Westminster Hall

Wednesday 9th November 2011 Westminster Hall

Wednesday 9 November 2011

[Philip Davies in the Chair]

Adoption

Wednesday 9th November 2011 Westminster Hall

Motion made, and Question proposed, That the sitting be now adjourned.—(Mr Goodwill.)

09:30

[Jessica Lee (Erewash) (Con)]

It is, as ever, a pleasure to serve under your chairmanship today, Mr Davies. It is my privilege to be able to bring this debate to the Chamber. The issue of UK adoption rates is topical and extremely important. Last week was national adoption week, and the issue has caught the public imagination. There is much to be said about the adoption process in the UK.

I must declare an interest as a family law barrister who has represented, over the years, parents, children and local authorities, in the child protection arena, since qualifying about 10 years ago. That has given me an insight into the many strains and pressures on those who work in child protection, and how those factors impact on the adoption process in the UK. I hope to set out some context, showing the different complexities that need to work together to improve the adoption process. However, I also consider the debate a perfect platform from which to encourage prospective adopters to come forward and be assessed, and to thank those who have stepped up to the mark and are now parents. The attendance at today’s debate shows that it is of interest across the parties.

The recent figures on adoption levels in the UK should cause alarm bells to ring. In the past year, of the 3,660 children in care under the age of one year, only 60 were placed for adoption. Those figures are a matter of concern, but they continue a trend that has troubled the Department for Education since the formation of the Government last year. For those of us with an interest in that area, the commissioning by the new Government of the Norgrove and Munro reviews, and the appointment of Martin Narey to review the adoption process—among other things—was most welcome. I know that the Children’s Minister, the hon. Member for Brent Central (Sarah Teather), and the Secretary of State have taken a real interest in the subject matter.

I read this week a moving account by my right hon. Friend the Secretary of State for Education of his experience of childhood after being adopted.

[Ann Coffey (Stockport) (Lab)]

I was looking at the adoption statistics, and it seemed to me that the decline in the number of adoptions is associated with an increase in the number of special guardianships being granted. When those are combined, the absolute numbers, in terms of giving permanence to a child, have increased since 2006. Does the hon. Lady agree that special guardianship orders, as well as adoption orders, can give the permanence that we seek for children?

[Jessica Lee]

I agree that when special guardianship orders came in, they brought about something that was much needed in the system. It is often, although of course not always, relatives of the child who step forward, and the orders provide another avenue of permanence and security for the child.

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

I congratulate my hon. Friend on securing the debate, about which many of us feel passionate. She has carried out a duty on behalf of us all in championing the matter in Parliament.

Although since 2005 special guardianship orders have been an important addition to the routes to permanence for children, is it not the case that the number of children being adopted had already flatlined in the two or three years before those orders were introduced? We need to be careful not to make a direct comparison between special guardianship orders and adoption orders and assume that one is replacing the other.

[Jessica Lee]

I pay tribute to my hon. Friend the Member for Crewe and Nantwich (Mr Timpson), who has shown leadership in the House in taking forward the issue of outcomes for looked-after children. I agree with his point. Special guardianship orders have their place and have been very useful in the child protection arena, but I do not accept that there is a direct correlation between the introduction of those orders and the reduction in adoption figures. It simply is not that straightforward. It should be borne in mind that often other residence orders or long-term foster care arrangements have supported special guardianship orders.

To return to what I was saying about the Secretary of State, he has taken the view that his life chances were transformed by the childhood that he experienced. He hopes to support looked-after children who are waiting to be placed for adoption. I was very encouraged by the interest shown by the Prime Minister in the issue in his party conference speech and subsequent remarks. I was delighted to hear him comment on the importance of improving adoption rates. I was also delighted with his response to my question at Prime Minister’s questions, which included this comment:

“It is also important that the Government pledge that we will make the process of adoption and fostering simpler. It has become too bureaucratic and difficult, and the result is that it is putting people off. I am absolutely determined that we crack this.”—[Official Report, 2 November 2011; Vol. 534, c. 923.]

I am sure that we would all agree with the Prime Minister about that.

Pulling all the indicators together, the message is clear. There is a momentum in the House and the country to tackle the challenges affecting the adoption process. We must seize the opportunity. The starting point must be the assessment process for prospective adopters. Last week’s national adoption week was an excellent opportunity to showcase, across the country, the need for adoptive parents, and the need to raise awareness. It is hoped that families and individuals will reflect on the possibility of adoption and make that important phone call to local authorities to start the process. Sadly, there are many anecdotal examples of that first step in the process—contacting children’s services—being a hurdle to overcome. I worked with and for social workers for many years, and I assure hon. Members that I am not going to turn my speech into criticism of those who work in the field. The difficulties I mention are merely an example of the problems that occur all the way along the process of adoption.

Anecdotally, some applicants report being discouraged from the outset, and more needs to be done to ensure that all possible applicants are appreciated and encouraged to apply. Until we get people up to the starting line for the assessment process it is difficult to improve the number of applicants. With the current numbers of successful adoptions, we cannot afford to discourage people at an early stage. The entire assessment process needs to be streamlined and improved.

[Mr Marcus Jones (Nuneaton) (Con)]

I congratulate my hon. Friend on securing this important debate. Last year I spent an afternoon out with Warwickshire social services, and met foster carers, who were doing a terrific job looking after some of the most vulnerable young people. They were very concerned because of the delays in adoptions, which caused problems, leaving the young people uncertain for some time. Does my hon. Friend agree that streamlining and speeding up the process would help our most vulnerable young people?

[Jessica Lee]

I am grateful to my hon. Friend, who has essentially summed up the problems. There is not one individual, agency, organisation or Department at fault. We are dealing with an entire system that needs to be examined and improved throughout. A domino effect of improvements is required.

[Susan Elan Jones (Clwyd South) (Lab)]

Is the hon. Lady aware of developments in Wales? The Welsh Assembly Government are consulting on the possibility of unifying the adoption capacities of local authorities into a super-agency, with the idea of reducing duplication and, hopefully, providing speedier and better matches between adoptive parents and children. I imagine that the hon. Lady, like me, would welcome that approach.

[Jessica Lee]

I of course welcome any initiatives that are being taken, and I am sure that more information will be presented about the pilots and process in Wales, which will help us all, throughout the country.

Turning to the streamlining of the process, I ask the Minister this: do the Government consider that the process takes too long on occasion? Are the assessments too lengthy? Is there too much bureaucracy? Again, I am not criticising individual social workers—adoption is not an easy area to work in, and those working in adoption teams are often passionate and committed to seeking a placement for children for whom they are responsible. My concern is about the culture that has developed regarding assessment and the heavy-handed approach to form-filling. We need to reach a position where professionals feel confident to exercise their judgment to make decisions. That is perhaps reflected in the conclusions of Eileen Munro’s review into social workers and how we can improve prospects for professionals.

[Mr Andrew Smith (Oxford East) (Lab)]

The hon. Lady has been generous in giving way, and I congratulate her on securing this important debate.

May I reinforce the hon. Lady’s point? Does she agree that Martin Narey’s evaluation of what is going on in the area is striking? He reported that one local authority required

“prospective parents to go through 146 pages of assessment.”

He also met a couple who had had to spend

“12 days with a social worker in their home assessing their readiness for adoption.”

At a time when almost

“three quarters of councils failed to place a child with their new adoptive family within 12 months of the adoption being finalised”,

does she agree that on both sides of the House we need to give the strongest support to Martin Narey in sending out the signal that pace and purpose need to be brought into the whole process, in the interests of the children?

[Jessica Lee]

I agree with what the right hon. Gentleman has said. Of course we need to support Martin Narey, and I will come on to his report.

Another anecdotal example that one hears is that households are assessed through a form that is several pages long about the number of pets in the household, the fire drill process and so on. It prompts the question: where does the balance fall? Of course we need to safeguard children—no one would object to that. However, if every family of every newborn child who goes home from hospital with their natural parents had to produce a fire drill, a pet assessment form and details about its private life, the country would come to a standstill. We do not want to discourage people who have agreed to adopt and who have made an emotional commitment and a life-changing decision from applying. The concern, which we must tackle, is that such people are distracted or discouraged from continuing the process. In his report, Mr Martin Narey gives some excellent examples of where the problems lie.

[Mr Marcus Jones]

My hon. Friend is generous in giving way. Regarding the point that she has just made, does she agree that although we need, first and foremost, to ensure that adoptive parents are fit and proper to take on an adoptive role, by no means should the Government or the state tell the people who are fit and proper to look after children how to run their lives?

[Jessica Lee]

The point is well made by my hon. Friend, and I thank him for the intervention. It is exactly that balance that perhaps we should all refer to this morning. There is a clear dividing line between assessing and safeguarding children and deciding whether they would be in any risk in a household, and commenting on people’s lifestyle choices and intimate details, which is simply not relevant to whether people are fit and capable parents.

Another aspect to speeding up the adoption process is the time limit for courts in completing care and placement proceedings. The family justice review, headed by David Norgrove, has just produced its final report. Sections of the report are relevant to the debate on adoption rates in the UK.

It is broadly accepted that children make their main attachments in the earliest months and years of their lives. It goes perhaps without saying that the more secure are their relationships with their main carers, the more likely it is that they will form secure attachments and relationships in childhood and beyond.

It is important to remember that the paramount priority of the family court has been and always will remain the welfare of a child. Again, I make no criticisms of all the professionals and others involved in the court process; I know at first hand how hard-working and committed the court staff, lawyers, social workers and children’s guardians are. However, there are long delays in the completion of cases. Care and supervision cases now take an average of 56 weeks. One can say that a young child is subject to proceedings for a high percentage of their life—often 50% or more. There is no magic wand for that problem. It requires consideration of case management, court availability and judicial leadership.

We already have in place the public law outline, which sets out the parameters for how cases should progress. Judicial continuity and strict case management are just one important aspect of how we could speed along proceedings.

[Mr Timpson]

Regarding the court process, judicial continuity and case management, is it not also important that the initial allocation of a care case is done with the utmost expediency and by a judge with the right level of experience, to ensure that there is not even more delay built into the court process, so that the time limits that we are trying to adhere to are more likely to be kept?

[Jessica Lee]

I agree with my hon. Friend’s point. At the moment, all public law cases automatically go to the family proceedings court. They may then be transferred to higher courts, such as the county court or even the High Court. However, when we are dealing with strict time limits and concerns to create outcomes for children, every extra court date is time not best used. It is a waste of the child’s time, and we must improve the situation. I would support any proposals that allocate cases more efficiently and directly to the correct level, so that they can be properly managed by appropriate judges.

The Norgrove review proposes a limit of six months in which to complete proceedings. That is certainly a good aspiration, but if that is to be achieved, it will require the coming together of many aspects of how the courts function. I realise that the report has only just been published, but I ask the Minister for any preliminary response to it, and what the time scale is for a detailed Government response to that important document. Six months is a reasonable period in which to make an assessment. A court’s primary and first consideration and hope is that a child may be returned to their birth family and stays with it. Following that is an assessment and consideration of the parents and any other family members. We need to speed up the availability of court time.

Judicial continuity is important. If a judge is charged with the responsibility of a case from the outset, they will have a much better understanding of the dynamics, personalities and initial concerns of a social worker. They will have a grip on the background and chronology of the case; they will have seen it through. It is much more difficult for a judge to step in halfway through a case and make important and life-changing decisions for a child. I am sure that many judges would wish to have judicial continuity throughout cases—they aspire to that as well—so I hope that can be achieved over time.

Once the court process has been exhausted and a placement order made, allowing local authorities to match a child with prospective adopters, there are further hurdles and challenges. A local authority has to consider the pool of adopters within its authority. Again, one has to think about the cost and other complications of looking further afield from the outset. However, is that a sensible, child-centred approach? Surely, we need a more straightforward structure in which adoption teams across the country can consider as wide a pool of prospective adopters as possible from the earliest opportunity. That could save months when matching children with prospective carers.

[Claire Perry (Devizes) (Con)]

I apologise for arriving late to this extremely important debate. I have considered adoption. I am 47 years old and have successfully brought up three children. I know that there is a big question over whether MP mothers are fit people to adopt, but I am also considered too old to adopt because of some absurd guidance on the age spread between the adopted child and the adoptive parents. Surely it is time to stop that insanity and allow these vulnerable children to be placed in loving homes regardless of ethnic background and age. We need a return to common sense.

[Jessica Lee]

I agree with my hon. Friend. Of course we need a common-sense approach. There are thousands of children in care who are waiting to be placed, and we must do all that we can to help them.

The issue of concurrent placements is important. Foster carers who are caring for children throughout the court process—the care proceedings—can also become the adoptive parents without having to be assessed all over again. The advantage is that children are in their prospective home and able to form those important attachments from an early stage. That is surely desirable and needs to be encouraged. Organisations such as Coram are skilled and successful in implementing such an approach, and authorities, including the London borough of Harrow, have championed it.

Of course there are consequences to such an approach. We are asking foster carers to make an emotional investment, and yet they are often left for months on end waiting for the outcome of the assessments of everyone else to see whether they can keep the child for the longer term, so it is not for the faint-hearted. None the less, there are many advantages to the concurrent placement approach. I hope that the Government will consider increasing the number of concurrent placements and also how they are undertaken across the country.

Another aspect of the adoption debate is the question of how important it is to secure a cultural and ethnic match between prospective parents and the child. In my experience, this is a debate in which feelings can run very high, and professionals and parents hold a variety of views. Of course there are many who have a greater knowledge and insight into this issue than I, but for what it is worth my view is that we have taken a step in the right direction with the recent change in the legislation that says that a culturally appropriate match is desirable but is by no means a prerequisite or a deal-breaker.

It is easy to be simplistic about this topic, but it is difficult to accept that it is better for a black and minority ethnic child to have to remain in care for all of their childhood instead of being placed in a loving home because there is not an ideal ethnic match.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this debate to the Chamber today. Often foster parents and those who wish to adopt go overseas to adopt. Does that not illustrate the problem that we are trying to highlight today—that it is quicker to adopt overseas than at home? Surely there needs to be a quick change to the system for the very reasons that the hon. Lady has stated.

[Jessica Lee]

I agree with the hon. Gentleman. I have many anecdotal examples of this issue. I have met many adoptive parents who have spent years hoping to adopt children and who have, eventually, had to turn to agencies overseas. It has taken years and cost them a huge amount to parent a child. That is a tragedy and must come to an end. Society has moved on considerably on this issue and those not involved in any way with the court or adoption process are often amazed to hear that they may not be considered as parents for a child because there is not a good cultural match. I do not think it is fair on BME children who are in foster care to be disadvantaged in such way. We must make progress on this issue.

On the issue of sibling placements, there is evidence that the loss of contact with birth siblings is a real regret to adopted children. We need to do more to support successful sibling placements and to encourage contact and communication between siblings throughout their childhood. I have friends who went from having no children to having three overnight, aged three, two and one. It was a life-changing moment for them, but it ensured that the sibling group were able to stay together. I can now report that those children are flourishing and experiencing a very happy childhood.

It is easy to be over-simplistic about this issue and there will be many examples of situations where it is not in a child’s best interests to maintain such relationships. None the less, if such relationships can be sustained they should be, and this is where the care plans that are devised at court and the role of the independent reviewing officer come to the fore.

When the case completes in court, the judge will sign off and approve the final care plan. A section in that will include the contact—contact with birth parents and with birth family, which will include siblings as well. A real regret for judges is that they do not know what happens after that point; they have no judicial role once the case has concluded. The case then moves to the management of the local authority and the independent reviewing officers, who have a key and pivotal role to play in the whole adoption procedure. I hope the role of such officers is supported and perhaps even increased and improved over the years. They are charged with the responsibility of checking on that care plan and seeing how it is being implemented. The loss of birth parents can be difficult for children as they grow up, but the loss of siblings with whom they may have been very close can be something of real regret. More needs to be done to improve and encourage not just the placement of siblings together but sibling contact if children have to be separated.

The issue of Criminal Records Bureau checks also needs to be considered and changed across many Departments. A constituent of mine wanted to volunteer to work with the local Home-Start charity. Erewash is lucky to have such a good Home-Start team who do great outreach work, especially for young mums, and work very well with the local authority. The constituent put in for her CRB check and she was confused with another lady who did not even share the same name. The check came back saying that she had a number of convictions. That is simply not the case and it has taken months to resolve the matter. My concern is again with the system that we have. We are dealing with an individual who wants to help; she wants to volunteer in her community and help young mums, and the system has done everything it can to try to prevent her from doing that. We must not let such problems with bureaucracy get in the way. Such problems are also reflected in the adoption process, but I have already covered them in this debate.

Martin Narey, the former head of Barnardo’s, has been appointed by the Government to advise on adoption. He has worked extremely hard and been bold and direct in his conclusions about how we move forward. Both his work and the campaign that has been championed by The Times have done a huge amount to raise the issues across the country.

[Richard Graham (Gloucester) (Con)]

I warmly congratulate my hon. Friend on today’s debate. On the campaign organised by The Times, would she join me in paying tribute to the newspaper for its leadership on the issue, to Martin Narey and to the Children’s Minister, the Under-Secretary of State for Education, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who commissioned Martin Narey to write his report and who has adopted his recommendations? The Prime Minister has both warmly welcomed the report and called for an overhaul of the adoption process. Does she not agree that for the first time in many years, this Government are showing real leadership on the issue of tackling these problems?

[Jessica Lee]

I agree with everything that my hon. Friend said. I reiterate that there is a real momentum—within Government, across parties and across the country through The Times and other publications—to raise the profile of this issue, so we really must do more.

There are many threads and complexities to this issue, but at the heart of this debate is a wish to raise the profile of adoption, to encourage adoptive parents to come forward and to point out how rewarding and valuable adoption of children can be. Like any life-changing decision, it will not be without its challenges and ups and downs, but from the many, many discussions that I have had with adoptive parents I know that their lives have been enriched by the decision to open their homes and to care for children.

As politicians, what we need to focus on now are the real challenges of making the system of adoption as streamlined and as efficient as it can possibly be.

[Ann Coffey]

I congratulate the hon. Lady on securing this debate, and she is making a very thoughtful contribution to it. Does she agree that although we must of course have more adoptions, we must also have more successful adoptions? The research indicates that about 11% of adoption placements break down and that is heartbreaking, both for the adopted child and the adopting parents. Does she think that the Department for Education could take more of a lead in commissioning research into adoption breakdowns, so that we have a better perspective on what goes wrong and can secure more successful placements in the future?

[Jessica Lee]

I thank the hon. Lady for her intervention. In my view, the Department is doing exactly that; it is examining the entire process of adoption, root and branch, in detail. So I am confident that those points are being considered. Her point about the need for post-adoption support is a good one, and it needs reflecting on. Perhaps it takes us back to the points that I made about the role of the independent reviewing officer in reviewing case plans and reviewing the position of children.

I conclude by saying that better outcomes for looked-after children should be our goal. It is attainable; I feel that the momentum towards achieving it is there, and I ask everyone to do their bit to improve the adoption system.

10:01

[David Simpson (Upper Bann) (DUP)]

I am grateful for the opportunity to speak. I will be brief, because I know that right hon. and hon. Members want to contribute to this debate.

I congratulate the hon. Member for Erewash (Jessica Lee) on securing this debate on an issue that is very important to a lot of people out there among the general public who are interested in becoming prospective parents. They are interested in this debate, because the hon. Lady has expressed a lot of the frustration that many of them feel when they have to go through the process of adoption.

In the research papers that we received before this debate, one figure given to us was that last year, only 60 out of 3,600 children under the age of one who are in care were adopted, and in addition the average time that the process of adoption took was two and a half years. We all know that when a child reaches the age of four, the possibility of their being adopted is very slim indeed. They may go into foster care, but it is certainly very difficult for them to be adopted.

The research papers state that one in four adopted children were forced to wait more than a year before they moved in with their new parents. I have to say that my experience as someone who has adopted—I will go into that experience more in a moment—is in relation to the prospective parents: those couples who believe that they can offer a good home to children and who have tried for many years to have a family in a natural process but have never been able to do so. They are frustrated with the legislation on adoption. We have heard about the form-filling. In the words of people who have come to me, they are frustrated with “the intrusiveness” of having to sit down with social workers. The hon. Lady mentioned the good work of social services, and I accept that point, as being a social worker is a very difficult job. However, for older prospective parents aged between 30 and 35, having to sit down and talk to a young social worker who has very little experience of life and rearing a family—their experience all comes from a textbook—and tell them why they cannot have a family is very difficult. The prospective parents have to tell the social worker all their personal details and the process is very frustrating from their point of view.

There is a balance to be struck in all of this. I understand—and I am sure that all right hon. and hon. Members realise this—that some of the things that have happened to children over the years, and even in recent months, for example, baby P, children being starved to death and all those sorts of things, are horrific. In my opinion, anyone who does that sort of thing to a child is not fit to live in society.

[Caroline Dinenage (Gosport) (Con)]

The hon. Gentleman has raised the issues that people who want to adopt, or even foster, children are faced with. There is a myth that if someone is a smoker, or unmarried or even overweight, they will not be considered a suitable adoptive parent. Of course, many parents throughout the country face all those issues and it does not make them any better or any worse parents. We must also address the issue that people are expected to be paragons of virtue in everything that they do before they are regarded as perfect adoptive parents.

[David Simpson]

I agree wholeheartedly with the hon. Lady. Certainly, if being overweight had been an issue, I would not have fitted the bill. Later on this afternoon, my hon. Friend the Member for East Londonderry (Mr Campbell) will introduce a Westminster Hall debate on the Government policy on obesity, and he has dared me to attend. [Laughter.] I will go to it.

The hon. Member for Gosport (Caroline Dinenage) is right. No one is perfect and it is very hard to get a role model of a parent. We all have frustrations. Even if people have children through the natural process, they experience frustrations because they do not know how those children are going to turn out, which is difficult. The hon. Member for Devizes (Claire Perry) raised the issue of the age of prospective parents and I think that she said she is 47. May I say that she looks very well for 47? If I was a social worker, I would take her for 27, but we will not go down that road.

Returning to the serious point, it is nonsense for social services to restrict the number of prospective parents just because someone is over 40, or 45. That is absolutely scandalous. One of the prospective parents who had come to see me and who had been told that they could not adopt, was told that one reason was they were over 45, so when the child reached their teenage years the prospective father could not play football with them. That is absolute nonsense—the whole thing is crazy.

We must try to get a balance in all of this. In Northern Ireland 25 years ago, what my wife and I did was very new. We went to an agency, we went through missionaries, and we adopted our first child from India. That was 25 years ago this December. I think that we were the second set of parents in Northern Ireland to adopt a child from a foreign country. The reason was simple; it was because the waiting list to adopt a child in Northern Ireland was horrendous. It was unbelievable. We felt that we could give a child a home, and as we could not have that child from the British system, we were forced to go down another avenue.

We did that 25 years ago. We have had no problems whatsoever from a cultural or ethnic viewpoint, and we have experienced no racism in any way. My daughter is now 25 and she runs her own business. Then we adopted twins from Paraguay. At that time, the dictator in Paraguay made it very clear that he would prefer it if children died on the streets of Paraguay than be adopted by a western society. He did not have his way and we adopted the twins. Someone asked us after we did that if we were trying to start our own United Nations, but we decided to stop at just the three children because we knew that the United Nations was nothing to be proud of. We did not go down that road.

Our twins are now 22, and again that adoption has worked well; there are absolutely no issues. However, the point that I am making is that because of the system we were forced to go in that direction. The system needs to be looked at. Two and a half years is much too long for any prospective parent to wait for a child. We need to deal with that, and we must address the ageism involved in beliefs about the age a prospective parent should be.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend the Member for Erewash (Jessica Lee) on securing this excellent debate. Does the hon. Gentleman agree that families who put themselves forward for adoption often have had fertility problems? Not only are they waiting throughout the lengthy bureaucratic process of adoption, but they might have been trying for children and have had a desire to contribute, by bringing up a family, for a long time—perhaps up to five or six years.

[David Simpson]

That is 100% right. The hon. Gentleman raises a very important issue, and we need to get to grips with the situation. On many such issues, the policy of the present Government and of previous Governments for many years—I am not pointing the figure at any one in particular—has been, “We’ll put a sticking-plaster over it and that will last for another while. Then we’ll perhaps bring out a wee bit of legislation or else we’ll go out for consultation.” The period involved is frustrating for potential adoptive parents. Last year in the United Kingdom, only 60 out of 3,600 children under the age of one in care were placed with families. That scandal must be dealt with, and I trust that the Minister will take note. Many families who are willing to give children a loving home are not given the opportunity to do so.

10:12

[Esther McVey (Wirral West) (Con)]

I congratulate my hon. Friend the Member for Erewash (Jessica Lee) on securing this debate. We have had an overview of the situation from her, and a personal story from my hon. colleague the Member for Upper Bann (David Simpson). I want to look at two issues raised by constituents of mine, one about the choice and selection of adoption agencies, the other about awareness in the education system of the needs and sensitivities of adopted children.

Statistics show that the number of children being adopted has fallen, with decreases of 5% from 2010, 20% from 2005, and 8.4% from 2009. I will look at that significant 2009 figure a little later. We must, however, look at the reality of the situation. We are talking about a child’s journey, about the most formative years in their life when they are at their most vulnerable and learn the most, not from the spoken word but from the things that shape their characteristics and personality traits for the rest of their life—how they are accepted and rejected, how they form a loving bond with their parents or new adoptive parents, and how that has a significant impact on their future relationships. That is key. Some 33% of children who leave care are not in education, employment or training, compared with a national average of 18%, so there are huge implications and ramifications later in life.

[James Morris (Halesowen and Rowley Regis) (Con)]

My hon. Friend makes an important point. Part of this debate is about policy that has social benefits down the line. There are clearly issues about parents being able to adopt as quickly as possible, but the critical point is that this is part of an early intervention policy and we need to get it right because it has benefits for society.

[Esther McVey]

I completely agree. There are benefits to society, but also huge benefits to the child who progresses into adulthood.

My constituents came to see me about the significant changes to adoption agencies under Labour’s 2010 equality laws, which state that the prohibition of discrimination on the grounds of sexual orientation is a fundamental principle of human rights laws and that such discrimination can be permitted only in the most compelling circumstances. I completely agree. That is the law; that is the way forward. The consequence, however, has been the closing of Catholic adoption agencies across the country. We have a huge problem, because those adoption agencies were the best at finding parents for older children—the most difficult to place with adoptive parents—and were the most successful in ensuring that those children remained in families.

People said to me, “You put the Catholic Church in a situation in which Parliament’s laws conflicted with the Church laws,” which they considered a higher law. They said, “When does tolerance become intolerance? Why were we tolerant of other people but not of the Catholic Church? When did equality for the Catholic Church become inequality?” We have seen that inequality, as all of a sudden the help that the agencies provided stopped because they were no longer given funding. Agencies that can trace their origins back to orphanages set up in Leeds in 1863 ended up closing down. Of course, we have to live within the law—of course, we must have the correct outcome—but surely that does not mean that we cannot have choice in how adoption agencies go about their work and in how they meet the needs of parents who come to them.

I looked slightly closer at the falling numbers of children being adopted. At the moment, there are 177 adoption agencies, 150 in local authorities and 27 voluntary ones, but if we go back, there were 11 more—Catholic ones that closed. That was a 5.83% decrease in the total number of agencies, but a 30% drop in the number of voluntary ones. How do we replace those valuable agencies? How do we find a selection—a choice—for people wanting to come forward, and how do we find those people? Some people come forward via the Church. This is a fundamental need for them, and they feel they are helping the Church, local communities and children. We must look very carefully at how we reach out to people who want to adopt, but for the past couple of years feel that they have been overlooked. There must be equality for everyone, but we need choice, which will ultimately provide equality for everyone and for the children who so desperately need to be adopted.

[Caroline Dinenage]

I want to reinforce my hon. Friend’s point. In my constituency of Gosport and in the wider Hampshire area, only 35 children were adopted last year. The older children are, the harder they are to place, and looked-after children have half the success rate of other kids in English and maths. We therefore need to explore every possible avenue to enable older children to be adopted, and the Catholic agencies were very successful at placing them and other harder-to-help children.

[Esther McVey]

Absolutely. The key point is, “When does tolerance become intolerance?” The Catholics who came to see me thought that that had happened. They believed that providing choice could bring about equality, but that what we had stopped was choice.

My second point, which a constituent of mine, Paula Davies, raised with me, is about the lack of awareness in the education system. She had adopted a daughter, and thought that she had unique needs arising from the adoption, which had happened later in life. She was concerned that the schools did not seem to be fully aware of the requirements of children from such backgrounds. She did not want something specific for her child; she did not want anybody taking her aside or teaching her differently. She was not looking for something different or extreme. However, she told me that two county councils, Hertfordshire and Somerset, have documents for staff who work with looked-after or adopted children in schools, and she wondered why every county council could not have those documents to hand for teachers to read, so that they could be aware of such children’s unique sensitivities and awareness.

Children adopted later in life are particularly vulnerable to rejection. They might take being told off or made to sit over there in a slightly different way, having been rejected early or later in life. It would be a simple change. The documents already exist, so I am not asking for anything with a cost implication. We are asking that they be made available to other councils, and therefore to teachers across the country.

[Richard Graham]

My hon. Friend makes a powerful point about education for adopted children. Does she agree that local authorities treat adopted children differently from children in care, in terms of the support that they get and the schools that they go to? Does she agree with the proposal to change that and enable adopted children to receive the same support as children in care?

[Esther McVey]

I thank my hon. Friend for raising that point. I was not aware that there were differences, but if so, of course they need to be addressed. Particularly for children adopted later in life, it is painfully apparent that they might need the same support as children in care. I will conclude on that point, but I would like replies from the Minister on my points about choice, equality and awareness of the need to help children in school.

[Mr Timpson]

rose—

[Jim Shannon]

rose—

[Philip Davies (in the Chair)]

Two colleagues are seeking to catch my eye. Just to let them know, I intend to call the Front-Bench speakers at 10.40 am, so they can divide the time between them.

10:22

[Jim Shannon (Strangford) (DUP)]

I want to make a few points to give the Northern Ireland perspective. I commend the hon. Member for Erewash (Jessica Lee)— I am sure that my pronunciation is totally wrong, but that is by the way. I hesitated to mention her constituency, because I was not sure it would come out right. I also congratulate my hon. Friend the Member for Upper Bann (David Simpson) on his heartfelt contribution. He has walked that road and knows it well.

I am a great believer, as I have said in other debates, in the importance of family life. Family is the core of society, and we build society around the family. I am fortunate enough to have come from a good family environment, from my point of view. I have three boys and am a grandfather to boot. I see the importance of family life in giving children stability and ensuring that they do well in life.

In my position as an MP, I have had the opportunity to meet many constituents who adopt and foster, and who give love and meaning to those who need help. Many wish to adopt, and I will make a couple of points relating to them. Some of those points have been mentioned, but I want to put on record the situation in Northern Ireland and the importance of family life to those who find themselves on their own.

I have seen many products of adoption and the good work done by foster parents. I know a family in my constituency who have adopted or fostered numerous children over a period of years. I remember one young boy; I mind well when he was adopted, and I have watched him grow all the way through the process. He started as a vulnerable young boy, and found parents who gave him an opportunity in life. Now he is a young man. I have watched his progress from a child seeking adoption to his present employment. He is stable, kind, well-mannered and a credit to both his parents and his foster parents.

Northern Ireland had 2,660 children in the care of the authorities in March last year, to give some statistics. Their needs included short-term care as well as long-term adoption and fostering. The breakdown is that 50% were boys, 17% were between the ages of one and four, 30% were between five and 11, 31% were between 12 and 15 and 19% were 16-plus. They all have their own unique needs.

Fostering and adoption are absolutely important, but in Northern Ireland, only 61 of those 2,660 young people found adoptive parents that year. That is a minuscule drop in the ocean. I have spoken to fostering authorities and organisations in Northern Ireland, and they have indicated some of the problems with the process. A better way is needed through the paperwork and bureaucracy that we have all mentioned and know about. I made a comment earlier about people going overseas to adopt children. It is not that children from across the water should not have the opportunity for adoption. It is not only celebrities who adopt them but people such as my hon. Friend the Member for Upper Bann, who wanted to give children a home, as do many people I know, who have looked at photographs in the paper and read stories on TV and in magazines about multi-millionaires who go overseas to adopt children. Such people give young people stability and opportunity.

The process worries me, because it takes so long. One key factor that other Members have mentioned is that the process can take anything from two to two and a half years. For those who are starting the process and are anxious to enable quick fostering or adoption, we must do something about that.

[Claire Perry]

I wonder what the hon. Gentleman would say about a case in my constituency involving an officer returning from Afghanistan. He and his wife had been trying for five years to have a child and decided to adopt. He was a smoker and was told that he had to give up, that he could not then restart the process for a year and that it would take another two years, by which time he is likely to be on deployment again. Surely we should do better and make the system more streamlined.

[Jim Shannon]

I thank the hon. Lady for that example. We are all frustrated by the process, which does not deliver when needed but adds anomalies, in this case in relation to smoking.

[David Simpson]

On that point, when we were going through the process, we were told that it would take a year or a year and a half to do the home study and so on, but if we were willing to pay for it, social services could do it in four months. That is exactly what we did. People who cannot afford that have to wait a year and a half or more, but those in a position to pay for a home study through social services can do it in four months, a bit like the health service. It is not right.

[Jim Shannon]

I thank my hon. Friend for his comments. There is something seriously wrong with a process where those who can pay get it and those who cannot pay have to wait.

[Mr Andrew Smith]

On that point, does the hon. Gentleman share the ambition that Martin Narey set out regarding the scale of change needed when he suggested that the number of adoptions ought to double and the time taken to complete them ought to halve? Is that not the scale of change that we must press for?

[Jim Shannon]

I welcome those constructive comments. I would say that the number should more than double. If only 61 people in Northern Ireland were adopted in a year when 2,660 were awaiting adoption—I am mindful that those figures are for both short-term and long-term care—I would like that figure to more than double. However, I accept that point.

[Mr Smith]

I mention that ambition because that is what Martin Narey said. He set it in context by saying that even people who are pro-adoption—incredibly, he comes across people who are anti-adoption—have a feeling that that is too ambitious and undeliverable, but like the hon. Gentleman, I think that we ought to be capable of doing better than that.

[Jim Shannon]

I think that we all agree that we have to set targets that meet the need. I thank the right hon. Gentleman for his comments.

[Richard Graham]

I am grateful to the hon. Gentleman for giving way; he represents Strangford, my old hunting ground. On the difficulties for those who wish to adopt or who have adopted, does he agree with my constituents, Mr and Mrs James, who told me the other day that, as people who have adopted children, had they known what they would have to go through, they probably would not have done so? Moreover, Mr and Mrs Nash told me that they did not know about the difficulties that they would have in relation to education or about the hidden trauma of the children whom they adopted—it was waiting to come out, but they did not get the same support as children in care. Does the hon. Gentleman agree with them that, if we could overcome those difficulties, we would be able to raise the rates of those who are adopted—in Gloucestershire, only 27 out of 500 children in care are adopted—and that the problem would be much less grave?

[Jim Shannon]

I thank the hon. Gentleman for that contribution. I wholeheartedly agree with him and think that every other Member present does, too.

I am conscious of the time, so I will come to a conclusion. I welcome the fact that the Prime Minister has indicated that he is keen and anxious for a time scale of six months. If that is to happen, we will need more than a verbal commitment. I want action. It would be good to see that happen.

Finally, I am concerned that, in some, not all, cases, it is as though Christian families are interrogated about their ethics and morality, their homes, and their desire to adopt. In some cases, Christians, Christian families and Christian parents are being penalised because of their beliefs, but we cannot pass by what they have to offer. Those potential parents wish to adopt and we have a list of young children who seek adoptive parents. The answer is simple—let us put the two together and do it right.

10:32

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

It is an unmitigated delight to serve under your chairmanship, Mr Davies. I congratulate my hon. Friend the Member for Erewash (Jessica Lee) on her deeply knowledgeable and constructive speech, which set out all the issues with which we need to grapple in order to improve our adoption system. It is worth setting down a marker from the outset that adoption is only one route to permanency for children who need to find another home, and that many foster carers and family members take on a caring role. Although adoption is a route to permanency that many more children could be the beneficiaries of, we have to recognise that it is not always the right option for every child.

I declare an interest. Like my hon. Friend, I am a family law barrister, although I do not practise at present. I also have two adoptive brothers—Oliver, who is now 35, and Henry, who has just turned 24, I think. They are an integral part of our family and one thing about which I can be absolutely confident is that they have enriched our family’s lives. I hope that we have provided them with the stable and loving environment that they so desperately needed.

It is worth acknowledging that successive Governments, including the previous one, did their best to try to help vulnerable children who were in need of a stable home. That included trying to work in ways that would help adoption become a more successful route. We could talk about whether targets are a good or a bad idea, but I think that the motivation behind them was absolutely right. It was to try to give the opportunity to more families to offer a home to children through the adoption route. Ultimately, this is about finding the right home for a child, rather than the right child for a home. I believe that the current Government’s work to achieve that end is moving the system in the right direction, but be under no illusions—there is no quick fix and it will take a whole cultural shift over a long period.

[Caroline Nokes (Romsey and Southampton North) (Con)]

My hon. Friend is making a valid point. Although we recognise that there will be no quick fix to the problem, one of my concerns is that, in the meantime, we as Members of Parliament must do our level best to make sure that those looked-after children and those going through the process are given the best possible voice and opportunity. Foster carers in my constituency have told me that they want looked-after children to have a voice and to be heard by us in this place, so that we can understand the issues that they face.

[Mr Timpson]

I am grateful to my hon. Friend for that intervention, which gives me the opportunity to remind her of the groups that I chair—the all-party group on adoption and fostering and the all-party group on looked after children and care leavers. Every time we meet, we manage to bring to Parliament about 150 people who are in care or have left care, so that their voice can be heard here. We are trying to begin a scheme whereby MPs will be matched with a care leaver in their constituencies. I encourage all Members present to engage with that and to ask their local authority if they can sit on an adoption panel, so that they can learn exactly how the decision-making process works.

In this debate, we have elaborated on the myth-busting that needs to take place in relation to the issue of who can adopt. The hon. Member for Upper Bann (David Simpson) has mentioned his experiences in Paraguay, which leave a lot to be desired. I remember visiting some Romanian orphanages in 1990 with my parents, who were so distressed by what they saw that they inquired about adopting a Romanian child. My hon. Friend the Member for Devizes (Claire Perry), who has left the Chamber for now, has told us that she was turned down for being 47. My parents were turned down in Romania for being over 35, which shows that some other countries have even more stringent conditions for adoption.

We need to bust myths. If someone has a body mass index that they are not proud of, it does not mean that they cannot adopt. If you like a flutter on the horses, Mr Davies, it does not mean that you cannot adopt. A lot of myths need to be shaken out of the adopted system. The Government’s important measures in relation to new adoption guidelines, particularly those centring on black and minority ethnic children, are an important step in that direction.

It has been suggested that the way to try to improve the number of people who put themselves forward to adopt and to ensure that more children are adopted is to go back to the targets system. I have already touched on that and do not believe that it is the right way. We need to do something similar to what has been done in Cheshire East council, in my constituency, which has a local but direct campaign called “Fostering and Adoption in Cheshire East”. FACE brings together people from all sorts of different backgrounds—married, single, gay, pensioners—who adopted successfully, to try to ensure that people realise that they do not necessarily need to count themselves out and that they are very much welcome. We also need to make sure that those local authorities that get more inquiries, as has been the case in Cheshire East, have the capacity to deal with those cases and provide those people with the services that they need. We do not want to end up in a situation in which people make the emotional decision to present themselves as potential adopters, only to be told, “Don’t call us, we’ll call you.”

I would have liked to have covered many other issues, many of which have been addressed by my hon. Friend the Member for Erewash, but what I will say is that it is outcomes for children that matter. If all children are going to be placed in an adoptive placement, it is important that the outcomes are successful. We need to look carefully at organisations such as Coram, which has a 100% success rate in finding adoptive parents for children with adoption plans. It has almost negligible breakdown rates, and post-adoption support plays a vital role in that. Adoption UK and After Adoption are just two of the voluntary adoption agencies that offer specific courses for adopters. I have spoken to adopters who have benefited from those courses, which are valuable in ensuring that adopters understand the issues they face, and that the children they look after get the support they need post-adoption. Just because a child is adopted does not mean that the problems disappear. My brother Oliver is 35. He still has difficulties that all relate to his early life trauma. I am pleased to say that he has just completed his first year in employment without changing jobs. That has been a huge breakthrough for him. For our family, it is a measure of the success from where he started.

10:40

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies. I sincerely pay tribute to the hon. Member for Erewash (Jessica Lee) for securing this important and well-attended debate. Her work in this area, both in Parliament and as a family law barrister before her election, is highly regarded, and she gave an excellent speech that acknowledged the complexity of the issue. The debate has been extremely interesting, with excellent contributions from all hon. Members.

The debate is timely. As mentioned, last week was national adoption week. It has been running since 1997 and provides us all with a reminder of the need to raise awareness of adoption, the importance of encouraging adoptive parents to come forward, and the need to highlight the importance of adoption for those children who, for whatever reason, cannot remain with their birth parents. Ministers used last week to make a number of important announcements on this issue. I add my support, in particular, to the announcement that adopted children will be given the same priority in school admissions as looked-after children, which builds on the work of the previous Labour Government.

I welcome the new adopters’ charter, which sets out clear principles on how adopters should be treated, and I welcome the fact that the Prime Minister is giving his backing to the Give a Child a Home campaign, which was launched by the British Association of Adoption and Fostering and the Fostering Network. As the hon. Member for Crewe and Nantwich (Mr Timpson) set out so well, it is as important to focus on fostering and the people who give up their time to foster children as it is to focus on those who adopt.

The most high-profile announcement last week was on performance tables, which the Department for Education will use to assess local authorities. The aim is to act

“as a challenge to local authorities to do better for the children in their care.”

I agree that all local authorities, and society at large, could and should do better in terms of support for looked-after children. We all know that outcomes for looked-after children are unacceptably poor. We all accept that the fall in the number of adoptions is a concern, and we certainly all acknowledge that an average waiting time of two years and seven months for a child to be adopted is simply far too long. However, I am concerned that naming and shaming local authorities seriously risks painting too simplistic a picture of an incredibly complex issue. Have Ministers considered what impact the threat of tough action against those local authorities will have on the morale, recruitment and retention of already overstretched social workers?

The Government’s performance tables risk failing to present a true picture of a local authority’s performance. Hackney borough council came bottom of the new league table, placing only 43% of children with adoptive parents within 12 months of a decision to do so. However, as Hackney borough council stated:

“Placing a child quickly should not be the only consideration upon which authorities are judged. A placement breaking down is one of the most traumatic things that can happen to an adopted child. In Hackney, we have one of the best records of stability of placements; such is the quality of our placements, hardly any, if any, ever break down.”

There is also the risk of creating perverse incentives for local authorities to push for rushed adoptions—in place of special guardianship arrangements, or concurrent planning that might be more appropriate in the circumstances—to meet what risk being arbitrary targets. As the hon. Member for Crewe and Nantwich mentioned, we need to listen to Coram, one of the country’s leading voluntary adoption agencies. It stated that the Department for Education’s performance indicators

“don’t tell the full story of the experience of children in care…For example, they do not reveal how delays owing to court processes may affect the speed of adoption or how a child who appears to have been ‘waiting for adoption’ may have in fact been consistently fostered by the same parents who go on to adopt them.”

As well as looking at how we increase the number of adoptions for siblings, black and minority ethnic children, children with disabilities and older children, surely the most important thing we must aim for is to increase the number of successful adoption placements, or talk in terms of permanent arrangements, rather than a simple increase in the number of adoptions. That point was also made by my hon. Friend the Member for Stockport (Ann Coffey). Perhaps the most crucial part of the jigsaw in increasing the number of successful adoptions is improving the level of post-adoption support available to adoptive families and their children. Despite the legal requirements in the Adoption and Children Act 2002 to provide long-term support to families after adoption, we are all aware, from anecdotal evidence and constituents’ experiences, that such support is currently not at the level it should be.

Indeed, Adoption UK reports that despite the fact that

“Great strides have been taken in acknowledging the need for adoption support services for families, and delivering some practical support…far too many families still come to Adoption UK, desperate for support.”

I recently received a heartbreaking letter from an adoptive mother of 20 years, who put the issue very succinctly:

“Given the number of adoptions that break down as well as the number of relationships which collapse under the pressure of attempting to deal alone with challenging behaviours, not enough consideration is being given to the consequences of not supporting adoptive families properly.”

She went on:

“I now know that providing a loving family for children who have had multiple carers and suffered abuse will never be enough. The children and indeed their adoptive families will need access to proper psychological/therapeutic support as well as respite and proper pathway planning during turbulent teenage years”.

The hon. Member for Erewash acknowledged this issue and that it deserves consideration and reflection. However, it is a crucial part of the jigsaw if we are to bring about an increase in the number of successful adoptions, which we all want to see.

The hon. Member for Crewe and Nantwich referred to the issue of care leavers. Last week was not only national adoption week, but national care leavers’ week. I had the privilege of attending the recent special meeting held by the all-party parliamentary group for looked after children and care leavers. I heard from several young people about the incredibly positive role that being in care had played in their lives, and their disappointment in the way that residential care, and being in care, is so often dismissed. I therefore wanted to put on record my serious concerns about some of the language used by Ministers in the media last week, who referred to children “languishing” in care. That language is not helpful for these young people, or in encouraging foster carers and adoptive parents to come forward.

Implicit in the Government’s decision to publish performance data is the view that adoption represents the gold standard for all councils to aim for. However, as was eloquently put by the hon. Member for Crewe and Nantwich, it should not be viewed as a one-size-fits-all solution. Adoption is not the right option for every child. Indeed, that approach has been criticised by the Fostering Network, which believes that focusing overwhelmingly on adoption risks skewing decision making, oversimplifying enormously complex and difficult decisions and ignoring the needs of the vast majority of children who come into care, who neither need nor want to be adopted.

In conclusion, the Government are absolutely right to focus on looked-after children and adoption. I look forward to hearing more about how the work of Martin Narey, the ministerial adviser, will be taken forward in the next two years. However, the Government must also recognise that adoption is not a panacea for looked-after children, or society at large. While being the most incredibly rewarding and enjoyable experience, raising a family can also be one of the most challenging and difficult experiences for people in the best of circumstances. Adoptive parents are not super-human. They, and their adopted children, need ongoing support if we are to increase the number of successful placements.

There is no doubt that the adoption process can and should be sped up, but that must not be done at the expense of ensuring the right path for the child. After all, to completely cut a child’s legal ties with their birth parents and family—choosing a family that can adopt them, making decisions about whether they will be able to live with any brothers and sisters and then moving them to live with a whole new family—is an enormous decision, which must be taken with great care.

I am sure that Ministers recognise that adoption is not the right answer for every child. I want to pay tribute in particular to the comments of the hon. Member for Crewe and Nantwich. I am sure that he shares many of my concerns—that we do not focus solely on adoption but on a child-centred approach that ensures results and the best long-term outcomes for all children, whatever their circumstances of care.

10:50

[The Minister of State, Department for Education (Sarah Teather)]

It is a great pleasure to serve under your chairmanship, Mr Davies. I am not sure that I can exceed the florid language of the hon. Member for Crewe and Nantwich (Mr Timpson). I congratulate the hon. Member for Erewash (Jessica Lee) on securing the debate hard on the heels of national adoption week.

The more observant Members in the Chamber have realised that I am not the Under-Secretary of State for Education, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who is incredibly disappointed that he cannot be present at the debate today—so disappointed that we spoke twice on the phone yesterday. He apologised personally to the hon. Member for Erewash, but he was in Birmingham yesterday and Sheffield today, speaking at child protection conferences among many other things. I will not say that he would rather be here, because that would cause terrible offence to people in Sheffield, but he was desperate to be present.

The debate has been fantastic—knowledgeable, passionate and informed by personal stories of adoption, whether as barristers or as families, whether as a brother or as adoptive parents. Hard on the heels of national adoption week, it is helpful to be able to do some of the myth-busting of which the hon. Member for Crewe and Nantwich spoke. It is helpful to air some of the myths, then systematically knock some down. We want to be open to many more people as adoptive parents and to be robust in challenging some of the things that have grown up and which prevent people who have an enormous amount to give from coming forward.

The hon. Member for Erewash is a member of the Under-Secretary’s ministerial advisory group on adoption, so she is aware of his particular interest and passion. He is very determined to ensure that more children who have been overlooked are considered appropriately for adoption, in particular older and disabled children, and to speed up the adoption process as much as possible, so that they can be adopted at a younger age.

Over the past year, a great deal of activity has been going on. The Under-Secretary has been leading a wide programme of reform. The Government have issued revised guidance and national minimum standards, and an adoption and special guardianship data pack is available for local authorities to use to challenge the operation and performance of their adoption service. The Under-Secretary appointed Martin Narey as the ministerial adviser on adoption, and approved funding for Barnardo’s in partnership with the Coram Foundation, to engage with 24 local authorities and help them to improve adoption outcomes for children and the adoption services. The Government have approved funding for the British Association for Adoption and Fostering, to raise awareness of and to promote adoption, and for a one-year pilot project with a number of local authorities to gain a better understanding of how the adoption register is used to find families for children in need of adoption, and how matching decisions are made, which picks up on a point made by the hon. Member for Erewash. Findings from the project will inform the work of the register in helping local authorities to increase their matching rates.

As a number of hon. Members stated, disappointingly, adoption figures have fallen this year. I recognise the point made by the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), as well as by the hon. Members for Crewe and Nantwich and for Erewash, that adoption is not the only process. Special guardianship and permanent residency orders might well be more appropriate for some children in some situations. However, today’s debate is specifically about adoption, so what I want to say from here on in is specifically about adoption.

As the Prime Minister made clear last week, for too long, many children have been let down by the whole system, which was a point well made by the hon. Member for Erewash in her opening remarks. One person at fault is not what leaves so many children who should be adopted not getting that opportunity. The system has many different barriers at the moment, such as local authorities or the family justice system. The Under-Secretary has a chart on his wall, on which he can see the particular blocks in the system that cause the delays—a visible image that he looks at every day, to remind himself of the barriers and of where the Government is pushing to make the whole system more efficient.

The hon. Member for Newcastle upon Tyne North mentioned performance tables, which we released last week. I absolutely recognise her point, that we need to get under the skin of what some of those data mean. In some cases, local authorities might appear to have a slower rate, but they may be extremely good at placing older children, for example. However, that is part of encouraging local authorities to look at their practice and perhaps that of their next-door authorities. The lack of such a process, in particular with children in care and adoption, is a continual frustration to Ministers and I have heard the Under-Secretary speak about it. Often, one local authority appears to be completely oblivious of the good practice in a neighbouring authority that is fantastic in some areas. By putting the information out there, we hope that local authorities will speak to one another more and question their own work and that of their neighbours, and so understand how they might improve their practice.

[Mr Andrew Smith]

If the underperforming authority does not improve, would the Minister go so far as to support the authority with good performance taking over the responsibilities of the underperforming authority?

[Sarah Teather]

Local authorities have been working with the Government to improve their performance, with more peer-led performance improvement across the piece, particularly in this area. We are encouraging much more peer mentoring and working together to challenge performance on the ground. I will ensure that the right hon. Gentleman’s suggestion is brought to the attention of the Under-Secretary when considering what action we might take.

Last week, we published an adopters’ charter, to ensure that anyone who really wants to adopt a child is welcomed with open arms and can receive all the help and support that they need. That picks up on what many hon. Members have said. We want adopters to feel valued and respected for offering a chance to transform a child’s life. Many of the issues raised earlier, such as age, smoking or obesity, are not written into statutory guidance or legislation. Some things build up on the ground, unfortunately, as an expected way in which people will be rejected, but those are not things that the Government are facing or that local authorities ought automatically to use to rule some people out as parents. The child’s needs must always be paramount. I hope that things such as the adopters’ charter will help to deal with all those issues that potential families might face, to ensure that they are given the necessary support.

The hon. Member for Stockport (Ann Coffey) asked whether we are doing any research on support for adopted—

[Esther McVey]

Will the Minister give way?

[Sarah Teather]

I will, but I only have two minutes left.

[Esther McVey]

I have two specific questions, one about the loss of 28% of voluntary adoption agencies because of the 2009 Labour legislation, and what we as a Government will do to fill that huge gap. The other is about support in the education system for children who are adopted.

[Sarah Teather]

On the first point, as I only have one minute left, a number of the agencies that closed reopened under new structures and new names. I will ensure that I or my colleague write to the hon. Lady with more information. On schools, that is exactly why we have commissioned research through Bristol university to look at support for adoptive families. Another specific issue raised was ensuring that the school admissions code, for example, takes such matters into account. How children are considered throughout their school life is something that the Under-Secretary keeps very much in mind. We are considering how we can support young people who might be vulnerable, as the hon. Member for Crewe and Nantwich said, for the rest of their life but certainly during their school life.

I have only one minute left, unfortunately, and so many issues were raised—in fact, it is now 11 o’clock. I thank hon. Members for their many contributions.

Organ Donation

Wednesday 9th November 2011 Westminster Hall

11:00

[Paul Uppal (Wolverhampton South West) (Con)]

It is an honour to serve under your stewardship, Mr Davies. We have half an hour in which to debate this issue, and I will try to be brief, because a number of hon. Members have told me that they may wish to intervene, and my hon. Friend the Member for Montgomeryshire (Glyn Davies) has said that he would like to speak in the debate. I have always found his contributions, whether here or in the House, valuable and I am sure that he will only enhance the debate, and give his personal perspective and the view from Wales.

Organ donation sounds far removed from most people’s lives. They have never considered it, or believe that it is something to consider later in life or when they are in need. We all know people who are waiting for donations and people who have received them. Perhaps the thought makes us uncomfortable, because it forces us to confront the reality of life and death, but we must not ignore the fact that more than 7,500 people are on a waiting list for a donor organ. Whatever the reasons and whatever the causes, profound changes in medicine have provided the ability to save people from illnesses with donated organs, but we are still grappling with a shortage of donors.

Although there are people on waiting lists, things are getting better. Since 2007-08, there has been a 26% increase in the number of people who have agreed to be organ donors after their death, and today there are 18 million donors on the NHS organ donor register, but we must hope for more. With many groups that work tirelessly to ensure that one day the waiting list will be short, I want to raise awareness throughout the country, and to change people’s perception so that being a registered donor will become the cultural norm.

I am here today because I do not believe that those improvements have gone far enough. I am worried that the target to increase the number of people who become organ donors after their death by 50% in 2012-13 will not be met unless the Government take urgent action. I am particularly worried that not enough progress has been made to increase organ donation in black and minority ethnic communities. People of black and minority ethnic origin are three to four times more likely to need an organ transplant, but are significantly under-represented on the NHS organ donor register. When asked, 75% of families of potential donors from BME communities refused to give consent for their loved one to become an organ donor. That must not continue. As a member of the BME community, as well as representing a seat with a large BME population, I know that we must continue to work hard to maintain a dialogue within those communities, and start to break down some of the stigma that organ donation may hold.

[Mr Marcus Jones (Nuneaton) (Con)]

I congratulate my hon. Friend on securing this extremely important debate. My constituency has a BME community that is centred around one ward—Abbey—where life expectancy is 17 years lower than other parts of Warwickshire. I am sure that my constituents in that ward will be heartened to hear my hon. Friend’s comments, but does he agree that we need to raise the profile of these important issues, particularly organ donation and transplantation, as well as diabetes and so on, in those communities to try to deal with those health inequalities?

[Paul Uppal]

My hon. Friend makes a valuable point. I know how hard he works with the BME community in his constituency, and he is a champion of such issues. I have been heartened by most of my colleagues, who have shown a wide and passionate interest in specific concerns involving the BME community. He is right to highlight the issue.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing this debate. It is great that he is standing up for such an important issue, and for the BME community. The issue affects all hon. Members, whether their constituencies are urban, or rural like mine. I declare an interest in that I once thought I needed a kidney donation because I tore my left kidney in half at Stratford when I was a jockey. That was due to poor jockeyship, and a good doctor saved me. My question is simple. Does my hon. Friend believe that GPs could play a greater role in the community in stimulating more organ donation?

[Paul Uppal]

My hon. Friend makes an important point. This is a difficult issue, and the nub of the problem is that clinicians and individuals in our communities often find it difficult to talk about the matter and to face reality. I see no reason why it would be harmful if GPs spoke openly and candidly about it to people who attend their surgeries. They could highlight the matter, and spread the broader message among the broader populace about how vital the need is.

[Mike Weatherley (Hove) (Con)]

I congratulate my hon. Friend on securing this debate. Does he recognise the work of those calling for an opt-out system of organ donation, which includes national campaigns such as the British Heart Foundation, as well as local campaigners, including Valerie Paynter, who underwent a kidney transplant 20 years ago, which saved her life? Her story is very moving. Will my hon. Friend encourage hon. Members to sign my recently tabled early-day motion, although I appreciate that he does not sign them?

[Paul Uppal]

My hon. Friend is correct: I do not sign early-day motions. On the opt-out, we have made some progress, and we should continue on that route, but increase the pace. I have seen some of the research from various task forces. Some work in 2008 suggested that there was no substantive evidence that going down that route would increase organ donation. That is probably a matter for debate another time, but my personal opinion is that we must deal with it sequentially. Let us get to 2013, then see where we are.

[Paul Flynn (Newport West) (Lab)]

If anyone is in any doubt about the desperate suffering at the moment, they should look at the evidence from my constituent, Matthew Lammas, and his family, who came to the House and talked about their six months of agony while he waited for an organ to become available. There were calls in the middle of the night, and drives of sometimes hundreds of miles with disappointment after disappointment. He came near to death, but finally and happily, he was given the heart that he needed, and he is surviving. Anyone who believes that the issue can be pushed aside should read about that family’s terrible suffering because of the lack of organs. For those who did not attend the meeting, the story is available on my blog. Unfortunately, another constituent died due to lack of an organ.

[Paul Uppal]

I thank the hon. Gentleman for his intervention. No one in the Chamber would in any way, shape or form underestimate the suffering of those who need a transplant. I am a trustee of a Sikh temple, and I have been approached specifically about the matter and people’s real concern about it. I have felt the pain that many families feel. We may leave the main thrust of the debate today, but I am sure that we will revisit the issue. I accept completely what the hon. Gentleman says, but for the time being we must go along the path of sequential progress.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend on securing this debate. He highlighted very well the fact that organ donation in urban areas is much lower than in more rural areas. That is partly due to population churn, but also because, as he rightly highlights, it is difficult to persuade people in black and ethnic minority communities to come forward and agree to organ donation. There are some cultural barriers to organ donation. How can we break down those barriers and focus on what really matters—ensuring that people have a chance of life?

[Paul Uppal]

I thank my hon. Friend for his intervention. As I said, I am a trustee of a Sikh temple, and I think it is important that we continue to spread that message in mosques, gurdwaras, mundas and temples in any shape or form. It needs to be consensual. It is about breaking down stigmas and prejudices that may be out there in certain communities. I would be very much in favour of anything that does that, and I have personally done that in my own constituency.

[Jason McCartney (Colne Valley) (Con)]

I thank my hon. Friend for his generosity in giving way. Many colleagues are here for this passionate debate, so perhaps next time we should have a full hour and a half for such an important issue.

We have heard the statistics. In my part of the world, Yorkshire and Humber, 581 people are waiting for an organ transplant, and 41 have died while waiting in the period 2010-11. I received a letter yesterday from a young lad aged 11, Matthew Taylor from Salendine Nook high school, which is doing a project on organ donations and the opt-in, opt-out processes. Will my hon. Friend join me in congratulating Salendine high school on engaging with young people and thinking about the processes? We can debate having a soft opt-in or opt-out process, but it is great that schools are engaging young people to think about organ donation.

[Paul Uppal]

I absolutely agree. My hon. Friend makes a good point. It is important that we raise the issue. That is the function of today’s debate. I am sure that the Minister will respond to that as well. I want to allow time for my hon. Friend the Member for Montgomeryshire to make a speech, so I will try to be brief. I will practise the skill of cutting down a speech to a few minutes.

I am concerned that leadership on organ donation and transplantation might be lost and that that will jeopardise the improvements that have been made since 2008. The national clinical director for transplantation, who was overseeing the implementation of the Organ Donation Taskforce recommendations, has now retired and I understand that his post is not due to be replaced. The Organ Donation Taskforce programme delivery board, which supported him in that role, has been disbanded. There is clearly a risk that in the absence of clear leadership, the improvements to date may be lost. Will the Minister tell us who is driving the agenda on organ donation and transplantation in the Department of Health, and whether the Department remains committed to the 50% increase in donors from 2007-08? What additional steps does he plan to take to ensure that that is achieved?

There is also the question of the goalposts being moved slightly further away when we reach 2013. I am sure the Minister is aware that there is no strategy for organ donation and transplantation beyond 2013, by which point all the Organ Donation Taskforce recommendations should be implemented. Will the Department of Health produce a strategy to ensure that the number of organ donors and transplants continue to increase after that date?

Organ donation is a gift, and that fact should be the focus of all policies involving donation, but it would be remiss to ignore those who have given. In previous years, the Government have recognised the incredible gift that organ donors have given by welcoming their families to a reception in Downing street. I would wholeheartedly support a continuation of that tradition. We are having a reception here at the House in December. It will be hosted by the hon. Member for Derby North (Chris Williamson) in his role as chair of the all-party group on organ donation, and we would welcome the Minister’s attendance. I am sure he would enjoy meeting the families and thanking them for what they have done for others.

There are big goals in place for 2013. We are all committed to working so that we have more than 20 million people on the official donor register. As people elected to serve our constituents, we can do no more than set a good example in our own communities, so I will take a moment to encourage all MPs to ensure that they are registered organ donors. We would all like to leave a legacy, and there can be no better one than that of saving a life.

11:13

[Glyn Davies (Montgomeryshire) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Davies. I particularly want to thank my hon. Friend the Member for Wolverhampton South West (Paul Uppal) for raising an issue that is hugely important to many people. Increasing the number of organs available has become a passion of mine. The comments of the hon. Member for Newport West (Paul Flynn) made an impact on me. We all want to see an increase in the number of organs available for donation. We need to look at the evidence available and decide the best route to go down to achieve the increase. Over the years that I have been involved, one of the main issues looked at has been a change to opt out. We have to look at what happened in countries where they moved towards presumed consent from the position of informed consent.

As well as looking at international examples, it is important to look at the evidence of the taskforce set up by the previous Government in 2008. I have looked at the matter in detail. Spain is often quoted by people who favour presumed consent; it was their exemplar, until perhaps 12 months ago, when it became Belgium. Presumed consent was introduced in Spain in 1979, but nothing happened for 10 years. In 1989, a new law was passed in Spain, which introduced a comprehensive transplant co-ordination system throughout the country to raise awareness and understanding. That is what made the difference. From that date on, there was an increase such that Spain is now one of the best examples in the world for organ transplant.

[Alun Cairns (Vale of Glamorgan) (Con)]

I pay tribute to my hon. Friend for the work that he is doing in this area. Is he aware of the independent analysis of the model in Spain by our former colleagues in the Welsh Assembly? When they went to visit Spain, they were in favour of presumed consent at the outset, but they changed their minds by the time they came back. There is extremely effective evidence that can be contributed to the debate.

[Glyn Davies]

I thank my hon. Friend for that intervention. That is a point that I want to make. Nearly everybody wants to increase the number of organs available, but we must be careful to look at the evidence to ensure we do not introduce changes that will hinder that. I have read the taskforce’s careful evidence. The Prime Minister of the day said that he wanted to move down this road. Members of the taskforce tended to be supportive of that move at the start, but by the end they unanimously said it was dangerous to move in that direction and that there was a real danger of it reducing the number of organs available.

We must be incredibly careful. I welcome this debate—and indeed the debate taking place in Wales, which started yesterday—because it raises awareness of the issue. Family members will know what the wishes of the deceased were and they will be able to give permission without there being a statutory register. There is no such register in Spain—or at least hardly anyone joins it. The family must know. As long as we raise awareness and understanding of what is involved and have people who can speak to those in a difficult position—because someone has just died, or a machine is about to be turned off—in an understanding way, it will encourage the nation. If we go down that road, I think we will produce the extra organs that we need.

11:17

[Duncan Hames (Chippenham) (LD)]

I know time is short, Mr Davies, so I will be brief. I want to draw the Minister’s attention to the Sign Up, Speak Up, Save Lives campaign, which is currently featuring in Channel 4’s youth engagement “Battlefront” programme. I am grateful that the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), has agreed to meet me and Abby and Hope, the young women campaigning to increase the number of people registered on the organ donor register. Given the arguments made in the previous speech, I want to draw everyone’s attention to an alternative suggestion that I have been advocating with Abby and Hope, which is that we use the opportunity afforded by the introduction of individual electoral registration during this Parliament to give all adults the opportunity to join the organ donor register at the same time as they are asked to register to vote.

From the evidence I have seen, it is clear to me that the welcome news about the reduction in fatalities on our roads means that there is a particular need for us to attract young, healthy adults on to the organ donor register. If people get the opportunity to do that with the paperwork that they complete when they join the electoral register, that will be helpful in meeting the objective, which we all share, of encouraging more people to register as organ donors.

11:19

[The Minister of State, Department of Health (Paul Burstow)]

I congratulate the hon. Member for Wolverhampton South West (Paul Uppal) on securing this debate, and on squeezing so much in. There were so many interventions that it felt almost as if a 90-minute debate had been fast-forwarded to include everything. I appreciate his approach, and the substantive contributions that we have heard during the short time in which we have debated this important issue. Transplantation is one of medicine’s great success stories, and I know that the hon. Gentleman has taken a keen interest in the subject for a considerable time. He is right to hold the Government’s feet to the fire when it comes to ensuring that we maintain progress in such an important area.

The coalition Government are absolutely committed to increasing the number of organs available for transplantation, and we believe that as many people as possible who need a replacement organ should be given the opportunity to benefit from a transplant. In many ways, the success of transplantation surgery and advances in technology have led to the current challenges of unmet need that have been described so powerfully and with personal examples.

Some 10,000 individuals now require a transplant, and tragically about three adults or children die every day either waiting for a transplant or after being taken off the list because they have become too ill. The hon. Member for Newport West (Paul Flynn) mentioned a blog that details the suffering and misery endured by families while they wait for a transplant, and that speaks volumes about why we must do more work in that area.

The Organ Donation Taskforce’s recommendations, published in its first report, “Organs for transplants”, in January 2008, were broadly based around the need for investment in the donation infrastructure. That is to ensure that the UK maximises its potential for donation rates, and makes organ donation a usual part of health care.

The Welsh Government’s recently published White Paper on organ donation has been referred to, and we will study their proposals carefully. In 2008, however, the independent Organ Donation Taskforce also examined the case for moving to an opt-out system but recommended against it, concluding that, although such a system might have the potential to deliver benefits, it would also present significant difficulties.

My hon. Friend the Member for Montgomeryshire (Glyn Davies) rightly drew attention to Spain, and the fact that, despite the enactment of a similar opt-out scheme in 1979, a significant transformation in the level of performance took place only after investment in infrastructure in 1989. The taskforce has drawn lessons from the Spanish experience, and it is right that we are guided by evidence.

I was asked about the taskforce’s intention that we achieve a rate of organ donation of at least 50% by 2013. That is certainly our aim, and we are on track to deliver it. Significant resources have been made available to implement the taskforce’s recommendations—largely through NHS Blood and Transplant—to increase the number of specialist nurses, who are a critical part of the system, and to appoint clinical leads, donation committees and donation chairs in acute trusts to drive improvement locally.

[Dr Poulter]

As the Minister will be aware, in 1994, there were 2,500 people on the organ donor waiting list, and last year there were over 7,500. Only 29% of the UK population are signed up to organ donation, which is woefully inadequate given that 552 people died last year while waiting for an organ transplant, excluding those who were taken off the list because they had become too unwell. It is a big problem; people are living longer, sometimes with multiple medical co-morbidities, which means that more people will need transplants. The problem will become an increasing challenge for health care providers and the Government.

Philosophically, I agree with the Minister and I am not in favour of compulsion. Does he agree, however, that we need a more targeted community-focused approach and, as with the cot death campaign that reduced cot deaths from 2,000 to about 300—

[Philip Davies (in the Chair)]

Order. Interventions must be brief.

[Paul Burstow]

The hon. Gentleman advances an important point. We cannot tackle the issue from the top down; it requires leadership from the bottom up in local communities. That is why NHS Blood and Transplant’s website provides constituency-level information about the number of people on the register, the number of transplants that have taken place, and the number of people waiting for a transplant. That information is invaluable to us as MPs and leaders in our local communities, and we should work with others in our community to break down some of the barriers of misunderstanding and misconception that were referred to by the hon. Member for Wolverhampton South West.

We have seen an increase in the number of organ donors by around 28% since 2008, and we are on track to meet the 50% improvement by 2013 set by the taskforce. As the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said, 29% of the UK population are on the organ donor register, and it is interesting to note how levels of registration change from one constituency to another—I urge hon. Members to look at that. The number of deceased organ donations rose to 1,010 in 2010-11, compared with 745 in 2001-02. The year 2010-11 also saw a record number of transplants from deceased and living donors, with 3,740 transplants carried out in the UK, compared with 2,633 in 2001-02.

Despite the considerable progress made over the past few years, however, there is still a shortage of organs donated for transplant. The situation is particularly serious for people from African-Caribbean and Asian backgrounds, because they are three to five times more likely to need a kidney transplant than white people. That is why we cannot be complacent, and we will continue to work with partner organisations to promote donations. That can be done through the Give and Let Live initiative in schools, where new information about the issue is circulated by NHS Blood and Transplant; by requiring people to answer a question about organ donation when applying for a driving licence; or by asking people to sign the organ donor register when applying for a European health insurance card and so on. The African-Caribbean Leukaemia Trust seeks to raise the importance of organ donation in black and minority ethnic communities, and local leadership is a key ingredient in delivering improvement.

Through various public awareness campaigns, NHS Blood and Transplant also publicises the need for more people to register as donors. Work continues at national, regional and local levels further to strengthen the donation programme, to support the excellent work of the NHS in identifying, referring and procuring donor organs, and to make organ donation a usual part of end-of-life care.

I am grateful for the opportunity to reassure all hon. Members in the debate that, as we modernise the NHS, we will continue to focus on driving forward an improvement in donation rates. To maintain that momentum, with the support of all UK health administrations, we have established a transitional steering group that includes health departments, NHS Blood and Transplant, the British Transplantation Society, and the royal colleges. It aims to focus on actions that will continue to embed donation within end-of-life care, and provide a link between oversight of the programme delivery board and the establishment of the NHS commissioning board in 2013. It will also provide a clear link to Health Ministers for any reports on progress.

The transitional steering group will focus on six key areas: increasing consent rates; brain stem death testing in all appropriate cases; donation after circulatory death to be considered in all circumstances; increased donation from emergency medicine; increased and more timely referral of potential donors; and improved donor management. The work of the transitional steering group will continue to drive improvements in the UK’s organ donation programme, and increase donation rates.

The hon. Member for Wolverhampton South West asked about leadership, which is an essential issue. The national clinical director for transplantation, Chris Rudge, has recently retired from that role, although I confirm that he will be appointed as leader of the transitional group, which will provide continuity of leadership. I hope that that reassures the hon. Gentleman, and others, about the Government’s serious intent to deliver on the important target. I can also inform the hon. Gentleman that we will not wait until 2013 to look at what should happen next, and we have already begun to develop a post-2013 strategy. NHS Blood and Transplant is starting to prepare the relevant documents, and is working closely with the transitional steering group.

This has been an incredibly important debate and significant points have been raised. I hope I have demonstrated that, in terms of leadership, intent and drive, we are committed to building on the improvements we have already seen and, where appropriate, to learn lessons from other parts of the world. That will require us all to play our part in raising awareness of organ donation, and of what the consequences for people’s lives will be if donations are not made.

As the hon. Member for Wolverhampton South West said, donation is a precious gift. We need more people to realise that and give such a gift by putting their name on the register and being willing to donate.

11:29

Sitting suspended.

Obesity

Wednesday 9th November 2011 Westminster Hall

[Mrs Linda Riordan in the Chair]

14:30

[Mr Gregory Campbell (East Londonderry) (DUP)]

It is a privilege to speak under your chairmanship, Mrs Riordan. I am delighted to have secured the debate. I have come to notice, particularly with health-related issues, that an hon. Member may think they are well informed on a topic when they succeed in securing a debate, but once they have succeeded in securing it, the administrative back-up kicks in and all the groups involved start supplying them with significant amounts of promotional material, and they are even more well informed by the time the debate arrives. I thank all the groups involved with this issue for providing me with information.

Sometimes it is wise to start a very serious debate with a slightly humorous anecdote. I am reminded of the overweight gentleman who was sent along to his local well man clinic by his wife, as men are wont to be. She instructed him to go to the well man clinic and to come back with precise instructions on what he was to do to lose weight. When he came back with a smile on his face, his wife said, “There’s something wrong here. What exactly were you told?” He said, “Well, I’m exactly the right weight—for someone who is 7 foot 8.” Unfortunately, that encapsulates part of the problem.

A sedentary lifestyle is not only costing those members of society who are overweight very dearly; it is costing all of us exceptionally dearly. From the correspondence that I have had and my own research, it appears that obesity currently costs us—depending on whom we believe—between £4 billion and £7 billion a year directly and indirectly. Whichever figure is right, the reality in 2011 is that we are talking about an exceptionally expensive but preventable series of conditions. The situation is bad at the moment, but unless we take radical steps and measures, unless we do something fundamental—I will come to that later—the rates of obesity are likely to double in the next 30 years.

Currently, almost one third of children are overweight, so obesity is not a condition that is the preserve of either the elderly or the middle-aged. All of us in society, right across the age spectrum, are being affected. Only 20 years ago, people who visited America—perhaps somewhere such as Florida—would come back here and say, “The United States has a terrible obesity problem. Thankfully we will never be like that.” But we are, and things are likely to get worse.

For example, 25 years ago, about three quarters of schoolchildren walked or cycled to school; now, less than 10% do so. When giving that figure, I take into account the fact that there have been lifestyle changes, school closures and so on, but the fact remains that there has been a significant increase in sedentary lifestyles. There has been a change in attitudes. The unfortunate reality is that more and more of us are spending more and more time at desks, in front of computers. Many people become couch potatoes—unfortunately, that analogy is all too accurate.

I will give another statistic to show how things have got considerably worse. In the early 1980s, roughly 7% of the population were classed as overweight. That ratio has trebled in the past 30 years. We can see the trend. It is likely to double again in the next 30 years. We must get to grips with a problem that, as I said, is proving exceptionally expensive for us all.

Obesity is linked to socio-economic deprivation. The figures that I have been able to establish indicate that the ratio of children in lower-income households suffering from obesity is twice that of those in higher-income households. Again, we see the repetitive nature of the problem, the cyclical response that is indicative, because many obese children are, unfortunately, the children of either one obese parent or two.

Of course, we all know of the additional and subsequent health risks associated with this condition. We are all aware that heart attacks and strokes, coronary artery disease and type 2 diabetes are much more likely among the overweight. There is an additional cost further down the line, in years to come, as people who begin to be overweight today begin to show the symptoms of those other conditions only in years to come and then of course have to be treated by the NHS.

[Jim Shannon (Strangford) (DUP)]

Type 2 diabetes is one of those hidden diseases that some people do not know they have. The indications are that there will be a 50% increase in the number of diabetics in the next couple of years. Does my hon. Friend believe that diabetes itself needs a direct Government plan in order for that issue to be addressed, because it is a hidden disease that can kill?

[Mr Campbell]

I thank my hon. Friend for that intervention. I hope that the Minister will respond to it. I want to come on to some of the things that Health Ministers throughout the United Kingdom—in the devolved regions as well as here—can do to deal with the issue, but my hon. Friend’s point is certainly well made.

Having diagnosed the problem, as it were, I want to consider what is being done. It is not all negative. A considerable series of measures is being taken, not just nationally but locally. Various councils, various health trusts in Northern Ireland and other bodies are actively engaging in trying to come to terms with the problem. Many programmes that promote healthier food choices are being actively promoted. I am aware of the healthy eating awards, and of course we are all aware of the food labelling issues that have come to the fore in recent years. There have been other programmes aimed at reducing the salt, sugar and fat in some foods. All those things are creating greater awareness among the wider community, but we are fooling ourselves if we think that the measures currently in place will arrest the problem.

I will turn at this point to what needs to be done now and for the foreseeable future. Obviously, the fast food industry is a key player in relation to the problem. Some people in that industry are quite responsible. Some have responded to the campaigns driven locally and introduced more healthy eating options—they are to be commended for doing so—but some have not. We need to see best practice not just nationally but internationally being analysed and then promoted, so that we can see significant progress.

At the moment, there is—certainly in Northern Ireland, and I assume across the UK—a better educational approach in schools. Our young children, particularly primary school children, are now getting information that simply would not have been proper protocol 25 years ago. Many people then would not have even seen the need for primary school children to receive that type of education. That is changing, but again, more needs to be done to increase awareness. We have all seen issues where, for example, healthy eating has gone wrong. Sometimes we see photographs in newspapers that show parents queuing up to give other types of food to children because healthy eating standards have gone awry. We need to ensure that the whole educational process about healthy eating for children is properly assessed and rationally implemented.

When we ally the fast food sector—I do not want to name any of the organisations—with a sedentary lifestyle, I think we can account for 80% to 90% of the obesity problem.

[Nick Smith (Blaenau Gwent) (Lab)]

The hon. Gentleman’s point about a sedentary lifestyle is important. The Welsh health survey 2008 showed that 21% of the population in Wales were obese. Does he agree that encouraging people to exercise and to avoid the sedentary lifestyle that he is talking about is important to reduce the alarming obesity rates, in addition to eating more healthily?

[Mr Campbell]

I agree with that; I was just about to come to the issue of exercising. I love walking, and when I get the time to walk, as I try to weekly, I despair at the rarity of seeing other people walking and exercising.

[Jim Shannon]

Surely, my hon. Friend does not just walk; he marches. When someone marches, they lose more calories, and I understand that he marches often.

[Mr Campbell]

I thank my hon. Friend for bringing us back to basics with a Northern Ireland and Scotland perspective on that. That is true.

I do despair when, for example, I see very few people exercising between October and March or April, and even fewer children.

[Simon Hart (Carmarthen West and South Pembrokeshire) (Con)]

The hon. Gentleman will be aware, as I am, that part of the problem lies in the Department for Education, not the Department of Health. One of the obstacles to kids exercising is that teachers do not want to take them out of the classroom because of the raft of health and safety obstacles in the way. We need to address that in this Chamber as much as we do the health aspects.

[Mr Campbell]

I knew that the dreaded health and safety would come in at some point, and I am glad that the hon. Gentleman managed to get it in. I agree with him totally. Many teachers, administrators and principals would dearly love to get their children to exercise more, but they know that all the dreaded health and safety boxes have to be ticked.

[David Simpson (Upper Bann) (DUP)]

I congratulate my hon. Friend on securing this important debate. I shall encourage him by telling him that I have started to walk; it has not made a lot of difference, but I have started to do it.

Surely fast food outlets have a responsibility in their marketing tactics, which offer “buy one, get one free”. That needs to be addressed.

[Mr Campbell]

My hon. Friend is absolutely right, and I hope the Minister will respond to that. I know that a small number of fast food outlets in Northern Ireland have acted responsibly, but unfortunately they are a small number. It appears that the behemoth of consumerism will simply market and promote the message of “stack them high and sell them cheap.” We have to come to terms with that reality, because it is driving many people to an early grave—it is as serious as that. In 2011, many in the younger generation are not only overweight, but will be diagnosed in 20 years’ time with health conditions that could shorten their lifespan by up to 10 or 12 years, unless we get to grips with the problem.

There is, as the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) indicated, an educational and health problem. It is for all of us in society to promote a healthier lifestyle. That is where I think we can do more to get role models to do what they can to promote healthy eating and a healthy lifestyle. Some role models, unfortunately, do anything but promote a healthy lifestyle, but we need to ensure that more suitable role models are approached and asked to try to promote such a lifestyle, so that we can address this horrendous and difficult problem.

[Mr Nigel Dodds (Belfast North) (DUP)]

I, too, congratulate my hon. Friend on securing this important debate.

Does my hon. Friend agree that although good progress on the issue has been made on a voluntary and self-regulatory basis, the time has come for more legislation? We have seen that approach with the compulsory wearing of seat belts and the banning of smoking in public places, which was resisted on all sorts of grounds. That approach has had a beneficial effect on health and public safety. Is it not time for the Government to go further in forcing food and drink companies to act more responsibly?

[Mr Campbell]

I agree with my right hon. Friend. We also need to look at the cost of products on supermarket shelves. Again I refer to some of the correspondence that has come my way. Fizzy drinks are quite attractive to younger people, and to some who are not so young. Is it fair that their low-calorie equivalents, some of which contain one calorie, and the fully fizzed-up versions, which can contain 139 calories, cost virtually the same?

A range of approaches needs to be co-ordinated and best practice needs to be introduced. I hope that the Minister will be able to speak about the devolved Health Ministers, with whom I hope he will have discussions about the best way to promote best practice and to ensure that, wherever practical and possible, close co-ordination can take place, so that across Scotland, Wales, England and Northern Ireland we can begin to address and—I hope—reverse this horrendous and difficult problem.

14:48

[Dr Sarah Wollaston (Totnes) (Con)]

I thank the hon. Member for East Londonderry (Mr Campbell) for securing this important debate. I do not want to repeat his message about the economic cost of the problem, but I would say, having been a general practitioner for 18 years, that once someone becomes obese, it is extraordinarily difficult to regain their normal weight in the long term.

I would like the Minister to consider the following points. We need to focus on better identification of those who are most at risk, particularly children, and to target action on those high-risk children. A nudge will just not go far enough, and it is time for more of a bit of a shove. We need particularly to look at the role of liquid calories in obesity among children. I ask the National Institute for Health and Clinical Excellence to update its guidance and review the evidence.

Nearly two thirds of adults are overweight or obese, but they do not start out that way. Around one in five four to five-year-olds are overweight or obese, but by the time they reach 11, that figure will have risen to one in three.

[The Minister of State, Department of Health (Mr Simon Burns)]

On the point about NICE, may I give my hon. Friend a reassurance that might be helpful at this stage in her contribution? As she may know, NICE has recently consulted on whether now is the right time to review its original guidance. As a result of that consultation, it will be making a decision later this month.

[Dr Wollaston]

I thank the Minister for that helpful response and look forward to hearing the outcome of that.

Children at primary school and in the early years before they have reached school are among the really high-risk groups. Some 85% of obese children go on to become obese adults, whereas only 12% of normal weight children become obese adults, so it makes sense to focus on that group of children, but that can happen only if we have better early identification. We should introduce annual measurements of weight and height, so that we can see when children are starting to slip towards obesity. We should target our resources much better on that group.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Years ago, parents with chubby children would be told, “It’s puppy fat and they will grow out of it.” There is still that idea around among otherwise bright and responsible parents. We need to press the point that chubby children grow into chubby adults.

[Dr Wollaston]

I absolutely agree with the hon. Lady. We need to be much clearer with parents that their children are at risk and that being overweight is not something that they will grow out of.

We should be much more creative about how we target help to high-risk children. Why not allow all those children to have free healthy school lunches? As poverty and deprivation have such strong links with obesity, considering that high-risk group is particularly appropriate if we are to address the Marmot agenda. Unfortunately, families on tight budgets are much more likely to be pushed towards unhealthy and cheaper choices. If we want to nudge them in the right direction, we must recognise the role that price plays in the choices that they make. We should look at the role of loss leaders. We urgently need a change in what supermarkets offer so that loss leaders are redirected towards healthy rather than unhealthy products.

Why not incentivise exercise in those high-risk families with vouchers for success and free access to good-quality sports facilities? We should incentivise a whole-family approach to cooking skills because cooking is a fun activity. An effective way forward would be to make such a service free and readily available to whole families.

On liquid calories, a survey conducted by the British Dental Association and Ipsos-MORI showed that 47% of children’s fluid intake is in the form of sugary and carbonated drinks. That means that one in five children is consuming 500 calories or more a day just in the form of sugary drinks and 73%—nearly three-quarters of children—are consuming more than 200 calories a day. It is a staggering number of calories that children are consuming.

If we look at adults, we will see that there is a particular issue with alcohol. The chief medical officer has already highlighted that around 10% of an adult’s calorie intake can be through alcohol. What we should understand from that is the role that discounting plays. I have mentioned that before. It really does not matter how disciplined the rational part of our brain tries to be—the irrational and impulsive side will continue to be irrational and impulsive. It is not helpful to see heavily discounted products in super-sized multi-buy packs piled high at the check-outs in supermarkets. If we want to move “nudge” towards “shove”, we should regulate how supermarkets market their products. I do not suggest that the whole answer to obesity lies in regulating supermarkets. I realise that there is a complex interplay between over-supply, pricing, culture, marketing, poor consumer choices and human nature. There is also the interplay between genetic predisposition and a lack of exercise. However, it is unlikely that our current strategy will go far enough in this regard. If we are going to do something about the £5 billion a year that this problem is costing us—the figure is predicted to rise to £10 billion a year by 2050—I suggest and hope that the Minister takes a strong line and abandons the idea of giving the problem a little nudge, in favour of giving it an almighty shove.

14:55

[Justin Tomlinson (North Swindon) (Con)]

I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this very important debate. I echo many of the points that have been raised this afternoon, but I want to concentrate mainly on the childhood obesity angle. It was mentioned that a third of children are overweight, and that 85% of those will then go on to be obese in adulthood. I want to cover four topics: planning, food, sport and youth provision.

Gardens are a third of the size they were in the 1960s. Front gardens are often more of an aspiration than a reality in new build areas. I am keen that we make greater use of accessible and usable open space. Before becoming MP for North Swindon, I was for 10 years a councillor for a new build estate. I used to complain time and again that there was not sufficient usable and accessible open space, and I was told, “You are wrong. You have more open space than anywhere else in Swindon.” It transpired that that is because the definition of open space includes hedges and heritage sites, neither of which is suitable for a child to play football on, and that is something that needs to be considered.

I am not asking for premier league, standard turf right across all housing estates. When I was growing up, our open space was an almost vertical hill. The twins, Matthew and Paul Gilbert, who were technically gifted at football, got to kick the ball uphill all day long and myself and my friends got the advantage of kicking it downhill. Such is the creativity of young people.

Open and accessible spaces are very important. As a child, I was very sporty. I grew up in the 1980s when children were fuelled with artificial colourings and flavourings—the sort of things that we are now worried about. None the less, I had the balance because I spent all day running around. We copied the television, so mostly we played football. If the Ashes were on, out came the cricket bats. When it was the Tour de France, the bikes came out. When it was Wimbledon, we brought out the tennis rackets. Normally, we brought them out for only two weeks or for one or two days if we were following our British hopes.

I was also the lead council member for leisure. People always said to me, “The emphasis is on creating lots of really good leisure centres.” The reality is that youngsters go to leisure centres only once or twice a year—normally for somebody’s birthday party. It is the jumpers-for-goalposts mentality that matters. It is really important that we build in to developments usable and accessible open space.

It became fashionable to build new public buildings under the private finance initiative scheme. Ignoring the advantages or disadvantages of the scheme, there was a particular problem for local communities in that they could not afford to access those community facilities. Again I know, from my time as a councillor, that we had some wonderful open spaces behind very big fences and the local community could not afford to hire the sports clubs, so that is another issue that requires consideration.

Local authorities are always under pressure on funding. One of the areas that I would like to see prioritised is investment in local country parks. Families would use them and we would see jumpers for goalposts, family walks, people walking their dogs and all sorts of different free activities to get people going.

Councils can be innovative in this area. Let me give three examples from my own local authority. First, £1 million has been invested in Mouldon hill through section 106 money—nothing new there. We had £5 million invested in Lydiard park, of which £4 million came from the Heritage Lottery Fund and £1 million from local private businesses and organisations. The best one of all was the £2 million investment in Shaw forest, which was a tip. We charged neighbouring authorities to put their rubble on top of the tip and then we planted trees and now it is a very enjoyable country park in which to walk the dog.

There have already been some very good contributions on food, so I will just mention my particular bugbears. First, basic cookery in schools should be compulsory. Nowadays, too many people’s idea of cooking is a three-minute wait and then the ping of the microwave. As an MP I have visited a number of schools to see how they provide cookery lessons. I am a big supporter of the £20 million national lottery-funded “Let’s get cooking” campaign, which is coming to the end of its five-year scheme. I hope that it will carry on. The main function of the campaign is to encourage cooking in schools. Last Friday, I visited a cookery session at Warneford secondary school in Highworth. Boys and girls from different backgrounds joined in enthusiastically. Cooking is not a bind for young people; they want to do it and they enjoy doing it. With “Junior Masterchef” and all the other cookery programmes on TV, they are inspired to cook.

The children themselves made another point to me. A lot of professional sportspeople are the role models for young people. Because professional footballers, for example, only train for a couple of hours a day, they have to do something with the rest of their time and a lot of them now are very good chefs, which has filtered through to a lot of young people, particularly younger boys.

I have also visited Haydonleigh primary school, which had what to my mind is the perfect example of cookery in schools. In Haydonleigh’s cookery sessions, the parents or grandparents of children were invited to come in, so that they were cooking with the children, who would then take their skills back home. However, there was also an allotment at the school, so the children got to see the full cycle: they planted the seeds; they grew the vegetables; they cooked in school with their parents or grandparents; and they went home and carried on cooking.

In my role as the vice-chair of the all-party group on heart disease, I fully echo all the points that have been made about the need for clear and uniform labelling of food, which allows people to make informed decisions.

[Dr William McCrea (South Antrim) (DUP)]

Does the hon. Gentleman believe that GPs have a greater responsibility and need to be more proactive in informing people about, and leading people in, healthy eating?

[Justin Tomlinson]

Yes, I absolutely do, but this is an area where the schools can lead, in terms of teaching the basic cookery and giving students the information they need, and I am covering that.

Then there is food labelling. I want to refer to labelling here in Parliament, because people often say, “Does labelling really make much of a difference?” Well, we have the “traffic light” system in our canteens in Parliament. As a general rule, anything that has a red sticker next to it is normally the most attractive thing, but we are able—even we MPs, with our limited intelligence—to say, “I can’t have too many of those,” although I confess that, as I was writing this speech earlier, I was eating a pork pie. So I failed by that rule myself.

I turn to organised sports now. I have already said that the most important element is the open, accessible and usable space on which kids will be creative. But organised sport also plays a very important role and there are a lot of opportunities that we can examine, in order to be more proactive.

I set up a sports forum when I was a councillor and that forum brought together about 60 different sports groups, who shared best practice. For example, there would be one group saying, “We’ve got a facility, but it’s underused,” and there would be another group saying, “We haven’t got the facility, and we need one.” We put those two groups together and between them they became experts at applying for external funding. There are lots of examples of external funding and I will talk about one in a moment.

I was quite an outspoken critic of the plan to scrap the school sports partnerships scheme and I was delighted when the Government changed their mind and delayed the scrapping of the scheme by nine months, to allow the good and successful examples of school sports partnerships to dig in and secure their existence. The principle of the school sports partnerships in schools was not to deal with those children who are already technically gifted, because by and large if a child is naturally good at sport—probably because their parents encouraged them—they are usually already involved in competitive sports clubs. Instead, it was to deal with the three out of five kids who were not naturally inspired to participate in sport and to provide them with a menu of alternative sports, because there is something for everyone.

It is not only a question of getting people to be active. One of the biggest challenges that sports groups tell me about is that they would like to provide lots of facilities but are struggling to do so because they are struggling for volunteers, for example to join the administrative staff and coaching staff who do all sorts of things, such as filling in forms to make all the bookings, to provide the organisation so that the kids can take part in activities.

I will touch on the point that my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart) has made today, and in previous speeches, which is the need to address the cost of insurance. One of the barriers for a lot of schools is that many teachers are very young and it costs a fortune to insure a teacher to use a minibus. I have pleaded with several Ministers to consider providing some national insurance scheme for all different schools, so that they can achieve economies of scale and make the cost of insurance cheaper. In addition, health and safety issues prevent a number of schools from taking up more opportunities.

Councils should also do more to open up facilities. It is a crying shame that many of our facilities are closed on Friday and Saturday evenings. We are talking about tackling antisocial behaviour and childhood obesity. Where there are leisure centres that are shut, surely we should open their doors and provide facilities.

A good example of how that process works is that we have just had an academy built in the last few years in Swindon; an old school was closed down to build it. However, just before the decision was made to do that, £4 million was invested in a fantastic new sports hall in the old school. Initially and regrettably, the council was going to bulldoze the new sports hall along with the old school, because there was no point in having a random, stand-alone sports hall. Through the sports forum, however, we managed to identify a sports group that could take over that sports hall. It was Esprit Gymnastics and Mark Hows, who runs it, is fantastic at identifying funding opportunities. He had about 250 kids a week in his old facility, but that was at full capacity. However, he had an income, so he could pay a rental income to the council, which is revenue-stretched, and he said, “Just don’t bulldoze it. I will rent it.” Now his group has more than 500 kids a week participating, including potential Olympic athletes, and they are a real jewel in the crown for Swindon. That is a good example of the council being proactive and working through the sports forum to identify other facilities that can be used.

One of the external bodies that provide funding is the Football Foundation, which provides funding through its “Grow the Game” scheme. That scheme aims not only to increase participation but the sustainability of it. I have seen a lot of funding come in and people will put on a one-off session. That is great, but it does not really make that much difference. The “Grow the Game” scheme slants its funding to ensure that it is not just used for one-off things. It targets things such as coaching qualifications to provide additional coaches so that more junior clubs can take part, and paying for facility hire if there is a group of volunteers, particularly in challenging areas where there may not necessarily be a huge amount of funding. Also, first aid provision is funded, as part of the process of ticking off the many items on the very long health and safety list that exists. Already the sports forum has increased participation by 12,000 new players and, crucially, by an extra 2,000 new coaches. That is just one of many, many schemes, but councils and the Government can do more to help sporting groups and volunteer groups to identify the different streams of funding that are available.

My final point is about youth provision. My suggestion is a little bit contentious, but I have road-tested it on a number of schools, youth clubs and colleges. In the past, there was a traditional divide, whereby children were either very sporty and they went to a sports club, or they might choose to go to a youth club, and the divide would never be crossed. But times have changed and when I talk to young kids they are all very keen, either on whatever sport is popular on TV or even on things such as cheerleading or street dance, which are not strictly “sports” but which get the heart rate going.

I think that the youth service and the leisure service in local authorities should be merged to become one service. The chief officer within those areas should be one person and they should not employ armies of youth officers with very expensive youth clubs attended by only a handful of children, where they do things that we may have liked doing when we were younger but which, I can assure hon. Members, these days kids are not particularly switched on by. Instead, we should open up schools, community centres and leisure centres. We would pay for football coaches, street dance instructors and so on, and say, “Right, it is 50p. You come along and for the next two hours you’re in a constructive environment, and you’re doing something that is active.”

That is not just some pie-in-the-sky thing. In Swindon, we have the ice-skating disco on a Friday night for teenagers and 600 kids chase around the ice after whoever they think is particularly good-looking. They are being very active for a couple of hours; they are off the streets; and the youth service could and should be parking its mobile facility outside. Those young children who need the traditional youth service, from which they can get advice and seek help, will find that that is available. For all of the others who might have been put off going to the youth club, because that was the only thing that was available, there is the enjoyable activity of ice-skating. I am very keen to push such projects and we could judge their success by the number of children who are engaged by them.

To conclude, it is for us—whether we are the local authority or the Government—to provide as many opportunities as we can: through the planning system, through making changes in teaching cookery and in food labelling, and also through the power of sport.

15:07

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am grateful for the opportunity to contribute to this debate. I will not speak for very long, but it is worth highlighting some of the issues that have been raised in a comprehensive way. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this debate.

Obesity in the UK is a growing problem. In 1993, only 13% of men and 16% of women were obese, but in 2009, 22% of men—and 24% of women—were obese, which represents almost a doubling of the number of men with obesity. I am not talking about people with a body mass index of between 25 and 30, which means that they are overweight; I am talking about obesity. Almost a quarter of the UK population is obese and I am sure that we all find that unacceptable.

How can we deal with obesity effectively, because whatever previous Governments have done, obesity has not been addressed in a way that has worked or has been effective? First, I will briefly outline how Government policy is moving towards more community-based interventions on obesity, and I will explain how that approach, through the health and wellbeing boards that will be set up under the health care reforms, will be effective and work well. Secondly, I will talk a little about nudge theory, because I am more hopeful and optimistic about it than my medical colleague, my hon. Friend the Member for Totnes (Dr Wollaston). There is good evidence elsewhere, particularly in Iceland, that it has worked, and I hope it will also work effectively in relation to obesity.

[Jim Shannon]

While the hon. Gentleman is giving us his thoughts, and given his experience in his previous job, will he comment on gastric band operations? Just two weeks ago, I had occasion to visit the Northern Ireland Health Minister, Edwin Poots, with some of my constituents. These people had tried everything to lose weight; they had tried dieting and exercise—some of them were not able to exercise, which was the other problem—but they had clear medical and health problems. As a last resort—this really is the last chance saloon, or the last chance restaurant, perhaps—should regions and Health Ministers set aside money specifically for gastric band operations?

[Dr Poulter]

We certainly have to look at how the Government can help people to take more responsibility for their own health care. That is fundamental to obesity issues, and it is a particular challenge in more deprived areas. People often require gastric bands at the point where the medical problems associated with obesity—diabetes, the risk of heart attack or stroke, or high blood pressure—pose a potentially life-threatening risk. Such people may not have that long to live if a gastric band is not put in place, so it is the only feasible mechanism for dealing with obesity in such cases. Gastric bands have been shown to be an effective mechanism for looking after that part of the population, and there is good medical evidence to support their use. There is also good evidence in terms of the health care economics, as helping people to become slimmer will lessen the burden on the NHS.

The gastric band is good for the patient, because their health improves dramatically when it is used effectively, but the challenge with obesity is to bring about long-term lifestyle change, and the question with gastric bands is whether they necessarily deal with long-term lifestyle changes. In a medical sense, there needs to be greater emphasis on the education that goes with the bigger issues around obesity and lifestyle at the same time as the gastric band is fitted. I hope that that helps to answer the hon. Gentleman’s question.

[Andrew Bingham (High Peak) (Con)]

Does my hon. Friend share my concern that celebrities regularly have gastric bands fitted, with the result that the bands are now seen as a shortcut to losing weight? People think that celebrities have them, so we must all have them.

[Dr Poulter]

That is a good point. There is good evidence that the celebrity culture around dieting causes anorexia in young girls. It would be much better for us and for many of our constituents if celebrities sometimes showed greater responsibility in the way in which they behaved. Gastric bands are an effective way of dealing with severe obesity, but they should not be used as a general method of bringing about weight loss. Weight loss is about education and people taking responsibility for their own weight and lifestyle. It is also about putting support in place in communities to let people do that, particularly in more deprived areas.

[Mr Dodds]

I have heard constituents talk about the use of statins and polypills. These medications have enormously beneficial effects for many people, and many people need them, but people almost seem to think, “Well, we have this magic pill available. We can eat and drink as much as we like, and then we can go on this pill.” Does the hon. Gentleman share my concern that we need more education about the use of such medications? At the moment, people are under the impression that there is something out there that can solve all these problems without their having to do anything to change their lifestyle.

[Dr Poulter]

Yes, certainly. There is an issue about how physicians prescribe effectively. Statins are an effective way of controlling cholesterol, and there is good evidence that they benefit people with heart disease and high cholesterol and that they increase life expectancy. There has been a lot of research, and I believe that it has been shown that statins may have beneficial effects in reducing the risk of breast cancer, although the Minister will correct me if I am wrong.

The right hon. Gentleman touches on the wider point that the emphasis in this debate needs to be on effective community-led interventions that tackle obesity and health care, and my hon. Friend the Member for North Swindon (Justin Tomlinson) discussed that very effectively. However, we need to ask how we will make those community health care measures effective.

The Government are setting up health and wellbeing boards, which are a very useful part of their health care reforms, because they will, for the first time, bring together different organisations in a meaningful way. Local councils in certain towns may run good community initiatives that connect GPs with leisure centres, exercise and sport, and some schools may encourage sport and physical activity in an effective way or have good links with local sports clubs. However, that does not often happen in a co-ordinated way across whole counties or, indeed, across the country. Health and wellbeing boards will help to bring together different organisations to address key public health problems, and obesity is a key public health challenge in all our constituencies.

As part of the health care reforms, the health and wellbeing boards will be able to address issues such as obesity. For example, if we know that there is an issue with teenage pregnancy or obesity in certain schools or among certain schoolchildren in my constituency, targeted interventions can be put in place in a much more community-focused way by getting the local authority together with health care representatives at a much more strategic level. That must be a good thing, because it allows much more targeted interventions.

The second thing I want briefly to discuss—I do not want to speak for much longer—is nudge theory. My hon. Friend the Member for Totnes has a slightly different view of it. I have more faith in nudge theory than she does, and I say that because we have had debates about agriculture—some of the Opposition Members here today were present—in which we discussed the need for corporate firms and supermarkets to show greater corporate responsibility on issues such as food labelling. We have now seen active movement from some supermarkets on honest food labelling. For example, we talk about food in a store being labelled British only if it is actually farmed in Britain, and not if it is merely processed or sliced here. We are beginning to see such initiatives come through, with supermarkets supporting British farmers. Morrisons is a good example of a supermarket where the British food stamp actually means something, and that allows consumers to make an informed choice. Supermarkets are therefore able to show corporate responsibility when they are asked to do so, although things are not entirely perfect, as we all know.

In a similar vein, the Government have introduced a public health responsibility deal, and it is a good initiative. Almost 200 different companies have signed up to the deal, including supermarkets such as Asda, the Co-op, Morrisons, Marks and Spencer, Sainsbury’s, Tesco, Waitrose and many others. Fast-food outlets such as McDonald’s, Pizza Hut and KFC have pledged to remove trans fats and introduce calorie labelling as a result of this initiative. Those are all pleasing and beneficial steps in the right direction.

[Dr Wollaston]

Does my hon. Friend share my concern, however, that organisations such as Asda, which have signed up to the new responsibility deal, are in some ways undermining it by offering hugely discounted alcohol products?

[Dr Poulter]

There are areas of obvious concern, where supermarkets can go further. As I said earlier, when we were talking about the agricultural sector, even though several supermarkets are backing honest food labelling, and showing responsibility in food labelling and calorie counting to tackle obesity, it is right to highlight the areas in which they need to show greater corporate responsibility. Cut-price alcohol is one of those, and we will continue to monitor it carefully in our work on the Select Committee on Health, and as physicians. My hon. Friend makes a good point.

In preparing for the debate, although I do not normally take an active interest in children’s TV, I found out about an Icelandic TV show called “LazyTown”—the Minister may want to expand on the subject a little later. The show is watched by children all over the world, and we have it in Great Britain as well. There is a healthy sports superhero character, called Sportacus, who motivates children to eat healthily and be active. In Iceland several “LazyTown” initiatives have been run in partnership with the Government and the private sector. For example, children between four and seven years old were sent an energy contract, which they and their parents signed, in which they were rewarded for eating healthily, going to bed early and being active. In one supermarket chain, all the fruit and vegetables were branded “sports candy”, which is the “LazyTown” name for fruit and vegetables. That led to a 22% increase in sales at that supermarket, and improved health and reduced obesity levels in Iceland.

The fact that Iceland’s child obesity levels have started to fall as a result of initiatives of that kind is good evidence in support of such corporate responsibility. Those initiatives are designed to support supermarkets coming together with Government, to make effective use of the nudge theory of improving behaviour, and they can work—and have worked. For that reason, we must support what the Government are doing, because there is evidence that it can work. It is a good thing and the evidence from Iceland is that we need to do what works, with children and communities.

I understand, and I am sure that the Minister will confirm, that the Department of Health has set up a partnership with “LazyTown” and is interested in expanding that initiative in the United Kingdom. We need more such approaches. The reason supermarkets sign up to such deals and initiatives is that it is good not just for the children, who become healthier and less obese, but for the supermarket and its brand image. Supermarkets see that working with corporate responsibility—we see it in our constituencies with Tesco schools vouchers—can enhance their image and custom, and do real good, for example, by reducing obesity levels.

I have greater faith in the nudge theory than my hon. Friend the Member for Totnes, and we need to allow similar initiatives to take root in the future. What has been done in the past has not worked very well; obesity levels have been going up. We have good evidence, from examples of corporate responsibility, that things can be tackled, so let us give nudge theory a chance. Let us also look to those health and wellbeing boards to provide community-based interventions that will work. If we do not do something, things will get worse, and the boards are a good way to address the problem.

15:23

[Andrew Bingham (High Peak) (Con)]

Thank you for giving me the chance to speak in the debate, Mrs Riordan. I had not applied to speak until I arrived today. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing the debate. Obesity is a problem that we underestimate at our peril. We have heard from Members who are medical people—I am not one of them—and have heard figures about the increase in obesity and the problems being stored up for the country. Those problems are to do with both physical well-being and the economy. Late onset diabetes, which can be related to obesity, will have an impact on health spending in the future, for example.

The problem has crept up on our society in the past 10 or 15 years. We have talked about diet, and I am at a slight advantage because I spent two years training to be a chef many years ago. To this day I always try to cook myself a balanced meal, although since being elected—other hon. Members’ experience will no doubt chime with mine—there is a tendency on getting back to the flat to get a little lazy and reach for the frozen ready meal. That behaviour—the sort of thing we are probably guilty of—is what pervades the country. As people cook less, they tend to eat less healthily. We have already heard discussions about school cookery classes. I tend to agree with my hon. Friend the Member for North Swindon (Justin Tomlinson) that those classes should be a staple part of children’s education.

As to the cost of ready meals, we have all been to the big-name supermarkets, where there are buy-one-get-one-free offers, ready meals for £1 and so on. I often have an argument with people outside this place about the fact that I still think it is cheaper to cook a balanced meal than to buy a ready meal, whatever its price. Fruit and vegetables are not expensive; they can be bought and prepared quite cheaply. The difficulty is that people are so busy—or the perception is that they are so busy—that they say, “I haven’t got time.” They prefer, as my hon. Friend the Member for North Swindon said, to do microwave cooking—three minutes, and ping. It is a question of education. We need to educate people to understand that it is quite simple to cook a balanced meal and live on a balanced diet.

I was visited some time ago by a constituent who came up with an idea called the Diet Plate. It is a fantastic idea—a plate that is portioned. If someone puts the relevant food group on the right portion of the plate it will be a balanced meal. Kay Illingworth was named in the British female inventor of the year awards in 2002 for that invention. I was given one, which I have in my office, and I am sure that hon. Members will realise, from looking at me, that I use it every day. It is a really good product, which looks nice and is made in this country. It demonstrates how to balance a meal and is a great way of educating people.

We have talked about sedentary lifestyle. I, like my hon. Friend the Member for North Swindon, remember the days of jumpers-for-goalposts football—kicking the ball around in the street, playing cricket in the summer, and so on. I still think that a lot of young people like physical activity. I spent 12 years as a councillor on High Peak borough council. We have a new all-weather football pitch in Hadfield. Hon. Members who know the area will know that someone coming down the road can see the floodlights, and every night there are dozens of people playing there. We used to do summer sports in the school holidays, to use the school facilities that were lying idle. Young people like to get out and play physical sport, and we need to encourage that as much as we can. There are two strings to this: it is not only what people eat, but how they burn it off. If the energy is not burned off, what is eaten becomes more important.

[Simon Hart]

My hon. Friend is making a strong case for children being inspired to take part in sport. Does he have a sense, as I do, that sometimes sponsorship of major sporting events by chocolate or crisp manufacturers creates a slightly false image, by relating unhealthy food to healthy activity? Does he have a view or some advice on that?

[Andrew Bingham]

I was going to come on to other activities shortly. I will watch or take part in sport, but who sponsors it does not chime with me much. However, ideally it would be better for an active product to support a sport. Interestingly, leisure centres all have vending machines full of chocolate. I know from experience that when the chocolate bars are replaced with cereal bars and healthy alternatives, the spend drops, because people like chocolate.

I am fortunate to live in the High Peak, which is a fantastic area with a huge amount of outdoor activity to do, including walking and hiking—the woods to play in. I am lucky, but inner cities do not have a huge playground such as the one I and my constituents have to play in. It is vital that people use leisure centres, and that they are encouraged into them. We can talk about what the Government should or should not do to get people to do that. I agree that the nudge theory will work. We have been subconsciously nudged into the present situation, because people have gone to the quick, easy meal and have taken up a more sedentary lifestyle. We have heard about the PlayStation generation, and we all walk around with BlackBerrys. If texting was good exercise and made people fit, the present generation would be the fittest ever. With young people in particular it is text, text, text. However, that is not active.

[Mr Simon Burns]

I am very interested in what my hon. Friend says and have listened carefully to the interventions. A number of Members have talked about what the Government, the Department of Health, the Department for Education or local government should do, but it strikes me as slightly odd that there has been little recognition of the responsibility of parents.

[Andrew Bingham]

I think that the Minister has been reading my notes. The point I was coming to was that we have talked a lot about what the Government can or cannot do, but this is one of many issues on which responsibility lies with us and with the parents of young people. My generation’s parents taught us how to poach eggs, for example; it is all about education in the home. I know that I sound like a grumpy old man, talking about how it was in my day, with rose-coloured glasses—[Hon. Members: “No, Never”] I will concede on grumpy; old I will argue with, at the moment. We can discuss different demographics, but if people are brought up on balanced, home-cooked food they will carry that on through their lives. It worries me that the more ready meal-type culture we have, the more it will go on and the bigger the problem will get.

We can expect, or ask, the Government to do this, that and the other, but as with many things, responsibility lies with individuals and with the parents of young children. That is where we need to start, with people being responsible for their own actions.

We have a fantastic opportunity with the 2012 Olympics, when we will see athletes from across the world. I will wager that in a year’s time, when Jessica Ennis wins a gold medal—I hope she does—we will see children out doing long jump and triple jump, using their own resources to copy their sporting heroes. We must capitalise on that. I played football in the winter as a kid because that was what was on TV, I played cricket in the summer and we all played tennis for two weeks when Wimbledon was on. We can use the Olympics. We talk about the legacy Olympics, and I would like the legacy to be the starting point for people getting active again.

[Justin Tomlinson]

We all have a role in encouraging our local schools to get 100% behind the school Olympics principle, so that when we have our successful athletes, in javelin or whatever we prove successful in, children can be inspired to take up the sport on a regular basis.

[Andrew Bingham]

Absolutely. There are dozens of sports in the Olympics, and everyone will watch and take an interest in one, so let us foster that and make the legacy of the games a healthier and more active society. We need to take that together with using the supermarkets, to get healthier eating.

We have a surfeit of cookery programmes on television. Every time we put it on there is someone gardening, doing DIY or cooking. Those three hobbies, or whatever we want to call them, can help to produce healthier people and a healthier country. Let us not necessarily rely on the Government. I agree with my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) that the health and wellbeing boards and the reforms in the Health Bill will help, but let us take on our responsibilities and get the message across to our constituents, getting the whole of society involved in this to make for a healthier and less obese Britain.

15:33

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Riordan. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this important debate, to which we have all been glad to contribute. He reminds us of how many issues we have in common in these British Isles.

I want to focus on the important subject of child obesity, and to talk about the responses so far to the Government’s obesity strategy entitled “Healthy lives, healthy people: a call to action on obesity in England”, which was presented to both Houses on 13 October. First, however, I want to say that some people might feel that Members of Parliament have a certain temerity talking about healthy lifestyles when their own lifestyle is relatively unhealthy, and I speak as someone who has been in this House for 20 years. Perhaps we should give credit to the few colleagues we sometimes see going through the Division Lobby dressed in their running gear after a bracing run. I am sure that Members will unite with me in congratulating those rare Members on that.

We are facing a crisis in childhood obesity. As I said earlier, gone are the days when we could look at a chubby child and say that they would grow out of it: chubby children grow into obese adults. I have to say, more in sorrow than in anger, that a wide range of people both inside and outside this House have expressed doubt about the effectiveness of the Government’s obesity strategy. Before moving on to what I think the Government should be doing, let me focus on the picture in London.

London has higher levels of childhood obesity than any other British region. The capital’s childhood obesity rate is 22%, compared with an average for England as a whole of just 19%. Across the capital, one in five youngsters are obese, with rates varying widely from 12% in leafy Richmond to 28% in Westminster. Childhood obesity costs the capital £7.1 million a year to treat, and the annual bill could reach £111 million if today’s young people remain obese into adulthood.

Research commissioned by the Greater London assembly found that adult obesity costs London £883.6 million a year, and in my own constituency—Members will forgive me for mentioning it—a quarter of all year 6 pupils are obese. That is one of the highest rates in the country as recorded by the national child measurement programme. In 2010 in City and Hackney, 13% of children in reception year were overweight and 14% were obese. The number of overweight children was similar to the national average, but the proportion of obese children was slightly higher. Greater efforts are needed to prevent overweight and obesity at the pre-school stage, because a high proportion of children are already obese and overweight by the time they start school. The escalation of the trend through to year 6 suggests that we also need to implement robust interventions in primary schools.

A number of Members have talked about parental responsibilities. I put it to colleagues that some of the parents who are doing what we might understand as the wrong thing are, in their own minds, trying to be good and vigilant parents. One of the problems that young children in Hackney and the rest of London have is their sedentary lifestyle, and part of what motivates parents to keep their children indoors is this idea of stranger danger. We all know that attacks on children have not gone up in 20 years, but childhood obesity has spiralled. Many parents—not bad or careless ones—think that they are doing their children a service by keeping them indoors, safely watching television or playing on the PlayStation, rather than playing outside.

I was not the most sporty of children, unlike some of the Government Members who have contributed to the debate, but in the summer holidays my mother thought nothing of us having breakfast and then going out to play all day. We might have come in for lunch, or have gone to a friend’s and come back for tea. Nowadays, no London parent would allow their child to play out all day without knowing where they were, and it is that sort of vigilance and possibly unwarranted fear of stranger danger that leads to many thoughtful parents deciding, perhaps because they have not had the education or do not have the understanding, that they will feel better if their children are indoors rather than outside playing.

Let us also remember that in a big city such as London a greater proportion than ever of our children live in flats, maisonettes and other accommodation without a back garden. As a child, if I was not out, I spent most of the day in the back garden, on the swing, climbing trees and shouting at my brother, but many children in my constituency are trapped in flats and it is not obvious to their parents where they can be allowed to play safely.

[Andrew Bingham]

That is a good point. We talked briefly about video games. Does the hon. Lady think that the advent of Wii Fit-type games is beneficial? I have seen young people playing them, and they involve a lot of jumping around and so on, which I suppose is a form of exercise, at least.

[Ms Abbott]

Far be it from me to advertise any particular product in this Chamber, but Wii Fit games are perhaps better than PlayStation games.

[Mr Simon Burns]

I have been listening carefully to the hon. Lady, who is making some valid points. The danger has to do with not simply the age of computer games but the age of television before that. For some parents—this is a generalisation—the easy option is to let their children spend hours watching television or playing games, because it involves less effort on the parents’ part. One must try to educate people that that is not only an easy option but an unfair one.

[Ms Abbott]

I am loth to agree with the Minister, but I think that he is right on that point. A particular interest of mine is the education of urban children and the challenges of getting them to achieve their educational potential. As part of working with parents, especially in urban communities, we must teach them that just putting their children in front of a television set is not necessarily the best thing for their health or their education.

I agree entirely with what has been said about exercise and sport, but we also need a particular focus on girls and exercise. Statistics show that girls give up exercise younger; after they leave school, they do not continue to exercise, as boys do. I was interested to hear about, was it ice hockey—

[Justin Tomlinson]

It was an ice-skating disco on Friday nights.

On the point about getting more girls involved, that is why I proposed merging youth and leisure services to identify opportunities. Girls, in particular, follow what is on television. If street dance, cheerleading or football is popular, let us provide those services and facilities, and they will come flocking.

[Ms Abbott]

I agree. That is the point that I was going to make. We need to be more innovative in the sorts of game that we encourage and make available to children. Girls do not want to play ping-pong, because they are quite self-conscious physically, but they will do things such as breakdancing and ice skating.

As other Members have said, we have a generation of parents, especially in inner cities, who do not know about food, have only the dimmest idea of where some foodstuffs come from and do not know how to cook. Because they are bombarded by advertising for processed food, when they whip out a ready meal from Marks and Spencer, it is not just idleness; they think that they are being good parents: “Look, I’m getting you something from Marks and Spencer which is advertised on the television.” We should work with communities and parents to educate them.

In my view, the Government obesity policy’s reliance on responsibility deals is a little problematic. Common sense suggests that companies that make billions of pounds every year peddling fizzy drinks and foods larded with trans fats will not seriously undermine their profits by genuinely trying to change the public’s eating habits. Although we must applaud the Government for whatever progress they think they have made with responsibility deals, we must go beyond them as they are currently fashioned if we are to stop the epidemic of obesity among our young people.

To return to the Government’s obesity strategy, the message from health professionals, key health groups and experts is clear. We need tough action now and a proper long-term strategy to stem the rising tide of lifestyle-related diseases. Jamie Oliver, probably the single most famous person in public health, has said in the past few weeks that this Government’s obesity strategy is

“worthless, regurgitated, patronising rubbish”.

As usual, he was not pulling his punches. Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said that the Government’s plan

“has no clear measures on how the food and drink industry will be made to be more ‘responsible’ in their aggressive marketing of unhealthy food…Suggesting that children in particular can be ‘nudged’ into making healthy choices, especially when faced with a food landscape which is persuading them to do the precise opposite, suggests this would be best described as a call to inaction.”

Which? executive director Richard Lloyd said that the Government’s approach to tackling obesity was

“woefully inadequate…The Government calls on people to cut down the calories they eat, but isn’t giving them the tools to do so.”

Charlie Powell, campaigns director of the Children’s Food Campaign, said:

“This is a deeply disappointing and utterly inadequate response which represents a squandered opportunity to address the UK’s obesity crisis.”

There is broad agreement in the House about the issues that we must address. It is a mix of issues; there is no silver bullet. Better labelling of food, including in restaurants and cafés, is part of the answer. Fashioning a sport offer for young boys and girls is crucial, as is better education and working with parents and communities.

I would like to say a word about gastric bands. We read an enormous amount about them, particularly in relation to celebrities. As a Conservative Member said, there are cases, if people have tried everything else, where a gastric band might be the answer, but I deprecate the promotion of gastric bands without some of the measures that we have discussed if that suggests to people that they can eat whatever rubbish they like because, at the end of the day, the NHS will pick up the tab for a gastric band. That is not the way forward, either for costs in the NHS or for people’s quality of life. I have read about people who, having got gastric bands, proceeded to liquidise fish and chips so they could continue to enjoy their favourite junk food. That suggests that a gastric band, in itself, is not the answer to the underlying issues.

I hope that, in his winding-up speech, the Minister will address the serious concerns raised about the Government’s obesity strategy by a wide range of stakeholders and specialists. I look forward to hearing what the Government plan to do further to address the growing epidemic of obesity among our young people.

15:47

[The Minister of State, Department of Health (Mr Simon Burns)]

It is a pleasure to serve under your chairmanship, Mrs Riordan, during this extremely interesting and thoughtful debate, to which there have been a number of erudite and imaginative contributions across the range.

I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing the debate and giving us the opportunity to discuss one of the major public health issues of modern times. He has spoken repeatedly on the subject in the House and should be congratulated on doing so. He knows, of course, the scale of the problem. Most adults in England, 61%, are overweight. Sadly, one third of those are clinically obese, giving us one of the highest obesity rates in the world. As for children, almost a quarter of four to five-year-olds are overweight or obese, rising to one third in 10 to 11-year-olds. I am sure that we all agree that those figures are genuinely shocking. The hon. Gentleman will be aware that the scale of the problem in Northern Ireland, to which he alluded during the course of his remarks, is similarly daunting, with 59% of adults and 22% of children overweight or obese.

As recently as the 1980s, obesity rates among adults were a third of what they are now. Although figures for the last few years show that levels of obesity may be stabilising, that is simply not good enough, because excess weight has serious consequences for individuals, the NHS and the wider community. Not only does it cause day-to-day suffering such as back pain, breathing problems and sleep disruption, but it is a major risk factor for diseases that can kill. An obese man is five times more likely to develop type 2 diabetes, three times more likely to develop colon cancer and two and a half times more likely to develop high blood pressure than a man with a healthy weight, and women face equally serious risks. That is not to mention liver disease, heart disease, some cancers and miscarriages, all of which are linked to excess weight.

Although the real and present danger of obesity in terms of immediate health risks is seen largely in adults, obesity also has significant effects on children and young people, as many hon. Members have mentioned. Obese children are likely to suffer stigmatisation, and there are growing reports of obese children developing type 2 diabetes. We also know that if a child is obese in their early teens, there is a high chance that they will become an obese adult, with related problems later in life.

As waistlines expand, so does the amount of money that we spend on the issue. As a number of Members have said, excess weight is a burden of approximately £5 billion each year, and costs billions more through days of work and incapacity. Neither can we ignore the link between obesity and health inequalities. Data from the national child measurement programme show a marked relationship between deprivation and obesity. The Marmot review in 2010 showed the impact that income, ethnicity and social deprivation have on someone’s chances of becoming obese. As things stand, the less well-off a person is, the more likely they are to be carrying excess weight, so we are talking about an issue of social justice, as well as a narrow health issue involving exercise and healthy living.

The hon. Members for East Londonderry and for Hackney North and Stoke Newington (Ms Abbott) both asked, in effect, whether the Department of Health should work with companies that produce and sell products that contribute to the nation’s obesity and alcohol problems. Up to a point, it is the responsibility of the individual how much they consume and what they consume. How do we make sure that people know what they are eating—the calorie, salt and fat content and so on? To my mind, that means clear, easily understandable labelling, and education about what is healthy and what is the best approach.

On the narrow point of the issue mentioned by both hon. Members, improving the health of the public is clearly a priority for the Government, but we need a whole-society approach to tackle the health problems caused by poor diet, alcohol misuse and lack of exercise. To change people’s behaviours, we need to make the healthier choices the easier choices for everyone.

Commercial organisations have an influence on and can reach consumers in certain ways that Governments cannot. They have a key role in creating an environment that supports people to make informed, balanced choices that will enable them to lead healthier lives. Through their position of influence, they can address some of the wider factors that affect people’s health, such as how healthy our food is and how easy it is to access opportunities to be more physically active. Through the work on the public health responsibility deal, despite what the hon. Member for Hackney North and Stoke Newington has said, we are tapping into that unrealised potential to help improve the public’s health.

[Ms Abbott]

rose—

[Mr Burns]

I will give way in a moment. It is also important to say that, if we can get an agreement with commercial companies to change the way they behave and some of their practices, it will be far quicker to achieve that and put it in place than to wait for the heavy hand of Government legislation, which can take a minimum of a year and sometimes years. Why wait for the heavy hand of legislation that might take a long time, if we can get a voluntary agreement that will work quicker and more effectively to start dealing with the problem?

[Dr Poulter]

rose—

[Mr Burns]

I will give way to the hon. Member for Hackney North and Stoke Newington first, because I promised her, then my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), and then I will make progress.

[Ms Abbott]

On changing commercial practices, when will the Government do something about the practice of so many supermarkets whereby they place rows of sweets next to the checkout? If a parent has fought off their children and not bought sweets on their way around the supermarket, the children then have 10 minutes to whine while the parent waits to pay for their shopping.

[Mr Burns]

I understand the hon. Lady’s point, because the charge has been made on a number of occasions and I have considerable sympathy with it. The supermarket at which I shop each week—I shall not name it, because I do not want to advertise for it—does not do that any more. I think that the hon. Lady will find that, throughout the country, the responsible supermarkets have stopped that practice, for the very reasons that she has mentioned.

[Dr Poulter]

Does my right hon. Friend agree that we need to be careful about introducing regulation for alcohol and other relevant products? It could be a very crude measure and have unforeseen consequences. For example, on alcohol, we may be concerned about the cheap sale of white cider, but the bigger issue is that introducing legislation may impact on brands that market themselves responsibly to responsible drinkers. We have to be careful about that sort of thing.

[Mr Burns]

My hon. Friend makes a valid point.

I will address a number of issues that some of my hon. Friends have raised. My hon. Friend the Member for Totnes (Dr Wollaston) talked about the important issue of weighing and measuring children. I hope that she will be reassured by the national child measurement programme. It measures children in reception class—four to five-year-olds—and in year 6. Those measurements and weights are fed back to parents, so that they can not only know the information, but make informed choices about the lifestyles of their children.

My hon. Friend the Member for North Swindon (Justin Tomlinson) made some valid and good points about the planning regime and open spaces that enable parents and children to exercise. His points were well made and sensible. It would be worthwhile for local government, which has responsibility for the issue, to read what he has had to say, particularly, as the hon. Member for Hackney North and Stoke Newington has said, because certain inner-city areas do not have the advantages of some of the more rural and smaller town constituencies, which have far more access to open spaces.

As a Government, our general approach to tackling the problem is based on the latest scientific evidence on the underlying issues and causes of obesity, as well as what has worked best previously. Ultimately, there is a simple equation: people put on weight because they consume more calories than they need.

[Nick Smith (Blaenau Gwent) (Lab)]

Will the Minister give way?

[Mr Burns]

No, I will not, because I have only three minutes. People need to be honest with themselves. We need to recognise that we are responsible for controlling our weight. That means eating less, drinking less and exercising more.

We are also calling on the food and drink industry to play a much bigger role in reducing the population’s calorie intake by 5 billion calories a day, to help close the crucial imbalance between energy in and energy out. That will build on commitments that businesses have already made, through the public health responsibility deal, on things such as eliminating trans fats, reducing the amount of salt in food, and proper calorie labelling.

Of course, it is for each of us to make our own decisions about how we live our lives. The best and most sustainable changes come not when people are ordered about, but when they are given the tools to change, given the justification and then take responsibility to do it themselves. That is why we need to work together to make sure that the healthier choices become the easier choices. Everyone has a role to play—the food industry, the drinks industry, the many organisations that encourage physical activity and sport, employers who can support the health of their employees, and the local NHS staff in talking to people more about obesity and its consequences.

Under the new public health system, local leadership will be critical. We want to move away from the days when legislation and demands came down from Whitehall like thunderbolts from Mount Olympus. Local authorities will be supported by a ring-fenced budget and will bring together local partners, including the NHS, to provide the most effective services for their communities. We will support local people and local authorities by making sure that they have access to the best possible data and evidence.

We will not shirk our duty to provide national leadership where it is necessary—by working, for example, with business and non-governmental organisations, and making sure that Government Departments work together in supporting better health. That is already happening. The Department for Transport is providing more than half a billion pounds of funding for local authorities to increase sustainable travel such as walking and cycling. The new teaching schools programme, led by the Department for Education, will explore how schools can support and encourage children’s health and well-being. We will also continue to try to inspire people, young and old, to embrace a healthy, active lifestyle, via, for example, Change4Life. Moreover, the London Olympics, as many of my hon. Friends have mentioned, give us the golden opportunity to perpetuate that legacy after they have finished.

The new national ambitions provide a clear goal that we can all aim for. We should all play our part in raising awareness. Once again, I congratulate the hon. Member for East Londonderry on securing this debate, and I hope that he sees the benefits in our strategy. I hope that he supports it and that he will continue to be an advocate for his constituents on the matter.

[Mrs Linda Riordan (in the Chair)]

Order. Mr Bryant has withdrawn his debate, so the sitting is suspended until 4.30 pm.

16:00

Sitting suspended.

Fire Service (Halesowen and Rowley Regis)

Wednesday 9th November 2011 Westminster Hall

16:29

[James Morris (Halesowen and Rowley Regis) (Con)]

It is a great pleasure to serve under your chairmanship, Mrs Riordan. I thank the Minister for being here to listen and respond to the debate, and for being so open and accessible when I have contacted him about this issue.

I applied for this important debate because, unless the Minister is able to come to our aid or the West Midlands fire and rescue authority can be persuaded to reject the proposals put to it by the West Midlands fire service, the fire service in my constituency is threatened with extremely deep cuts. I will offer a brief summary of how we got to this point.

In 2008, the West Midlands fire service conducted a comprehensive review of its operations to improve its effectiveness and to ensure that resources were best deployed to maximise the level of fire cover across the county. The review recommended that a number of fire stations should be merged, while maintaining the same number of fire engines and crews across the county, to offer a more effective service. Among its proposals, the review recommended that the two fire stations located in my constituency, Halesowen and Cradley Heath, should be merged with a new fire station built at a suitable location between the two towns.

The proposals were put out for consultation at the end of 2008, and a large number of responses were received from different sections of the community. Despite strong opposition to the proposals to replace the two existing fire stations with a new fire station, including a strong campaign mounted by the Fire Brigades Union and submissions from Labour-run Sandwell council, the fire service decided to press ahead with the proposal and the merger was agreed by the fire authority in February 2009.

Although the fire service did not change its plans to merge the two fire stations, it did agree to modify its proposal in one important way following the consultation exercise. The review originally proposed that instead of having one 24-hour pump located at each of the two fire stations, the newly merged fire station should have one 24-hour pump and one 12-hour pump. Following the consultation, that proposal was changed and it was agreed that there should be two 24-hour pumps at the new fire station. That proposal was agreed by the fire authority in February 2009.

After the fire authority’s decision, not much happened. In fact, with regard to the two fire stations in my constituency, nothing happened at all. While the review’s proposals were implemented in other parts of the west midlands, the fire stations in Halesowen and Cradley Heath continued to operate as before. To all intents and purposes, it appeared that the proposal had at the very least been put on the back burner. The first indication that the plans might be back on the table came when the chief fire officer wrote to me last December to lobby me on the local government finance settlement. He said:

“I will do everything possible in order not to close your local fire stations—but at this level of cuts I see some closures as an inevitability.”

The first time that the proposal was publicly resurrected was this summer, when the West Midlands fire service announced that it would press ahead with the decision to merge the two fire stations. However, when that was formally announced, it became clear that the fire service intended to implement only parts of the decision agreed in February 2009. Whereas the 2009 decision explicitly stated that the two fire stations would be replaced by a new fire station that would be built between the two existing stations, the proposals that the fire service now intends to implement could see the fire stations replaced by a rented industrial unit somewhere in the area, or—as seems to be the favoured option—the merged fire station would actually just be Cradley Heath fire station.

I hope that you will not think that I am overly pedantic, Mrs Riordan, if I suggest that closing one fire station and moving the service it provides to another fire station is a very different proposition from building a new fire station to cover both areas and locating it between the two towns. Back in 2009, the fire authority accepted that distinction. In its response to the consultation, the fire authority dismissed suggestions that Cradley Heath could serve the whole area. It said:

“Cradley Heath fire station was built in 1942. It is a cramped old fashioned building with no training facilities and it has been the intention to replace the station for some years. There will be significant costs if the Authority attempts to maintain the station on the present site. The Authority believes that the risks in the areas covered by the existing Cradley Heath and Halesowen fire stations will be better served by having a combined new fire station located between the two existing sites.”

That is as true now as it was in February 2009.

While the physical presence of a fire station in a town is of enormous emotional importance to local residents, and having a fire station locally has significant practical benefits, I recognise that there is some truth in the argument used by the fire service that fire stations do not put out fires—firefighters do. That is why I am even more concerned that, having agreed to preserve two 24-hour pumps in 2009, West Midlands fire service is now proposing that that provision should be halved and the new—or perhaps not so new—merged fire station would have only a single pump to serve the area. That clearly has grave implications for the level of fire cover available in my constituency.

Unlike the 2008 review, the new proposals are not part of a comprehensive assessment of the needs of the county and how best to deploy resources to provide the best possible level of cover in all areas. This summer’s proposals would affect only Halesowen and Cradley Heath, thus reducing the service in my constituency. Clearly, like all services, the West Midlands fire service has had to bear a share of the savings needed to reduce the deficit that the Government inherited. Indeed, because the West Midlands fire service has set a much lower council tax precept than other parts of the country, the overall impact of the local government finance settlement is even greater in the West Midlands than in other metropolitan fire authorities. I urge the Minister to bear that in mind when considering the settlement for future years to ensure that metropolitan fire authorities in general—and the West Midlands in particular—are not forced to make deeper savings than can possibly be afforded without significant front-line cuts.

While there are significant financial pressures on the fire service, it seems that Halesowen and Cradley Heath are expected to carry a disproportionate share of the burden to produce the required savings. As I have said, my constituency is the only area in the county to face a reduction in the number of pumps through these proposals. As I explained earlier, the West Midlands fire authority recognised in 2009 that it was not appropriate to reduce the number of pumps covering the area from two to one and a half, yet the fire service is now proposing that, instead of sharing the burden across a number of stations, the number of pumps in my constituency should be cut from two to just one. It would seem to be basic common sense—something on which my constituents pride themselves—that either the decision to preserve two full-time pumps in 2009 was extraordinarily wasteful or, as local residents suspect, reducing cover to just one single pump represents a serious risk to the local community.

Although the fire service points to the relatively low number of call-outs from the two stations, the local community does not believe that those statistics tell the whole story. Halesowen fire station is close to junction 3 of the M5, and helps to cover call-outs to the motorway network. With the weekend’s tragic accident in Somerset, we saw again just how important it is that our motorways are properly covered by the fire service network.

Halesowen town is changing. The reduction in the number of incidents over recent years is partly the result of effective fire prevention, but is partly due, too, to a decline in the local manufacturing industry. New growth in the town is changing that, but although the new hotel, supermarkets, fast-food restaurants and petrol stations provide a vital boost for the local economy, there is no doubt that they represent a greater demand for the local fire service that did not exist when the review was conducted in 2008. It therefore seems folly on the part of West Midlands fire service to propose deep cuts to the service in Halesowen precisely when demand could be about to rise.

Although there was significant local disquiet about the 2009 decision, the case could at least be made that it was being done to improve the quality and efficiency of the service—my predecessor broadly accepted that argument. However, the new proposal to cut the number of fire stations and fire engines can only be seen as a reduction in service. There is a great deal of opposition to the proposals in my constituency, bringing together the unlikely alliance of a Conservative Member of Parliament, all local political parties and the Fire Brigades Union. The FBU held a well-supported rally in the town centre, and petitions against the proposals have collected more than 1,000 signatures.

Under the Local Government Act 2010 and the Fire and Rescue Services Act 2004, fire authorities, as best-value authorities—

16:42

Sitting suspended for a Division in the House.

16:52

On resuming—

[James Morris]

As I was saying, under the Local Government Act and the Fire and Rescue Services Act, fire authorities, as best value authorities, have a responsibility to consult the public effectively. They must also ensure that consultations comply with guidance from the Secretary of State. This week’s High Court decision on the Royal Brompton hospital serves as a reminder of the importance of ensuring that public consultations, particularly on service closures, are conducted effectively and fairly.

When the new proposals were announced in the summer, the West Midlands fire service said that as the decision to merge the fire stations had already been agreed, it was necessary to consult only on the staffing changes. The Minister has extensive experience of local government and knows how a competent consultation process should be conducted. It is questionable whether a three-year-old consultation exercise holds much value in the best of circumstances. However, it surely cannot be right to claim that a decision taken on the basis of a three-year-old consultation process remains valid, but then choose selectively to implement only parts of that decision. Either the 2009 decision should have been implemented in its entirety, or there should be a new, comprehensive review of the fire service’s operations, so that a proper judgment can be reached on how resources should be allocated in order that the service complies with its obligations under the national framework. Even the chief fire officer accepts that the consultation has “not been ideal”. But for parliamentary protocols, I would be tempted to use somewhat stronger words.

There is a real threat that unless the Minister can intervene or the fire authority recognises that the proposals before it have not been properly thought through, my constituents will find themselves with a much-reduced service that is radically different from anything on which they have been consulted and that represents a significant risk to the community.

To conclude, I shall ask the Minister three questions. First, can he provide detailed assurances that the process followed by the West Midlands fire service is consistent with its statutory obligations to consult and to minimise risk? Secondly, will he work with the Secretary of State to draw up clear best practice guidance for the minimum standards required of fire authorities’ consultation procedures? Finally, given the shortcomings in the way in which the fire service has consulted the public and other stakeholders—shortcomings recognised by the chief fire officer himself—does the Minister agree that the best course of action would be for the West Midlands fire service to withdraw its proposals, so that a full and comprehensive review can be conducted of how the service’s resources can best be deployed to provide the fire cover that my residents require?

16:55

[The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill)]

It is a pleasure to speak under your chairmanship, Mrs Riordan. I congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) on securing the debate. I am very glad that he has done so. It is on an issue in which he has taken a very considerable interest and on which he has been campaigning for some time. I am grateful to him for the care that he has taken in providing me and my officials with information about this matter, and for the concern that he has shown for his constituents in seeking a constructive meeting with me, which we had earlier.

I understand my hon. Friend’s concern about service provision in the west midlands. There is no doubt that fire stations provide a vital community safety and protection service. Of course, the pumps stationed in them are important, too. Running up the stairs to get back to this debate in time after the Division, I was reminded that they often carry defibrillators as well, because I thought I might need one at one point. Joking apart, these are life-saving, front-line services, and it is right that communities are sensitive about their placement.

Fire and rescue authorities have successfully improved the safety of their local communities in recent years. The number of fire deaths has halved in the past 20 years, and there has also been a fall in the number of fires, so there have been real achievements. That is the background. We recognise the very strong commitment that my hon. Friend has to his local service. However, we have to step back a little and see what the appropriate use is of the Secretary of State’s intervention powers and what the appropriate means are of dealing with the issues of controversy in this case. The Government, like their predecessor, are of the view that fire services are best delivered locally. The Government’s own commitment to localism reinforces that. It involves decisions about local deployment of services generally being taken at local level.

In the case of fire and rescue services, the democratically accountable fire and rescue authorities are the bodies charged with that responsibility. Those authorities are required by the national framework to produce and regularly update an integrated risk management plan, which identifies and assesses local need and sets out plans to mitigate effectively both existing and potential or future risks to communities, because of course those can change as a result of demographics and other matters. It is therefore a very localist process that has been built into the system with the IRMP. Each fire and rescue authority’s IRMP should enable the local authority to decide how best to provide the services. That includes prevention and protection, as well as the service provided by the stations and the placing of the pumps themselves. Strategic and operational matters, such as the manning and hours of operation of stations, and cross-border arrangements can and should be taken into account in considering the IRMP

It is against that background, as I understand it, that West Midlands fire authority has proposed to change the fire cover arrangements in Halesowen and Cradley Heath. I am advised that those proposals have been made in the light of both the assessed risk and the available resources. The matter is of local controversy, as my hon. Friend fairly says. I am aware that the proposals have generated a great deal of debate. In one respect, the debate is a healthy one—the community is obviously concerned about the proposals, and it is speaking up about them and engaging the fire authority. It is much assisted by the work of my hon. Friend, for which I commend him.

I understand that there are concerns about the adequacy and transparency of the consultation on the proposals. The question, however, is whether those concerns justify the use of the Secretary of State’s intervention powers under section 22 of the Fire and Rescue Services Act 2004. My hon. Friend has recited the criticisms made about the consultation, which relate to the adequacy of the up-to-date assessment and whether using a consultation from some time ago is appropriate.

The intervention powers are designed to deal with the worst cases of systemic or corporate failure of fire authorities. The 2004 Act is framed in that way. Section 21 charges authorities to have regard to the national fire framework in carrying out their functions. The framework expects that there shall be proper consultation on service changes, but it does not specify in detail the means that such a consultation should take. However, we expect fire and rescue authorities to work in partnership with their local communities on such matters.

The powers of intervention under section 22 are designed to deal with failing authorities as opposed to failures of a particular decision process or a decision on a particular proposal. That is analogous to the situation in Haringey with the case of Baby P, where there was such a degree of failure that the system was not operating at all. On the evidence that we have, the situation raised by my hon. Friend does not seem to come into that category. Our policy approach on Government intervention in a failing authority is set out in that way.

We have set out our expectation that, where there are failures with an authority, first of all, the authority, working with its political and professional leadership, will put in place processes to seek improvement. That should normally be the means of dealing with a situation. Where that does not happen, the powers of the Secretary of State under section 22 would be invoked. They are used only for the most serious failings. Under those circumstances, the Secretary of State may give certain directions to an authority.

On what I have heard, that does not seem to be what we, as yet, have here. The authority has been advised by its professional advisers and the chief fire officer. The decision, which has not yet been taken, is one for the members of the fire authority, who are all elected councillors in their area. Like any local authority, a fire and rescue authority must act in Wednesbury reasonableness in its decision making, and it is therefore susceptible to judicial review. Generally, failures of process and of consultation relating to individual decision-making processes tend to be remedied by applications for judicial review rather than by the Secretary of State’s intervention.

Whether such a review is appropriate in this case is not for me to say, because it is not for the Secretary of State or his Ministers to comment on the merits, or otherwise, of a particular application; I am sure that my hon. Friend understands that. I think that that point is reinforced by the reference in his speech to the case of Royal Brompton hospital, in which a judicial review was seen to be the appropriate route. Section 22 of the 2004 Act does not envision that the merits, or otherwise, of an individual decision should normally be of such a magnitude as to trigger the intervention powers. Against that background, an intervention under section 22 does not seem to be appropriate.

It is worth saying a little about the funding of West Midlands fire authority, since my hon. Friend made reference to that. It is fair to say that, like all local authorities, West Midlands fire authority and other fire authorities have had to take their share in our efforts to reduce the deficit. However, taking into account its other sources of funding, such as council tax precepts, reserves and its formula grant, the overall reduction in the spending power of West Midlands fire authority is 5.6% in 2011-12 and 2.2% in 2012-13, which is the same as nine other single purpose fire authorities.

As West Midlands fire authority is one of the largest authorities in cash terms—perhaps the largest outside London—the reduction is a large one. However, it receives the largest protection of all such authorities from the floor damping system, which is part of the formula grant mechanism. It will receive £5.2 million in 2011-12 and £3.58 million in 2012-13, which is more than their needs indicators would allocate if the Secretary of State had not applied the damping. It is also worth noting that West Midlands fire authority receives £27 formula grant per head, compared with the shire average of £20. If anyone were to suggest that funding alone were a necessary trigger for the changes, I would suggest that the figures do not bear that out. That is not my hon. Friend’s contention, but that might be said in other quarters. It is also worth bearing it in mind that West Midlands fire authority has benefited from an 82% increase in capital grants on the previous year, which brings it to £2.9 million. How the authority disburses the resources is a matter for the authority, acting on the advice of its chief fire officer.

I am sorry that I am not able to give my hon. Friend all the detailed assurances that he is seeking. We have generally not sought precisely to identify a statutory form of consultation, for the reasons that I have set out—other remedies best apply. As yet, I do not see a situation in which the authority can be said to have acted in breach of its statutory duties under the 2004 Act, because action in accordance with the IRMP, on the face of it, tends to indicate compliance. However, a Minister is not in the best position to judge every detail of the case. As such matters are devolved to local authorities, it is not appropriate for the central Government to advise on the best course of action. They are right to set out the legislative framework, what the remedies are, and the facts, as far as are available, to all those concerned.

That is why I urge my hon. Friend to continue to raise the issues with West Midlands fire authority. I know that he has been in regular contact with the chief officer, the chair of the authority and the other elected members, who include elected members representing the metropolitan borough in his constituency. They are rightly to be held accountable to their electorate for their decisions.

Although the door is always open, I do not want to raise expectations at this stage that the—if I may put it this way—ultimate long stop of statutory intervention power is necessarily the appropriate route in this case. However, I hope that the members of the fire authority and their advisers will listen to my hon. Friend’s carefully and cogently made points. He makes a reasoned case, particularly on some of the issues that he raised about consultation, timing and how up to date the information is. However, as things stand, the matter is for the fire authority and its advisers.

Question put and agreed to.

17:08

Sitting adjourned.