Westminster Hall
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Access and Facilities (House of Commons)
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mrs Linda Riordan (in the Chair)
This morning’s first debate, on visitor access, is slightly unusual, as it is on a House of Commons matter, not a Government one. The winding-up speech will made by John Thurso on behalf of the House of Commons Commission, and I expect to call him no later than 10.50 am, depending on how many other hon. Members want to speak.
There will be time for Front-Bench speeches, should the speakers wish it. The Administration Committee’s report on visitor access is relevant to the debate. The House of Commons Commission response to that report was published at 9.30 this morning and copies are available.
Sir Alan Haselhurst (Saffron Walden) (Con)
Mrs Riordan, you and I are in an unusual position, in that for several years our roles were normally the other way round, but I am delighted to see you occupying the Chair. I am aware that this morning’s subject of debate is not exactly at the epicentre of colleagues’ consideration, given other events that may be taking place not too far away from the Palace. However, it is important that we have occasional opportunities to discuss matters connected to Parliament’s operation, rather than those that concern the rest of the country. I hope to show that we are concerned, when we consider access to the building, about the convenience of the public—the people we serve.
The report of the Administration Committee on visitor access and facilities was published in May and, as you announced, Mrs Riordan, the House of Commons Commission has responded. We have published its response and I am pleased to say that the main thrust of the Committee’s recommendations has been accepted. We expect that, if all goes well, £3 million should be raised annually by 2014-15, to help towards the annual £224 million cost of running the House. Although we were open to receipt of evidence and comments from colleagues, the response was not overwhelming. The purpose of today’s debate, as I see it, is to air some of the underlying issues relating to visitor access, so that the unfolding of plans may be further informed.
The Committee’s starting point was to recognise that access to the Palace of Westminster for the various purposes pursued by members of the public can sometimes be very difficult—uncomfortable, even—with no shelter from extremes of weather. Public access was probably not a very high consideration when the new Palace was designed and built by Barry and Pugin in the 19th century, when people did not regularly lobby in their thousands. Parliamentary activity was not as extensive as it has become today, with all the Committees of the House and, indeed, the introduction of this Chamber as a parallel source of debating opportunities. There were not more than 500 all-party groups competing for space and attention. Visits to tour the building were not the feature that they have become today. The use of banqueting facilities was very limited and the education service, with its aim of encouraging school visits, had not been founded. Those and other activities have contributed to an ever increasing demand for access. More than 1 million people have visited the Palace in the past year, and the capacity of our entry points, unfortunately, has not kept pace with demand.
Security is obviously a factor. We must protect the building and all the people who may for one reason or another be in it. The need to ramp up security has led to controls on access that severely limit throughput. Worse than that, on occasions contradictory moves have been made in different parts of the administration of the Palace. On the one hand, there is a desire to encourage people to visit Westminster to see proceedings, or to come on school visits for induction to Parliament by the education service, but at the same time, the physical means of entry have not been expanded commensurately. On occasion, decisions have been made not to expand the entry points on the grounds of public expenditure. The consequence has been queuing. People queuing to get into the Palace are a regular sight, which has led to considerable inconvenience not only for them, but for the hosts who handle the queues and for those holding functions in the House where visitors are expected.
The second problem is the inefficient handling of tour parties. The Palace is an almost unique visitor attraction, as visitors are taken through one way, then brought back again. It is an extremely unusual circumstance, which was remarked on by those who gave evidence to the Committee. The introduction of visitor assistants is a positive step. Perhaps they are the parliamentary equivalent of the “games makers”, because they give visitors a warm reception. Overall, however, we do not give the visitor the best welcome. We are strangely reticent about advertising the fact that people can come into the Palace for various legitimate reasons. The notices outside Westminster abbey, not far from us, are an example of what might be done—and I hope will be done—to give simple information to visitors about their rights of access.
We identified the fact that the Palace has a double role. It is primarily a working building at the heart of our democracy: that is unquestionably its prime purpose. However, we recognise that whether we like it or not, it is a leading visitor attraction. People see it and understandably want to share the wonderment of what it represents and contains. The twin roles can more easily be separated when Parliament is not in Session. They can become confused when one or other House is sitting. People want access to view proceedings, give evidence to Committees, visit their Member of Parliament and attend receptions and meetings. Also, many Members want to encourage visitors from their constituencies to come on a tour of the Palace—something that is now further limited by the recent decision of the House to change Tuesday sitting times.
For all the purposes I have just described, entry to the Palace must be free and, one would like to think, unimpeded, although for the reasons I have set out that is not always so. There should be no barrier to members of the public for those purposes. However, Parliament’s role as a visitor attraction is another matter. We are among the top five historical attractions. We could say that visiting has nothing to do with the operation of Parliament—we could disavow it and very strictly define the occasions on which people enter the Palace—but the Committee’s view was that we should welcome the opportunity to be seen in such a light. We could see nothing undignified about charging people who want to come in purely for the purpose of seeing a major historical attraction. There is undoubtedly a demand for visits, which has been created in all manner of ways, and would be further swollen if people passing by realised that there was an opportunity to come into the building.
The Committee felt that a clear distinction should be made, in the way that Westminster abbey makes a distinction—if people wish to attend a service in the abbey, there is of course absolutely no question of charging for access, but if people wish to visit the abbey as a visitor attraction at other times, there is most certainly a charge. We therefore think that we can apply that distinction to the Palace of Westminster. Of course, if we welcome visitors, there will also be a demand from them for refreshment and souvenirs.
We recognise that the whole issue of charging is quite sensitive, but we believe that some clear thinking on the subject is needed. We already charge for commercial tours when Parliament is in recess during the summer and on Saturdays, and for civil ceremonies and banqueting. We are increasingly charging for the specialist tours that have been developed—for example, for examining works of art—and it is thought reasonable to add to such tours opportunities for taking tea or even something more substantial.
However, we touched a nerve with a proposed charge for access to what we are now pleased to call the Elizabeth Tower. A charge for visitors was proposed on no more than a cost-recovery basis, but the House recoiled. Arguably, the Elizabeth Tower is not key to the parliamentary process, so we have blurred the distinction that the Committee felt ought to be maintained. The tower has severely limited capacity and, ironically, the consequence of the debate on charging in the House has been an upsurge in demand. Until then, many people did not realise that such tours were a possibility. It is now difficult to get any slot for visitors from one’s constituency for the rest of this calendar year—opportunities are being soaked up very quickly.
We suggested in our report that the line should be clearly drawn between the Palace as the place of the legislature and as a visitor attraction, and that that distinction ought to be reasonably clear and well defined. We do not feel that we should neglect what is an important source of income that is designed either to help us to reduce the taxpayer’s subsidy or to support the upkeep of this building. It has been reported in the press that the Commission is considering what needs to be done to ensure that the Palace is in a full state of repair, and there will doubtless be announcements about that in due course, but a great deal of work is being done and has to be done to make sure that it operates effectively as the home of Parliament and, indeed, continues to be a place of attraction and beauty for those who wish to visit.
The charge that one might apply for visits, whatever the purpose for which visitors are allowed in, is another matter. In evidence to the Committee, we were told that we probably undercharge. One approach is simply to go on cost-recovery; the other is to recognise that we are in a competitive marketplace in relation to visits, so we should consider whether a profit could be made that contributed to the purposes I have described. I do not think that many people would thank us if, through any kind of neglect or reluctance to spend money, we allowed this building to fall into any measure of disrepair.
As I have mentioned, another source of income connected with visitors to the building is the sale of souvenir gifts, on which we have been half-hearted over the years. If people visit a stately home run by English Heritage, it is impossible for them to escape without going through the gift shop and the cafeteria, and English Heritage freely admits that it makes a great deal of money that way. The public make no complaints about that, because they see it as part of the visitor experience. It has been very difficult to achieve what might be our full potential in that respect in the Palace. Ironically, that is because English Heritage has been especially protective about Westminster Hall, which is the logical place for a souvenir shop. Of course, at one time in its history, Westminster Hall was very commercial, with shops and market stalls, but that was a long time ago.
Undoubtedly, there is a right and a wrong place to put a gift shop. At the moment, it is in St Stephen’s Hall, which is a congestion point, and people do not want to stop there on the tour to decide whether to buy something. People complete the tour in Westminster Hall and a relatively small number go back to the shop, while others go elsewhere, so opportunities are being missed. We are now addressing that, in the hope of increasing revenue and, indeed, of further contributing to people’s pleasure in visiting the Palace. I hope that such a benefit will soon be seen.
Overhanging our whole approach is the question of security. We recognise that high security is needed in respect of all aspects of access to the Palace, but our entry points are nearly all constrained either through sheer lack of capacity or, as the Committee suspects, in some cases for want of manpower, in that extra security guards mean extra cost. In the Committee’s view, that is not a reasonable ground for holding off improvements to the smoothness of access. At many times, throughput is now very badly hampered. We welcome what the Serjeant at Arms is seeking to do to ease some pressure points, but we think that that can make only a minor contribution to improving the flow. We have made a suggestion about improving the categories for prioritising visitors who should be fast-tracked into the building through the Cromwell Green entrance.
Two major problems persist. One is trying to separate what one might call the urgent visitor—the person who has an appointment with a Member of Parliament or has a commitment to give evidence to a Select Committee—from the rest. It is quite wrong that such people should be held up and, in practice, it is quite difficult physically to separate on the ground the genuinely urgent visitors, who need to be in the building by a certain time, from everyone else. We have proposed a restoration of the cabin that was previously stationed adjacent to the St Stephen’s entrance, which would allow a proper and more physical separation and, at the same time, ease the pressures on the Cromwell Green entrance.
Sarah Newton (Truro and Falmouth) (Con)
I pay tribute to my right hon. Friend for securing this debate and for the way he is explaining the work of the Committee in such great detail. I want to emphasise the point that he has just made. Many people come to the Palace for good reason, including helping parliamentarians in their duties in all-party parliamentary groups. Meeting rooms are often changed at short notice. I have seen the most terrible scenes of people, who are giving their time freely, who are often professionals and who have come from all over the country to participate in the work of Parliament, scurrying around the building because they have been delayed on entry and then find that the Committee Rooms are changed at the last minute. I wholeheartedly agree that urgent measures must be taken so that people who are visiting Parliament for business purposes can get on with their work in a timely way.
Sir Alan Haselhurst
My hon. Friend, who is a valued member of the Committee, makes an excellent point. It is a real problem and a source of embarrassment for many Members of Parliament that visitors can be messed around to such an extent.
The second problem is the line of route for visitors. In accordance with telling the story of Parliament, visitors would traditionally begin at the House of Lords’ end of the building and exit through Westminster Hall. Since the introduction of the Cromwell Green entrance, the route has been reversed and visitors are now brought into Westminster Hall first. I repeat what I said earlier: we have the unusual circumstance of having to escort them, at varying pace, right the way through the building, which causes congestion and sometimes leads to confusion. I remember taking a party through the House. When we got to the House of Lords’ end, we found that we were missing someone. That was simply because not everyone keeps the same pace. Despite politely saying, “We must go through, but you will see all this on the way back,” people may be suspicious of that and will naturally gaze up in admiration at what they are seeing, and that delays them, which is a general inconvenience to the group. It lets time slip. The professional guides, who are possibly contracted to do two tours for members of the public in the morning, find that their schedule is also held up and the next lot of visitors who have arrived on time are kept waiting until they are free after the first tour. I am happy to say that I am involved in informal discussions with the House of Lords to see how we can tackle this matter and improve the whole visitor experience. I hope something fruitful will come out of those discussions in the not too distant future.
Let me say a brief word about the longer term. Most people would surely agree that a good job is being done by our education service, the information office and parliamentary outreach to engage the public. As elected representatives of the people, we should delight in that fact and recognise that we need to get more people to come here for an understanding of what parliamentary democracy is all about if belief in parliamentary democracy is to be sustained. We worry about people abstaining from voting in elections and so on, but perhaps that is because they do not fully appreciate Parliament’s potential. We should do all that we can to bring Parliament’s role to people’s attention. Nothing is better than for people to come here and learn about what happens and that may light their own ambition to come here in due time as an elected representative.
There is a strong case for magnifying the efforts of the education service, the information office and parliamentary outreach to introduce young people to an understanding of parliamentary democracy through greater access. However, the education service has no proper home within the Palace. In 2007 both the House of Commons and the House of Lords agreed that there should be a proper base for the education service, but that has not yet been achieved.
If we look at what is done in other Parliaments, we will see that we could do better by our citizens if we had a proper visitor centre where a warm welcome could be afforded and a proper introduction to parliament made. Both these functions—the education service and the visitor centre—could be combined in a purpose-built facility, but we have fought shy of the expenditure that would necessarily be involved. We owe it to the public to be bolder in our approach. That is a longer-term aspiration, but it is something that would allow us to look the public in the eye and say, “This is not a matter of aggrandising the position or the comfort of Members of Parliament. This is for you, and you have a right to get the best out of the Parliament that is here.” We should make it clear that they are welcome and when they come here we should handle them in a way that is informative and makes the experience something that they will remember for a long time.
We need to be courageous in our approach, and the question of access and the reception of visitors deserves much greater attention. I hope that the deliberations of the Administration Committee and the report that we have produced, plus the welcome that it has had from the House of Commons Commission, will alert colleagues to what our priorities should be. We need to move forward in a way that understands the clear distinction that we have tried to emphasise in our report that yes, we are first and foremost a place of parliamentary legislative business, but secondly, that we are seen as the mother of Parliaments and the home of parliamentary democracy, and it is a home to which we should want to welcome people as much as we can.
Dr Thérèse Coffey (Suffolk Coastal) (Con)
I did not notify you, Mrs Riordan, that I wished to participate in this debate, but the subject of visitor access to Parliament is close to my heart. My right hon. Friend the Member for Saffron Walden (Sir Alan Haselhurst) is right to say that this is a place of legislation. It is primarily a place of work. Members are here representing constituents, and most of them want to facilitate access as much as possible. Given the arrangements of this debate, I am not sure how we get a response to our questions, but I will raise a few issues anyway.
In the report, I was struck by the varying ways in which the fast-track scheme can be used. I welcome the idea of giving access to that scheme to members of our armed forces. Those brave men and women serving our country should be able to take up the rare opportunity of visiting Parliament without having to stand outside for an hour waiting to get in. To be honest, I did not even realise that there was a fast-track lane until I read the report. I do not remember it at all. Before I was a Member, I would just hang about in the back.
I read about the capacity flow-through and some of the changes that are proposed to increase the number of people coming through at Cromwell Green and Portcullis House. I was struck by the fact that while 500 people an hour can be processed through Cromwell Green, only 125 people can be processed in Portcullis House, which makes no sense to me. That is far worse than BAA’s operations in Heathrow, which are pretty appalling. We need to understand why the capacity at that entrance is so poor, although I appreciate that there are issues about it being a holding place.
One thing that I often do, and it is mentioned in the report, is to bring people in through 1 Parliament street. I go against the Committee’s recommendation of introducing another entrance facility through the St Stephen’s entrance, even if it was for VIPs. There are plenty of other ways that can be used. Using 1 Parliament street is an appropriate way to bring people into the Palace. I remember going through St Stephen’s entrance, and it always felt very grand, but the opening up of Westminster Hall has been good—although the visual blockage at the top end of Westminster Hall may not be particularly sightly—even though it is not the end with the new stained glass window being erected.
On other aspects of access, to ensure that we do not just focus attention on Cromwell Green, we could let some of the visitor assistants escort people from different entrances through to Central Lobby. At the moment, it is quite easy to say to a constituent, “I will see you in Central Lobby,” because they can just come into Parliament and walk to Central Lobby. The same is true of people attending banquets and other functions. But, quite rightly, nobody can walk through by themselves from Portcullis House to the main Palace; they must be accompanied by a pass holder. I wonder whether there are other ways in which we can use the existing visitor assistants to facilitate people arriving around the clock.
I have some sympathy with the view that was expressed about the inefficiency of tours. Dare I say that there is also an issue with the timekeeping of some of our guides? Having asked a guide to try to get round in 60 minutes instead of the usual 75 minutes, my guests came back to me 100 minutes later. There is a real inconsistency in how some of these services are delivered: if a guide suddenly extends a tour to closer to two hours than one, that is not great productivity.
I want to mention two issues that are not raised in the Administration Committee’s report. In doing so, I am perhaps straying from the report’s remit, which concerned visitor access and facilities. However, dare I mention first the issue of access to the bars of the House of Commons? We know that there are rules about taking people into Strangers Bar, including about who can purchase drinks. It is beholden on Members to try to respect the rules. It is frustrating to see Members take 20 guests on to the Terrace in the Members-only section on a very busy day. Frankly, to do so is to show bad manners to other Members, as I point out to Members—although not in front of their guests—who do so.
Secondly, regarding other access, a lot has been said already about the education service. I support the development of the education service. Some of the things that we have done with the Speaker’s Council awards have been very good. However, the hon. Member for Caithness, Sutherland and Easter Ross (John Thurso), who is a member of the House of Commons Commission, will know that I have asked parliamentary questions about the subsidy that is available to help children to come to Parliament. I am raising that issue again now in a very parochial way, from the point of view of Suffolk, where my constituency is. The constituents of my hon. Friend the Member for Waveney (Peter Aldous), who is my neighbouring MP in Suffolk, live up to 130 miles away from Parliament, and my constituents live an average of 120 miles from Parliament, yet Suffolk schoolchildren receive no subsidy to visit Parliament. If we went the same distance and travelling time from Parliament in the other direction, we would start to reach beyond Birmingham, but the amount of subsidy that is given to schoolchildren from that area to visit Parliament is considerable in comparison to the zero subsidy that is given to schoolchildren from Suffolk. Will the Administration Committee, and perhaps also the House of Commons Commission, look at that issue again? Why is it that schoolchildren in Peterborough can receive a subsidy to pay for up to 50% of their travel costs, even though the time it takes them to get to Parliament by train is less than an hour and Peterborough is much closer to Parliament than my constituency?
I have strayed from the parts of the report to which my right hon. Friend the Member for Saffron Walden referred. However, I think that we should try to be as friendly to visitors as possible. I would love it if we started to rename the Strangers Gallery as the visitors gallery, and changed some of the words that are used in Parliament, as we have started to do in our parliamentary procedures. We no longer use the phrase, “I spy strangers,” and we have a different way of referring to visitors. In the 21st century, we can also change the names of Galleries and bars.
Nigel Mills (Amber Valley) (Con)
Thank you, Mrs Riordan, for calling me to speak. It is a pleasure to follow my hon. Friend the Member for Suffolk Coastal (Dr Coffey) and my right hon. Friend the Member for Saffron Walden (Sir Alan Haselhurst), who is the Chairman of the Administration Committee.
I have the pleasure of serving on the Administration Committee and I think that my right hon. Friend was right to say in his introduction to this debate that the issue of visitor access and facilities is not a great topic of interest either for today or for most Members most of the time. However, it is one of those important issues about how a Parliament runs. Those of us who have a sad busman’s holiday occupation of going round other Parliaments see a very different situation to the one here. We have not just a working Parliament, which people want to see because they have an interest in how the Government work and how laws are made, but a hugely attractive historic building, which people want to see for its architecture and the art that is contained here. That creates twin pressures on visitor access: there is a huge amount of interest from people who want to come to meet their own MP and see what we do here, but also from those who want to see the surroundings in which we do it.
The Committee rightly brought out that theme in its report. It is quite reasonable to charge people who want to come to Parliament as a tourist, but it is completely inappropriate to charge people who want to come here to engage in the democratic process and to see their MP. If people want to come here to see how Parliament works, how legislation is made or to lobby their MP, they must be able to do so in a timely manner and for free. We cannot and should not charge people to do that, and as far as I know there are no plans for that type of charging to be introduced. However, if people are coming to Parliament to have a tourist experience, they should more than cover the costs to Parliament of their doing that and they should make some contribution towards the upkeep of these historic buildings. I am not recommending that any subsidy should come from that contribution to support the parliamentary function, for which the taxpayer in general should rightly pay. However, the upkeep of these historic buildings needs to be funded somehow.
My right hon. Friend the Chairman of the Administration Committee also worked his way around how we fund the catering establishments in this place. Clearly, visitors have a role to play in that process. We sit here as a Parliament for only about 70% of the year, but we are funding catering establishments to be here for 100% of the year. That is one reason—there are many others—why we have such a large subsidy, or loss, for those catering operations.
I am not one who thinks that MPs should have glorious, luxurious eating establishments, but clearly there need to be catering establishments in a place such as this so that MPs and all their staff have somewhere to eat—and drink too, probably—and so that visitors, too, can eat. The more use we can get out of those catering establishments when Parliament is not sitting, the less demand we will make on the taxpayer to subsidise them. Hopefully, we will try to neutralise some of the issues that exist. People’s perception of those issues is partly correct, but they are also partly misinformed about where some of the catering establishments’ loss comes from. The more visitors that we can get in, the more we can enable them to be here and make full use of the catering establishments when Parliament is not sitting. That would be a far better situation than the current one.
I can give an example from my busman’s holiday this summer, in the state Parliament in Victoria. We had a free tour of the Parliament; it did not take very long. It was interesting to see the Parliament, but not all that exciting. However, we were then offered the chance to have lunch in the Members’ dining room. We went in there, we handed over some identification, we were given a security pass, we could walk through the corridors and, as I say, we could go to have lunch in the Members’ dining room while the Parliament was in recess. That is not something that a visitor can do here in this Parliament on spec. I am not necessarily saying that the Members’ Dining Room should be opened all year round for that purpose, but freeing up access and allowing more people to come and see what these House dining rooms are like and have a chance to eat the meal that we get to eat would have huge advantages all round. People could get to use the whole place and see it, and that would reduce the amount that we require from the taxpayer to subsidise those facilities.
I agree with all the other points that have been made, very articulately, about the importance of educational visits. However, it is very hard for schoolchildren from my constituency to get down here. It is quite hard to get a slot when schoolchildren can come on a visit. I know the organisation that is required to arrange such a visit; people need to be on the phone the minute those slots open to try to get a decent one. Also, visiting Parliament is a long and expensive journey for many schools to arrange, especially when there is not even the budget available to pay for half the travel costs that are still required.
The more that we can do to get children to come to Parliament from other places that are further away in the country than London, rather than just having children from the London area, the better it would be. Children really gain a lot from understanding how democracy works and how important Parliament is; they can see it. In the two and a half years that I have been here, I have had about half a dozen groups of schoolchildren come down to visit, out of the dozens of schools in my constituency. It really is a very small percentage of children who get to do that.
Before I was elected as an MP, I had been in this building only once before, and that was on an organised tour 14 years ago. Visiting Parliament gives people a completely different picture of this place. They come and have the tour, they have the experience and they see how Parliament works; they even see how small the House of Commons Chamber is. People get a very different picture of democracy from actually being here rather than just seeing those clips on a Wednesday night on TV of MPs behaving rather badly at Prime Minister’s questions.
Sir Alan Haselhurst
Does my hon. Friend not see that there is an incongruity in what he is suggesting? I absolutely agree with him that we should maximise the opportunities for schoolchildren to visit Parliament, which may require subsidy, as it already does to some extent. However, if we simply increase demand without spending money on ensuring that visitors can get into the building, they will not exactly have the best of welcomes. The two things go together.
Nigel Mills
I absolutely agree with that point. There are things that we can do in the short term to make access easier. We can make better use of the various large rooms that we have. In this building in particular, we have this room itself—Westminster Hall—that is not used for much of the week. We also have the Commonwealth Parliamentary Association Room and the Inter-Parliamentary Union Room, which are also not used the whole time. Those rooms could be used more for educational visits than they are now.
My right hon. Friend was making the point about how we get visiting schoolchildren through security and into this place more efficiently. We must use the existing access routes more effectively; they do not run at capacity. We do not use No. 1 Parliament street or Derby Gate effectively at all; Derby Gate is a fully effective security access route. There is no particular reason why, especially on days of nice weather, a party could not be led round there, through security and back through the building if there was a queue somewhere else. I know that option was not favoured, but if there is a half-hour or hour wait and accesses elsewhere are empty, there must be a better use for those accesses.
I am tempted to raise one of the thornier issues that affects the running of the Palace. Most people would be surprised to learn that the House of Commons runs half the Palace and the House of Lords runs the other half, and that, at times, never the twain shall meet. We are talking about sensible things such as starting the tour route and putting visitor and education facilities in the right places, but much of that has nothing to do with us. We have no say because those decisions are for the House of Lords.
In the interest of the good, sound, efficient and economic running of this place, we need to make more progress on jointly running catering, visitor access and security through one organisation, rather than artificially dividing them somewhere down the corridor where the carpet goes from green to red. That is an historical anomaly that leads to inefficient practices. We will not resolve those issues efficiently and sensibly until we have one management team running the whole building. We can skirt around that for historical reasons, but at some point, if we really want to address the issues, that point must be settled.
John Thurso (Caithness, Sutherland and Easter Ross) (LD)
It is a pleasure to serve under your chairmanship, Mrs Riordan. Although this is not the first time that a Commission spokesman has replied to a debate, it has not happened for some while. This is a novel experience for me, and I hope that I do justice to the excellent introductory remarks of the Chair of the Administration Committee and contributions from hon. Members.
I pay tribute to the right hon. Member for Saffron Walden (Sir Alan Haselhurst) and to the work of the Committee, the members of which are often unsung heroes. Having served on the Committee during the 2005 Parliament, I am well aware of how much work is done. On behalf of the Commission, I assure the Committee that its report and, indeed, its other work are taken extremely seriously. We are grateful for that work, which is extremely helpful in assisting the Commission and management to formulate the strategies and policies that the House management will follow. I am extremely grateful to the Chair of the Committee for securing the debate, and I hope that he will pass on to those members of his Committee who are not here the Commission’s thanks for his and the Committee’s hard work.
The report is an important body of work that will inform Members and management on the principles of the House and the management of visitors for years to come. The report’s first conclusion, which the right hon. Gentleman set out in his opening remarks, says it all. The central idea that has emerged from the inquiry is the critical point that two conceptions of Parliament are required: the working institution and the visitor attraction. Indeed, I would go so far as to say that the Palace of Westminster is, first and foremost, a home to Parliament as a working institution, and that all procedures of Parliament are and will remain freely available to all citizens who wish to observe and visit Parliament or their MP. Secondly, subject to that primacy of free access for parliamentary purposes, the Palace of Westminster is a world-class visitor attraction that should be open to visitors, provided that the costs of providing any maintenance and of servicing those visitors are fully recovered from tourist visitors, thus ensuring that no supplementary finance is required from the taxpayer. Those are my words, but I hope that they accurately reflect the Committee’s recommendation and the Commission’s acceptance of that recommendation.
There is an interesting debate to be continued on what “recovery of costs” might mean. Obviously, there is a cash on-cost, because if a visitor walks around, a member of staff is required, and if there are no visitors, there is no staff cost. If there are more visitors, more staff are needed, so there are more direct costs. However, there are also indirect costs: wear and tear to the Palace and other costs that build over time. I argue that there should be full recovery of costs, with a surplus on the operating profit line of the resource account to put against further costs as time goes by, but that is a debate to be had in due course.
I will briefly address several of the points raised by the Chair of the Administration Committee. He highlighted all the important points, particularly the conflicting demand for access. Our business and tourist visitors are often in conflict, and we need to resolve that conflict. Again, as he said, we need to address the challenges of modern security and the way queues build up. The recommendations on that are central and have been taken on board, and I shall address them later.
The right hon. Gentleman touched a slight nerve when he referred to the debate on charging for access to what is now the Elizabeth Tower, the full consequences of which are only beginning to be understood. He stated that that debate raised awareness, which is a good point, as marketing a free service tends to increase use. The problem now is to deliver on that demand. He also made some good points about interaction with the Lords and the education service.
The hon. Member for Suffolk Coastal (Dr Coffey) raised some extremely good points, particularly on visitor access. She referred to recommendation 3 in the report:
“It is our view that members of the United Kingdom armed forces wearing uniform should…be eligible to be fast-tracked into the House”.
No one would gainsay that recommendation. Particularly in these times, but probably at all times, that recommendation should be given effect. The Commission has directed the Serjeant at Arms to consider all these matters carefully, so although I cannot give a categorical assurance on any particular point, I assure both the Chair and members of the Administration Committee that that recommendation is being seriously considered.
The hon. Lady also talked about children’s access and the fact that children from Suffolk Coastal receive no subsidy. Of course, as my constituency is on the north coast of Scotland, I am literally at the other end of the scale. Interestingly, schools in my constituency receive the maximum subsidy, but I have had only four school visits in 12 years in Parliament, because the part schools have to pay is so great. I suspect that the sum is greater than the full cost for schools from Suffolk, although I do not know that. The way we provide sufficient subsidy to ensure that kids from Kinlochbervie, Farr or Golspie—or wherever—are able to get here as easily as kids from Islington or anywhere relatively close by is an interesting conundrum.
Indeed, the hon. Member for Amber Valley (Nigel Mills) also addressed that theme in his excellent contribution, and this goes back to what the Chair of the Administration Committee mentioned and a matter that we on the Committee during the 2005 Parliament discussed at length, but never implemented. Are we going to provide facilities properly designed for education, which includes a proper reception for children and proper areas for classroom activities? I can give no commitment on behalf of the Commission, but I remain convinced that providing the capital expenditure necessary to provide a proper facility—one that would enable teaching to be done comfortably without using other rooms in the Palace, as currently happens, and that would enable children to be looked after properly and taken through the Palace to see what happens—would represent a tremendous addition to our outreach. Obviously, we are in straitened times, but if we accepted that principle—I stress again that I am speaking for myself on this point, not the Commission—it would be a tremendous step forward.
The hon. Member for Amber Valley also touched on the important question of how catering is funded. As a former caterer, that is something that has always fascinated me about this place. It all depends on how we look at it, because if we do a price comparison, many of our dining rooms are in line with commercial competition in the area. The prices are not particularly generous in many outlets, especially in banqueting and some of the dining rooms. The operating profit—what we used to call the kitchen profit, or sales minus food cost—as a percentage is absolutely bang on with commercial percentages found in the industry.
As the hon. Gentleman pointed out, the problem is that the profit generated three days a week for 30-odd weeks of the year is expected to fund the building, the catering outlets, the kitchens and the staff seven days a week for 52 weeks of the year. That equation does not work. Consequently, the final bottom line is a negative figure, which implies a subsidy, but it is not a subsidy on a daily operating basis—it is due to how we work. I have therefore always been keen to use the fallow times when staff and facilities are available in a way that would allow the subsidy and requirement for taxpayer funding to be reduced or even eliminated, and that is a critical point.
The hon. Gentleman also raised the question of the relationship between the Lords and the Commons. Again, I have slightly peculiar inside knowledge, in that I served on a Sub-Committee of the House of Lords when I was in the other place. When one sits in the other House, there is a desire not to cede its sovereignty to anyone for any purpose, which makes negotiations slightly more difficult. I commend the Chair of the Administration Committee on working hard with his opposite number, but I think that we in this House must proceed wherever we can. If we wait for their lordships, we may wait for a long time.
I want to respond to the points raised in the report, and particularly to the Commission’s agreement in principle to a package of measures that will improve the services available to visitors to Parliament and make a significant net contribution to defraying the additional costs to the public purse that arise from occupying the Palace. I stress again that, first and foremost, we are a Parliament providing free access for those attending parliamentary proceedings and meeting their Members. However, as has been pointed out, the building is available thereafter to contribute significantly to defraying costs.
In that light, the Commission has agreed in principle to open for commercial tours during the Christmas and Easter recesses, bank holidays and Sundays between April and October on the same basis that we have opened during the summer for the past decade, and more recently on Saturday. In addition, it has agreed in principle to open for an extra hour on each commercial day of opening; to increase the range and frequency of specialist tours, such as the new art and architecture tour of Portcullis House; to introduce new options for tours, including a short tour of Westminster Hall and an audio-guided tour in addition to the current tour with a guide; to relocate the St Stephen’s shop to the Westminster Hall area; to relocate the bookshop to a more suitable new retail unit at 49-50 Parliament street; to introduce an online retail facility for souvenirs; to develop the range of guidebooks offered for sale following the successful launch in July of a new official guide to the Palace; to develop filming possibilities in the Elizabeth Tower—for the purposes of clarity, I add that that will be charged for; to offer afternoon teas to those taking tours; and to offer the atrium in Portcullis House, the dining rooms in the Palace of Westminster, the Pugin Room, the Jubilee Room and the Terrace Pavilion for commercial hire—I stress on an experimental basis—for two years, on a limited number of occasions when they are not expected to be used by Members. There will be a limited trial in those facilities. Finally, the Commission has agreed to establish or work with an existing small charitable body to raise funds to support the advancement of public education and information on, and access to, the history of UK parliamentary democracy and its processes.
Detailed plans are being drawn up for implementing each of those ideas. The current public-facing services that generate income—visitor tours, catering, retail outlets and so forth—are operated at a net annual cost to the House of £900,000. That includes a small surplus on retail operations, a break-even for the bookshop and a net deficit for visitor services, which represents the cost of free access and tours sponsored by Members. Initial estimates suggest that the proposed activities, as the right hon. Member for Saffron Walden said, would generate an additional £3 million in net income by 2014-15, thus turning the current net cost into an annual net contribution of some £2 million.
The various groups of staff responsible for managing tours, visitor catering and retailing have been brought together under single management, which is expected to bring greater commercial imperative and financial clarity. That has been welcomed by the Finance and Services Committee, which I have the honour to chair and on which the Chair of the Administration Committee also sits.
The Commission is also taking action to tackle the queues for entry that can occur at peak times. We take the issue extremely seriously, and the Commission considers that ideally, apart from on days when there are mass lobbies or exceptional events, people should not have to queue. The search facilities at Cromwell Green have been reviewed by the Serjeant at Arms, and changes have been made to alleviate lengthy queues. In addition, the Serjeant is continuing to explore options for making changes to improve the flow at both the Cromwell Green and Portcullis House entrances.
However, current security requirements pose challenging resource and practical constraints on resolving the problem immediately. As a first step, officials will seek actively to manage the situation, focusing on limiting waiting times to no more than 15 minutes. That might require the House administration to set up a central booking system, as suggested by the Committee, although the Commission recognises that constraints on when activities can take place could inconvenience individual Members.
Mr John Spellar (Warley) (Lab)
Is it not a fact that, as with most security systems, minor improvements to operation can often result in considerably increased throughput? For example, when the Administration Committee went to look at the Cromwell Green entrance, the main bottleneck was at the camera taking photos for passes. It turns out that there is a second camera. Had it been manned, all the security gates could have been operated, which would have relieved the process considerably. It is not about huge capital investment, or even significant manpower investment; it is about better management of the system. It is the same as at airports. They have improved a lot, and our operation needs to as well.
John Thurso
The right hon. Gentleman is absolutely spot on. Indeed, as somebody who flies north and back again every week, I have seen the improvements as people work out how things should operate and make small suggestions about the way they are handled. To take one example, I more often than not go via Gatwick. The way Gatwick’s security has improved—from the absolutely ghastly experience of five years ago to the relatively painless experience of today—is an object lesson. There has been some careful capital expenditure on the right kit, but most of all good management. That point has been taken on board, and it is precisely what the Serjeant at Arms and other members of the management are considering. All suggestions are gratefully received. The House management wishes to get people through as quickly as is consistent with decent security.
Sir Alan Haselhurst
Will my hon. Friend refrain at this stage from ruling out the possibility of reintroducing a cabin to provide a separate entry, which was a possibility on which my hon. Friend the Member for Suffolk Coastal (Dr Coffey) poured cold water? As I understand it, the Commission has embraced the idea of mini-tours through Westminster Hall, which would be the way of handling those people, quite apart from any other easing of capacity that it would provide.
John Thurso
I can certainly confirm that nothing is ruled out. In all my dealings with the officials and management of the House, I have been deeply impressed by how much they are seeking to give effect to our wishes. Clearly, as is apparent from the debate, there are contrary views. It is the job of advisers to advise on the pros and cons; ultimately, it is for Committees and the Commission to come to a decision. However, I assure the right hon. Gentleman that that point will be given active consideration.
I hope that the Committee will welcome the positive response that I have outlined, although it clearly is not possible to resolve quickly all the issues it raised. Paragraph 77 of its report refers to the idea of an education centre, to which I referred earlier. That was endorsed by the House as long ago as June 2007, but despite a number of studies, it has proved very difficult—actually impossible, to date—to find a suitable space for such a facility within the existing secure perimeter. The Commission continues to support the need for an education centre and to look for a suitable opportunity.
Paragraph 36 of the report recommends that the Commission should organise a full debate on its savings programme. In June, the Commission agreed that it would seek a debate in October on the draft savings programme, the administration estimate and the House’s medium-term financial plan. Such a debate will provide an excellent opportunity for hon. Members to discuss the savings programme and to return to some of the issues we have been considering today. It is my hope that such a debate, which would be on an amendable motion, meaning that it could involve votes, would ensure that hon. Members made a key contribution to the strategic decisions faced by the House.
We have an exceptionally loyal and hard-working staff who are led by a management that, in all my dealings, I have found seek nothing more than to give effect to what we want. However, it is sometimes difficult to be certain of what we want, because the manner in which we communicate, via Committees, is not always the most perfect. A debate in the House will be an opportunity for all hon. Members who have a point of view to express it. It will result in a single decision, as it were, that is made by hon. Members collectively. That will enable those who look after us and the management to operate within a clear strategic framework and to be able to manage much more effectively on our behalf.
On behalf of the Commission, I am very grateful to the Chair and members of the Administration Committee for their report, which is a serious and important piece of work. I am also grateful to hon. Members who have taken part in the debate. I have tried to address the points that have been raised as best I can in the somewhat greater time than I originally imagined I would have, but if there are any further points, I am more than happy to take them up with hon. Members informally, or to respond formally to any written or oral questions.
Atos Healthcare
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mrs Riordan.
I am pleased that the Minister of State, Department for Work and Pensions (Chris Grayling) is here. I am not sure whether this will be his valedictory performance in that role, but I saw pictures of him going into Downing street earlier, and if he has been promoted to the post of Secretary of State for Justice, I would like to be the first to congratulate him. I remind him, however, that in that post he will be responsible for the tribunals service, which deals with appeals relating to the work capability assessment, so he will not completely escape responsibility for some issues that will be raised this morning.
I am conscious of the number of people present for this debate, which highlights the fact that although hon. Members may be consumed by events in and around Downing street today, many people outside are concerned about aspects of the work capability assessment and employment support allowance. I am sure that hon. Members will want to reflect those views and with that in mind, I shall endeavour to be brief. I shall take only a few interventions, to allow more Members to contribute.
There are three points on which we probably all agree: first, there are benefits in working. I have seen many of my constituents—although it is harder to do so now than it was a few years ago—return to work after long periods of unemployment. As well as any material benefits, the positive impact on their health and well-being is obvious. We should all encourage as many people as possible to work and get back into work if they have not worked for some time. Secondly, as most of us would acknowledge, helping and supporting those who have not worked for a long time can be difficult and time-consuming. It needs to be done sensitively, so that people feel helped and not as though they are being punished. Thirdly, although not everybody completely accepts this point, many feel that an assessment for those who rely on sickness and disability benefit is useful and appropriate. That was the envisaged purpose of ESA: to support those who can work into work, as well as those who sadly will never be able to work again.
Six months ago, I was fortunate enough to secure a debate on this issue in this Chamber. At that time, the Minister confidently predicted that the performance and situation would massively improve and some changes that had been made had not yet fed through. Six months later, I suggest to the Minister that the number of people present today indicates that very real concerns and problems remain, many of which are sure to be reflected during the debate.
In our previous debate, I focused on the experiences of constituents who had undergone the assessment. I told the story of a constituent trapped in the system who went through an assessment, a successful appeal, a reassessment, followed by another successful appeal and then another reassessment. For too many people, that remains the experience across the country. The Minister and whoever his successor will be need to look carefully at that issue and address it. I have spoken with many constituents who would love to go out to work, but it is not possible to do so because they suffer from a disability or a chronic condition, and I am sure that many Members in the Chamber will want to speak up for such people.
Jack Dromey (Birmingham, Erdington) (Lab)
I congratulate my hon. Friend on securing this debate on a vital public concern. He has spoken of his own constituents. In my constituency, Paul Turner, a manager and proud family man, contracted a serious heart disease. He was off work and although desperate to work, could not do so. However, he was told that he was fit for work and was denied benefit. As his wife says, he went into serious decline and died only weeks later. In the work capability assessment, his heart was not tested. Does that not demonstrate how fundamentally flawed the assessment process and its conduct by Atos are? Does my hon. Friend not agree that it is absolutely wrong in a case such as that for the Minister to refuse to refer it to the serious case review, so that profound lessons can be learned? Never again should anyone be treated in the way that Mr Turner was.
Tom Greatrex
My hon. Friend makes a powerful point. A number of cases could be cited that indicate the lack of comprehensiveness in the assessment process and the failure sometimes to incorporate other evidence to ensure that not as many people are wrongly assessed.
I want to concentrate on some contractual issues this morning, and I am sure that others, like my hon. Friend, will make comments about individual cases to illustrate those points. The work capability assessment must be tailored in the interests of both the individual and the taxpayer. Unfortunately, both are getting a raw deal from the system. It is true that the work capability assessment was introduced under the previous Government, which is a point that Government Members frequently make, as I am sure that they will today. It is also the case, however, that in late 2010 the contract with Atos Healthcare was amended, extending it to 2015, beyond its original conclusion date of 2012. The work capability assessment was rolled out to millions of people on incapacity benefit under this Government, despite pilot projects in Aberdeen and Burnley highlighting serious concerns. The Minister said during our previous debate—I paraphrase him slightly—that, in his judgment, the Government should get on with that process and try to work on the basis of the expert reviews as they were going on, rather than fixing it in the first place.
Kevin Brennan (Cardiff West) (Lab)
My hon. Friend is right to point out that the work capability assessment has been around for some time. For many years, I have been helping my constituent, Mr Robert Shafer, who was the victim of a poor assessment. Is my hon. Friend as concerned as I am that the chief medical officer of Atos is now Professor Michael O’Donnell? He was previously employed as chief medical officer by the American insurance company, Unum, which was described by the insurance commissioner for California, John Garamendi, as an “outlaw company” that has operated in an unlawful fashion for many years, running claims denial factories? Is that the kind of person that the Government should allow to be in charge of a work capability assessment system?
Tom Greatrex
My hon. Friend makes an important point about the organisation of the company contracted to undertake that work on behalf of the Department for Work and Pensions. I shall go on to make points relating to other legitimate concerns about Atos Healthcare that need to be addressed. In many respects, given that the cost of appeals has more than doubled in two years, from £25 million in 2009-10 to £60 million in 2011-12, the performance by Atos Healthcare has, in many ways, been extraordinarily poor.
Wayne David (Caerphilly) (Lab)
On appeals, does the fact that nearly 40% of the people who are initially unsuccessful are then successful on appeal not demonstrate a fundamental flaw in the work capability assessment process?
Tom Greatrex
The level of appeals and successful appeals indicates that, although no process is 100% accurate all the time, many decisions are wrong and need to be corrected through the tribunals service. No one should forget, however, that that process can take six to nine months because of the backlog of appeals. During that time, people suffer from severe anxiety and concern about their fate, so my hon. Friend makes an important point.
Joan Walley (Stoke-on-Trent North) (Lab)
This issue affects us all, in all our constituencies. The whole test is deeply flawed. Does my hon. Friend agree that, in the short term, we can advise our constituents that when they are undergoing the test, they can request that it be videoed, which would at least assist with further appeals? It has just been pointed out how much the appeals cost the taxpayer, so the Government are paying twice over for what is essentially a flawed capacity assessment.
Tom Greatrex
I thank my hon. Friend for her intervention. I am not unaware of what Atos says to people who seek to video their assessment, because cases have been highlighted to me in which people have asked for their assessments to be recorded. In the previous debate, the Minister said that if anyone wanted to have their assessment recorded, they could have it recorded, but that has not been the case in many instances and people are refused permission to record the assessment themselves. I would be interested to hear the Minister’s response to that point.
Richard Burden (Birmingham, Northfield) (Lab)
I am grateful to my hon. Friend for giving way again; he is very generous. He has hit on an important point about the interface between the appeal problems and Atos’s work. Is it not true that there is a weird revolving door now? People get an assessment, question it and wait ages for the appeal. They may or may not win the appeal, but by the time the appeal comes up, they have had another assessment and therefore they go through a revolving door of losing benefits. Something is fundamentally wrong and unfair.
Tom Greatrex
My hon. Friend touches on a very important point. When I raised it with the Minister at recent DWP questions, he indicated that, finally, some of the information coming back from the tribunals service would go to DWP decision makers, so that they were better informed. I will make this point now, so that the Minister can, I hope, respond to it. That started to happen in July. I want to raise the issue of the status of those reports and what impact they will have on people being called for further assessments. In particular, some tribunals now have a section at the end of that information that suggests that that particular applicant should not be reassessed within 12 months or 24 months. Is that something that the DWP is taking into account and appreciating before it calls people back? I ask that because my hon. Friend the Member for Birmingham, Northfield (Richard Burden) is exactly right: there are many cases of people who have been caught in this process, which is no good for their health and no good for taxpayers, because we end up paying again and again over time.
Tom Greatrex
I will take one more intervention. I apologise to everyone else, but I want to leave time for other hon. Members to make contributions. I give way to my hon. Friend the Member for Airdrie and Shotts (Pamela Nash).
Pamela Nash (Airdrie and Shotts) (Lab)
On the point about recording assessments, a constituent of mine was told recently that they could record the assessment, but only if they paid for a private, independent company to come in and do it. Obviously, someone who is living on benefits cannot afford that. I wrote to the Minister at the time about the issue. I wonder whether he can deal with the recording of assessments in his closing remarks.
Tom Greatrex
I thank my hon. Friend for her intervention. She has made a point to which I hope the Minister will be able to respond.
I will attempt to move on. Back in February, I wrote to the National Audit Office to outline concerns about the contract between Atos Healthcare and the DWP. The correspondence centred on two issues: first, a lack of efficiency in the use of public funds, to which I have referred, and, secondly, a lack of accountability inherent in the disbursement of those public funds. As the recent House of Commons Library note and many of the figures that I have received as answers to parliamentary questions over the past 18 months or so have confirmed, and as my hon. Friend the Member for Caerphilly (Wayne David) reflected, 41% of those found fit for work appeal the decision and 38% have their appeal upheld. For those who seek the advice and support of professional advocacy groups such as Citizens Advice, the appeal success rate is closer to 70%. Just last week, Kent’s largest citizens advice bureau indicated an appeal success rate of 95%.
The impact of what is happening is twofold. First, too many sick and disabled people are being found fit for work when they are not. They become entangled in a lengthy appeal process that can occupy up to nine months of their time. In many cases, even when the appeal is successful, the individual is placed in the work-related activity group and then they have to begin the whole process anew.
Tom Greatrex
I will not, because I need to make progress. I apologise to my hon. Friend.
The second impact of the high appeal success rate is cost. The cost to the public purse from appeals relating to the WCA was £60 million in 2011-12. That figure has more than doubled since 2009-10. It is almost 50% of the total yearly value of the Government’s contract with Atos Healthcare to carry out the assessments in the first place. In effect, taxpayers are paying for the process not to work, and then to correct it. Given the unprecedented pressures on the public purse, it beggars belief that the Government are apparently content to sit back and do very little to rectify that situation.
In oral evidence to the Work and Pensions Committee in June 2011, the Minister claimed that if the migration of those on incapacity benefit to ESA was successful, it would save money. He said that the aim is not a
“savings measure—it is not a financially based exercise, although clearly if we succeed it will save money”.
The Minister appeared to accept that an indicator of success was saving money, so does he accept that the significant increase in costs associated with the number of decisions being appealed—and being successfully appealed—shows that, on that measure, the Government have failed?
One measure that I and many others have been questioning is the imposition of financial penalties on Atos Healthcare to compensate for poor performance. In February, in response to my written question on whether the Government had considered imposing such sanctions, the Minister appeared to absolve Atos of the blame for the number of decisions overturned on appeal by saying that:
“it would not be appropriate to impose financial penalties on Atos to reflect the number of work capability assessments which are overturned on appeal.”—[Official Report, 22 February 2012; Vol. 540, c. 852W.]
I tried again in July by asking for a note of when penalties had been imposed and what their total value was, but that time, rather than absolving Atos of blame, he decided to protect the company’s commercial interests, replying with the frequent defence of “commercial sensitivity” as the reason for withholding that information. I find it difficult to understand how commercial sensitivity comes into play when we are talking about a single company that is paid from the public purse to carry out an exclusively public function on behalf of a Department. Transparency would help to ensure that there could be confidence in the system and to highlight where performance was not being properly managed. It is important that the Minister seeks to address that.
It was not until the NAO responded to me last month that some light was shed on the issue:
“We do not consider that the current contractual targets are sufficiently challenging, and in our view this allows the contractor to deliver a significant number of assessments before financial penalties become due.”
It continued:
“Our review also concluded that the Department has not sought adequate financial redress for contractor underperformance.”
One of the most concerning revelations from the NAO was that in only 10% of the cases in which financial penalties could have been imposed did the Government do so. That is astonishing. Given that the Government and the Minister quite frequently comment on the importance of value for money for the taxpayer—in some respects, I agree with that—it beggars belief that when there are opportunities to put that into practice, the Government have done so in only one in 10 cases.
I quote:
“In these times of tight budgets, we need to make sure the money we do spend is better spent. If we don’t we are failing disabled people and their families.”
Those were the words of the Prime Minister in 2009 at a conference on autism. In that same speech, the then Leader of the Opposition cited a NAO report that examined value for taxpayer money in relation to autism. I am sure that, even given his elevation today, the irony is not lost on the Minister.
There are many questions that the Minister must answer to account for the failure properly to manage the contract with Atos Healthcare. Why did he impose financial penalties on only 10% of the occasions on which they could have been triggered? What was the value of compensation clawed back from Atos Healthcare to reflect that poor performance, and what was that as a percentage of the cost to the public purse for the original contract and appeals? Does he agree with the NAO that targets that trigger financial penalties are not sufficiently challenging? What are the key performance indicators that the NAO described as insufficiently challenging? That is a particularly important issue.
On a number of occasions, I have attempted to gain clarity on what is expected of Atos in relation to customer service, the number of assessments conducted, the number of people found fit for work, targets, statistical norms and many other issues. The Minister has refused to be fully transparent, releasing a very limited excerpt from the medical services agreement with Atos that relates only to waiting times. As I said, maximum transparency is important to enable people here to hold the Government properly to account, and to hold Atos Healthcare, through the Department for Work and Pensions, properly to account for the work that it is undertaking in a very important area.
The NAO was also scathing about the Government’s failure properly to monitor the performance of Atos. According to the NAO, there is
“Limited routine validation of information provided by Atos Healthcare”.
It went on to recommend that
“the Department develop processes to validate key performance information supplied by Atos Healthcare.”
Back in February, in the previous debate on the issue, the Minister stated, with a certain degree of confidence:
“On capacity issues, as we stand here today, the incapacity benefit reassessment is on time. New claims for ESA have fallen a bit behind, mostly because of the introduction of the personalised statement…We discovered in the first few weeks that it took health care professionals…longer to complete the statement than expected, so the number of completed assessments dropped. That has changed. They have caught up again, and we are chasing through to clear the backlog, as we are doing with the appeals backlog”.—[Official Report, 1 February 2012; Vol. 539, c. 292WH.]
Unfortunately, the evidence does not bear out that assessment.
The target waiting time from when the ESA50 form is issued to the claimant to when Atos Healthcare completes the work capability assessment and hands the case back to the DWP is 35 working days—seven weeks. Between September 2009 and August 2010, the target was met with a clearance rate of 33 days, yet in less than two years, not only has the target not been met by an astonishing margin, but the time sick and disabled people have to wait for their assessment has risen by 85% to 61 working days, or more than 12 full weeks.
More than 20,000 people are waiting more than 13 weeks for a work capability assessment. The reason the Minister gave was:
“Atos Healthcare’s ability to deliver a service within the AACT was also impacted by the service volumes for this period which were significantly above departmental forecasts; in addition Atos had recruitment demands/challenges. These issues…resulted in an increase in the AACT.”—[Official Report, 9 July 2012; Vol. 548, c. 51W.]
Atos Healthcare receives more than £110 million a year to deliver a contract, but is unable to meet its recruitment needs to deliver it properly. That, at best, is an example of the underperformance and the level of failure due to which the Government should ensure that financial penalties are brought against Atos Healthcare. Such contractual failure feeds directly into the experiences that I am sure we will hear about in the remainder of the debate. Many people across the country have found themselves waiting an excessive time for their assessment. They are under pressure and feel hounded, and they may well wait a significant period for the appeal to follow. A degree of the chaos in the system is caused by the Government’s decisions and the failure to hold Atos properly to account.
This is not the first time that recruitment challenges at Atos have been highlighted as reason for failure. In December 2011, the Minister advised that a key Harrington recommendation would not be implemented beyond the pilot stage due to capacity pressures at Atos. In less than a year, the Government have twice cited the failure of Atos to recruit enough staff as the reason why those undergoing the WCA are being short changed, which gives rise to a question: if the Government are content to blame Atos, why has the Minister spectacularly failed to do anything about it? Why, in his answer to written questions, does he lambast Atos when waiting times increase, yet sit on his hands when it comes to making the company pay financially for its underperformance?
In 2010, the average WCA customer journey was 36 working days. That rose to 44 working days in the first half of 2011, and increased still further to 53 working days in the second half of 2011. Unfortunately, 2012 brought more misery for ESA claimants, as between January and May, the average customer journey increased to 64 working days, or just under 13 weeks. The Minister inherited 36 working days and transformed it into 64—an increase of 78%. It might seem that I am talking about the dry detail of contractual issues, but we see the defects at the heart of the process—the failure of the management of the DWP and the failure of delivery at Atos—reflected in the experiences of many people we represent.
I want to say a few words about the award of the £400 million contract for the personal independence payment in many parts of the UK to Atos Healthcare. A further criticism in the NAO review, which interestingly enough was dated the same day as the announcement of the PIP framework agreement, was about medical services contracting. The NAO stated specifically in relation to the PIP procurement process:
“Our review of existing arrangements concluded that the Department needed to make changes to secure effective leverage over future medical services contracts...we have recommended that the Department focus on reducing the barriers for new suppliers to making a sustainable entry to the medical services market, in particular addressing the current risk that a single incumbent supplier has significant cost advantage which makes delivery of a level playing field in the market more challenging”.
The NAO went on to lament the DWP’s
“dependence on a sole national supplier”
that has
“limited opportunities for routine assessment of value for money, for exercising contractual leverage and for wider market development.”
Like many Members in the Chamber who represent constituencies within the areas for which Atos Healthcare will undertake the PIP assessment process, I received a letter from Atos confirming that it had been successful in securing the contract. It included the chilling phrase that it had won the contract on the basis of its record delivering assessments for the Government over a period of years. This is a serious point, because as the PIP process is established, it is vital that some of the problems encountered in the WCA are not simply repeated. There is concern that there is an increasing risk that that will be exactly the case, given the chosen contractor.
Contractual arrangements, performance measures, penalty clauses, and monitoring and delivery failures are technical, dry and dull matters, especially when contrasted with the sometimes heartbreaking and tragic cases that I have heard about, not only from my constituents, but from many of those who have contacted me prior to the debate. Many of those experiences are due to the flawed delivery of the WCA and the record of Atos Healthcare.
Whoever is the responsible DWP Minister tomorrow afternoon, we need a process that works in the interests of taxpayers, and of individual claimants and applicants. We need a process that is comprehensive enough to encompass complex conditions and that recognises that it is a waste of time and money to keep reassessing people with progressive and incurable conditions, while also recognising the fluctuating nature of many other conditions—that people have good days and bad days. We need a process that appreciates the very difficult challenges of assessing mental health needs and that takes account of expert medical evidence much more fully than the current process, particularly in some of the cases we have heard about. We need a process that does not make blanket assumptions about the time it takes to recover from very serious illnesses, such as cancer, nor imposes blanket conditions as a result. We need a process that helps people who can work and does not hound those who cannot.
Mrs Linda Riordan (in the Chair)
Order. With the permission of the Chairman of Ways and Means, and due to the number of Members wishing to speak, I will limit speeches to three minutes. When you hear the bell, you have one minute left. I remind Members that interventions should be short and remind those in the Public Gallery that they should listen in silence and not interrupt the debate. I call Duncan Hames.
Duncan Hames (Chippenham) (LD)
Given the number of Members wishing to speak, I am happy to forego the opportunity. Thank you for calling me, Mrs Riordan, but I would prefer to listen to other speakers who are clearly keen to take part in the debate.
Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)
I will take the opportunity to speak, but for the reasons the hon. Member for Chippenham (Duncan Hames) gave—the number of Members who want to speak—I shall be brief.
I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing the debate, but more importantly on the work that he has done over almost a year in highlighting the problems of Atos and the work capability assessment. Like many Members, I came to the debate today with a dossier of cases from my constituency of people who had suffered in the process, and not only that which involves Atos. Let us be clear: not only Atos is at issue, but how the system operates, how it is being put into effect and how Atos is asked to carry out its work. There are certainly major deficiencies in the organisation, but it is not only Atos with which we need to be concerned.
Given the time, I will make just a few points. Many applicants find the experience of going through the WCA process terrifying. There is plenty of evidence, especially in the cases of those with mental health issues, that the process does not take account of the particular circumstances of those who suffer from conditions that may vary from day to day, as my hon. Friend made clear. Inevitably, any process, under any system, will lead to stress and tension for many people, but what makes it worse is that the process is felt by many applicants to take away from their dignity as human beings. It does not lead to proper consideration of their personal circumstances and they believe, notwithstanding what the Government and the contracts say, that it is a method of keeping down the cost of benefits. I know that that is not in the policy or the contracts in any sense, but in a climate where there is a feeling that the Government are trying to drive down costs at any expense, it is inevitable that many of those who apply for benefit will feel that way. Those subjective feelings are borne out by the high rate of successful appeals.
The high rate of successful appeals, which hon. Members have pointed out, leads one to conclude that there must be people who do not appeal or even apply for benefit who would have been successful or been entitled had they done so. It is essential that the process is right first time. That is partly the responsibility of Atos; it is also the responsibility of Government. What must be ensured is that all available evidence is used at the earliest possible stage in the process. We are all familiar with cases in which the medical evidence from GPs and consultants is overwhelming, yet the applications are unsuccessful. It is only at appeal that such people receive the right decision. It is also important to reduce unnecessary reassessments, as there have been cases where it is overwhelmingly obvious that a reassessment should not be carried out. I would like to know what the Minister is doing about that.
I make this final comment to the Minister. He may be leaving his post today, but I seriously hope that in his new role he will ensure that the backlog of appeals is dealt with speedily. That is important for individual applicants and for the system. Until that backlog is dealt with we will not get out of this vicious circle in which new applications are put in at the end of the appeal process and the process starts again. That should be a priority for the Minister to address in his new role.
Katy Clark (North Ayrshire and Arran) (Lab)
I am delighted to have the opportunity to contribute to the debate, because many constituents have contacted me about this issue over the past few weeks. For a number of years many constituents have been in touch with my office with concerns about Atos. The publicity over recent weeks has meant that many people not directly connected with the process are now aware of the problems. I ask that the Minister listen not just to what is said today, but to the concerns raised over a long period.
I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing the debate and on all his work on the issue. It is not just MPs who are expressing concern. All those involved, whether in representing claimants—organisations such as Mind—or the professionals involved in the process, such as the PCS trade union or the British Medical Association, are expressing concerns and taking the view that the process is fundamentally flawed. I also ask the Minister to recognise the anger Atos caused by sponsoring the Paralympics. Many feel that is an insult to the people going through this process.
A year or more ago, many of the constituents contacting my constituency office were doing so about new employment and support allowance claims. The problems seemed to come largely from the Atos medical assessments. As has been said, constituents who get in touch with their MPs are almost invariably successful, either at the initial reconsideration or the appeal stage. When constituents approach MPs with a credible claim, invariably that person is successful at appeal. However, there has been a change and the constituents now getting in touch are mostly those transferring from incapacity benefit and being put on the work-related activity scheme. That basically means they get only contributions-based benefit for one year rather than the permanent help they would get if they were put in the support group.
That is quite different from the previous situation. Apart from the financial implications of being means-tested after a year, it involves reassessments, attending interviews and the requirement to look for a job. Most of us are aware of many constituents in extremely difficult medical situations who are being caused huge stress. I ask the Minister to listen to what is said today and make serious changes to the current position.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Member for Rutherglen and Hamilton West (Tom Greatrex) on bringing this matter to the House. The issue affects us all as MPs. With benefits changing now and in the future, the impact on our constituents is greater than ever.
I want to focus on one thing, as I am conscious of the time. I will give an example of how the Atos system does not work when it comes to basic knowledge of the interaction involving the applicant who is appealing against the decision to refuse incapacity benefit or ESA to those who are wheelchair-bound and have severe mobility problems. They are asked to attend the appeal on the third floor of a building in the centre of town. The first question the receptionist will ask is, “Can you leave this building on your own if there is a fire?” That is a very important question, but the fact is they could not do so, so they have been asked to attend an appeal tribunal that cannot take place. They go home and join the back of the queue once again, having to wait perhaps another six or eight months. They are then asked to attend an appeal that takes place about 45 to 60 minutes away by car, going through traffic, pain and other problems to get where they want to be.
There are clear problems in the basic knowledge of the scheme. Whenever an elected representative makes a complaint about that to the relevant bodies, whether Atos or the Minister responsible in Northern Ireland, they take it on board and seem to respond. That is great, because we think we have won the battle for the constituent and the system in future. However, it does not work that way. Guess what happens? Next time, someone else in a wheelchair with severe mobility difficulties encounters the same problem. I want to illustrate that with an example, because we have a system that has failed my constituents again and again.
There has to be a grassroots change in how the system works. That is what the hon. Member for Rutherglen and Hamilton West is saying and why we are all here today. There are many people who fall into the category. It is assumed that if someone is not able to walk they can sit and do a job. That is unfair for many people because the problems they have with their back or the difficulties severe mobility they have mean they cannot stand or sit on a regular basis. I am very conscious of these issues and want to raise them. I hope the Minister will give a positive response. We need change or accountability—either one or the other, or indeed both.
Dame Anne Begg (Aberdeen South) (Lab)
Congratulations to my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing this important debate. This is my first time speaking after my extended absence and therefore a good subject.
The Minister of State, Department for Work and Pensions (Chris Grayling)
On behalf of everybody in the room and in the House, I welcome the hon. Lady back to the House. We are delighted to see her in such good shape. We were sad to hear of the difficulties in the long period of recovery she has had to go through. She is very welcome.
Dame Anne Begg
I thank the Minister for being gracious. He may not be quite so gracious by the time he has heard what I have to say. I do not think that the Government have grasped how disastrous the ESA assessment system is. It is not something that can be fixed by a few tweaks here and there; we tried that with the Harrington review. What we have heard today in the Chamber—and in the “Dispatches” and “Panorama” programmes filmed in June this year—suggests that not much has changed. The people complaining are not just the usual suspects, not just the radical crips, the workshy or those who want money without being assessed. They are ordinary people, most of whom worked hard all their lives until the sky fell in and they lost their job because of an illness or an acquired disability.
It is not enough for Government to say that the genuine claimant has nothing to fear. In too many cases, genuine claimants are not scoring any points in their initial assessment. There is something fundamentally wrong with the system and the contract that Atos is delivering. When the British Medical Association votes at its conference to say that the work capability assessment is not fit for purpose there is something wrong with the system. When GPs are reporting an increased workload, not just as a result of providing reports but as a result of treating patients whose condition has worsened as a result of their WCA experience, there is something wrong with the system.
When my constituent, who has lost his job because he has motor neurone disease, scores zero on his WCA and is found fully fit for work, there is something wrong with the system. When that same constituent appears in front of a tribunal and in less than five minutes is awarded 15 points, there is something wrong with the system. When people with rapidly progressive illnesses are not automatically put in the support group, there is something wrong with the system. When some people would rather do without the money to which they are absolutely entitled rather than submit to the stress of a WCA, there is something wrong with the system. When someone with a severe illness has to fight for a year through an appeal to get the correct benefit, only to be called in almost immediately for another assessment, there is something wrong with the system. When the recall and assessment happen the following year, and the following year, there is something wrong with the system. When people feel so persecuted, there is something wrong with the system. To top it all, they lose their contributory ESA after only a year if they are in the WRAG group.
When up to 40% of appeals are successful and there is no penalty for the company carrying out the assessments, there is something wrong with the contract. When so many appeals result in an award of ESA support group status when the original assessment was no points, there is something wrong with the contract. When there is no penalty for a high percentage of wrong decisions, there is something wrong with the contract. When there is no incentive for assessors to get the assessment correct first time, there is something wrong with the contract.
It is time for the Government to act, because there is something fundamentally wrong with the whole system.
Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)
I am pleased to be called in this debate. I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing the debate and on giving a superb speech. I wish to add my voice to those concerned about the operation of the WCA by Atos, and to highlight specific concerns in relation to people with autism.
I accept that we have a problem in the UK with the number of people who are not in the labour market owing to illness or disability. I asked the Library for a comparative analysis across the EU. Although it is hard to make such an analysis given the differences in scope, eligibility and recording of information, the European labour force survey clearly shows that the UK has a much higher proportion of the population aged 20 to 64 outside the work force owing to illness or disability. It is 6.1% in the UK, against an average of 4.3% in the rest of the EU. I think we know why that is. From the Thatcher Government onwards, people were put on the incapacity benefit rolls to hide the true scale of unemployment. There are people who were dumped there in the 1980s who have been there ever since. That is why I do not have a problem with the principle of a medical assessment; otherwise the Government can too easily push people into inappropriate benefits to massage the unemployment figures. Equally, I do not have a problem with three classifications: fit for work, unfit for work; and the possibility of work, but not in the short term, because someone has been out of the labour market for so long.
My concerns and objections relate to the way the Government are allowing Atos to conduct the test. Like other colleagues, my observations are heavily based on the experiences of constituents who have come to see me. It is not sensible, prudent or fair to have a test in which 40% of appeals against decisions are successful. That is a waste of money and it causes unnecessary distress. The Government need to hold Atos to account for an assessment that is clearly not working as it should. Atos is not coping with the complexity of the cases that are seen, and it is clearly struggling to deal with people with complex conditions, particularly those with less visible symptoms. Some specific problems are particularly evident: the Royal National Institute of Blind People has reported that the descriptors against which blind and partially sighted people can score points are primarily those based on navigation and communication, with no account taken of other barriers that blind and partially sighted people might face in obtaining work.
I am one of the vice-chairs of the all-party group on autism, and I remind the House of my declaration of interest in relation to my son. For people with autism, such face-to-face assessment can often be extremely problematic. People with autism face problems with communication that other people would not see. They may misunderstand questions that are asked, find it hard to answer questions, and fail to pick up on inference and assumption. For example, when asked, “Can you travel to work on a bus?”, they may say yes, but not explain that they can use only one bus route, planned with the help of a support worker, provided that the bus is not late or a different colour from usual, or that no other factors have arisen.
In addition, the testing of some people is too frequent. I have a constituent with a degenerative disease who passed one assessment, but failed another within a year. As his condition was degenerative, it was surely medically impossible that he had got better. It does not make sense. At the extreme end, I have heard accounts of people in the support group being tested again after as little as three months. The worry that that causes is exacerbated by the freak results that an assessment can produce. I have another constituent who was deemed fit for work despite having a broken back.
The Government need to listen to the feedback that is coming in across the country about the very real problems in the operation of the WCA. Crucially, they must begin to hold to account private companies with important Government contracts when they do not deliver for the taxpayer. The quality of life of thousands of people depends on getting this right, and that will soon be even more the case given that Atos has won the contract for the personal independence payment assessment. Let us not get into the usual party political rhetoric and stereotypes that tend to mark welfare debates. Let us focus on meaningful changes that will improve many people’s lives.
Nick de Bois (Enfield North) (Con)
I have a small contribution to make to the debate. All MPs watch closely and listen carefully to charities, as I do in my constituency. I meet charities regularly and I am always seeking to handle cases in which it appears that odd decisions have been made, and with which I am uncomfortable. I will always pursue such cases, like any good MP, if someone feels that the system is not working correctly.
I rise to speak today to make a point. In all my time and in all my dealings I have never lost sight of what is fundamentally driving the WCA. We are asking what people can do and encouraging and helping people who have been ignored by the system. We seek to find what they can do and not what they cannot do. Many people in this Chamber will agree with that premise.
However, I will turn specifically to the statistics. If we look only at the statistics, it is easy to get a distorted picture. It is recorded that 55% of new claimants have been found fit for work; that is a good thing. I accept that appeal levels appear somewhat high. When we hear that 40% of those who are found fit for work appeal, we have to remember that 38% of them have a decision overturned. To put that in perspective, of all the claimants, overall we are talking about 15% fit-for -work decisions being overturned. I am not saying that that is satisfactory or that that is necessarity a good thing. However, I am determined to make a point.
Anne Marie Morris (Newton Abbot) (Con)
Although it is a good idea to help people who can work, we need to look at providing a more flexible work opportunity. There are permanent job opportunities, but there is nothing flexible such as working from home for those who have mental health problems, which would help to achieve what the Government want. To make the system work better and to save taxpayers’ money, the people who will never be able to work again—people who have very serious problems with blindness or mental health problems—ought to be in an exclusion category so that they do not get reviewed.
Nick de Bois
My hon. Friend is absolutely right. My point—my argument—is that if we stick to the headline statistics, we start to get into a debate that dwells on statistics. If we are going to do that, I am keen that we dig down and analyse them correctly before we make sweeping judgments.
I am pleased that the Government, along with the specialists, the occupational therapists and Professor Harrington, have not sat back since coming to power, and have not failed to review the process. They have reviewed it twice, and Professor Harrington has been asked to review it a third time. That is right, but it should not detract from the overriding principle that the hon. Member for Rutherglen and Hamilton West (Tom Greatrex) highlighted. It is right that we should encourage and help people back to work where possible. After all, they were not assessed for a long time and it would be wrong to ignore them, because many have returned to work and will continue to do so. [Interruption.]
Mrs Linda Riordan (in the Chair)
Order. May I remind Members and those in the Gallery that other Members must be heard?
Alison Seabeck (Plymouth, Moor View) (Lab)
I thank my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) for securing this debate, which has not come a moment too soon for many of my constituents. The principle that people should be supported into employment when they can work is the right principle. The problem is that the system is not achieving that. It is causing untold grief and serious concern to many vulnerable people. There are several issues. Will the Minister explain why there is still confusion between ESA and JSA? Cases have been brought to my attention of constituents being passed back and forth, with both the relevant Departments feeling that the benefit is not the right one. A constituent of mine was claiming JSA and was notified by her hospital that she had to have an operation on her wrist. She was told by the jobcentre adviser to claim ESA instead of JSA, because no one would employ her for five or six weeks. She was then refused ESA, because she scored no points, and was left in limbo, with no money. That is not acceptable.
That incident occurred over a relatively short period, but some of my constituents have had to wait up to 18 months for a tribunal decision. When seeking updates on progress one was told that no update was available, because there was no one in the area to hear her case. Consequently, other benefits to which people are entitled are not given to them. A constituent applied for cold weather payments and was told that because her position had not been resolved she could not claim them. She might have frozen to death in the meantime, during the bad weather, while a decision was reached.
There are many incidents of poor claim handling by Atos. I am sure that every hon. Member in the Chamber has dealt with tens of them. A constituent recently came off contribution-based ESA. He was assessed by an Atos nurse who advised him that he needed a wheelchair but at the same time assessed him with no points. Another constituent had a major cancer operation. The GP’s report said that she was
“currently in wheelchair, not fit for travel”,
but it took three goes to get a home visit for her. Eventually, she was given a wheelchair, received disability living allowance and had home adaptations. Then Atos said it wanted to see her, and insisted she should come, with the threat that if she did not her money would be stopped. She had to cancel a hospital appointment to do so. That is not acceptable.
I ask the Minister whether independent assessments can be considered at the front of the process, not the back. That would, I am sure, save untold numbers of appeals in due course, as well as saving my constituents untold misery. They feel—particularly those with multiple issues, including mental health issues—that the medical advisers who are asked to assess them do not fully understand their cases. The Government should be ashamed of the slump in Atos’s performance that my hon. Friend the Member for Rutherglen and Hamilton West has highlighted. It has had an unacceptable impact on disabled people, particularly in my constituency.
Hywel Williams (Arfon) (PC)
I, too, congratulate the hon. Member for Rutherglen and Hamilton West (Tom Greatrex) on securing the debate, because there can hardly be an MP who has not had a constituency case involving Atos and the work capability assessment. The Members present in the Chamber are only a small sample of the people who have had to work with that system.
From my casework I find that the faults in the system fall into clear categories. First, as to the form of the assessment, there is insufficient information. That is a particular problem for decision makers, who are trying to take reasonable decisions without enough information. Information is also lost or disregarded. There are persistent complaints that Atos is working to targets to fail people, and about continual reassessments. Missed appointments are another issue. A couple of weeks ago, a constituent of mine stayed in all day, and the doctor did not turn up. I turned up, by the way, and wasted a couple of hours of my time. My constituent will not complain, because he is scared to do so. He does not want the attentions of the Atos doctor again, thank you very much.
As to the content of assessments, to give a snapshot of something we have already heard about, it is unsubtle—it consists of ticking boxes, and it does not work well with intermittent conditions. There are questions about the competence of Atos staff to assess mental illness, for example. In another constituency case, apparently, the doctor involved was not allowed by the medical authorities to work with patients or perform any form of medical intervention, apart from undertaking Atos assessments.
There has, I concede, been some improvement since the Harrington review. However, it is interesting to consider the nature of the mistakes that the system produces. For example, I was told by my local citizens advice bureau that since April it has launched 62 appeals, of which it has won three and lost two; the rest are still pending. That is a common experience for MPs. Incidentally, as a Welsh MP, I have been told that appeals in Welsh are taking longer, and I would like some response on that issue.
Atos should be put into special measures. It should report frequently—monthly, perhaps—on the number and percentage of cases that lead to appeal and to a change in the decision, and also on the number and percentage of revolving-door appeals. Most importantly for the public debate, we should have some qualitative information about people’s experiences. I think that that would influence the public debate on disability and benefits in a positive way, given the current climate fostered by some newspapers and commentators, and by Government policy.
John McDonnell (Hayes and Harlington) (Lab)
Yesterday, I met constituents who have gone through the system. They call themselves victims of Atos, and I promised them that I would briefly set out the experience that they described. The assessment was exactly as others have said. Applicants are often met by an assessor with no expertise or specialist knowledge of their condition; it is a tick-box exercise—my constituents completely agree with the BMA about that. Despite the Harrington recommendations for improvements, the test bears no relationship to the real-world challenges that people with disabilities face. There is no recognition of fluctuating conditions, as has been said—particularly in connection with mental health. The procedure largely ignores the assessments and advice of applicants’ own GPs.
[Mr Philip Hollobone in the Chair]
In addition, the process even ignores previous Atos assessments. A constituent of mine was employed by Royal Mail, which used Atos to assess capability for work, and was assessed as not being capable. My constituent then retired and applied for benefits, and following another Atos assessment was found capable of being re-employed in the same type of work.
The fly-on-the-wall exposés by television programmes have exposed the pressure exerted on assessors to fail people. If people are assessed as capable of working correctly, they are then regularly harassed with challenges that they are unable to cope with, and they lose their benefit as a result. If they succeed at the assessments, they are harassed with reassessment after reassessment. We have heard the appeal statistics, but most of my constituents must wait six months or longer for an appeal. Those who have support—and I do support them; I represent people now at appeals—win. However, there is a lack of support, because of cuts in local government support for advice centres, and Government cuts so many people are not supported.
The result? To be frank, it is financial hardship. People are living in poverty because they lose their benefits. In addition, there is emotional stress, breakdowns, and, as Mind points out in its briefing, self-harm and suicide. Why do the Government defend the company? Why have they awarded it the personal independence payments process?
I share the disgust of many disability groups about Atos being allowed to sponsor the Olympics. That is a disgrace. I support Disabled People Against Cuts, and the Black Triangle campaign, which organised the protest against Atos sponsorship. I am calling for an inquiry into violence against people with disabilities who protested last week at the Department for Work and Pensions, and elsewhere. A few months ago, I tabled an early-day motion calling for Atos’s contract to be withdrawn, and for the establishment of a new system; 103 hon. Members have signed that early-day motion. Surely after that, and following debate after debate and the protests on the streets, the Government must reassess the role of Atos, and establish a new system based, as my hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds) suggested, on reputable, fair and equitable criteria.
Mr Philip Hollobone (in the Chair)
Order. Ladies and gentlemen, please take your seats. To be frank, there are more people standing than we shall have time to hear from in the debate. The Opposition spokesman has said he requires eight minutes. I suspect that, because of interventions and so on, Members will want the Minister to have slightly longer. I propose that we begin the winding-up speeches just after five past, so we probably have time for two more speeches. I have a list given to me by the previous Chairman, and I shall take speakers in that order.
Yvonne Fovargue (Makerfield) (Lab)
I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing the debate. It is worth reminding people that behind the statistics we are talking about are people who have wrongly been denied the money they need to live on and the support they need.
Like many hon. Members, I have dealt with innumerable cases, and I want to return to the issue of recording. A constituent who came to me wanted his Atos assessment to be recorded, because he had heard of problems in the past. He was told that there were 10 working sets of recording equipment for 140 centres, and that he would have to attend an assessment that could not be recorded, although I believe that it is his right to have it recorded.
Recording might have helped another constituent who came to me, who had been suffering from depression and anxiety, and who had an assessment. She does not cook; in fact, she has not got a cooker, because her lack of concentration means that it would be unsafe. She could barely communicate with me, but the Atos assessment said that her communication was good. She forgot to mention that she lives with her sister—she had to be reminded by her mother—so that was never mentioned in the assessment.
Those clients are appealing with the help of advice agencies, but I fear that when legal aid goes in 2013, there will be a drop in the number of appeals. That drop will not be because Atos is getting it right first time; it will be because people have nowhere else to go for an appeal and will be living without the benefit to which they are entitled. In particular, Atos needs to request medical evidence, which costs money—I have known doctors’ reports to cost anything from £35 to £200—and people eligible for legal aid can get those reports paid for, if they go to an advice agency. What will happen when that system stops?
Lastly, in the short time we have left in this debate, I want clarification on the compulsory reconsideration phase that will come in from April 2013. Will claimants still receive employment and support allowance during that period, as is vital? As we have already heard, 35% of appeals are successful, which means that those people were not fit for work—the decisions were wrong—and if they are not fit for work, they cannot meet the work search requirements. It is therefore essential that ESA continues during that period, and I want clarification about that in relation to all the groups.
Mr Philip Hollobone (in the Chair)
Order. If there are no interventions, we can hear from two more speakers before hearing from the Front Benchers. On the list provided to me, those speakers are Julie Hilling and Bill Esterson.
Julie Hilling (Bolton West) (Lab)
I am so grateful to have been called, Mr Hollobone. I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing this important debate, because there is no doubt that Atos work capability assessments are not working. When campaign groups adopt the slogan, “Atos kills for profit”, something is deeply, deeply wrong. Any organisation that is proved wrong on 40% of its decisions is failing, and it certainly came as a real surprise to us all when Atos was given the contract for the personal independence payment. Of course, we want to help into work disabled people who are able to work, but removing benefit from those who cannot work is heartless, cruel and just plain wrong. Assessments should take notice of medical reports, whether from GPs or specialists, and of prognosis and treatment programmes, and they must take better account of fluctuating conditions and mental health issues. I want to ask the Minister two questions: how many people have died between being rejected for ESA and their appeal, and how many people have committed suicide?
Time is short, so I shall give only two examples. Aaron, who came to me last week, was injured in a bomb blast in Afghanistan in 2009. The explosion broke virtually every bone in his body, and he suffered a crushed-leg injury. Despite immediate medical care, his injury resulted in a partial leg amputation—below the knee—in 2010, and he has had several other surgical procedures. He originally received disability living allowance, but after his Army discharge, his benefit was stopped. He was reassessed for benefit in November 2011 and was told that, as his walking had improved, he would no longer get it. That was a bit of a surprise to him, because he is still struggling with his transition to having a prosthetic leg as his stump is regularly infected, he has required other surgical procedures, and he is still waiting for an operation this autumn. I have a second question relating to Aaron. It is not only the Department for Work and Pensions that has failed him; what about the Prime Minister’s assurances earlier this summer guaranteeing welfare support for ex-servicemen and women injured in military conflicts?
I have been visited by the mother of someone whom I will call Tony. Tony lives alone and is struggling to have as normal a life as possible, despite the world appearing to be very difficult for him. His mother was desperately worried about him, because he has just scored zero in his Atos assessment, despite the fact that he is bipolar and has obsessive compulsive disorder and Asperger’s. Tony has really wanted to work and has tried several jobs. He tried a job as a postman, but because of his OCD he could never get out the door—he would sort the letters by address and would then have to re-sort them by size and colour. Although he has been supported by a number of employers, he found that he was unable to work. In the end, he had a breakdown and ended up in hospital. His consultant has said that he cannot work, and his family is now terrified about his suicide risk.
Mr Philip Hollobone (in the Chair)
Order. I call the last speaker: Bill Esterson.
Bill Esterson (Sefton Central) (Lab)
More than 40 people have approached me with cases of being denied benefit following a WCA, or about their fear of that happening. The Member who mentioned the culture of fear among that group of people is absolutely right. A number of them have described being afraid to appeal, because the experience that people they know have had of Atos staff members has been so terrifying that they are scared to proceed. That is why some appeals do not take place, and it is artificially depressing the level of appeals.
I want to describe a few of those 40 cases. One involved a lady who had a serious operation because of cancer—what operation is not serious, following cancer?—and it took her more than a year to get her backdated pay after her claim was denied. In a second case, it took four months for a decision to be overturned after someone’s ESA claim was rejected following their heart-bypass surgery.
Colleagues have mentioned the work-related activity group; I will talk in detail about what happened to my constituent, George Mullen. Mr Mullen had one leg amputated at the age of 18, after an accident as an apprentice joiner. Despite that, he continued to work full time for more than 35 years. A solicitor told him that he would be a fool to try to get back to work, but he ended up as a successful clerk in a small business, even though he was in considerable pain. To aid his mobility for work, he did not use a wheelchair, but got about either on a false leg or on crutches. He suffered with chronic infections and abscesses at the amputation site, and he developed arthritis in his neck, shoulders and back, and in the knee and foot of his remaining leg. In spite of all that, he continued to work until he was told that he was being retired on health grounds, because there was absolutely no way his health would allow him to continue performing his job. He is on 24-hour blood-pressure monitoring, because stress pushes his blood pressure to a dangerously high level.
Mr Mullen applied for ESA as an absolute last resort. When he attended the WCA with his wife, the questions he was asked included: “Are you married? How did you travel here? How long have you been married?” There was not one question about his physical or mental condition, and no physical examination was carried out. Mr Mullen insists that he tried to offer information about his condition, but he was ignored. He was placed in the work-related activity group, but at no point was it explained that that lasts only for a year, and that ESA is then means-tested, or that if he felt he ought to be in the support group he had to appeal within a month. It came as a complete shock to have his ESA stopped when the year was up. He has applied again, and he awaits his assessment. He has had to attend counselling, because the situation has caused him so much stress. There was no explanation that, in the work-related activity group, ESA stops after a year—that is the reality that faces the real people who are affected. As someone said earlier, this is not about figures; it is about real, vulnerable and at-risk people in our society.
Stephen Timms (East Ham) (Lab)
I, too, congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing this debate about a matter of huge importance to hundreds of thousands of people, as well as on the work that he has done to highlight the problems that people face. I give the Minister my hearty congratulations on his appointment as Secretary of State for Justice and thank him for turning up to discharge his final responsibility in his old job. I am also very pleased that my right hon. Friend the Member for Stirling (Mrs McGuire) is in the Chamber because she and I have had a close interest in this issue for a long time.
The previous Government introduced the work capability assessment and employment and support allowance to provide support for people who are out of work for health reasons, but who are able to plan for a return to work. The current Government chose to take a drastic short cut by curtailing the bedding down period for the new benefit and rolling out the assessment without any improvement, even though by that stage improvements had been identified and proposed. The predictable result of that has been severe problems. Ministers are failing in their task of managing the contract with Atos, of ensuring that people who claim employment and support allowance are treated as they should be, and of reviewing and reforming the test so that it works as it should. The test needs major improvement. Two of Professor Malcolm Harrington’s reviews have reported so far—the hon. Member for Enfield North (Nick de Bois) was right—and while the Government say that they have accepted most of the recommendations, they simply have not implemented them, and that is the heart of the problem.
One simple example that shows the muddle that the Minister has got into has been raised several times in the debate. The year 1 Harrington review recommended that Atos should pilot the audio recording of work capability assessments, and a pilot of 500 claimants followed. Atos said that it was a good idea, but we have heard what has happened in practice from my hon. Friends the Members for Makerfield (Yvonne Fovargue), for Stoke-on-Trent North (Joan Walley) and for Airdrie and Shotts (Pamela Nash).
In a previous debate secured by my hon. Friend the Member for Rutherglen and Hamilton West, the Minister made a commitment that
“we will offer everyone who wants it the opportunity to have their session recorded”.—[Official Report, 1 February 2012; Vol. 539, c. 291WH.]
He has not delivered on that pledge, and it turns out that the problem is a shortage of tape recorders. I was contacted by someone who struggled for weeks to get her assessment recorded. Eventually, Atos wrote to tell her that she could not have a recording or a rescheduled appointment. I wrote to the Minister about that and reminded him of the commitment that he had made. He said that he thought it would be unreasonable to delay the assessment indefinitely for such a reason, but that was not the commitment he gave to the House in February. I am afraid that this mess and shambles shows all we need to know about the Minister’s management of this process. The Government need to get a grip on Atos. I wish the Minister great success in his new job, but I wish he had put a bit more effort into this aspect of his old one.
We have also had a series of mishaps. For example, the Minister made rather farcical efforts to suppress a YouTube video giving advice to people who were claiming against their work capability assessment. It turned out that the subversives who were responsible for this pernicious video were his colleagues at the Ministry of Justice.
Perhaps the most harmful thing to the credibility of the work capability assessment has been the delay in making the changes needed so that the test can work. Professor Harrington’s first review in 2010 asked Mind, Mencap and the National Autistic Society to propose better descriptors for people with mental health conditions. They produced recommendations in November 2010, and Professor Harrington commended them to the Department in April 2011. Further recommendations went to the Department in November 2011 about changes to the descriptors for fluctuating conditions.
Mr Kevan Jones (North Durham) (Lab)
Several announcements that have been made, including about having mental health champions, have not been rolled out to assessment centres. Atos is still being inconsistent about allowing support workers or friends to assist those with mental health illnesses who are going to assessments.
Stephen Timms
I agree that commitments have not been delivered, and my hon. Friend cites a good example.
The work capability assessment must not be a snapshot of someone’s condition on the day they attend the medical assessment. By definition, that is likely to be a good day, because otherwise they would not be able to show up. The assessment needs to take account of the frequency with which they can do work-related tasks and that with which they suffer the ill effects of their condition. The alternative descriptors proposed do just that. They are now in the public domain thanks to the Grass Roots disability blog, without which we would not have known what they were, and they look like a real step in the right direction.
The Department has had the recommendations on mental health descriptors for 17 months and those on fluctuating conditions descriptors for nine months, but hardly any progress has been made in that time. On 25 June, in a written answer, the Minister said that
“we have been carefully considering how to build an appropriate evidence base around the proposed new descriptors…Terms of reference have been agreed and we aim to publish a report of the Evidence Based Review in the spring of 2013.”—[Official Report, 25 June 2012; Vol. 19, c. 54W.]
The Minister’s successor will need to get a grip on this. If that ambiguous deadline is even met—and that would be a first—it will be two years after expert guidance was received on how to improve the assessment for people with mental health conditions, and a year following the other recommendations.
Ann McKechin
Does my right hon. Friend agree that if a person suffers from cancer but does not require chemotherapy, they should still be deemed to be not capable of working if they are in treatment? Why have the Government not changed that indicator when they could do so immediately?
Stephen Timms
My hon. Friend raises a good point that we discussed when we considered the Welfare Reform Act 2012. My understanding was that the Government had committed to make precisely that change, but it appears that that has not happened.
I want to ask the Minister two questions. First, on recording assessments—this might appear to be a minor issue, but it has been raised several times in the debate—will he stand by the commitment he made in Westminster Hall in February that people who want recordings will be able to have them? He seemed to renege on that commitment in the letter to me that was written by officials, but signed by him, about a case that I raised. Secondly, will he get these new descriptors evaluated quickly—he can urge his successor to get a move on—do so transparently, and make the changes quickly after the evaluation is completed?
The Minister of State, Department for Work and Pensions (Chris Grayling)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I know that this is an issue of great concern to many Members, as it was always going to be. I totally accept that this is a long and difficult process, and I have always said that, both in this Chamber and in the House. I will not be able to respond to every individual point. One or two hon. Members have raised individual constituency cases, and if they write to the Department, I will ensure that it addresses their specific questions.
Let me make one point in relation to a comment made by the hon. Member for Hayes and Harlington (John McDonnell). He drove to the absolute heart of what we are trying to achieve, and this is an ambition that was and is shared by both the Opposition and the Government. If people can make a return to work, even if it is a different form of work from the one they did before their health issue arose—[Interruption.]
Mr Philip Hollobone (in the Chair)
Order—[Interruption.] Order. Parliamentary rules state that there should be no noise at all from the Gallery—[Interruption.] Madam, if you persist in carrying on talking and shouting, I will have no choice but to suspend the sitting and clear the Gallery—[Interruption.] This is your last chance. If there is any more noise from the Gallery, I will have no choice but to suspend the sitting, meaning that no one will hear from the Minister.
Chris Grayling
If people can make a return to work, even if it is a different form of work from what they were able to do before their health condition arose, that is better for them than spending the rest of their life on benefits. That is the principle that we are working towards.
Helen Goodman
If the Minister has read the current descriptors, will he explain what kind of work a person could do when their engaging in social contact with someone unfamiliar is always precluded due to difficulty relating to others? There are those who have reduced awareness of everyday hazards, which means that they face significant risk of injury to themselves or others, and those who are at risk of loss of control leading to extensive evacuation of their bowel and bladder. What work can these people do?
Chris Grayling
Let me pick up on that point straight off. It is all well and good for Opposition Members to stand up and rail about the system, but it is a system that was created by Labour four years ago when they were in government, and it is a system that we have consistently tried to improve.
Let me be absolutely clear. I put it on record that this is not a financial exercise. There are no targets attached to the reassessment of people on incapacity benefit—[Interruption.] The assessment that is in place for new claimants for employment and support allowance—
Mr Philip Hollobone (in the Chair)
Order. If there is any more noise from the Public Gallery, I am afraid that, under the rules of Parliament, I have no choice but to suspend the sitting and clear the Gallery. I understand that people are very concerned about this issue—my constituents are concerned about it as well—but under the rules, I will have to clear the Gallery if there is any more noise. This is the last time that I will say it: if there is any more noise, I am afraid that I will have to suspend the sitting.
Chris Grayling
It is really important to emphasise that the reassessment of people on incapacity benefit is not a financial exercise and that there are no financial targets attached to it. It is about finding the right number of people who can make a return to work. It is not an exact science—it never was and never could be—but it is all about trying to help people back into the workplace if they can possibly return to it. That was the previous Government’s motivation when they established the work capability assessment. When we took office, we put in place the changes that they themselves had put in the pipeline through the internal review of the work capability assessment.
When we took office, I fully accepted that the process needed to be improved. That was why we brought in Malcolm Harrington and it is why I am absolutely clear that we have implemented his recommendations. I have regularly met and talked to Malcolm Harrington, and at no point has he said to me that the process is not fit for purpose. At no point has our independent adviser, whom I believe has the confidence of most people in the charitable sector who are involved in this work, said to me that this system has to stop or is unfit for purpose. He has made suggestions about improvements, and we have followed his advice in that regard. Our objective is to do the right thing, but of course this is not an exact science. We will never create a system that is perfect, which is why people have a right to appeal.
Stephen Lloyd (Eastbourne) (LD)
Following the substantial improvements that the Government have made, does my right hon. Friend the Minister agree that the number of people who have been moved into the support set of the ESA has increased by 20%?
Chris Grayling
It is a matter of record that since we implemented changes as a result of the Harrington process and the internal review that we inherited from the previous Government, the number of people going into the support group, including the number of people with mental health conditions, has increased. That is a good thing and I am pleased that we made those changes.
The issue of cancer has been raised. It has taken us longer than I expected to address that, because of various issues that arose in our discussions with Macmillan Cancer Support, but I believe that we are now in the right place. We will be making a formal announcement very shortly, but I have said before that I believe that we should extend to those receiving oral chemotherapy the access to the support group that is offered to people receiving intravenous chemotherapy.
Chris Grayling
I will give way very briefly, but this is the last intervention that I will take.
Stephen Timms
The Minister will acknowledge, however, that the new descriptors that have been proposed for mental health conditions and for fluctuating conditions are nowhere near being implemented. When does he expect that they will be implemented?
Chris Grayling
I will make just one more point and then I will answer that question.
It is really important to put it on record that Atos does not take decisions. In no circumstance does Atos take a decision about whether somebody receives a benefit or does not. A claimant will be asked to fill in a form that goes to Atos for consideration of whether they should be put to an assessment, or passported straight through to the benefit. Atos carries out the assessment, but the decision about benefits is taken by a Department for Work and Pensions decision maker in Jobcentre Plus. It is really important that people understand that Atos does not take decisions.
When we talk about Atos, we are talking about a team of perhaps 1,500 health care professionals, many of whom have trained in the NHS. Those professionals are carrying out an assessment that was designed by the DWP under the previous Government and that has been continued under the current Government. Atos does not take the decisions itself.
As a result of the Harrington recommendations, we have gone out of our way to address people much more directly. Rather than letters, they now receive phone calls, in which they are asked to bring forward additional evidence. A question was asked about the mandatory reconsideration phase. Effectively, that phase already happens. Every case in which the person says they are not happy will now involve a reconsideration within Jobcentre Plus. I am keen that we have that second opinion, because we will not always get things right and I want to try to see whether we can bring forward further evidence that would enable us to make the right decision before a case ever reached the tribunal service. Effort is being put in to make that happen.
The right hon. Member for East Ham (Stephen Timms) asked about recordings. Let me be clear that Harrington recommended that we carried out a pilot to test recordings. I was keen that we just did it, but Harrington said to me, “Actually, it may not work, so I really think that you should pilot it. It may prove to have a negative effect.” We therefore tested recording and found that there was little enthusiasm among those being assessed to have their assessment recorded. In the end, the conclusion was that we should make recording available on a voluntary basis, but it should not be something that we do across the board.
I do not rule out recording. If there was overwhelming evidence showing that it was necessary, I would make it available, but let me give some statistics. There are 300 claimants waiting for an audio-recorded assessment, while Atos is conducting 8,000 assessments a week. We are ordering additional audio-recording machines so that people can have their assessment recorded, if they want. They are perfectly entitled to bring their own recording equipment to an assessment as long as it can record two copies of an assessment, because they need to be able to take one copy with them and leave the other behind. That is why we have to buy what is fairly expensive equipment, and we have ordered additional equipment because there has been an increase in demand in the last few weeks.
I am perfectly relaxed about recorded assessments and perfectly happy to make recording facilities available. However, the advice that I received from Malcolm Harrington was that we should test recording. The result of the pilot was not only that there was not a need for recording, but that many people felt uncomfortable being assessed with a tape recorder running.
The right hon. Gentleman also asked about the new descriptors that were brought forward by the charities, but he is out of date. The charities have been working with us for the past few weeks on the assessment project of the package that they brought forward. The work was finished last week. The charities wanted more time to work with us because the process is complicated and we are trying to mesh mental health issues and fluctuating conditions. As I said in Westminster Hall about 12 months ago, the problem that I had with the recommendations that the charities made in the first place was that they came forward not simply with adjustments to the existing descriptors, but instead with a comprehensive reorganisation of the assessment, which would also have involved a redesign of the physical descriptors. Given that the right hon. Gentleman has carried out such projects in the DWP, he will know well that that would be a two or three-year project.
We have tried to take forward some of the suggestions that the charities made and embed them into elements such as the ESA50 form, and we are now working with the charities to road test all this work to see whether it really makes a difference. However, I am not going to embark on a major overhaul of the whole exercise based on recommendations that are not backed by evidence without our having tested them in the way in which the previous Government tested recommendations: by putting real cases against proposed descriptors and making a comparison between the outcomes of the theoretical new descriptors and the old descriptors. Such work is on track. We are pushing the charities to make progress, because I want to get the work done, and we are still on track to complete the gold standard review in the spring.
The hon. Member for Rutherglen and Hamilton West (Tom Greatrex) referred to the National Audit Office report. I have had the benefit of having read that report, although I know that he has not. The reality is that the report highlights a number of what I regard as not particularly major areas of improvement. If he reads the report, he will see that it reflects a big and complicated contract. It makes some suggestions for improvement, but it is not as he portrays it.
When the hon. Gentleman talks about the performance of Atos during the last two years, the key point he must remember is that the recommendations that Malcolm Harrington made, combined with some fluctuation in volumes coming through to Atos, which are certainly beyond its control, have caused significant operational difficulties. I can give him my word that I have sat in meetings with representatives of Atos and put them under intense pressure. Atos has brought in extra capacity at cost. We have made sure that we deliver at every stage. However, it is not possible to change the goalposts totally and then expect the subcontractor to take it on the chin with no consequences.
We have seen some consequences of the introduction of the Harrington recommendations, particularly the personalised statement. However, as I stand here today, we are on track to close the backlog time to where it should be later this autumn. The numbers that the hon. Gentleman gave are already well out of date. We have brought down the backlog in the number of appeals that we inherited two years ago, but it is a big task. We are dealing with a large number of people and this is a big challenge.
Let me be clear that we want to get this process right and we want to do the right thing. I want people who need long-term ongoing support to be in the support group. The Government have no interest in doing anything other than looking after those people who need that, but we will also give encouragement and support—and a bit of a push—to those who can get back into work, because I believe that that is the right thing for them.
Mr Philip Hollobone (in the Chair)
I thank those Members who have attended this important debate for coming along today, and I encourage everyone to leave Westminster Hall quickly and quietly so that we can proceed to the next important debate.
Census (Local Government Funding)
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mark Field (Cities of London and Westminster) (Con)
I assumed there would be a large crowd interested in every word on this subject, but, unfortunately, I often have this effect when speaking in the House: the Chamber empties.
The census particularly affects one of the two cities I represent: the city of Westminster. Unfortunately, the hon. Member for Westminster North (Ms Buck) cannot be here today, but she associates herself with most of my speech. We have worked together throughout the 11 years that I have been in Parliament to try to ensure that the problems of previous censuses are ironed out. We have fears for the future, given the funding arrangements that have been put in place.
The city of Westminster is one of the most complex and diverse areas of the United Kingdom. As the cultural and political hub of our capital city, Westminster attracts a vast number of people each and every day, on top of the residential population, who come either to work or to visit Westminster’s wealth of attractions. Unsurprisingly, Westminster is a destination of choice for people arriving in the United Kingdom for the first time. Many plan to work or study for a short period before returning home; others hope to make a permanent new life here. The true extent of that population is unknown. Also hidden from official statistics are asylum seekers awaiting a decision from the Home Office, countless migrant workers from the European Union who are often willing to sleep in crowded rooms, illegal immigrants working in the black economy and those whose application for leave to remain has been rejected but who are yet to be removed. That huge tide of humanity must be catered for, no matter the unique difficulty of measuring its extent. For Westminster city council, that means funding services for a population well beyond that catered for by central Government money.
I made that point in Westminster Hall some four years ago. In 2008, Westminster city council, one of the two local authorities in my constituency, spent an estimated £6 million looking after that unaccounted-for population. The council had repeatedly warned the previous Government that methods of counting migration numbers were not keeping pace with modern patterns of population movement. That became especially problematic for the council after the 2004 accession of 10 new member states to the European Union, bringing a wave of immigrants to the capital that included Poles, Latvians and Estonians. Lessons were not learned and services came under renewed pressure when, only a few years later, a fresh influx of people came to London when Bulgaria and Romania were brought into the European Union fold.
There was enormous optimism that the 2011 census would at last provide an accurate indication of the numbers living in central London and ensure that the council’s funding settlement from central Government finally provided sufficient moneys to cover the cost of services for all those using them. Undoubtedly, the 2011 census was handled differently from the 2001 census. The Office for National Statistics made significant changes to address some of the obvious shortcomings of the previous population count, to which the hon. Member for Westminster North and I referred in the debate four years ago. We were pleased that Westminster was designated in the hardest-to-count category across all of its wards and received considerable resources to conduct the census.
Nevertheless, although the 2011 census estimate of 219,400 represents an increase in population since 2001, when the figure stood at 181,300, it comprises a large reduction of 21,800, or 9%, from the previous revised 2010 mid-year estimate of 241,100. The situation looks worse if one considers the figures used in the last local government finance settlement, which was based on 2008 mid-year estimates projected forward. Against those numbers, the 2011 estimate represents a drop of 43,500. Despite the resource given to counting Westminster’s population, the council understandably believes that the ONS remains wedded to a one-size-fits-all methodology that does not properly recognise the specific problems of areas such as central London.
Westminster city council believes that the 2001 experience set a precedent that should not be ignored by the Department for Communities and Local Government when determining which data to use when allocating local government resources. Westminster, with its thriving economy and world-class, highly regarded universities—Imperial college London, King’s college London and the London School of Economics, to name but three—is an especially attractive destination to live and work in. Westminster draws people from across London, the UK and the world and consequently provides services to the largest volume of non-residents in the country.
Historically, through a commitment to efficiency and innovation, Westminster has managed to soak up many of the cost pressures that go hand in hand with providing a high-quality cityscape. With the tightening of public finances, however, the council can no longer meet those costs. Westminster city council is underfunded by the revenue support grant and is unable to increase council taxes owing to the Government’s commitment to freezing the levy. I do not disagree with that commitment, but local authorities find themselves wearing that straitjacket.
The subsequent impact on services for people living in central London has been significant. The costs, however, are much wider and include deteriorating environmental services that affect almost 50,000 businesses, and the risk that the 22 million foreigners who visit the borough each year will form less favourable impressions not only of London but of the UK as a whole. That may seem a relatively trivial risk, but think of the impact of the magnificent showcasing of the capital and the UK during the Olympics that will fashion the world’s view of Britain for years to come.
I accept that there will always be a multitude of difficulties in collecting accurate population data in places such as Westminster compared with local authorities such as your local authority in Kettering, Northamptonshire, Mr Hollobone, or the relatively leafy suburb that the Minister represents in the south-east London borough of Bromley. Those problems include getting people to open their door—an estimated 89% of properties in Westminster operate multiple door entry systems. Westminster had the second-lowest response rate to the national place survey, and the profile of those who responded was overwhelmingly white, with almost every other ethnic group and those in the 20 to 34 age bracket under-represented. Similarly, in 2010, Westminster city council conducted a mini census coverage survey in four key areas. Some 54% of Edgware road respondents were found to be white, with only 35% identifying themselves as Asian despite the surveyed area being in the heart of London’s Arab community. In Soho, where Chinatown is based, one enumerator reported that she encountered many doorbells with Chinese names but few people answered the door. Yet, according to the 2009 pupil level annual school census, English was found to be the main home language for only three in 10 children attending Westminster’s schools. One consequence of an over-representation of white respondents is likely to be a reduction in average household size because migrant groups tend to live in larger households.
Although the estimated response to the 2011 census was better, at some 85%, than a decade earlier, when the response was only 74%, response rates still look very low for some demographic profiles, with a particular under-representation of young males. That is especially critical in Westminster, where those with the lowest response rates—males aged 25 to 44—are the most prevalent in the population and the most unlikely to register with comparator data sets such as GP lists.
Although I am sure that the Minister will update us, I understand that the ONS has not yet published the detail necessary for Westminster or any other local authority to evaluate and initiate the adjustment process, which strives to deal with the difficulties to which I have referred. However, Westminster city council is concerned about the methodology that is used. For example, part of the bias adjustment is the within-household bias, which refers to census returns that report a lower number of residents than are present, resulting in an under-count. To correct that particular bias, the ONS matches social survey data to the census data and makes an imputation based on the characteristics of respondents. However, it is not clear whether the data will sufficiently correct the bias for an area such as Westminster, where the number of visitors, migrants and large households is unprecedentedly high and unlikely to be accurately represented in voluntary social surveys.
The council also has concerns about administrative data. Although comparisons of administrative data to census outputs should be treated with a certain amount of caution until we are able fully to understand the ONS’s assumption, there are some anomalies that Westminster believes require further investigation. For example, 2011 census data claim that there are 4,800 fewer occupied households in Westminster than were identified on Department for Communities and Local Government council tax lists, meaning that almost 5,000 fewer households completed census forms than pay council tax. Why is the shortfall so large even after vacant and second homes have been formally accounted for? It is plausible that those properties are only partly occupied. If that is the case, it takes us back to concerns that the city is providing services for part-time people who are never captured in population counts and therefore never properly funded.
Other comparative data require close examination. The register of patients for Westminster GPs, for instance, listed 19,400 more people than the census outputs. GP lists in some parts of the country are deemed to be inflated, as people fail to deregister when they move out of an area, but Westminster is not like other parts of the country. It is likely instead that a substantial part of the population never registers with a GP due to population churn, migration and the prevalence of walk-in and accident and emergency services.
Department for Work and Pensions data on the number of people aged 80 to 84 in Westminster are 50% higher than the census output. The 2011 census estimates that only 3,100 over-85s live in Westminster, despite the fact that 6,800 claim a pension there. The census included questions on length of stay in the country for the first time, thereby providing some estimate of short-term migration, yet only 6,900 in that category were suggested as living in Westminster. Again, that is likely to be a massive underestimate, as it implies that a little over 1% of the number of people employed by Westminster businesses are short-term migrants. A cursory look at any restaurant or shop in the centre of London suggests that that is a underestimate.
Furthermore, the annual population survey 2008-09 estimated that 15,500 people aged 18 to 24 were full-time students in Westminster and might be here for only part of the year, adding a further burden to the issue of short-term migrants. Of the estimated 442,000 illegal migrants living in London, we believe—on a pro rata basis, although there is likely to be a bias towards central London—that 20,000 to 25,000 live in Westminster. All those uncounted and under-counted people are not represented in the funding formula.
For all those reasons, the council requested continually that the 2011 census be tested in Westminster, yet the ONS refused. If data based on the census are used in central Government’s calculation of Westminster’s funding grant, the local authority will be affected to its detriment. It is hard to grasp the exact financial implications, as the details of the revenue support grant model are not yet published. However, I believe that it is likely that Westminster’s RSG will drop substantially.
I calculate that Westminster’s new, substantially reduced census population, when compared with the population estimates used in the previous financial settlement for local authorities, could result in an estimated annual loss of £10 million to £15 million in funding, which will disproportionately affect the most vulnerable in the community. Although I am sure that the Government’s damping mechanism would mitigate some of that loss— the vagaries of the funding mechanism may mean that the estimates could change considerably—those sums are substantial, particularly in a time of tightening financial settlements, which I support, understanding the reasoning behind them.
As I see it, three options now face the Minister and DCLG. The Government can plough ahead with the 2011 census data and lock Westminster into perhaps seven years of underfunding via the business rates retention model. Alternatively, it can recognise that for a very few local authorities—a small number of special cases—the one-size-fits-all 2011 census model may not have worked well enough, and there should be an opportunity to discuss a population top-up. The third option is to continue to use the 2010 mid-year estimates for all authorities until the 2011 census can be adequately quality assured.
DCLG ought to give more recognition to the fact that modern population movement—many UK cities are hyper-mobile and hyper-diverse communities—means a constant turnover of people in inner urban authorities. Those people should be counted as part of the resident population. The Department should, after six years of ONS deliberation, include short-term migration in its funding formula. I must confess that I had hoped wistfully that the 2001 experience would have set a precedent that could not be ignored. I respectfully suggest that the coalition Government now seize the chance to rectify the situation. Otherwise, they face fundamentally undermining one of their flagship local authorities, which has for years served as a beacon of best practice in spite of its gargantuan task in managing this fine capital city of ours.
The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill)
It is a pleasure, as always, to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Cities of London and Westminster (Mark Field) for raising this issue, which is important for his constituents and generally. I recognise, as do the Government, that it is important to get the most accurate census data possible, because they are a key element that feeds into the distribution of public funding. As I will explain, they are not the only element, but they are important, so I understand his concerns.
I agree with and accept his analysis that it is more difficult to conduct a census in an inner-city area with population churn such as Westminster than in some parts of the country. I hope that I can demonstrate that efforts have been made to take that on board. It is worth starting with the situation that confronted us after the 2001 census, when there were concerns and steps were taken by the Office for National Statistics, which is a body independent of Ministers, to improve the methodology and quality assurance underpinning the figures.
Since 2001, as my hon. Friend recognised, considerable effort has been made to improve census returns, as has been demonstrated. He is right that particular resource was put into Westminster to reflect the difficulties, resulting in a significant increase in the response rate. Although it is less than in many authorities, the gap has diminished considerably. The response rate in Westminster in 2011 was 85%, compared with 66% in 2001. Both those responsible for the census and those on the city council are to be congratulated on the hard work that they did collaboratively to achieve that. I hope that gives a better starting point.
Generally, the 2001 census figures have been welcomed by local authorities. There have been a small number of areas—Westminster is one of them—where issues of concern have been raised.
Mark Field
I appreciate that these issues are sensitive and that the Minister will therefore not necessarily want to name each and every local authority, but would it be fair to say that the local authorities that have expressed concern tend to be urban and therefore have the particular characteristics I referred to in my speech?
Robert Neill
Some, but not exclusively—some are inner city authorities, but some are district authorities. There may be other causes of churn, which we will continue to look at. Other urban authorities—for example, Newham—have welcomed what they regard as an improvement in methodology. I recognise that particular circumstances apply to each case, but it is worth putting the Westminster situation into that broader context. Where there are issues, ONS is working collaboratively with those authorities who have sought clarification. Westminster is one of those authorities, and a meeting recently took place between the officials of Westminster city council and ONS. Westminster—I hope I can put this fairly—has said that it would like to consider its position further, in light of the discussions that have taken place. Of course, ONS stands ready to continue those discussions, as does my Department.
It has always been our intention—given the nature of a census count, there are certain caveats—to use the most up-to-date and nationally consistent data available. We are consulting on proposals for the basis of calculating the next local government finance settlement. The consultation will close on 24 September, and I know that Westminster council will respond to it in detail. Population is one figure. As you will know from your local government experience, Mr Hollobone, a number of other factors are churned into the regression analysis—the bane of all of us who deal with local government finance—and the product then emerges. As my hon. Friend says, the Government intend to continue the protections of floor damping—we have made it clear that that will be the case.
We have consulted on the proposal to use the interim 2011 census base population projections. I confirm that it is the intention for them to be released by ONS on 28 September—they will be available in good time for use in the settlement. Of course, other factors will have to be taken into consideration: assessments of relative need and resources, as you will know, Mr Hollobone; the operation of the floor damping; and, because we are setting up a baseline for the new system of retained business rates, the calculation of the tariffs and the top-ups that will apply for the reset period. It is our intention not to reset those baselines until 2020 at the earliest, subject to wholly exceptional circumstances. The new system will be an incentive for go-ahead authorities such as Westminster—I am the first to recognise that Westminster is a flagship authority in many respects—and an incentive for those local authorities to drive growth in their area over the period of the seven-year reset period. It is estimated that this new means of financing local government, with 50% of the growth in the business rate being retained, will increase gross domestic product by approximately £10 billion. There will also be a safety net, which will protect local authorities from unexpected volatility in their rate base.
On quality assurance—a particular issue that has been discussed with Westminster—we have seen considerable improvement in the census take-up. The issues raised by my hon. Friend were discussed with officials of the city council and ONS—the officials in my Department will obviously want to continue to discuss them with ONS, too—to ensure that they were taken on board. As my hon. Friend said, what we have is not in fact a decline, necessarily, in the population, but an estimate based on the census that is less than a projection anticipated it to be. Therefore, the projection must be treated with some caveats, too.
After the 2001 census, there was an independent review of the means of quality assessment used to double-check the reliability of the census figures. The independent body suggested 23 actions to improve quality assurance, all of which were taken on board by ONS. Significant steps have been made to improve the quality, and other measures can be looked at. For example, my hon. Friend referred to patient registers. He is right to say that they must be treated with caution. I agree that the level and risk of inflation may vary from place to place, which is something that we can discuss. Across London, it is thought that GP registers can be inflated by approximately 8%. I am not saying that that is necessarily the figure in Westminster, but that is a reason why one must approach them with caution. Although that is a factor, there is not one single figure that can be used as an alternative benchmark.
It is worth saying that we have done checks, with that caveat, against the council tax data. The census estimates are in line with those sources, if allowance is made for some known differences, including an allowance made for the very high proportion of short-term residents, of which, as my hon. Friend says, Westminster has particular numbers. There is also a question concerning second residences.
The Department believes that this approach represents a considerable improvement on the methodology of the previous census. In the Westminster scenario, I agree that it is always difficult to get as high a return as one would wish—I think my own local authority’s return is approximately 95%; it is approximately 85% in Westminster. None the less, in sheer numerical terms the number of questionnaires returned increased from 134,200 in 2001 to 186,800 in 2011—a 39% increase thanks to the work both of ONS and Westminster city council. I hope that that demonstrates that we are going in the right direction—it has generally been well received.
The constructive way forward is this: I will take away the specific points raised by my hon. Friend and I will liaise with him. Westminster city council is going to come to ONS directly after it has reflected on their conversation. That liaison will continue, because we want to see what can be done further to explain and clarify apparent or potential differences between the census and other data sets. ONS remains confident that improved methodology more accurately captures the figure on the ground. Of course, the census is in effect a snapshot taken on one day. I understand my hon. Friend’s concerns. As a former leader of the Conservative group on the London assembly, I raised the issue when I was wearing that hat. The issue ongoing in London.
Mark Field
On the liaison to which the Minister referred, will he confirm that we can expect something in writing? I accept, given the representations I have made today, that he and his officials will want to consider this. I also accept that, in allowing a particular change to be made in relation to Westminster, there is a risk of setting a precedent. Can I expect a formal letter in relation to the liaison to which he referred?
Robert Neill
I am very happy to do that. My hon. Friend makes an important point. We must have methodology that can be applied consistently across the country. I can say both to him and to the hon. Member for Westminster North (Ms Buck) that if I remain in a position to do so, I am more than happy to continue to discuss this ongoing issue with them.
Science and Public Service Broadcasting
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
It is a pleasure to serve under your chairmanship, Mr Hollobone, and a pleasure to have the opportunity to discuss the important but oft-neglected subject of science and public service broadcasting. By “science”, I also mean engineering. I must declare an interest. For 23 years before coming into Parliament, I worked as a professional engineer, so the representation of science and engineering on the BBC, Channel 4, ITV and Channel Five is of some personal interest to me.
The Minister will be pleased to know that I shall not simply ask him to account for the representation of science and engineering. I shall set out their importance to our economy and culture and mention the role of public sector broadcasting and the general great contribution it is making to the popularisation of science and engineering, and discuss how it could do better.
Like many people, I was inspired by Danny Boyle’s wonderful Olympics opening ceremony, which brought to life the importance of science and the industrial revolution in our history. If it is possible, I was even more pleased watching the Paralympics opening ceremony, which Paul Nurse, the president of the Royal Society, said highlighted
“the achievement of human will in overcoming the adversity of disability and tackling the difficult problems of science.”
Science and engineering are an important part of our economic prosperity, especially now we are seeking to rebalance our economy, get out of a double-dip recession made in Downing street and at the same time address that grave legacy of the first industrial revolution: climate change. Research compiled by Josh Lerner of the Harvard Business School, looking at the last 100 years of growth in various economies, suggests that only 15% of growth in any economy can be accounted for by increasing inputs. That means that 85% of growth in economic output must come from innovation. Science and engineering drive innovation; without them, we will lose our place as a leading economy. Other countries know this. Some 1.5 million science and engineering students graduated from Chinese universities in 2006 alone. In the UK, more young people chose to study fine art than physics. Fine art is a fine choice, but so is physics.
In its 2009 review, Ofcom set out the purpose of public service broadcasting and said that it should stimulate our interest in and knowledge of arts, science, history and other topics through content that is accessible and can encourage informal learning. Ofcom said that public service broadcasting should be high quality, innovative, challenging and engaging. In addition, Channel 4 is required to support and stimulate well-informed debate on a wide range of subjects. I hope the Minister will say whether he believes that those criteria have been met in regard to science.
There are great strengths in our public service broadcasting science coverage, which has improved considerably over the past 10 years. We no longer see so much of the Q format. Q was the gadget man in the 007 films and all too often in the past science programming consisted of a man with a gadget explaining why it would get some Bond wannabe out of a tricky situation. Now on BBC radio we have the “The Infinite Monkey Cage”, “Saving Species” and “The Life Scientific” to name just three. BBC television has given us the “Secret History of…”. “Bang Goes the Theory”, “Stargazing” and “Frozen Planet”. “Horizon” continues to offer great science specials, such as “To Infinity and Beyond”, which discussed the science of endless time and space—something politicians have a particular problem grasping. Channel 4 also has a wide range of science programming, from “The Science of Seeing Again” with Katie Piper to “Brave New World with Stephen Hawking” and one of my favourites, “Dambusters: Building the Bouncing Bomb”.
Ofcom’s most recent survey, published in June, did not reflect general satisfaction, with 65% of respondents thinking that showing interesting programmes about history, sciences or the arts was important but only 46% saying that the public service broadcasting channels were doing that. The level of satisfaction varied highly: 71% for BBC 2, which is excellent, but a worrying 26% for Channel Five. The fact that science is lumped in with the arts and history makes it hard to see precisely where the problem is. Equally, it is difficult to get hard figures on the percentage of commissioned programmes on science and the viewing figures associated with them. I am not aware of any specialist programming aimed specifically at children. Perhaps the Minister will respond to those two points.
Although there is much to be proud of, there is still much to do. I watch and listen to science and engineering programmes with both a personal and professional interest, and I believe that there is one significant weakness. The BBC and Channel 4 have separate science programming, so if people want to watch science and engineering programmes—if they are already interested in infinity, arctic wildlife or how the bouncing bomb was designed, for example—they know exactly where to go. Science programming is heavily signposted, ensuring that those who do not already have an interest in science and engineering can easily avoid it. The Olympic and Paralympic opening ceremonies managed to integrate those subjects successfully, but public service broadcasters have not integrated science and engineering into general programming that can be enjoyed by all. I am afraid that the public service broadcasters have created high-quality, well-resourced science ghettos.
Andrew Miller (Ellesmere Port and Neston) (Lab)
My hon. Friend may have visited the Royal Society exhibition on broadcasting science. It is interesting to note that the challenge she describes goes back to the beginnings of broadcasting in the 1920s. I should like the House to set up a working group to work with broadcasters and examine that challenge, because it has been around for a long time. My hon. Friend has raised an important point.
Chi Onwurah
I thank my hon. Friend for making that important point, and I pay tribute to his work as Chair of the Select Committee on Science and Technology. I have not yet visited the Royal Society to see that exhibition.
Chi Onwurah
Excellent; I shall attend. Working together with broadcasters to address this subject is an excellent idea. I am by no means suggesting that the fault—such fault as there is—lies entirely with the broadcasters.
Non-specialist science programming all too often displays a depressing lack of scientific literacy. I wrote to the outgoing director-general of the BBC, Mr Mark Thompson —the first of many letterss— and the correspondence is on my website.
I thought about reading it in all its Kafkaesque beauty, but I took pity on the Minister and decided that a summary would do. In a programme called “Foreign Bodies”, a BBC reporter said that there was a high proportion of Chinese students on engineering courses in the UK because engineering was more valuable in China. I pointed out that that was not the case: engineering is an excellent career choice for students concerned with material reward—I should know—as engineering degrees dominate the top 10 most well-paid graduate professions, with chemical engineering graduates earning the third highest wage in the UK on graduation at more than £27,000. As I said, in terms of UK plc, engineering is incredibly valuable.
What the journalist may have meant to say was that engineering was not as valued in this country, although that is certainly not the case in the north-east and in my constituency. That might be true for a certain section of the population and, perhaps, some of those people may find themselves commissioning public service broadcasting programming. Certainly only one member of the BBC Trust has a background in science or engineering, as against 11 humanists. In a famous 1959 lecture, the British scientist and novelist C. P. Snow warned of the dangers of two cultures—science on the one hand, and the humanities on the other—and of the limitations that that would place on our society. Only last year, Google’s chair Eric Schmidt used his MacTaggart lecture at the Edinburgh festival to condemn the same gap. The UK, he said, was culturally divided into luvvies and boffins. Schmidt called for art, technology and science to be brought together—a call endorsed by popular TV scientist Brian Cox.
All too often, public service broadcasting programmes present science and engineering as boring, freakish, immensely difficult, or all three. I have lost count of the number of times that interviewers have said something such as, “So you thought about going into science but then you decided to do something creative instead.” I sometimes imagine how broadcasters would react if a reporter treated Shakespeare as they often treat science. Imagine a reporter saying, “I dropped Shakespeare when I was 12—it was just too difficult,” or, “Oh, Shakespeare—I have to ask the kids to help me out with that.”
The consequences can be serious. The BBC’s approach to scientific balance seems to be culled straight from the world of politics, without any understanding of scientific method. Even though the vast majority of scientific evidence supports climate change, the BBC will put up one pro-climate change and one anti-climate change scientist and think that that constitutes balance. Equally, its general interest programmes will be chock-full of historians, artists, celebrities and journalists, but with few engineers or scientists.
Andrew Miller
The point just made by my hon. Friend was central to the discussion of the Select Committee with Professor Steve Jones before his recently published review for the BBC Trust. I would welcome a response from the Minister about any discussions that he has had with the BBC about the implementation of recommendations on precisely the point made by my hon. Friend.
Chi Onwurah
I will certainly leave time for the Minister to respond on that and other important points.
The general interest programmes of the public service broadcasters are chock-full of historians, artists, celebrities and journalists, but include few if any engineers or scientists. I wrote to “Woman’s Hour” to ask if it had interviewed as many women engineers this year as women sex workers. Unfortunately that information was not available, but an admittedly unscientific Google yielded more hits for “Woman’s Hour” coverage of prostitution than for science and engineering. The fact that only 6% of engineers in the UK are women, compared with 30% in Latvia, contributes to an environment in which half our scientific and engineering talent goes to waste.
To go back to my original example, the opening ceremonies of the Olympics and Paralympics proved that it is possible to show scientific themes to a general audience successfully. Further, they showed that non-scientists can successfully represent scientific themes alongside other ones. Surely public sector broadcasters can do so as well.
Alun Cairns (Vale of Glamorgan) (Con)
I congratulate the hon. Lady on securing the debate. I strongly support all that she has highlighted. In the spirit of what she has just discussed, the Royal Institution Christmas lectures are a fantastic example of bringing science to young people, and make it extremely interesting rather than focusing on celebrities. The BBC, however, has squeezed the lectures in recent years into a slot on BBC 3 and, bearing in mind that they are aimed at children, broadcast them at an obscure time of night.
Chi Onwurah
I thank the hon. Gentleman for that important contribution. Had I more time, I would certainly highlight the many great efforts being made by learned institutions and campaigning groups. It is clearly not acceptable that a show aimed at children should be broadcast so late at night. I hope that we can all work together to ensure that such examples of good, mixed-interest, general broadcasting are more widely available.
I do not imagine the Minister can or should wave his hand and change the culture of our public service broadcasters. Public service broadcasters are independent of Government and should be. It is right, however, that they should be held accountable for their adherence to the purpose of public service broadcasting and to the broadcasting code. It is also right that we debate what is important in our culture and society. I want the Minister to make it clear that we need a public service broadcasting culture that integrates scientific literacy. He is an opinion leader in the area, so his thoughts will be influential.
The gap can be addressed in a number of ways. Since it was announced that I had secured the debate, suggestions have poured in, and include new guidelines on the reporting of science, to be drawn up by science journalists and used primarily by news editors and general reporters; media organisations taking on more science journalists and journalists with scientific training; access courses, so that scientists and engineers can convert into journalists; and, to pick up on a recent point, learned institutions such as the Institution of Engineering and Technology or the Royal Society sponsoring scholarships. Certainly engineers and scientists, as well as broadcasters, need to do more to integrate science and engineering into popular culture.
Those are only a few suggestions. I am sure that the Minister will acknowledge the importance of science and engineering to our culture, to our economy and to our public service broadcasting.
Mr Philip Hollobone (in the Chair)
I call the opinion leader and Minister, Ed Vaizey.
The Parliamentary Under-Secretary of State for Culture, Olympics, Media and Sport (Mr Edward Vaizey)
Thank you, Mr Hollobone. It is a pleasure to serve under your chairmanship, considering that you gave me an additional job in your introduction.
I am grateful for the chance to respond to an important debate that I would describe as unusual, albeit meaning to be complimentary. The hon. Member for Newcastle upon Tyne Central (Chi Onwurah) has raised an important subject that merits debate—it does not get debated often enough. I am also grateful for the contributions of the hon. Member for Ellesmere Port and Neston (Andrew Miller) and my hon. Friend the Member for Vale of Glamorgan (Alun Cairns).
I wish to be the first to congratulate my hon. Friend the Member for Basingstoke (Maria Miller) on her appointment as Secretary of State for Culture, Media and Sport—I should now hold the record for being the first Member to mention the reshuffle in Hansard—and I also pay tribute to her predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt). He was an excellent Secretary of State and it was a great privilege to work with him.
Although I am speaking as, in effect, the broadcasting Minister, the Minister for Universities and Science, or indeed an Education Minister, could have responded to the debate, given the points that the hon. Lady made. I hope that she will take some comfort from the fact that I represent a constituency that is stuffed with science. I am privileged to represent Harwell’s Rutherford Appleton laboratory, the Diamond synchrotron and many small and emerging businesses that base their success on the science that happens in my constituency. I hope that all hon. Members in the Chamber will join me on Wednesday afternoon when we celebrate the British contribution to the large hadron collider and the discovery of the Higgs boson particle. I am privileged to be sponsoring that event in my capacity as the constituency Member for Harwell.
Before I address some of the general points on public service broadcasting that were raised by the hon. Member for Newcastle upon Tyne Central, it is worth noting that my right hon. Friends the Minister for Universities and Science and the Minister of State, Cabinet Office, were instrumental in setting up the new engineering prize that is sponsored by the Government, as well as being supported through private sponsorship. The Government hope that it will rank alongside the Nobel prize in terms of prestige and that it will raise the profile of engineering. Although some might regard that point as slightly ephemeral, I certainly do not—it is an important example of the emphasis that the Government place upon science. It also demonstrates where the Government agree with the hon. Member for Newcastle upon Tyne Central. It is important to raise the profile of science as a career and to praise and celebrate its triumphs in this country.
Chi Onwurah
I, too, welcome the creation of the Queen Elizabeth prize for engineering, which was launched by all three party leaders. Far from regarding it as ephemeral, I think it is an important way to establish and promote the significance of engineering in this country and worldwide.
Mr Vaizey
Then we are as one on that point. The Science Minister was also instrumental in ensuring a freeze in our science budget, which, again, is an issue close to my heart because of the importance of science in my constituency.
The hon. Lady talked about last year’s famous MacTaggart lecture by Eric Schmidt, who is now the chairman of Google. That speech was also close to my heart because, as she may be aware, one of my first acts as a Minister was to commission a report on skills for the computer science industry. That very good report was completely ignored by the Government until Eric Schmidt stood up and said that computer science teaching in our schools was not up to scratch and could be improved. Following that speech, I was pleased that the Government promised to redesign the computer science curriculum, so look out for Mr Schmidt’s name in the reshuffle because he clearly has a great deal of influence.
I turn now to the subject of our debate: science in the media and broadcasting. I was glad to hear the hon. Lady say that science broadcasting has improved, but clearly her reason for securing the debate is that there is room for further improvement. I will not rehearse all the science programmes that are on the BBC, as many have been mentioned, but they are numerous and continue to come on stream. For example, BBC 2 will be launching a science magazine show in the autumn, and BBC 1 will broadcast programmes such as “The Genius of Nature” and “Generation Earth”. We all know about the success of the kind of programmes that Brian Cox has made, and there are many others.
I note the hon. Lady’s concern that there are not enough science programmes for children. On a personal note—having young children, I am now an aficionado of children’s television—I can point her to “Nina and the Neurons”. This is perhaps an opportunity for me to thank BBC Scotland, because after a recent visit there, at my instigation, it kindly arranged for signed photographs of Nina to be sent to my children. For those worrying about whether that appears in the Register of Members’ Financial Interests, the pictures are well within the value that is required, but they are priceless to my children. As I did not send a thank-you letter, I would like to thank BBC Scotland in Hansard.
We have not spoken about other public service broadcasters. I do not know how well ITV is doing, but my officials have come up with “The Alan Titchmarsh Show”, “This Morning”, and “Daybreak” as examples of science coverage on ITV, so there might be room for improvement. Channel 4 has “Brave New World with Stephen Hawking” as part of its scientific coverage. It is important to note that broadcasting science is one of the requirements that public service broadcasters must fulfil under the Communications Act 2003, which is being reviewed, as the hon. Lady knows. I will ensure that science is kept at the forefront of our thinking as the review proceeds.
I would also like to mention some foreign broadcasters that broadcast here, such as the Discovery channel. In a few days, we will be announcing record figures for inward investment in this country, and it is worth noting the contribution that foreign broadcasters make to science programming here.
Andrew Miller
One simple thing that could really help would be to ask the BBC directly what it is doing to ensure that the recommendations of Professor Jones are adopted, and that progress is maintained over time.
Mr Vaizey
The hon. Gentleman makes a good point. As the hon. Member for Newcastle upon Tyne Central pointed out, the BBC is independent of the Government. Ministers must be careful about how far they stray into being seen as influencing or directing the way the BBC programmes. I am sure, however, that the hon. Gentleman can approach the new director-general directly to ask how he intends to take forward the BBC Trust’s report, which, as the hon. Gentleman mentioned, was undertaken by Professor Steve Jones, the emeritus professor of genetics at University college London. The BBC’s science coverage was praised in that report, which noted that science was well embedded in programming and on a diversity of platforms. It is also important to note that the BBC’s science coverage was commended by a number of external scientific bodies, and it says in my notes that “Woman’s Hour” was also praised. The report raised some concerns and made recommendations on how the BBC could improve its science coverage, and the BBC Trust and BBC executives have responded to them. A key recommendation that was taken forward in January 2012 was the appointment of a science editor, who is David Shukman.
Another important report that is relevant to our debate was set up by the previous Government. It was produced in January 2010 by the science and the media expert group, which is chaired by Dr Fiona Fox, the chair of the Science Media Centre. The report outlined a number of actions and recommendations with the aim of supporting the accurate reporting of science and fostering an environment in which engaging science programmes can be made. Specifically on broadcasting, it found that more than two thirds of people had watched a science programme on television in the year previously and that almost one in five had listened to one on the radio. It concluded:
“Those heralding the death of broadcast science are clearly premature…Whatever the medium and however they are commissioned, science programmes will continue to be a significant part of the public’s engagement with science”.
The hon. Lady has raised an important issue through this debate. Being mindful of the independence of broadcasters, it is not for Ministers to dictate their day-to-day schedules. I am sure that every Member in the Chamber would like to be director-general of the BBC for a day and to shape its programming according to their passions. However, it is important that all hon. Members feel that they can contribute to the debate and engage with relevant broadcasters to raise concerns, as my hon. Friend the Member for Vale of Glamorgan did with his well-made point about the Christmas lectures, which I remember growing up with.
Alun Cairns
I pay tribute to the way my hon. Friend has responded to this important debate. He is absolutely right that it is not the job of any politician to dictate what the BBC should be doing, but does he agree that the role of a public service broadcaster should not be always to chase ratings with light entertainment programmes? Such programmes could well be provided for through the private sector, and issues such as science should be focused on more, given that public money is being used.
Mr Vaizey
My hon. Friend invites me to fall into the trap that I said no Minister should fall into, so I think that a period of silence from me on that point would be appropriate. All I will say is that every hon. Member can engage with this ongoing debate. We should be proud of our science heritage and the science that is happening now in this country. As a constituency MP, I am certainly aware that we are one of the foremost science nations in the world.
Finally, speaking as a Culture Minister, I am pleased that more people are talking about the link between the arts and the sciences. Again, the hon. Lady was right that we cannot have a society divided between boffins and artists. They are two sides of the same coin, and both flourish when they work together.
Mr Philip Hollobone (in the Chair)
I thank hon. Members for taking part in that interesting and important debate.
Rickets
(12 years, 2 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Kate Green (Stretford and Urmston) (Lab)
I am very pleased to have been given the opportunity of and time for this debate and to introduce it with you in the Chair, Mr Hollobone. I start by acknowledging two Manchester GPs, Dr Hans-Christian Raabe and Dr Avril Danczak, who came to see me some months ago to draw my attention to the shocking rise in the incidence of rickets in this country over the past 15 years. A written answer that I received on 9 November 2011 contained figures showing that the number of reported cases of rickets had risen from 183 in 1995-96 to 762 in 2010-11. Earlier this year, it was reported that the chief medical officers of the UK had contacted health professionals to highlight the need for vitamin D supplements for at-risk groups. Therefore, the issue is clearly one of concern. I welcome the steps that the Government have taken so far to deal with it, but more needs to be done.
Rickets is a disease that affects the growing of bone in children and is associated with moderate vitamin D insufficiency. It is mainly characterised by deformed bones, bone pain, convulsions and delayed development, particularly in relation to height rather than weight. Current Government guidance is that most people can get all the vitamin D that they need by eating a healthy balanced diet and getting some sun. However, it is not at all clear that that advice is adequate. The national diet and nutrition survey found that 90% of people in the UK do not get enough vitamin D from their diets, and there is widespread confusion in the public mind about what constitutes an appropriate amount of exposure to sunshine.
Certain groups have particularly high levels of vitamin D deficiency. They include pregnant and breastfeeding women and their babies, young children, elderly people, those who are not exposed to much sun—perhaps because they cannot get out of the house or because they cover up their skin for cultural reasons—and people with darker skin pigmentations, such as those of African, African-Caribbean or Asian origin. Levels of air pollution may also have an impact on sunshine exposure levels, and there is certainly a gradient of rising incidence of vitamin D deficiency as we move north across the UK, so it is clearly a concern in the north-west region, where my constituency is located. When one member of a family has a vitamin D deficiency, it is also likely to be replicated among siblings and children.
It is therefore clear that steps need to be taken to deal with vitamin D deficiency in quite large sections of the population. I am pleased that the Scientific Advisory Committee on Nutrition is examining the issue, but it is not due to report until 2014, and it is likely that any recommendations made by the committee could take time to implement in any event. However, there are things that can and should be done now, not least in terms of informing and educating the public and health professionals.
A recent study by the clinical effectiveness unit at Stockport NHS Foundation Trust highlighted a quite surprising lack of awareness among health professionals about vitamin D. That study, across eight acute and six primary care trusts in the north-west, found quite poor knowledge among midwives and health visitors surveyed. Only 24% of health visitors and just 11% of midwives reported having had training in vitamin D supplementation. As a result, they felt less confident in discussing vitamin D with pregnant women and mothers, vitamin D was poorly promoted at the booking of appointments and 90% of the women were not provided with information about vitamin D. However, the study found that where trusts had good policies or expert personnel in place, staff reported greater confidence in discussing vitamin D and more women received verbal and written advice.
Last year, my hon. Friend the Member for Bolton South East (Yasmin Qureshi) hosted an event in Parliament, in conjunction with the Proprietary Association of Great Britain—the UK trade association for manufacturers of over-the-counter medicines and food supplements—at which it was suggested that doctors, nurses and pharmacists receive very little nutritional training at undergraduate level and that there is no obligation for health professionals to undertake such training once in practice. Therefore, I would like first to ask the Minister to comment on the steps that the Government are taking or planning to improve training, awareness and knowledge among health care professionals. I would also like to ask what steps are being taken to raise awareness among the wider pool of professionals working with families and children, and what discussions the Minister and colleagues in the Department may have had with Ministers in the Department for Education to ensure that staff in schools, Sure Start workers, child care professionals and so on are aware of the importance of vitamin D.
There are also concerns about financial incentives. I have looked at the quality and outcomes framework for GPs, and there is a lack of a clear financial incentive for GPs to address their patients’ nutritional needs. Will the Minister say what steps are being taken to develop the quality and outcomes framework to focus more GP attention on nutrition and vitamin D intake, and how she expects that that framework will be kept under review?
I come now to the question of vitamin supplements, which the Department of Health recommends for at-risk groups—the groups I mentioned in my opening remarks—and which are available free of charge to certain low-income families via the Healthy Start programme. However, that targeted approach has resulted in only very limited uptake, which unpublished PCT data suggest could be as low as 2% to 4%. Clearly, many at-risk families are missing out on the recommended vitamin D supplements; and although some families may obtain supplements, from over-the-counter sources, that can be expensive and the dosage may be inappropriate. I would be interested in the Government’s attitude to allowing food supplement manufacturers greater freedom to develop and market a wider range of vitamin D products, targeted at different population groups. I would also welcome the Minister’s view on how the European Food Safety Authority might make it easier for manufacturers to make legitimate claims about the role of vitamin D in good bone health.
I particularly hope that the Minister will consider a report published online, on 21 August, by the British Medical Journal that considers an initiative by the Heart of Birmingham PCT to provide universal vitamin D supplementation to all children from the age of two weeks to five years and to all pregnant and breastfeeding women. That provision of supplements was supported by a programme of continuing professional education of health staff, including GPs, health visitors, midwives, pharmacists, paediatricians and obstetricians and by a public communications campaign. In that initiative, uptake of vitamin D supplements rose year on year to reach 17% among children and pregnant women. That was still low, but considerably higher than the 2% to 4% achieved under Healthy Start. Public awareness of vitamin D also rose from just over 60% to nearly 90%, and a 59% fall was recorded in the number of cases of vitamin D deficiency.
Clearly, there are some important lessons to be learned from the Birmingham initiative. Although some problems were experienced with distribution through the NHS supply chain, limited opening hours at pharmacies and so on, and with the availability of trained staff, the initiative was very successful overall in reaching a considerable number of families who might be at particular risk of vitamin D deficiency by virtue of ethnicity, skin pigmentation or lifestyle, but would not be eligible for free supplements.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Lady on bringing this matter to Westminster Hall today. I am of an age group, and others in the House may be of a similar age, that can remember that when we went out to play at school lunchtime, the milk was on the table when we came in. Is there a role for the Department of Health in the education of children to ensure that children’s health is better monitored and supervised?
Kate Green
I absolutely agree with the hon. Gentleman. Health professionals, and other professionals from across different disciplines, have pointed to the absence of a holistic approach that draws different practitioners and professionals together to ensure that the message is promoted and the education of children and families is pursued coherently.
The absence of trained staff was certainly seen as a factor that limited the effectiveness of the Birmingham initiative, but overall it was very successful in improving vitamin D uptake in families who would have been at risk. I am keen to invite the Minister to look carefully at the Birmingham experience. Is she willing to analyse the costs and benefits of a universal approach based on the study’s findings?
On food fortification, relatively few foods are naturally rich in vitamin D, and consumption of many of those that are, such as full-fat dairy products, eggs and oily fish, has fallen in recent years. Yet in the UK, we fortify relatively few foods, such as margarine, some processed cheeses and breakfast cereals. We do not fortify milk, which has been fortified in Canada and the US for many years. Finland, Jordan and the Irish Republic have all taken recent steps to introduce food fortification. Will the Minister indicate the Government’s attitude to statutory food fortification? There seems to be scope for a more robust approach. Can she confirm whether the work of the Scientific Advisory Committee on Nutrition will look at the experience of other countries? Will the committee’s report reflect an analysis of the effectiveness of food fortification measures in those countries?
Finally, there appears to be scope to make greater use of the public health outcomes framework, to focus attention on vitamin D. I looked at the framework, and, with the exception of some quite vague indicators on diet and hip fractures, there appears to be nothing specific to highlight the need for action to tackle vitamin D deficiency and its consequences, including the risk of rickets. I welcome the Government’s focus on public health, but we must ensure that the framework and the new health structures being put in place more widely achieve the best possible outcomes.
This is a crucial and, I have to say, challenging time of transition. We are settling into the new public health infrastructure against a backdrop of far-reaching changes in the NHS more widely. Although I appreciate that the public health outcomes framework will be kept under regular review, I would like very specific and early attention to be given to the issue in the framework and by the new health and wellbeing boards. I would welcome the Minister’s comments on that.
Jim Shannon
I thank the hon. Lady for giving way again. She is being very gracious. Is she aware of the statistics and figures that show a greater problem in the United Kingdom—England, Wales, Scotland and Northern Ireland—with not only rickets, but osteoporosis, from the lack of vitamin D? Is there a need not only for a pilot programme, such as the one she mentioned in Birmingham, but for a programme for the whole UK, working with all the regions?
Kate Green
The hon. Gentleman is quite right. The impact of vitamin D deficiency is felt in not only rickets and diseases in children, but osteoporosis and other diseases. Vitamin D deficiency inhibits the absorption of calcium, for example, which is important for bone health and growth.
Professionals have identified the lack of joined-up advice—for example, telling a woman recovering from a cancer operation and having chemotherapy that there could be an impact on her bone health and the steps that she could take to address it. It is right that professionals have expressed an interest in the development of a strategic approach, both geographically and across health conditions. Perhaps the Minister will comment on how the Government might react to that.
Rickets is a largely preventable disease that many of us thought had been left firmly in the past. Its resurgence is not in question, yet the distress and pain it causes are preventable, and we know what steps we need to take. What is more, the solutions are mainly systemic—within the control of public policy and health care practice. Although I acknowledge that some gaps in the evidence remain, the importance of vitamin D for at-risk groups—children, pregnant women and mothers—has been understood for many decades, as has the need for effective supplementation where intake is inadequate. There is therefore no need to delay working on and developing appropriate systems and a programme of public and professional education to maximise vitamin D intake. I hope that today’s debate raises public and professional awareness of the issue.
The Parliamentary Under-Secretary of State for Health (Anne Milton)
It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone. I congratulate the hon. Member for Stretford and Urmston (Kate Green) on securing the debate. She is right that these are important opportunities to raise awareness. Although we sometimes underestimate our impact, such debates are sometimes picked up by the media, and anything is useful.
As the hon. Lady eloquently set out, with vitamin D, we are talking about children, strong and healthy bones, and bone health generally. Often, rickets occurs because a child is born without enough vitamin D due to the mother’s deficiency in pregnancy. Alternatively, it can be a post-natal condition due to a poor diet or lack of sun exposure. That is why successive Governments have long recommended that young children and pregnant and breastfeeding women take a daily supplement of vitamin D.
As the hon. Lady says, most people would imagine that rickets is something from the Victorian era. The incidence of rickets fell dramatically in the 1920s, and, in the past, several public health policies have helped to reduce its incidence further. The law now requires the addition of vitamin D to all infant formula, and vitamin supplements containing vitamin D are made available for pregnant women free of charge and to young children from low-income families via the Healthy Start scheme.
Unfortunately, we do not have good data on the national prevalence of rickets in the UK. The hon. Lady has been provided with data on episodes of rickets recorded by hospitals in England, but sometimes a problem when we produce data is that they are about episodes, not people. I believe that she was given that information through an answer to a parliamentary question. The figures appear to be slightly higher, and looking at the percentage increases, the statistics are startling, but episode data do not represent the number of patients, because a person may be admitted more than once in a year. The number of patients diagnosed with rickets is therefore a better measure, and that has increased from 134 to 395 in 2010-11. It is important to consider those figures in the context of increased population size and improved reporting and recording. Those numbers appear quite low when compared with other diseases, but rickets is still a problem, particularly since hospital episode statistics do not show the number of children who may have been treated as outpatients or those diagnosed by a GP. We are aware that over the past few years there have been several reports of clinically apparent vitamin D deficiency and rickets in children from doctors in Manchester, London, Glasgow and Burnley. That is not an exhaustive list; there will be other places.
As the hon. Lady pointed out, the tragedy is that rickets is preventable. That is why it is so important that at-risk groups such as pregnant women, babies and toddlers take those vitamin D supplements. As she also rightly pointed out, that is particularly important for women of south Asian, African, Caribbean or middle eastern family origin, because people with darker skin do not produce as much vitamin D in response to sunlight. It is also important for women who are not exposed to much sunlight, either because they cover their skin for cultural reasons or because they do not spend much time outdoors. The hon. Lady referred to older people who might, due to immobility problems, not be able to get out.
Our national infant feeding survey tells us that about half of mothers across the UK reported taking some form of vitamin or mineral supplement other than folic acid during their pregnancy. On the one hand, that is encouraging but on the other it means that 50% do not. There is a problem and clearly more needs to be done.
Kate Green
The Minister is right that we should worry about the 50% that may not be taking the supplements that they may need, but another concern is the lack of clarity among pregnant women and others about what supplements they should be taking and in what dose.
Anne Milton
The hon. Lady is absolutely right. A huge amount of data and confusing information are given to women. That is one thing we need to tackle in our public health changes. She also talked about joining up services and having a strategic approach. Given the many different information sources, particularly on the internet and some very reputable websites, it is hard for women to know exactly what to do.
The 2005 infant feeding survey found that only 7% of infants aged eight to 10 months were given any type of vitamin supplement. The hon. Lady talked about raising awareness, which is indeed what we need to do. We need to ensure that GPs, midwives, health visitors and other health professionals—she talked about schools—are fully aware of the need for those groups of the population to take vitamin D supplements. That is why in February all four of the UK’s chief medical officers wrote to GPs, health visitors, practice nurses and community pharmacists to reiterate the Department of Health’s recommendations. I would put particular emphasis on the role that pharmacists can play in informing the public, as they have quite a lot of contact.
The chief nursing officer for England also highlighted the issue in her February newsletter bulletin for all nurses and midwives in England. The Department of Health is liaising with the Royal College of Midwives to explore how we can work with them to spread advice further. It was also encouraging to hear that the Royal College of Obstetricians and Gynaecologists welcomed the CMOs’ letter and that it, too, promotes the importance of daily vitamin D supplement during pregnancy.
The National Institute for Clinical Excellence’s public health guidance on maternal and child nutrition, and clinical guidance on antenatal care—quite a mouthful—also support the Department of Health’s advice on vitamin D, reiterating the importance of consistent messages. We have also asked NICE to develop public health guidance on how to improve implementation of the advice on vitamin D and on safe sunlight exposure for the UK.
As the hon. Lady alluded to, there have been issues concerning the availability of prescribable vitamin D preparations. The NHS London Medicines Information Service has produced a document that lists the preparations with appropriate levels of vitamin D for different age groups, so health professionals know exactly what to prescribe. That list was sent to pharmacy organisations in March.
Healthy Start vitamins are not available on prescription, but the Department encourages NHS organisations either to sell the vitamins or consider supplying them free of charge to target groups who are not eligible for the scheme. I was pleased to see the positive effect of the CMOs’ letter—I do not know whether the hon. Lady is aware of this—on the number of orders placed. Orders for the children’s drops have increased from around 72,000 bottles in quarter 4 of 2010-11 to more than 97,000 bottles in quarter 4 of 2011-12. That is a significant increase, which demonstrates, although we are starting from a low base, that we can have an impact. Similarly, orders for the women’s tablets have increased from around 58,000 to more than 105,000 in the same period—an 80% increase.
We all need to keep up our efforts. The hon. Lady raised the issue of awareness and training, which, I suggest, should apply to all the professions. There would be no harm in the person who takes blood from a pregnant woman also reiterating some of the simple advice.
The Department of Health has produced a leaflet entitled “Vitamin supplements and you” as part of its Start4Life campaign. That contains up-to-date advice on the importance of vitamin D. Health care and child care professionals can download it. On top of that, in May we launched what I think will be one of the most significant initiatives, the new NHS information service for parents. Through regular e-mails, online videos and texts, it gives parents information and advice as they progress through their pregnancy and beyond. The service is very new. About 47,000 parents have already signed up, and I would urge those who are reading or listening to this debate to encourage the people they know to do so, too. Members of this House can have a significant impact by raising the issue in their local press and getting people to sign up. This is about trusted advice from the Department, cutting across a lot of the confusion.
We have also asked the Scientific Advisory Committee on Nutrition to undertake a comprehensive review of the scientific evidence on vitamin D and health. That will include a review of the existing dietary recommendations on vitamin D for all population groups, as well as looking at the options to improve the amount of vitamin D we get as a population. The risk assessment is due to be completed in 2014. In the meantime, it is important to ensure that the existing recommendations are put into practice, which is what this debate is all about.
The hon. Lady raised a number of other issues. I probably cannot give them the time they deserve today but I am happy, if she would like to know more detail, to talk to her on another occasion. We strayed a little into EU legislation—worthy of a three-hour debate—about health claims of vitamin supplements. She also asked about universal access and food fortification. Some of those issues are quite tricky. One needs to be sure that what is done has the desired impact. There is also quite a lot of resistance to fortification of food from another quarter.
In the final minutes, I would mention the public health outcomes framework, which she mentioned, the health and wellbeing boards and the opportunities that lie ahead. To some extent we now have an opportunity we have not had before, with public health moving into local authorities. Local authorities will have a remit to do a lot more work in this area. The hon. Lady mentioned schools. I think we will see an opportunity for local areas emerging, particularly when the joint strategic needs assessment reveals some of the issues. There may be opportunities, for example, where there is a high proportion of people who may be at risk from low vitamin D, for local areas to take action. That can be across the board, involving not just GPs and midwives, but schools. We will see changes. We will keep this under review; we know how important it is. The numbers might be relatively small but the increase is significant.
Question put and agreed to.