allocated; they have to pass the rest on. My hon. Friend the Member for Northampton South (Andrew Lewer) referenced the whole-child approach, the first 1,001 days and family hubs. I recognise that he welcomes the £300 million investment that the Government are making in this area.

Numerous hon. Members mentioned funding. I agree that high-quality childcare supports children’s learning and development and prepares young people for school, as well as having a huge impact on later outcomes. That is why the sector is working really hard to support children and their parents. It is also why the Government have spent more than £3.5 billion in each of the last three years on early education entitlements, and we will continue to support families with their childcare costs.

As my hon. Friend the Member for Winchester rightly pointed out, we announced additional funding of £160 million for 2022-23, £180 million the year after and £170 million the year after that, compared to the current year. That is for local authorities to increase the hourly rates paid to childcare providers and reflects the cost pressures that are anticipated and the changes in the number of eligible children.

So what does that mean? For 2022-23, we will increase the hourly funding rates for all local authorities—by 21p an hour for the disadvantage entitlement for two-year-olds in the vast majority of areas and by 17p an hour for the entitlement for three and four-year-olds.

I want to come on to the point about recruitment and retention, because they are really important.

If the hon. Lady will give me time, I will come back to that point if I can.

Recruitment and retention are really important. Early years provision in 2021 was delivered by an estimated 328,000 staff. The majority of providers work to the required staff to child ratios for each age group, with some providers reporting that their ratios are more generous than the statutory minimum. We recognise that recruitment and retention are key issues for the sector, and local authorities are reporting significant pressures on providers. Importantly, we are working with the sector to build our understanding of the situation and how we might better support providers. We have commissioned qualitative research interviews on the theme of the early years workforce and a survey on the impact that covid is having on the workforce. We are working closely with the sector to identify some of those issues.

To aid recruitment and retention, we have also invested £153 million in programmes to support workforce developments as part of the £180 million package that I referenced. However, I hear what my hon. Friend the Member for Winchester said about the pressures and the questions he rightly raised about salary and how that impacts on recruitment. I will continue to listen to him, the all-party parliamentary group and the sector.

On ratios, the statutory framework for early years foundation stage sets out the staff to child ratios to help ensure that there is adequate staffing to meet the needs of, and to safeguard, children. They assume that the youngest children are the most vulnerable—I think that is the right approach—and need the greatest number of staff, but providers may need more staff where other needs are identified—for example, special educational needs. The Government are committed to working with the sector to support covid recovery, as well as on the broader concerns.

I want to clarify that there is a difference in ratios between England and Scotland, and I will look at that closely, but I assure all those who have raised the issue of ratios that I will always take an evidence-based approach. I will be very careful and considered in the way that I approach this and I will always put at the heart of this issue the needs of children and young people and the safeguarding of children. I will of course work with the APPG.

My hon. Friend the Member for Stroud (Siobhan Baillie) referenced military-style childcare planning. I very much recognise that myself. Childcare costs and pressures are acute for many families. They are the second highest cost only to their mortgage or rent. We recognise that and it is something I am looking at that closely as part of my portfolio. I am interested to hear about her work on the universal credit offer. At the moment, the take-up for that is, frankly, too low.

With regard to maintained nursery schools, the points were well made and I echo the comments made about the late Member for Birmingham Erdington, Jack Dromey, who was a passionate advocate in this area. He last raised this with me just before Christmas and his voice will be sorely missed. The funding rate for maintained nursery schools will increase by 3.5% next year. That gives them the long-term certainty that they asked for. However, I recognise that they have some unique characteristics, such as a headteacher and a special educational needs co-ordinator, so I am looking at this closely and I will raise this with the Treasury.

Finally, I will touch again on SEND, which is absolutely a passion of mine. As part of the SEND review, we have to get early identification and early action at the heart of that. The earlier we identify the need, the better the support we can put in place, giving parents confidence, but most importantly, providing better outcomes for children and young people with special educational needs.

To close, I am enormously grateful to my hon. Friend the Member for Winchester for the support he has given this agenda today and to all those who have contributed to the debate. The steps we have taken underline the importance of early education and the role of educators in that sector. The Government have made a substantial financial commitment that will in decades to come provide the workforce with the skills and expertise to ensure that no child is left behind. I look forward to continuing to work with my hon. Friend, the APPG and the sector to progress these issues further.

I thank the excellent Minister, who has given us much that we across the sector and the different all-party groups represented here today can work with. He is a breath of fresh air to the sector and I thank him.

There has been a consistency and clarity across the speakers today, and they have all made very good points. However, there has been some consistent messaging around the workforce and pay. An early years worker once sent me an advert from the local newspaper that showed that dog walkers were offered more pay than those who look after our precious little ones. As long as that is the situation, Houston, we have a problem.

I repeat my call that we have to treat early years workers as educators and we have to pay them at a level commensurate with reception year teachers. We should have a policy aim to bridge that gap. It is very much a policy aim that I and the all-party group have and we would like to get it on to the Government’s agenda and make it their policy aim.

I thank my colleagues, and I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) on the Opposition Front Bench for her constructive comments, although I would have liked to see more of her Back Benchers behind her—I really would.

Question put and agreed to.


That this House has considered the role of early years educators.

Sitting suspended for Divisions in the House.


I beg to move,

That this House has considered the matter of cyberflashing-related harms.

It is a pleasure to see you in the chair, Mr Gray. Let me start by explaining the perverse act of cyber-flashing. In essence, it is where a person is sent an unsolicited sexual image. There are two currents to this, and the first is through social media. More often than not, indecent images are persistently sent to Instagram, Snapchat or Twitter accounts. The second, more perverse angle, is where an image is received in a public place on someone’s device, just because their Bluetooth or AirDrop happens to be on. It often happens in public places such as on trains and buses or in lecture halls, where someone is in close proximity to people they do not know. It happens to men and women of all ages, and, sadly, is only increasing.

Cyber-flashing can be intimidating and distressing but, more than that, if someone receives an indecent image from a stranger in a public place, they are in a very vulnerable position. They are often alone with their perpetrator. Sometimes, the perpetrator is there, deliberately watching them, waiting for their reaction. It is a way of creating anxiety, a feeling of being watched and lack of safety, with the inherent threat that it could be followed up by a physical act of sexual harassment or violence.

There is evidence that cyber-flashing in this way is a gateway offence to more serious acts of violence. The man who killed Sarah Everard was accused of flashing before he went on to commit his horrific crime. It is time we made cyber-flashing a criminal offence on a par with its physical counterpart, to ensure the law catches up with technology.

My hon. Friend has done incredible work highlighting the seriousness of cyber-flashing. Does she agree that it needs to be a specific criminal offence, alongside public sexual harassment? I would love to hear the Minister’s views on that.

I thank the Chair of the Women and Equalities Committee not just for her intervention, but for her work in this area. I agree with her, and I would be interested to hear the Minister’s response later on.

At present, if someone is a victim of cyber-flashing the avenues to seek justice are limited at best. The Indecent Displays (Control) Act 1981, which criminalises the public display of indecent matter, is little known and likely to be little used. Laws on image-based sexual abuse are not based on an understanding of power and entitlement as the factors behind sexual harassment. They focus too narrowly on perpetrator motivations and do not provide the protection of anonymity for complainants, which I think is crucial.

Cyber-flashing is not an entirely new or recent problem. I am not the first to raise the need to criminalise cyber-flashing in this place. I pay tribute to hon. Friends who have partnered with the magazine Grazia, including my right hon. Friend the Member for Basingstoke (Mrs Miller) who has endorsed this campaign.

Since I have started talking about making cyber-flashing an offence in its own right, I have received not just many messages of support, but countless emails and social media messages from women who have been subjected to this cruel act. I pay particular tribute to the television actor and personality, Emily Atack, who was invited to Parliament by my hon. Friend the Member for Stroud (Siobhan Baillie) to talk about her experiences. I explained that I had sent her a message on Instagram asking to work with her on this campaign; she apologised to me, explaining that she never saw the message because her account is deluged with indecent images. I congratulate Emily, and others, for having the courage to speak out.

One field in which cyber-flashing is extremely common is online dating apps. I have been working with the app Bumble, which says that cyber-flashing is shockingly prevalent in the UK and disproportionately affects young women. According to a Bumble survey, in the past year alone 48% of millennial women said that they had been sent an unsolicited sexual image. One in four of those surveyed found that the prevalence of unsolicited lude images had got worse during the covid-19 pandemic, while one in three believed that cyber-flashing had become part and parcel of online behaviour. I do not know about you, Mr Gray, but I find that shocking. If we can agree on one thing this afternoon, it is that the unsolicited sharing of lewd images is not a part of normal courtship.

Education is one way in which we can seek to address this growing problem—making young people aware of the harm that this act can inflict on someone. This is already happening, thanks to campaign-led organisations such as Brook, which provide relationships and sex advice in schools throughout England and Wales. Its campaigners are also spending this freezing-cold Tuesday afternoon sitting on College Green with their advertising van. I encourage all Members, if they have a moment, to go and show their support for the campaign to ban cyber-flashing. I credit them for being hardy enough to stay there all afternoon.

Brook’s campaign to raise awareness of the harm caused by cyber-flashing is based on changing people’s behaviour and educating around consent. It is illegal to send someone younger than 18 an indecent image, yet almost half of millennial women who have received such an image were younger than 18 the first time that it happened. This figure rises to 71% when looking at 18 to 24-year-olds. What is illegal offline should be illegal online, and the law needs strengthening to achieve that. In June 2018, the Government introduced the Voyeurism (Offences) Act 2019, which sought to make upskirting a specific criminal offence. This is a prime example of how the law is involved in catching up with technological advancement.

I congratulate my hon. Friend on securing this debate and on her fantastic campaign. She is talking about the law keeping up; it seems to me that one of the key problems when it comes to offences using digital technology is the speed with which criminals exploit technology—in this case to sexually harass people, and mainly women—far outstrips the speed of our legislative process. While it is important that we get things right, does my hon. Friend agree that we need to take steps to speed up our response to new sexual offences such as upskirting, threats to share intimate images and cyber-flashing, so that we can better protect people sooner?

I absolutely agree with my hon. Friend. This is an area where Government and technology companies need to work hand in hand and at pace, in order to catch up. Until the specific offence of upskirting was properly legislated for, the best alternative offence of outraging public decency was used to prosecute offenders. Victims deserve better.

In 2018, the Women and Equalities Committee recommended that cyber-flashing must be addressed by Government. It said:

“The Government should introduce a new law on image-based sexual abuse which criminalises all non-consensual creation and distribution of intimate sexual images, including altered images, and threats to do so. This should be a sexual offence based on the victim’s lack of consent and not on perpetrator motivation, and include an automatic right to life-long anonymity for the complainant, as with other sexual offences.”

Four years on, if the Government want to make their Online Safety Bill a gold standard for internet safety—I commend their ambition—they must include legislation against cyber-flashing. I was concerned by the report published yesterday by the Digital, Culture, Media and Sport Committee, which said that, as currently drafted, it is not robust enough to tackle some forms of illegal and harmful content.

The Online Safety Bill is the vehicle to give victims the power to seek prosecution and hold perpetrators to account for their actions. That has been backed by the draft Bill Committee, and by the Law Commission’s recommendations. I was delighted at the end of last year when my right hon. Friend the Prime Minister, when questioned by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), agreed that cyber-flashing should be a criminal offence. That was later echoed by the Secretary of State for Digital, Culture, Media and Sport. We are on the right track, but I press the Minister to go as far as she can, and to say when we can see more detail of the Online Safety Bill.

I thank my hon. Friend for all that she is doing. As we know that most cyber-flashing is sent from anonymous accounts, making it scarier, particularly when the perpetrator might be in the same vicinity as the victim, does my hon. Friend agree that tackling anonymity online and anonymous abuse is a key part of dealing with cyber-flashing, as is being able to track perpetrators?

We are in danger of all agreeing with each other, which is a very good thing. I pay particular credit to my hon. Friend, who has done so much work on anonymity through her ten-minute rule Bill. That is crucial. Social media companies also have a huge role to play in this.

Going back to the point on consent, which I touched on earlier, I put on the record my thanks to Professor Clare McGlynn, who has been a leading figure in the campaign to legislate for a consent-based offence. It is critical that any new law is comprehensive, covering all forms of cyber-flashing, and therefore giving all victims the reassurance they need.

I congratulate my hon. Friend on securing this important debate; we all wait for the Minister’s response. She touched on the issue of a consent-based approach. That touches on the core wrong, which is that it is a non-consensual sexual act. Does she join me in urging the Minister to look at what is happening in Texas, California, New York, Virginia and Wisconsin, all of which are adopting a consent-based approach when legislating for this offence?

I agree with my right hon. Friend. Looking through the prism of consent empowers victims and lowers the threshold for people to take this forward. Consent is extremely important. The lawful consensual sharing of images between adults is fine and appropriate if it involves free choice, but it is important to recognise when that crosses the line, and that is through consent.

To my hon. Friend’s point, a consent-based offence covers all forms of cyber-flashing, regardless of the motives of the sender. Motive requirements create an unjustified hierarchy of abuses and victims, which does not reflect victims’ experiences. Technology companies, the media, politicians and employers all have a part to play in developing policies and practices to challenge everyday sexism, structural sexism and harmful sexual behaviours.

I want to point out the work that Bumble is doing. Bumble is a dating app on which women initiate the conversation, and its ethos is around protecting those who use the app. Not only does Bumble have a one-strike-and-out policy for people who are reported for lewd activity, but it has “private detector” technology that recognises and blurs explicit images, and offers recipients the chance to view the images or block the senders. That is industry-leading technology, and I commend those at Bumble for taking that approach. They have been involved in other initiatives around the world, as my right hon. Friend the Member for Basingstoke said.

I had best draw my remarks to a close because I know that we all want to hear from the Minister. It is imperative that we criminalise cyber-flashing in England and Wales as soon as possible. Every day without an offence in place means that victims are denied an effective route to justice. Let us lead the way by continuing the progress that the Government have already made, and make cyber-flashing illegal once and for all.

May I say what a pleasure it is to serve under your chairmanship, Mr Gray? Thank you for your munificence in holding on until I raced my way here this afternoon.

I also thank my hon. Friend the Member for Brecon and Radnorshire (Fay Jones) for securing the debate and for all her work on this vital issue since entering Parliament. Looking at my right hon. and hon. Friends across the Chamber, I genuinely see a group of very, very committed female parliamentarians who are doing everything that they can from the Back Benches to ensure that women and girls are protected in our society. I will try to reference them in my response.

I reiterate the horror set out by my hon. Friend in some of the experiences that we know about through campaigning organisations such as Brook. Women travelling on public transport or just going about their day-to-day lives can have such images thrust upon them and inserted into their lives without any consent.

My right hon. Friend the Member for Basingstoke (Mrs Miller) raised the absolutely valid point of consent. Indeed, she has been doing really groundbreaking work in highlighting the threat of deep fake pornography. Sadly, I think that we are only just beginning to see the potential and pernicious effect of that form of pornography. My right hon. Friend is very much leading the campaigning and raising awareness of those new ways in which criminals and others are using the internet.

My hon. Friend the Member for Brecon and Radnorshire quoted the Prime Minister’s response to a question about cyber-flashing from my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) during a sitting of the Liaison Committee. He said:

“I don’t care whether flashing is cyber or not, it should be illegal.”

In his own inimitable way, he has set out the Government’s approach to cyber-flashing. We absolutely support the development of such an offence, and we are carefully considering an offence along the lines of that proposed by the Law Commission.

My hon. Friend the Member for Brecon and Radnorshire asked whether the Online Safety Bill might be the vehicle through which that law was brought about. We are actively looking at that, but we very much understand the need for speed and, indeed, the wish of women and girls around the country for the issue to be dealt with quickly and effectively.

As my hon. Friend set out, criminal offences that may serve to deal with such situations already exist, and she listed a few of them. We recognise, however, the potential problems that may limit the application of some of those offences. In our discussions, the police and Crown Prosecution Service raised the practical difficulties of using section 66 of the Sexual Offences Act 2003, for example, because that particular offence requires that the genitals exposed are those of the offender. That may of course be very difficult to prove. In a situation where a woman received such a photograph on a crowded bus or tube carriage, for example, it would be an almost impossible element to prove, by definition. As such, we understand that there is a need to change the law, and also to reflect on the impact that these images can have on women and girls going about their business day to day. They may be distressed, worried, humiliated or frightened. Imagine a 15-year-old girl getting a bus home from school on a dark winter’s night, and this image pops up on her phone. She will be worrying, I would imagine, about what will happen to her when she gets off that bus to make her journey home. We absolutely understand that.

That is why, as a result of the concerns expressed by my hon. Friend the Member for Brecon and Radnorshire and others, as well as wider concerns about the development of new technology and how it is being used by perpetrators to commit offences, we wanted to understand whether the law as it is has kept pace with modern behaviour. It is why we asked the Law Commission to review the law on harmful online communications, to ensure that if change is needed, we do so in the right way. It reported last year, and I am extremely grateful to the Law Commission for that report, which recommended, among other things, a new criminal offence relating to cyber-flashing.

It is worth noting—indeed, my hon. Friend, in her usual thorough manner, did exactly this—that the offence of cyber-flashing is increasing in prevalence. According to the British Transport police, there were 66 reports of cyber-flashing in 2019, compared with 34 in 2018 and just three in 2016. Of course, as campaigns such as that of my hon. Friend get more traction, we are very alive to the risk that we will hear of more instances, because women and girls will know that they are not the only ones suffering these incidents and will, I hope, have the confidence to report them to the police. Having commissioned the Law Commission review, we are now working to ensure that we can change the law to reflect the realities of life in the 21st century.

My right hon. Friend the Member for Romsey and Southampton North, in her usual thorough and rightly pressing way, invited me to discuss the issue of public sexual harassment. Again, through the tackling violence against women and girls strategy, we have looked at that phenomenon, because we hear from campaigners that they believe that not just the nature but the frequency of such incidents has got worse and more prevalent over time. We keep under review the existing offences that are in place, but I know that my right hon. Friend will continue to be a strong advocate for a change to the law in this area.

Will the Minister briefly reflect on the fact that it is not just campaigners, me and Members from across the House who are calling for a change in the law, but the Law Commission?

Indeed. I was just about to say that my right hon. Friend has been joined by excellent company in the form of the Law Commission. She will, I am sure, appreciate that we are taking a little bit of time to consider this issue carefully.

My hon. Friend the Member for Brecon and Radnorshire spoke about the Online Safety Bill being the perfect vehicle for such a change in the law. As she would expect, we are working closely with our DCMS colleagues to explore the potential of that. Reference was made to the Women and Equalities Committee report that was published this week, and we invited the House to join us in drafting that Bill through pre-legislative scrutiny. My hon. Friend will know that a Joint Committee reviewed it very carefully and, of course, all of those considerations will be taken into account as DCMS takes the Bill forward.

My hon. Friend the Member for Rushcliffe (Ruth Edwards) made the fair point that while the Government look to legislate in due course, there is nothing to prevent internet companies from acting now. We should absolutely encourage these tech companies to consider their own moral duties to the public. They do not need to wait for us to pass a law: they can do the right and decent thing to stop women and girls suffering this sort of behaviour.

I would like to reassure my hon. Friend the Member for Brecon and Radnorshire and every colleague who has joined us this afternoon that we are actively and carefully considering the Law Commission’s recommendation on cyber-flashing, and are looking to identify a legislative vehicle as we aim to introduce a new, specific offence to criminalise it.

Question put and agreed to.

Skin Conditions and Mental Health

I remind Members that Mr Speaker has asked us to wear our masks if at all possible and to maintain social distancing where we can.

I beg to move,

That this House has considered skin conditions and mental health.

I want to start my speech by making a point that I will make at the very end: mind and skin are linked, and we have to take action on both if we are to break the vicious cycle of psychological harm. I suppose, really, I should declare an interest right at the beginning of this debate. It is not a financial interest but a personal interest: I have rosacea, which makes one’s face red and can ultimately deform it, and I take antibiotics every day. There are many more serious conditions—I do not make a great thing of it—but only today, in relation to something else I said on a completely different subject in the House of Commons, I have already received one email accusing me of being a red gammon head and a ruddy-faced buffoon.

I take it very lightly, because I know I am already old and ugly, but for young people this kind of personal abuse about their appearance is deeply upsetting and drives many people into deep psychological harm, because mental health and physical health are intrinsically linked. Knowledge of this link has driven recent advances in NHS service delivery and underpins much of the thinking in the long-term plan. Although that has led to the development of trailblazing and new services for many people with long-term conditions, for some reason people living with skin conditions continue to have dire access to psychological services. Indeed, in 2020 the all-party parliamentary group on skin, which I chair, published a report on the mental health issues faced by people living with skin conditions. It demonstrated that the psychological impact can be severe, in terms of the effect on people’s work, education and healthcare use. We should all worry about this, as 60% of us live with some form of skin condition.

Since the publication of the report, the developing impact of the covid pandemic has inevitably made a bad situation worse. One of my colleagues—who might speak in the debate—said that he was told by his GP only recently that he might have to wait a year for an appointment about a skin condition. With many patients with inflammatory skin diseases now experiencing a 12-month wait for a first appointment with a dermatologist, the stress and anxiety experienced by many individuals has risen significantly. I therefore want to spend this debate outlining the need for commissioners and health leaders to rethink how the NHS provides psychological care for people living with a skin condition.

The APPG’s report on the mental health associated with skin conditions is available on the group’s web pages. The report was based in part on a survey conducted by dermatologists and psychologists of 500 skin patients, with evidence also collected from 100 clinicians and 16 dermatology-related charities. The report was led by experts from the British Association of Dermatologists. The survey part of the report found that 98% of skin disease patients felt that their condition affected their emotional and psychological wellbeing; yet astonishingly, all the patient representative and professional organisations providing evidence stated that the NHS mental health provision for skin was “poor” or “very poor”. In addition, over half the patients surveyed did not even realise that they could ask for help with managing the mental health impact of their skin disease. That clearly demonstrates just how under-resourced services are in this part of the NHS.

I would like to draw the attention of the House to some other worrying findings that our research for the report highlighted: 93% of patients surveyed said that their skin condition had a negative impact on their self-esteem; 83% said their skin condition negatively impacted on their sleep; 73% said their skin condition negatively impacted on their intimate relationships; and 5% said that they had contemplated suicide. Sadly, I have been informed by healthcare professionals working in our NHS dermatology services that patients living with skin conditions are at increased risk of self-harm, as we well know, and that a number of them, sadly, go on to take their own lives.

There is also a great economic impact, with the double whammy of skin disease and the psychological burden associated with it. Some patients surveyed said that their skin disease had been so distressing that they had felt they had to give up their job. Let me read a brief excerpt from a quote in the report:

“When I turned 19 it [the eczema] became so bad that I couldn’t participate in normal life anymore due to the pain…I had to give up my job as I am always too unwell.”

Of course, our skin is implicated in everything we do and it is often not understood that skin conditions affect not just the individual living with them but their wider family. As for the impact on intimate relationships, let me read out another quote from the report:

“My skin is often too painful to have intimate relations with or to even to hug or kiss my partner. I had to postpone my wedding as I can’t cope with the idea of a flare up on my wedding day.”

Recent research and evidence suggests that parenting a child with a chronic skin condition can trigger parental stress, and the all-party group’s survey also included responses from some children. Every one of the children surveyed indicated that their skin condition had negatively affected their mental wellbeing, with the vast majority reporting that it had impacted on their performance at school. One of the children is quoted in the report as saying:

“I was so depressed. I felt like I was rotting away inside an alien growth on my face. I didn’t wanna exist like that. I wanted to chop my own head off.”

All this emotional turmoil was experienced by a child living with cystic acne. Clearly, if we do not support such children, the distress that they experience in relation to their condition may have a long-term impact on their future wellbeing.

There are some good services out there. The report highlighted a few trailblazers, such as the specialist IAPT —improving access to psychological therapies—service in Sheffield and the well-established psycho-dermatology services in some London hospitals. Psychological interventions are also being tested, and approaches involving cognitive behavioural therapy, merged with mindfulness and self-compassion, are showing great promise.

Nevertheless, our report demonstrates that there is very much a postcode lottery, with many hospital dermatology services not having access to psychological services or clear pathways to refer people at risk to the support they need. Alarmingly, less than 5% of dermatology clinics across the UK are providing any level of specialist mental health support for children and young people. And believe it or not, but in Wales there are no dedicated psychological clinics, and there are certainly none in Lincolnshire. Only a very small minority of trusts have such clinics.

This is a ludicrous situation. Research shows that psychodermatology clinics are more cost-effective to run, compared with managing skin patients with psychological distress in more generalist healthcare settings. Therefore, I urge the Minister to consider how funding is allocated and spent in this area. Covid has made things worse for dermatology patients, with poorer access to face-to-face consultations further preventing assessment and identification of mental health issues.

It is not just our report that stresses the need to embed in dermatology services psychological screening and access to psychological intervention. That is also a feature of most of the recent treatment guidelines that have emerged from reviews of the academic literature and consultation with experts. For example, the recent guidelines of the British Association of Dermatologists on the treatment of the depigmenting skin condition vitiligo make it clear that access to psychological support should be available.

Furthermore, while some conditions might be primarily psychological in nature, they pretty much always present in dermatology services. For instance, skin-specific delusional conditions and medically unexplained itch disorders can be devastating, and without clear access to psychological services, such patients can be put at considerable risk of having their underlying condition go untreated. Again, recent British Association of Dermatology guidelines in this area of practice make it clear that services need to be developed to meet the needs of this specific group of patients. However, investment has not been forthcoming.

As I draw to the end of this speech, let me share another disappointing fact with the House. The all-party parliamentary group has looked into the mental health of skin patients and service provision on two prior occasions, in 2003 and 2013. Our most recent report shows that, despite a general recognition of the need for better care in this area—and leaving aside the more recent impact of the pandemic—most of the recommendations of the previous reports have, I am afraid, not been acted on by Government. That seems to ne to be an indictment of those responsible for the planning and commissioning of these essential services.

What should we do? We can start by building parity of esteem between dermatology services and other long-term conditions, both in access to specialist dermatologist care—which would of itself reduce the psychological impact—and in access to psychological services.

In order to achieve that, our report makes a number of recommendations. All NHS dermatology units must have regional access to psychodermatology services, with clear pathways for patients to be referred to for appropriate psychological intervention or support. There must be a stepped care pathway that starts with good quality screening and enables patients to speedily access the most economic and effective psychological services that they require and deserve. This is already in place for many other long-term health conditions, such as diabetes, but not for skin conditions. This cannot remain the case; it is simply not good enough.

To achieve that, we need to increase staffing in dermatology services and improve the dermatology and psychological training of all NHS staff who have regular contact with patients with skin conditions. That includes training for trainees, primary care clinicians and secondary care specialists.

Research funding for psychodermatology should be prioritised. It should focus on the development, evaluation and implementation of a range of psychological and educational interventions for patients with skin conditions. The inclusion of patient support organisations in service development is critical to amplify the patient voice and to ensure that patients have clear access to some of the excellent services available in the community. NHS mental health funding provided to local commissioners must urgently be used to invest in and improve mental health services.

In conclusion, I commend our report on mental health and skin disease, which demonstrates the alarming lack of psychological support available to people living with a skin condition. It provides national policy makers, commissioners and local service providers with an expert consensus on how mental health support for people with a skin condition should be structured in a range of clinical settings. This can be delivered cost-effectively.

The report also outlines the urgent clinical need for healthcare professionals to be equipped with the necessary skills and resources to provide the holistic care that patients need. This must include patient assessments and care that treats the mind and skin together; otherwise, we will not break the vicious cycle whereby problems create psychological problems that in turn exacerbate the skin condition. We ultimately hope that through the publication of this report and debate, the need for action will be made clear to policy makers and service commissioners working in Government and the NHS. I look forward to hearing from the Minister.

Thank you for calling me in this debate, Mr Gray. I also thank the right hon. Member for Gainsborough (Sir Edward Leigh) for bringing this issue to the Floor of the House.

I want to raise the case of one of my constituents who experienced topical steroid withdrawal and the side effects of that as a result of the treatment she received for her eczema. I very much concur with the conclusions of the right hon. Member for Gainsborough on the steps that now need to be taken, not least in instituting mental health support in the care pathway.

Having been prescribed topical corticosteroid medicines over a long time, my constituent experienced a very severe reaction upon withdrawal that caused far worse symptoms than those her eczema preparations were intended to treat. The nerve pain was unbearable and inescapable; the skin split and bled; it was sore and painful. The oedema impacted on her care and was debilitating in itself. Those symptoms, exacerbated by the insomnia she experienced and by not going out—being housebound—therefore had a massive toll on her mental health.

The Medicines and Healthcare products Regulatory Agency and the Commission on Human Medicines have reviewed the impact of withdrawal and the over-prescribing of those preparations, which they often are because people need to treat their skin condition continually. As a result of an investigation under the yellow card system, they identified how poorly managed the condition is and how little known.

It comes back to the need for education around dermatology. At each GP practice, there should be a doctor who not only specialises in dermatology but has a good understanding of topical steroid withdrawal, who can therefore manage the pathway of patients. Patients should regularly see their GP for a review of the application of their medicine. It is even harder to trace what happens because there is no coding for this condition. We need to see coding to help to trace exactly what is happening. However, without proper research and investment in research into dermatological conditions, alternative preparations for the treatment of skin conditions are not being advanced at the pace that they should.

The debilitating process that my constituent suffered over not just days and weeks but months and years had a massive impact on her mental health. Depression is one of the side effects listed for these preparations. However, there is no point listing such conditions in the small print; we need to ensure that those side effects do not happen in the first place. We therefore need to ensure a proper review process within the education given to patients and the availability of other services.

That is why I support IAPT—improving access to psychological therapies—services being made available to people undergoing this treatment so that they can get the support they need. It is also worth noting that 81% of the people who experience topical steroid withdrawal are women; I notice that imbalance across healthcare and I will raise it every time. We continually fail on women’s health, and that needs to be looked at specifically.

Finally, I would like to say that there is good support from charitable organisations. Globally, the International Topical Steroid Awareness Network is looking at this issue, as well as Scratch That—I know it is quite a name for a charity—which does fantastic work supporting people and building a network, particularly to help people with their mental health issues. It suggests that it can advance support by building a community, but also by giving people hope. People with a debilitating illness often particularly need hope. I trust that a proper pathway for people with TSW—but, more importantly, prevention—will be developed.

It is a great pleasure to serve under your chairmanship, Mr Gray. I want to talk about mental health support for those with skin conditions, which is something that is often forgotten about by health providers across the UK and beyond. That is surprising, because 60% of British people currently suffer or have suffered from skin conditions at some point in their life. Those figures are comparable with cancer—it is a much bigger problem than we recognise. Some 98% of skin disease patients currently report that their condition affects their emotional and psychological wellbeing, yet only 18% have received any form of psychological support. That is a dichotomy that I want to explore very briefly—notwithstanding my sore voice, for which I am very sorry.

A key reason why support for these conditions is so important is that recent studies have proven that there has been an increase in psychological distress, and in the last two years in particular. That applies in particular to adults over 18 and children aged between six and 16. For over-18-year-olds, there has been an increase of distress from 20.8% in 2019 to 24.4% in March 2021. That in my view is a reflection of the pandemic, from which we have all suffered.

A study of adults over 18 also found that 26.1% of respondents reported self-harm thoughts at least once between March 2020 and May 2021. That is a hidden danger that we must all be aware of. It is even worse for those who are a bit younger. Among children aged six to 16, 39.2% have experienced some kind of deterioration in mental health since 2017—no doubt as a result of schools being closed and the isolation we all suffered from during the pandemic. For me, this debate is about the hidden dangers of the pandemic and the mental health cost on individuals.

That is made worse as young people emerge from the pandemic and their hibernation. How do they look? How do they feel? How low or high is their confidence? What about not having been in the sun for the last couple of years for those living in high-rise blocks in London and inner cities? What about skin conditions, such as acne? What about not going to school at that key age as a teenager? What about the lack of confidence that comes from having a skin condition? I want to raise these questions today. We can easily acknowledge the problem, but the solution is much more difficult.

Having discussed mental health, I want to move on to dermatology. The number of eczema sufferers in the UK has been steadily rising for the last 10 years. It stands currently at 1.3 million people. Interestingly, eczema is diagnosed much earlier. In around 90% of cases, it is children below the age of five. Psoriasis is much more of a problem for people that are slightly older. The prevalence of psoriasis in the UK today is a similar figure, at about 1 million to 1.3 million people. I am very familiar with it myself. Psoriasis is a problem that can affect how people look, and it is just one of many skin conditions, as we heard earlier from my right hon. Friend the Member for Gainsborough (Sir Edward Leigh). It is part of the whole panoply of skin issues that affect people so badly.

So what can we do? I want to raise three key points with the Minister. We need to improve the support for all those with skin conditions. We need to focus on the link between dermatology and mental health. First, I want to call on the Government to review their spending on dermatology to enable clinics to provide specialist mental health support for children and young people who suffer from skin problems. As we heard earlier, that may break the link between skin issues and mental health, which people are increasingly suffering from.

Secondly, we should ensure that, whenever possible, face-to-face appointments are available to those who need them. That is really important. It is about human contact and touch. A Zoom call with a doctor is fine, if people can get an appointment, but it does not recognise the problem. The doctor cannot see it nor feel it. That, for me, is very important.

The hon. Gentleman is giving an excellent speech. I, too, pay tribute the right hon. Member for Gainsborough (Sir Edward Leigh). This is such an important issue. I have been contacted by a constituent of mine called Margaret who is a lifelong sufferer of psoriasis. To judge from his opening speech, I think that much of what she said in her email to me would be very familiar to the right hon. Member for Gainsborough. Does the hon. Member for Bracknell agree with me about the importance of first contact with the doctor and how important it is that sufferers of all kinds of skin conditions can feel confident about reaching out to their doctor? As the hon. Gentleman says, face-to-face contact is so important. I also want to emphasise to anyone, anywhere, who might be suffering from a skin condition that help is available and they should not hesitate to seek it.

I thank the hon. Lady for her intervention; I could not agree more. The simple answer is that doctors cannot see anything on a Zoom call. Also, people need to be able to see a doctor to get a prescription. If someone has a skin condition, they cannot just go to the chemist to get a prescription. They have to get an appointment first in order to get the prescription, and that is where face-to-face appointments come into it.

My third point is that we need to increase the range of psychological support for all those who need it. That is part of the panoply of health support that we need. A 2014 study showed that 94% of the patients who had completed psychodermatology treatment reported reduced stress, 92% reported increased confidence, and 90% reported that their skin condition was better understood. Wow. Those figures are amazing, but if someone asks for that treatment at this point in time, it takes up to a year for a referral, which is worrying.

I want to commend the excellent services locally in my constituency. The Frimley integrated care system is one of the best in the country, if not the best. The treatment that I have had personally has been pretty good, notwithstanding the delay that we are all suffering form. Lastly, I ask the Minister to reinvest accordingly in this very important area so that young people and adults are not suffering.

This debate can continue until 6.07 pm. However, the House will know that there is very probably a vote at 6 pm. Coming back for five minutes seems odd, so it would be helpful if we can conclude by 6 pm. We have three further Back-Bench speeches and 15 minutes to conclude them in, so four or five minutes each will be helpful.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate.

As co-chair of the all-party parliamentary group on beauty, aesthetics and wellbeing, I am deeply concerned about the impact on mental health of having a visible difference, particularly for our children and young people growing up in a world where body image seems to become so significant, with the explosion of social media platforms. Living with a skin condition or any form of disfigurement impacts on an individual’s everyday life. At best, they might have to put up with strangers staring or pointing fingers, but for many it is a steady stream of teasing, harassment or bullying, which has a detrimental effect on self-esteem and subsequently on psychological wellbeing.

Almost one in five people across the UK self-identify as having a visible difference—a mark, a scar or a skin condition. We know that at least 1.3 million people are living with a significant disfigurement, which includes 569,000 with facial disfigurements. Although many dermatological clinics can provide support and advice on the physical challenges and treatments, fewer than 5% of them offer any level of specialist mental health support for young people.

I have talked before in this place about the fantastic charity Changing Faces, which provides unique and life-changing counselling and emotional and psychological wellbeing support for those with visible differences and their families. It does an amazing job and relies on voluntary funding and grants that stretch only so far, which means that it can reach only a tiny percentage of the people who need its help. Its mission is to challenge prejudice and discrimination and to change attitudes towards people living with skin conditions and scarring. Its “Pledge to be seen” campaign was launched to ensure that people with a visible difference that affects their appearance are seen and heard across mainstream culture and in workplaces.

I was absolutely delighted last year when the Welsh Government signed the pledge and became the first UK public body to make the commitment to represent and support those with skin conditions or disfigurements. I certainly encourage businesses and brands to do the same and to help to make society more inclusive. Research carried out by Changing Faces showed that people with visible differences are often vulnerable to isolation, loneliness and social anxiety, which is something we would have seen intensify over the last two years of covid.

As we start to emerge from the pandemic, our NHS services across all areas are stretched to full, beyond capacity, and we risk a looming mental health crisis. Something has to be done to tackle the growing gap in specialist mental health support for people with skin conditions. These people are not different; they simply have a visible difference. By seeing them represented in job adverts, brand marketing and campaigns, we will start to reduce the stigma, and I hope, in turn, some of the ridicule and bullying that they currently encounter.

I encourage colleagues from across the House to promote the “Pledge to be seen” campaign, and ask the Government to follow the lead of the Welsh Government by signing the pledge themselves. We all acknowledge the need for better mental health care, but alongside that it is up to us to demonstrate our commitment to reducing intolerance and prejudice, and to promoting opportunity and inclusivity.

It is a pleasure to serve under your chairmanship, Mr Gray. I pay tribute to the APPG, and to my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) for securing this important debate. I will try to keep my comments brief, but the challenge is that there is so much to talk about.

I, like the hon. Member for Swansea East (Carolyn Harris), pay tribute to Changing Faces, which has done incredible work to promote the cause of those with visible difference, who too often in our lives face discrimination and bullying. We know that 55% of young people will be bullied about their appearance. With the skin the largest organ of the body, it is almost inevitable that those who have a visible difference, such as eczema, cystic acne, scars or burns, will face some horrendous bullying at school—the sort of bullying that means that they do not take part in the ordinary activities that other children do. When I say “ordinary activities”, I mean that they do not want to take part in PE or put their hand up in class in case attention is drawn to them. Is it any surprise that children who have conditions that require medical treatment also need psychological help to overcome all of that?

I pay particular tribute to the most amazing man in Southampton, Professor Keith Godfrey—a dermatologist at Southampton General Hospital who runs the paediatric dermatology service.

Nobody likes talking about acne. I have been in this Chamber when I have heard Members say to me, “Nobody died of a few spots.” But actually, we heard my right hon. Friend the Member for Gainsborough highlight acts of self-harm in young people who feel so bullied and pressured because of the state of their skin that they do not leave their bedrooms and do not want to take part in school activities. Tragically, some do take their lives; they lose their lives because of “a few spots”. That is why it is so important that they are given the psychological help they need to get through their conditions.

Sometimes this is terribly controversial and upsets people, but I want to pay particular attention to the drug Roaccutane, which in itself can cause low mood. It is therefore important that young people who are prescribed it get the support they need when under prescription. We are terribly good at ensuring that young girls who are taking that drug go on the pregnancy prevention programme, but terribly bad at ensuring that the young men who take it get the support they need to get through low mood swings and the depression that some—I am quick to emphasise, not all—feel.

The Women and Equalities Committee last year conducted our inquiry into body image and the pressures that young people face. Of the evidence that we took, particularly from witnesses put forward by Changing Faces, two stick out in my mind. Tatyana, who was a burns victim when she was a very small child—she was at primary school when she was disfigured—gave us the most incredible evidence, in which she spoke about the importance of being open and talking about her skin condition.

Tatyana also spoke about the importance of role models. Pretty much everybody we see on social media today—those influencers of young people—is seen through a filter, so they look perfect at all times, yet young people look in the mirror and do not see that same perfection. Tatyana drew attention to Katie Piper, who she said was the only person she saw in public with visible burns who she could hold up as a role model. She said that she talks about it because she wants that young boy or young girl in their bedroom to see somebody who looks like them who is prepared to speak up publicly and ensure that other people have the courage to take part in everyday life.

I conclude with a plea from Changing Faces, which provides a brilliant, charity-run service that includes its skin camouflage clinic and one-to-one counselling support. Changing Faces would love to work with the Government. My plea to the Minister is: please, go and talk to the people there, listen to the lessons that they have learnt and the support that they can give, and work out how we can bring them into the NHS and help clinical commissioning to ensure that the psychological support is available for those who need it.

I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate. I want to focus on that issue of major importance to which he referred: mental health. As my party’s health spokesperson, I am keen that these issues are addressed. Skin is always completely visual. For young people in particular, looks can seem like the most important thing, which is why it is crucial that we recognise skin conditions that are normal and those that are not. We have 4,000 skin cancer deaths annually in the UK.

The reason I am interested in this subject is that my second son was born with psoriasis. He had to have cream three times a day. The doctor told us that although he would grow out of the psoriasis—and he did—he would then develop asthma. He did develop asthma, but he is now married to Ashleigh, and they have two boys, Austin and Max—life has changed for him. I remember that when he was at school it was terrible for him; all over his skin was a rash. My wife was the person who looked after him, but that is what happened.

In Northern Ireland, in my constituency alone, we have 2,713 people who suffer from inflammatory skin disease. It is really important that the issues are taken onboard. Some 4,351 people develop skin cancer each year, and around 300 of those cases involve malignant melanomas. It is crucial that there is special psychological care to deal with the impact of skin problems, to help people to cope and to ensure that the condition does not worsen. The right hon. Member for Gainsborough referred to the fact that 18% of people suffering with skin conditions have received some form of psychological support—that is really important. They have to learn how to live with it, as well as learning how to deal with it. As I have said before, young people are growing up in a world where looks seem like everything, and we must do more for them.

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate on such an important matter, and for informing us all so much through his excellent contribution. Millions of people across Scotland and the UK suffer from skin conditions, which can have a devastating impact on a person’s mental health. The skin is the most noticeable part of our body that could be impacted by psychological factors, yet very few psychologists are researching it. It is classic health psychology, just in a different area. It may seem purely aesthetic to the unaffected, yet the impact goes much deeper, as we have heard.

Skin conditions can be extremely distressing. They can affect all aspects of people’s lives, from schooling, relationships, self-esteem and career prospects to social and leisure activities. Unlike hypertension, diabetes or other health problems, skin problems are usually obvious to any onlookers. That can lead to feelings of isolation, embarrassment, depression or anxiety. People may have psychological reactions that seem out of proportion to their actual skin complaint. Around a quarter of the UK population consult a GP every year for a skin complaint, the most common being for stress caused by the complaint. Despair and other psychological issues can exacerbate the skin problem, creating a vicious spiral.

Acne, psoriasis, eczema and hives are just a few of the dermatological conditions that have been scientifically proven to be exacerbated by stress. Psychodermatology treatment is becoming more accepted among dermatologists, and psychologists are becoming more involved in assisting dermatology patients. Dermatologists and other skin experts are still researching the role of stress and other psychological factors on skin conditions. They are also working on therapies to help dermatology patients deal with the mental health difficulties associated with their conditions.

We heard the hon. Member for York Central (Rachael Maskell) speak about her constituent’s issue, as well as about women’s health more broadly. My hon. Friend the Member for Bracknell (James Sunderland) spoke about the number of people impacted by mental health issues compounded by their skin condition, such as eczema or psoriasis. Despite all that, there is still a gap in services available for people experiencing distress. A report released in September 2020 by the all-party parliamentary group on skin, undertook some fantastic research and found that many primary healthcare professionals lacked access to dermatological training—even fewer are trained to support patients with the psychological effects of these conditions. We may miss critical signs of distress if primary healthcare providers lack the expertise to conduct a psychological evaluation.

According to the British Skin Foundation, 70% of people across the UK have noticeable skin disorders or scarring that will lower their self-esteem. For example, psoriasis is an illness that primarily affects the skin, and occasionally the joints through psoriatic arthritis. It presently affects between 2% and 3% of the UK population, which is over 2 million people. Psoriasis can have a significant and sometimes catastrophic psychological impact, causing anxiety and depression. Despite that, there is a lack of resources to help persons with inflammatory skin feel less stigmatised. I am myself a psoriasis sufferer, and fully understand the implications of the condition and the effect it can have on a person’s self-confidence. I developed psoriasis in my teens: it is a genetic, hereditary disease, passed on to me from my mother. In fact, my granddad, my mum, my auntie Anne, and now myself have all been long-term sufferers.

The damage that this condition can cause does not simply arise from the impacts on a person’s skin, many though they can be. I am maybe fortunate that my psoriasis manifests mainly on my scalp and head: I often jest that as long as I keep hold of my hair, I should be okay. However, I have also seen first hand the impacts of severe and extreme breakouts resulting in hospitalisation, and have touched on the stress and anxiety of sufferers, none more so—in my opinion—than that of the parent watching their child growing, hoping against hope that they will not have unwillingly passed their condition on to their children. My 13-year-old has so far been unaffected, but that seems to be by the grace of God.

I put on record my thanks to NHS Scotland for its continued work in this field, which has been made possible by the Scottish Government boosting mental health spending by over 65% in the past year alone. I am sure that Members will agree that the mental health consequences of skin diseases are vast, and that as a morally responsible society, we must do more to combat those effects.

It is a pleasure to serve under your chairmanship, Mr Gray, and I commend the right hon. Member for Gainsborough (Sir Edward Leigh) both on having secured this debate and on his ongoing work in, and commitment to, this area. He introduced his comments by saying that yet again, he had had more ridicule through an email, which is appalling. He stands up for people, and I am sure that that is well appreciated by fellow sufferers.

The APPG’s report is very powerful. It is very sobering that, despite similar reports in 2003 and 2013, so little has changed for people suffering from these conditions, both from childhood and among adults and people who are older. The link between skin conditions and deterioration of emotional and psychological wellbeing are well documented, and have been for some time. As we have heard said so eloquently this afternoon, people with skin conditions report that they have experienced social isolation, stigmatism, depression, anxiety and in some cases suicidal thoughts and, indeed, action. There is also strong evidence to suggest that, although people with skin conditions have much higher rates of common mental health conditions, they struggle to access psychological support. Members have given some very good examples from among their constituents. This is particularly prevalent in children, as the hon. Member for Bracknell (James Sunderland) discussed. The APPG’s survey found 98% of respondents stating that their condition impacts their mental health, and only 18% saying that they could access support.

The rise of social media has exacerbated these problems. As my hon. Friend the Member for Swansea East (Carolyn Harris) has said, children and young people with these conditions are particularly reporting bullying and being mocked on social media, all of which we obviously condemn. We cannot disagree with all the evidence that has been presented today—the reports and recommendations on what is needed to support people. It is very clear, Minister: we need to improve access to specialist support, improve training and awareness through the health service, commission more psychodermatology services, improve staffing, support further research, and encourage further integration between psychology, psychiatry and dermatology. The Government need to do much more to support these people, particularly those who are battling through the primary and secondary care interface—I am particularly thinking about parents who are trying to do so. The IAPT service, with which I have worked in my previous career with the health service, offers a route through. However, as all of us know from our constituencies, IAPT is heavily over-subscribed and really struggling with current caseloads.

In the final few moments of my speech, I will pick up on the issue of teledermatology. Although people over the past 20 years might not have experienced much difference in services, the world has changed quite considerably in those 20 years. A decade ago, I was a commissioner for a primary care trust—now they are CCGs—of a teledermatology service, encouraging GPs to use that service as a way of supporting them, providing better link-in to secondary specialist care, and ultimately providing a better, quicker, more responsive service to local people, particularly for parents who can sit with children and avoid trips into hospital. It was clinically led, working with the private sector, new technology and willing GPs, and it was innovative. It was incredibly hard to achieve: at some point, I may share my stories of trying to implement a new service in the NHS. It is not easy, because new practice is always hard to achieve and savings and effectiveness are hard to demonstrate.

Although as we have heard, covid has made the situation much worse for many people, the pandemic has provided a catalyst for some rethinking of how we deliver services. Though I heed the warning in the report —also made by hon. Members today—about the loss of face-to-face services and about how important those are, I think that we can learn some lessons. With waiting lists at 6 million people and rising rapidly, I wonder how the Government will make developments in this area, as well as in many others, without thinking about more radical approaches, while clearly bringing people with them. Technology and digital access provide some of the solutions.

I have a number of questions for the Minister. Given the clarity of the evidence, will she outline how she would support embedding innovation and the lessons of the pandemic to create a more responsive, faster and better service? Will she outline how she will work with her counterparts in the Department for Digital, Culture, Media and Sport to deal with online bullying about skin conditions, which we have also talked about today? It would be helpful to understand the Government’s strategy on employing and training more psychodermatologists and, indeed, how the Minister will support GP training so that GPs understand the effect on people’s mental health of skin conditions, again as has been so eloquently outlined over the past two decades.

What plans does the Department have to invest in further research into psychodermatology and the wider mental health implications of skin-related diseases, as the right hon. Member for Gainsborough mentioned? I sincerely hope that we are not all here in another decade’s time, with another report from the APPG saying the same things. I am sure that we would all like to see some progress for people suffering from the mental trauma of their poor skin conditions.

It is a great pleasure to serve under your chairmanship, Mr Gray.

I add my thanks to my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) for securing the debate. The subject is clearly important to many people in the House and to many people across the country who have skin conditions and are concerned about their mental health. I also thank my right hon. Friend for championing this cause for so many years. I am relatively new to my role, but I look forward to working with him. I thank him for sharing his story, which I am sure will have given a great deal of comfort, as well as having resonance in this debate. It is real that people suffer bullying. I was very interested to hear about Changing Faces, the visible signs and the pledge, and I am happy to hear more from the hon. Member for Swansea East (Carolyn Harris).

Skin conditions, such as acne, psoriasis—we heard the personal story about psoriasis of the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar)—the rosacea we heard about from my right hon. Friend the Member for Gainsborough and eczema can be complex and affect people of all ages. Many young people are affected by acne and one in 50 of us will develop psoriasis. Eczema is also very common, affecting one in five children, including me when I was younger. It can also start later in life.

Some of those conditions can be relatively minor, as in my case, and will clear up over time, but others are much more serious, causing pain and scarring and being for the long term, perhaps lifelong. Clearly, that can and will have a negative impact on a person’s life, often causing stigma, discrimination and bullying. It can seriously affect their self-confidence, self-esteem and overall mental health. I understand that. I assure the Chamber that the Government are committed to supporting people with all dermatological conditions.

I note the report on “Mental Health and Skin Disease” by the all-party parliamentary group. I will be happy to attend the group on occasion. I acknowledge that the need for specialist mental health support for people suffering with often debilitating long-term skin conditions was raised as a particular issue, as has been discussed. As my right hon. Friend the Member for Gainsborough stated, the mental health issues faced by people living with skin conditions can be severe, in particular when people are not getting the treatment they need—or waiting for more than a year, as he outlined. Obviously, the longer someone waits, the worse the condition often gets. I reassure my right hon. Friend that mental health and ensuring that people get the treatment that they need will continue to be a priority for the Government.

We are committed to achieving parity between mental and physical health services, and to reducing mental health disparities. We know that we are not there yet, but we are committed to that. We are making good progress, however, with investment in NHS mental health services continuing to increase each year from almost £11 billion in 2015-18 to more than £14 billion in 2020-21. We are investing at least £2.3 billion of extra funding a year in expanding and transforming our mental health services by 2023-24.

Some people with dermatological conditions will be on a long-term condition pathway, due to the nature of their illness, such as cancer, including skin cancer. In these cases, the team responsible for the patient’s physical health should discuss and review the patient’s emotional and psychological status regularly and support them, through access to information and services for their mental health if needed.

Commissioners are encouraged to ensure that local pathways include assessment and ongoing support of patients’ mental and psychological wellbeing and cognitive status. They should also ensure that health practitioners have ongoing training—a number of Members mentioned that—to understand the emotional, cognitive and psychological needs of patients. We have continued to expand our flagship talking therapies programme—a number of hon. Members welcomed that. The improving access to psychological therapies—IAPT—programme for all adults with common mental health problems has been accessed by more than 1 million people in 2020 and 2021. We have expanded the programme to help people with their mental health and long-term conditions, including dermatological conditions.

A person’s mental and physical health are intrinsically linked—they are in one place, in one person. People with long-term physical health conditions, such as dermatological ones, may also need emotional and psychological support. Conversely, two thirds of people with anxiety and depression have a long-term physical health problem—the two go hand in hand. Integrating psychological therapies with physical health services can provide better support to this group of people and achieve better outcomes. That is something we discuss regularly when talking about integration and the new integrated care systems, as one of the benefits of taking that approach. It is also why we have expanded our IAPT programme to include an integrated approach for people with mental health as well as long-term conditions.

All clinical commissioning groups are expected to commission IAPT services, integrated into physical care pathways, as part of their IAPT expansion plans locally. That should bring together mental and physical health providers so they can work in a co-ordinated way to achieve the best outcomes for all people irrespective of their diagnosis. While there is some excellent practice of services offering talking therapies for people with dermatological conditions, such as those in Southampton mentioned by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), I acknowledge that that may not be the case in every area, but IAPT services are continuing to grow and develop all over the country.

I would like to take the opportunity to remind people that IAPT services are accessible to all adults in England. I fear there is low awareness of the understanding that people can self-refer to IAPT. They do not have to wait for a GP, although that is one route, and can self-refer to IAPT. We have also launched a “Help!” campaign, accompanied by The Beatles music, which is raising awareness so people know they can access those services. They can be referred by a range of practitioners in the community or by primary care, but they can also refer themselves. They will receive a person-centred assessment that covers the person’s mental health problems and acknowledges the impact of their long-term condition. Clear pathways and processes should be in place to enable a person to progress between those services and existing pathways.

As mentioned by my hon. Friend the Member for Bracknell (James Sunderland), I acknowledge the impact of the covid pandemic and the excellent work going on in mental health services to respond to the pandemic. The past two years have been really tough. There has been a lot of innovation, as the hon. Member for Bristol South (Karin Smyth) said. We need to take that innovation and embed it in the services. There has been unprecedented demand on mental health; it was growing anyway, but the pandemic has accelerated demand. They are doing their utmost to make sure that services are there for everyone who needs them—for patients and our NHS colleagues who have been on the frontline— but services have been strained and it is harder for people to get an appointment at times. That is why, in addition to our long-term plan commitments, as part of the Government’s commitment to build back better, we have published our mental health recovery action plan, backed by an additional £500 million for this financial year, to ensure we have the right support in place and that we embed that innovation to access more people.

The plan aims to respond to the impact of the pandemic on the mental health of the public, specifically targeting groups who have most been affected—young people and children, clearly, are in that group. That investment and expansion of mental health services will help to address the needs of those people with long-term conditions, as well as other people in need of support. To deliver on our commitments, we need to ensure we have the workforce available. That is important but it takes time to deliver and that impedes our progress. It is vital that we have the right skilled workforce in place; we have improved that and we will continue to improve it.

Question put and agreed to.


That this House has considered skin conditions and mental health.

Sitting adjourned.