Westminster Hall

Tuesday 15th May 2018 Westminster Hall

Tuesday 15 May 2018

[Mr George Howarth in the Chair]

Infection Prevention and Control

Tuesday 15th May 2018 Westminster Hall

00:00

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered raising standards of infection prevention and control in the NHS.

This issue has been brought to my attention by a number of health organisations, and by lobby groups within the House as well. We are very aware that 5 May marked World Hand Hygiene Day and I am very glad to have secured this debate, to draw attention to the importance of infection prevention and control in the NHS and, in particular, the role of good hand hygiene in raising standards.

The first time the matter came to my attention was when my brother Keith had a serious motorbike accident some 12 years ago. Whenever we visited him in the Royal Victoria Hospital, we were told by the nurses to wash our hands: “Everything has to be very, very hygienic in here.” We washed our hands almost to the point of obsession because in that ward people were between life and death, and infection could have meant the end of a life.

This year, World Hand Hygiene Day focused on raising awareness about sepsis. We all know about sepsis through our constituents and the stories in the press as well. The World Health Organisation estimates that sepsis affects some 30 million patients worldwide every year. In response to a business question that I put to the Leader of the House, she suggested I seek a debate in Westminster Hall on the matter. As I am not very often here, I thought I would introduce a debate myself for a change—it would perhaps be an occasion. Here in the UK, there are 44,000 deaths from sepsis every year and it is a priority area for the Secretary of State. Effective hand hygiene plays a key role in reducing the risk of healthcare-associated infections such as E. coli, which are a major risk factor for developing sepsis.

I told Professor Didier Pittet, director of infection control at the World Health Organisation, that a debate on infection control was taking place in Parliament—I wished to inform him about what we were doing.

[David Simpson (Upper Bann) (DUP)]

I congratulate my hon. Friend on obtaining the debate. Yes, he is not often here and it is good to see him speak. On infection control, when we go to hospitals it is amazing to see patients standing in their dressing gowns, outside the front doors, smoking—human rights and all the rest of it—some of them running about with a drip in. All that infection is brought back in. Does my hon. Friend agree that something surely needs to be done from that end as well?

[Jim Shannon]

My hon. Friend is right. I hope that hospitals will take note of what is said in this debate and take action accordingly. It is all very well a visitor washing their hands almost to the point of obsession—every time they go out and come back in again—but hopefully that same level of hygiene control is being done by the hospital as well.

When I notified him of the debate, Professor Didier Pittet said:

“In the early 2000s, the NHS was the first ever health system to use a hand hygiene promotion strategy modeled on the World Health Organisation’s. This strategy went on to be active in 186 of the 194 UN member states. I call for the UK and the NHS in particular to reinvigorate hand hygiene promotion as the main strategy to reduce infections. The WHO hand hygiene promotion strategy saves between 5 and 8 million lives in the world every year, and will save hundreds of thousands in the UK.”

So, the importance of the debate is clear.

I spoke to the Minister before the debate and gave him a copy of my speech, to make him aware of what we are trying to do and the questions I want to ask him. I have absolutely no doubt that the shadow Minister and all of us here will be saying the same thing. We are looking for the same thing. There are some pilots in place and some recommendations coming from across the NHS, and we want to look towards those as well.

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

My hon. Friend talks about similarities and about issues being the same. Does he agree that, on the various standards—all of which are improving all of the time across the United Kingdom—we should all strive for best practice, with the most successful practices being replicated right across the United Kingdom in all the devolved institutions?

[Jim Shannon]

What my hon. Friend says is wise—we always hear very wise words from him, no matter what the debate. If we have best practice in Middlesex, Edinburgh, Cardiff, Newtonards, Bangor or Belfast—wherever it may be—let us replicate it everywhere else. My hon. Friend is absolutely right.

It is true that here in the UK we have made good progress in reducing the number of healthcare-associated infections over the past 10 to 15 years. The introduction of mandatory reporting of infections in the early 2000s has certainly helped to track the trends. When we look at some of the things we have done, there is good news. In 2003-04 the average quarterly count of MRSA bacteria was 1,925, but by 2008 it had reduced by 57% to 836—a significant reduction. Although that should be a cause for celebration, rates of healthcare-associated infections remain stubbornly high. Today’s debate is really about getting to the stubborn hard-core hygiene-related infections that do not seem to want to move.

The results of the most recent point-prevalence survey show that the number of patients contracting an infection in hospital is staggering. Every one of us knows how important the matter is. When my dad was in hospital for a time, he was always catching infections there. I am not saying that that was the fault of anyone, but I had thought that the possibility of infection would be greater at home—in hospital you expect it to be lower. Unfortunately, in the cases that I am aware of of people going into hospital with an illness, the rate of infection is high. People worry about that. My constituents worry about it, and I believe that everyone else’s do as well.

One in every 16 patients contract an infection in a UK hospital. That is only 6.4%, but it is 6.4% too many. There are 5,000 patient deaths every year from healthcare-associated infections. That is the thrust of the matter. If we are having deaths in hospital due to these infections we need to address the issue, and I look to the Minister for some thoughts on how we can do that. I am confident that he will come back with something that will help us in our debate.

The human cost of infection goes without saying. However, healthcare-associated infections also have a significant financial cost, which cannot be ignored. The health issues are one consideration, but the financial spin-off is also great. If we can address the infections early on, we can reduce the financial implications and also the deaths and infections. At a time when the health service is facing an unprecedented strain on services, reducing that financial burden is all the more pressing. It is estimated that hospital-acquired infections cost the NHS in excess of £l billion a year, which is 0.8% of the health service’s total budget. That is not an insignificant amount; £1 billion would change a lot of things for the health service and also, I believe, for people’s lives. That amount includes the immediate costs of treating patients in hospital, and also downstream costs due to bed-blocking—we all know the problems with bed-blocking. The costs are especially relevant, given the challenging winter that the NHS has just come through, with hospital capacity reaching 100% in some cases.

If I ask my constituents back home, where we unfortunately have a non-functioning Assembly, what the key issue is for them, they will say that it is health, and it will continue always to be health. If I may make a political statement, but not for any reason other than to illustrate the point: if Sinn Féin were to grasp what is important—and health is one of the things we can agree on—we could move forward together.

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

I congratulate the hon. Gentleman on securing this important debate. I spent some time in hospital a few years ago and it was a positive experience with a happy outcome—and I escaped infection. Does the hon. Gentleman agree that it is important to get right locally the fundamentals of fighting the global threat of anti-resistance to so-called superbugs?

[Jim Shannon]

The hon. Gentleman is absolutely right; we have got to get it right in our own hospitals and across the NHS and the whole United Kingdom of Great Britain and Northern Ireland, and then we can look further afield to other countries. He reminds me that last year I had occasion to be in hospital three times for various operations. I never had any infections. I had nothing but the best care. The surgeon’s knife went in the right direction and removed what had to removed. It was important to do that. The important thing is that we have hospitals and an NHS that are excellent. When the NHS works well, it is the best in the world, but sometimes we need to think about things.

The cost of infections to the NHS includes the immediate costs of treating patients in hospital, bed-blocking and so on. There are also issues with hospital capacity, which has reached 100% in some cases. The World Health Organisation estimates that 50% to 70% of hospital-acquired infections are transmitted by hands, so improving hand hygiene must play a central role in any strategy to reduce hospital infections. It would be remiss of me not to note the work carried out by the Secretary of State to improve patient safety in the NHS—let us give credit where credit is due. In November 2016, there was a commitment to halve gram-negative infections by 2020. The Secretary of State announced he would appoint a new national infection prevention lead, Dr Ruth May. Both are important steps in bringing down infection rates and show a commitment to do so.

Given that 50% to 70% of hospital infections are transmitted by hands, I was encouraged to see alongside those measures a commitment for the NHS to publish staff hand hygiene indicators for the first time. If hand hygiene is done—it should be, and perhaps there are indications of places where it has not been—then publishing hand hygiene indicators will allow benchmarking between hospitals and help drive up standards of hand hygiene. If we can have a system that can help drive hand hygiene, we should have it. Perhaps the Minister can respond to that point in his summing up.

The policy should not be implemented by weighing or counting cartridges used in hospital hand sanitiser dispensers. If it is done by the number of cartridges used, we might be under the impression that things are going the right way, but there has to be a wee bit more to it than that. Without factoring in patient bed numbers and staffing levels, the information is, I gently say, somewhat meaningless in showing hand hygiene compliance levels. The intention is right, but other factors need to be looked at.

The Secretary of State is a strong proponent of the use of reasonable technology in the NHS. Like me, he believes it has the power to radically change how we deliver care. Electronic monitoring technology can monitor hand hygiene to deliver real-time, accurate data to drive behavioural change. We want to see behavioural change where staff are not as active on hand hygiene as they should be.

Electronic monitoring is an innovative practice that is used internationally. Studies from a hospital in the US have shown that following the adoption of the technology, hand hygiene compliance improved by 30%. If we use that methodology, hopefully we can replicate what has happened in the US and reduce infections. That 30% increase corresponded with a 29% decrease in the number of MRSA infections, saving that one hospital more than $400,000. Here in the UK, electronic monitoring is being piloted at a number of hospital trusts in what the Care Quality Commission describes as “outstanding” and “innovative” practice. It goes back to what my hon. Friend the Member for Upper Bann (David Simpson) said in his intervention: where we see good things happening, we should be doing those things across the whole United Kingdom. My hon. Friend the Member for East Londonderry (Mr Campbell) also referred to that.

If the results from the US are replicated here in the UK—they can be—the national adoption of electronic monitoring technology could see 30,000 fewer infections, saving the NHS more than £93 million. More importantly, it would mean less infection, fewer people staying in hospital and fewer deaths. Dr Ruth May, the national infection prevention lead, said that,

“the collection, publication and intelligent use of data…will ensure organisations improve infection control and help…poor performers get the support they need”.

Those are very wise words. While I welcome the announcement of the hand hygiene indicator policy, it appears that progress on its implementation has stalled. I suppose that is the point I am coming to and the reason for this debate. The Department of Health and Social Care has missed its own deadline to publish the data by the end of 2017. Data is so important in drawing up a strategy, policy and vision of how we can address the issue.

We have been collecting mandatory data on the number of healthcare-associated infections, such as MRSA and Clostridium difficile, since 2004. When hand hygiene is so critical to reducing the number of healthcare-associated infections, it is difficult to see why it has taken more than 14 years to publish data on staff hand hygiene—data that we are yet to see. I find that incredible. I spoke to the Minister last night, so he knew I would raise this issue. The key issue for me is how we use the data we have to make a policy and a strategy from which we can all benefit. To mark World Hand Hygiene Day, the World Health Organisation is calling on Health Ministries worldwide to make hand hygiene a marker of care quality. If we do that right, we will be going in the right direction.

Will the Minister consider making hand hygiene a national marker of care quality? Will he, on behalf of the Secretary of State, outline who is responsible for the implementation of the policy? Will he set out a clear timeline for the collection and publication of this data, which is critical to driving up hand hygiene standards in hospitals? Someone walking through the door of any hospital will always first notice the smell. They will probably notice the warmth of the hospital, because it is there to care for patients and those who are ill. They will also see nurses running about with their gloves on. Hand hygiene is important for them, but we need to drive it a wee bit harder from the ministerial point of view and the local hospital point of view, to ensure that it happens.

Publishing data on hand hygiene compliance is a simple first step in improving hand hygiene, which is essential to raising standards of infection prevention and control in the NHS. It will save lives and money, and we cannot afford further delay. The UK and the NHS have been at the forefront of worldwide infection prevention and control strategies since the early 2000s. While a good deal of progress has been made since then—we welcome that progress, some of which has been significant—there is much work to be done to realise the Secretary of State’s ambition: that the NHS will be the safest health service in the world. We should strive to be the best. In many cases, we are the best, but we can certainly do better. The role of good hand hygiene in reducing hospital-acquired infections and improving patient safety cannot be overstated. We must also acknowledge that the current method of direct observation in monitoring hand hygiene in hospitals is no longer fit for purpose, and that technology can and should play a role in changing behaviours.

I look to the Minister for his response. I thank all Members for taking the time to come to Westminster Hall on a Tuesday morning to make a contribution. We look forward to those contributions.

[Mr George Howarth (in the Chair)]

I do not propose setting a time limit on speeches. It might be helpful by way of guidance to suggest that if everyone speaks for no more than 10 minutes, it should be possible to accommodate everyone who has indicated that they want to speak.

09:48

[Andrea Jenkyns (Morley and Outwood) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I congratulate my hon. Friend the Member for Strangford (Jim Shannon) on securing a debate on a matter that is of great personal importance to me, as I lost my own father to MRSA that he caught in hospital.

In 2011 my dad, Clifford, went into hospital for a routine operation to drain fluid from his lungs. What should have been a 20-minute procedure turned out to be two and a half hours as trainee doctors practised on him. The whole event was a real catalogue of errors regarding cleanliness in the hospital. To begin with, the cleaners kept their mop buckets in the room where the procedure was done—it was not a sterile environment. Also, located in the adjacent rooms were patients infected with MRSA. So, the staff did the procedure next to rooms where people had MRSA. Also, a number of doctors and nurses came into my dad’s room and did not wash their hands. I saw some of the same nurses later, having cigarettes outside in their uniform. My hon. Friend the Member for Upper Bann (David Simpson) mentioned patients doing the same. One nurse came into my father’s room to administer some antibiotic cream that was to be placed in my father’s nose, and she used her bare hands and did not wash them afterwards.

The scale of the problem is vast. The World Health Organisation estimates that 50% to 70% of hospital-acquired infections are transmitted by hands, and that more than half are preventable through good hand hygiene. Yet, in the UK, a patient admitted into hospital has a 6.4% chance of contracting a hospital infection. In total, more than 300,000 patients are affected by hospital infections in the UK every year. There are 5,000 patients who, like my father, die from a hospital infection every year. That is 5,000 too many. For me personally, it meant that my wonderful dad, my hero, never got to meet my husband; my dad never got to walk me down the aisle at our wedding last year; and my beautiful baby son Clifford, who is named after my dad, never got to meet his amazing granddad. That is just my own personal story. There is an inadequacy in existing practice.

The Government have done a lot to move forward on hospital-acquired infections, and I know that the Secretary of State and the chief medical officer really do care about the issue, as I have had several meetings with them over the past three years and my all-party group on patient safety has worked closely with them. The hon. Member for Central Ayrshire (Dr Whitford) has also worked closely with me on this. The chief medical officer has done a great deal globally to lead the way in highlighting antimicrobial resistance.

However, it is important that this debate draws attention to the fact that the current system of hand hygiene monitoring in hospitals needs updating, and is inaccurate and outdated. There are better monitoring systems out there. The old system allows poor hand hygiene practice to spread, and can put patients’ lives at risk. The system currently in place is known as “direct observation”, and there are three fundamental flaws within it. First, many of the nurses currently performing direct observation audits on colleagues are not trained to perform such tasks. That means that audits are often incomplete, inconsistent and ineffective.

Secondly, direct observation artificially inflates reported compliance, owing to something called the Hawthorne effect. Naturally, staff wash their hands more frequently when they know they are being monitored. In 2015 I ran a hand cleanliness awareness campaign here in Parliament and 40 colleagues, cross-party, signed up to it. The Deb Group collaborated with me on my Handz campaign and I was astounded at the research that the group showed me. It has conducted peer-reviewed research that shows that the true levels of hand hygiene compliance are in fact between 18% and 40%, rather than the 90% to 100% typically recorded in UK hospitals. That means that direct observation as a means of monitoring artificially inflates reported compliance by as much as 50%. We cannot begin to address the problems of poor hand hygiene when our hand hygiene audits report figures of 90% to 100% compliance.

To increase hand hygiene standards in our hospitals, basic behavioural psychology dictates that we need accurate and timely feedback to drive behavioural changes. Yet direct observation audits are often only completed quarterly or, at best, monthly.

The Government have had a big focus on patient safety and there has been a renewed focus over the past five years, from initiatives to reduce prescribing errors to the commitment to halve gram-negative infections by 2020. If my right. hon. and hon. Friends will permit me, I must thank the Secretary of State for driving those initiatives and for his personal commitment in trying to make the NHS the safest healthcare system in the world.

Looking to the future, the Secretary of State said that the 10-year plan for the NHS must enable it to be “more teched up”, so my question to the Minister is: what role can and should technology play in raising standards of infection prevention in the NHS? Electronic hand hygiene monitoring offers the potential to improve health outcomes and save money at a time when health services are coming under increasing pressure. Improving hand hygiene requires behavioural changes that are reliant upon frequent, accurate and relevant feedback. In his review into NHS productivity, Lord Carter discussed the need to have,

“real-time monitoring and reporting at NHS leaders’ fingertips”.

Electronic monitoring can deliver real-time, accurate data to drive behavioural changes. There are currently pilots in electronic monitoring technology in two acute hospital trusts in England. The Care Quality Commission has noted the innovative practice to improve hand hygiene using technology as an area of “outstanding practice”. However, the technology is not new; it has been in use in the US for several years.

The UK has one of the safest healthcare systems in the world, but 5,000 patients a year dying from hospital infections is 5,000 too many. Does the Minister acknowledge that, to improve hand hygiene and reduce the number of infections in our hospitals, using direct observation as a means of monitoring hand hygiene is no longer appropriate or effective? Finally, does the Minister agree that using technology, if adopted in the right way, offers an excellent opportunity to improve patient safety and reduce the £l billion in associated costs of hospital infections?

09:55

[Nigel Mills (Amber Valley) (Con)]

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. It reminds me of a debate on much the same topic that we had a few months ago. Its aim was to find out from the then Minister when the Government might enforce the strategy they had announced. It is a pity that we are repeating that debate a few months later and we still do not have the answers. The case has been set out very clearly by the previous speakers. There is not much advantage in repeating it, but, just to reinforce the point, we are talking about 5,000 deaths annually. The World Health Organisation estimates that half of those are preventable through effective hand hygiene. I do not know of other situations in UK life where we could have 2,500 people die each year unnecessarily and that would not be a national scandal. We would do anything we possibly could to fix it. There are things we can do to save a large proportion of those lives that are not very difficult or expensive. Our strong message today is: let us get on and do them.

I accept it will not be easy. We are not talking about finding the number of people who do not practise any hand hygiene and making them practise it; we are talking about making sure that as many health staff as possible get up to the very high levels of compliance with hand hygiene rules, rather than being in the middle. I suspect that no health service staff are deliberately not cleaning their hands as often as they ought to. We know they work in high-pressure situations. They do their very best for patients, and occasionally some behaviours creep in that perhaps should not. The important thing is to have processes in place that can identify when performance is perhaps slipping and then remind people, gently and constructively, how important hand hygiene is. That is why we need accurate and sensible monitoring.

We all know what happens when a colleague in a team says, “We have got to do one of these audits today. I’ll go round and watch to make sure you are all practising the right hand hygiene.” We all know what will happen. We have all been in those situations. We are all very careful to make sure we wash our hands as best as we possibly can. We all think we know the same rules, so we all comply with the same things. The person observing probably does not know the rules any better than those being observed. It is no surprise, therefore, that we end up with near 100% compliance. In fact, it is a surprise that we do not end up with 100% compliance in that situation. It is like the driving test. I have never looked in my mirror as much in my life as on my driving test, because I knew I was being checked on that.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Is there not a simpler approach? Should not the audit be unannounced and carried out by people like secret shoppers, which is a technique that we use in Scotland?

[Nigel Mills]

Yes, that would be clear progress. However, I sense that we would notice an unknown person walking round the ward with a clipboard, which might make someone behave more carefully. I am not sure how easy it is to stop the word going round the hospital that such work is being done, but I accept that that is better than one member of the existing team doing it. The question is: can we find a better way of monitoring compliance and getting the data we need, so that we can work out what is happening, see what the trends are, and see whether they are reflected in infection rates? As hon. Members have pointed out, there are various techniques on the market to do that electronically.

Simply counting how many times the ward dispensers are squeezed will not work because we need to know the type of ward, how many patients there are and how sensitive the work is to know how many times people need to squeeze the dispensers. We need a system that says, “On a ward carrying out this sort of activity with this number of patients, we would have expected this level of hand hygiene-compliant moments, and we actually got this many squeezes on the dispenser. That is only a quarter of what it ought to have been. That tells us there is a big problem on this ward.” Or it might tell us that we got 80%, which is probably a sensible level to get.

In my constituency is the Deb Group, a large employer that produces hand hygiene gel and monitoring techniques. I accept there are many rivals on the market and many different ways of monitoring. Some people prefer to have each member of staff wear a badge with a sensor that can tell how often that member of staff approaches a hand hygiene gel dispenser, so that we can monitor at an individual level rather than a ward level.

All those ideas are out there. We need the Government, and presumably the Care Quality Commission or NHS Improvement, to say to hospitals, “We want you to collect real data. We don’t want you to do stupid observations that give you 99% compliance, which we know is meaningless, just so that you can tick a box to say that you’re compliant. We want you to collect real data. We don’t mind how you do it, and we’re not going to punish you, take money off you, or put you in special measures if that data shows that you’re at 25% or 35% compliance, and all your rivals are at 97% because they’re doing it wrongly. We want you to do it properly, get the data, use the data, and improve your performance where you can see that it is linked to infections being too high.”

When the CQC reviews hospitals and other health environments, it should check that hospitals are collecting that data sensibly and using it to improve performance. The CQC should be very serious about that when it assesses a hospital. Can we see that hospitals know what their performance is, have a plan in place to improve it, and are improving it, and that infection rates are falling? It would be a serious matter if hospitals were not doing that work properly—if they were just having a quick half-hour assessment now and again, and producing data that they must know is complete rubbish.

We have the right plan; we know what we want hospitals to start doing. Let us get it in force, and task the CQC to ensure that hospitals are doing it. Let us set out clearly what we want hospitals to do and ensure that they are not too scared to go down that line, thinking that their data will suddenly get worse and they will be punished for it. Let us do what we know we need to do, and hope that we do not have to come back in another couple of years to talk about the fact that 2,500 people have died because we have not managed to put something in place that is easy and relatively cheap, and that we know works.

10:01

[Douglas Ross (Moray) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I, too, congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. Naturally I wanted to take part; this issue is important to my constituents in Moray, as it is to those of all other right hon. and hon. Members. Furthermore, the hon. Member for Strangford is an assiduous contributor in this place. Indeed, some of my debates have been supported by him, so I was keen to reciprocate the support that he gives to others by coming along today.

The role of healthcare is, in essence, to treat and heal patients. That is why healthcare-associated infections, where someone acquires an infection in a hospital or another healthcare facility, can be so cruel. They can also be especially dangerous. Healthcare-associated infections, or HCAIs, lead to comorbidity and can interfere with the treatment that people are in hospital for in the first place.

Naturally, in today’s debate, which is looking at UK-wide issues, I want to focus, as I am sure the hon. Member for Central Ayrshire (Dr Whitford) will, on what we are doing in Scotland, and I will pick up on some of the points that have been made about sharing best practice across the country. It is particularly concerning that in Scotland, according to a Health Protection Scotland report, the incidence of HCAIs in intensive care units is higher than other parts of hospitals, with an incidence rate of 2.7% in 2016. Likewise, surgical site infections are among the more common HCAIs, with, for example, an incidence rate of 1.37% in the first 10 days after a caesarean section. Surgical site infections can be especially painful for patients, and in some cases can even require further medical intervention afterwards.

Healthcare-associated infections are distressing, painful and often dangerous to patients, and are costly for the NHS. Such infections frustrate, complicate and even undo the hard work of our medical staff. They exacerbate the strain on hospital resources, and cost money in compensation payments. In 2016-17, for example, 89 wards and 97 other bays were closed across Scotland due to outbreaks of norovirus. Clearly, action is necessary to prevent and control infections in hospitals and other NHS facilities. By reducing the incidence of HCAIs, the NHS would no longer need to treat those infections, and would avoid the complications that are caused in the treatment of the disease or disorder for which the patient was originally admitted to the hospital or healthcare facility.

Moreover, reducing instances of healthcare-associated infections will help to reassure patients seeking treatment in the first place. Unfortunately, some people, especially elderly people, worry about the possibility of picking up an infection while in hospital. That can lead to reluctance to seek treatment in the first place, which can be very dangerous. It is vital that we work to reassure people that an NHS hospital is a safe place where the risk of infection is low.

In Scotland, the picture for progress on preventing HCAIs is mixed, and there is more to be done by the Scottish Government in that area. In positive news, there was a decreasing year-on-year trend in the incidence of clostridium difficile infections between 2013 and 2017. However, the incidence of HCAIs in intensive care has crept up slightly, from 2.5% in 2014 to 2.7% in 2016, while the incidence of ventilator-associated pneumonia increased by more than 26% in the same period. There has been some good work, but there is room for improvement.

The NHS faces a number of challenges with respect to preventing infection—from the density of people in one place to the threat of superbugs and resistance to antibiotics, as we heard earlier. It is thanks to the hard work of our NHS staff across the country that infection rates remain as low as they are. There has been a discussion about unannounced hospital inspections. The main hospital in Moray, Dr Gray’s, was subject last November to an unannounced inspection. The findings were reported earlier this year. Importantly, it was found that the standard of domestic cleaning and compliance with standard infection control precautions was good. However, the head of quality care at the healthcare environment inspectorate said:

“NHS Grampian must ensure the environment is maintained and, where possible, refurbished to allow effective cleaning and reduce the risk of infection.”

Despite all the great work by the staff in Dr Gray’s and other hospitals, their hands are slightly tied behind their back if we have older, crumbling buildings that need capital investment. There is much more that we can do to support our staff, who want to do the best for patients but are sometimes hamstrung by the conditions in which they work.

There is still room for improvement, and the Scottish Government must ensure that staff have the support they need to make further inroads in the fight against HCAIs. That should include the Scottish Government and NHS Scotland working with their counterparts elsewhere in the United Kingdom to share ideas and good practice, as the hon. Member for East Londonderry (Mr Campbell) highlighted in his intervention. This issue does not stop at the border; we can learn from one another. Will the Minister explain how health departments across the country share best practice and work together to ensure that we deal with this important UK-wide issue?

There must be zero tolerance for failings, such as poor hygiene that can put patients’ health and lives at risk, as we heard in the very emotive speech made by my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns). Remarkably, as recently as 2013, one in 10 senior medics in Scotland were not complying with hand hygiene standards. That is a worrying message, and the situation must improve.

We should be proud and thankful that we live in a society where we have high-quality universal healthcare, with a low risk of infection. However, in every part of the United Kingdom we must not stop striving to control, and hopefully prevent, such infections from occurring in future.

10:08

[Lee Rowley (North East Derbyshire) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I, too, congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. As my hon. Friend the Member for Moray (Douglas Ross) said, the hon. Gentleman has attended some of the debates that I have led in previous months, so I am grateful for the opportunity to speak in a debate that he has introduced. I know the topic is important to him, and he made a great and passionate case when introducing the debate.

Like my hon. Friend the Member for Amber Valley (Nigel Mills), I am not sure whether I can do justice to some of the issues that have been outlined. I do not wish to repeat things that have been said in a far better way than I could say them—I am by no means an expert in this area. My hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) and I have known each other for many years. I know how difficult it was a number of years ago, with the loss of her father, and what a passionate advocate she has become for infection control and resolving some of the issues that have been mentioned. I cannot hope to match some of the discussion that we have had today.

As a relatively new Member of Parliament, I have been surprised in the 10 months since the election by the number of people who have come to my surgery to raise these sorts of issues. I am not new to politics—I was a councillor for eight years before becoming a Member of Parliament—and perhaps because previously I was looking at a different section of government and how it operated, but I was taken aback by the harrowing stories and challenges that many constituents have highlighted and have been willing to share with me.

There are a couple of issues in particular that have come through. The first is anaemia and the second is sepsis, which the hon. Member for Strangford has raised, and I have tabled some parliamentary questions on them. On anaemia, the best way to prevent infection is to prevent people from going into hospital in the first place. We need to reduce admissions, but it is a challenge to achieve that in our health service. One reason why many people are admitted is that they have undiagnosed illnesses, they experience problems and they automatically go to A&E. They present in a way that could be avoided.

The Anaemia Manifesto Steering Committee estimates that around 4 million people live with iron deficiency. It can be a secondary diagnosis, which means that people present with symptoms that they think are something else, but which in fact are anaemia. That costs the NHS up to £50 million every single year. Recognising and acknowledging that, and doing more work on anaemia, might help to address some of the admissions issues we have. Anaemia is the fourth most common cause of admissions for people over 75. It is, by common consent, an underdiagnosed and undertreated condition, and addressing that could be a route to reducing infections, by reducing the number of people in hospital in the first instance.

Sepsis has been discussed. I have heard about a number of cases about sepsis in my surgery: a lady with a young child whose life has been completely changed as a result of contracting sepsis, and who now has a completely different outlook and different requirements in how she lives her life, because of the limitations that sepsis has created; and a family who lost their mother to a sepsis infection that was not identified early enough. I could see the pain on their faces when they were talking about this hugely personal challenge that they had faced and which was created by sepsis.

There is recognition of the problem, and the Department of Health and Social Care is doing an incredible amount to raise sepsis awareness, and to move forward the acceptance that more needs to be done, but there remain challenges in diagnosis, in ensuring effective monitoring when people are in hospital, and in appropriate and adequate treatment. I am aware of the sepsis action plan and the public information campaigns on sepsis that are under way and which no doubt will continue. My parliamentary question was answered a number of months ago; it remains the case that there is a gap in understanding and focus in the health service on sepsis. I am sure that the Department of Health and Social Care and the Minister are seeking to close that gap as quickly as possible, but there is more work to be done, particularly with more than 100,000 cases a year and the deaths that the hon. Member for Strangford has outlined.

[Jim Shannon]

I thank the hon. Gentleman for his kind comments earlier. To underline the number of deaths, Northern Ireland had a peak in 2008 of 191 deaths where C. diff was mentioned on the death certificate. That has been reduced to 67. It comes down to the hard core of problematic infection that is still there. That is where we are looking for some direction from the Minister.

[Lee Rowley]

I absolutely agree. I think everybody would recognise that there is more work to be done.

I will not take up any more time. I welcome the commitment from the Government on matters such as sepsis. There is acknowledgment across the House and from the Government, I hope, that there is more to be done in this area—there is public concern and a desire for public focus—and that process is already under way. I hope it can be restated and redoubled. We all recognise that there is further progress to be made so that we are not here in five or 10 years’ time, debating the same subjects, listening to the same stories in our surgeries.

10:09

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I pay tribute to the hon. Member for Strangford (Jim Shannon) for securing this important debate. As he said, it is only a few weeks since the World Health Organisation’s “Save Lives: Clean Your Hands” campaign and we are talking about how to reduce healthcare-associated infections. Most hon. Members have rightly focused on hand-washing and hand hygiene, because it is crucial, but that alone will not tackle hospital infection. It is not just about hand-washing; it is about the cleaning of wards.

We started to see the rise in MRSA, MSSA and so on after we started to outsource cleaning. I remember watching a young man cleaning with a machine in the Royal in Glasgow. He looked about 20, and if anyone who has a 20-year-old son can tell me that he knows that there is such a thing as corners, I would be delighted to admit defeat. We need people who are committed to the space. I was very glad that my hospital in Ayrshire never outsourced. We kept ward maids who had their own patch, in which they took pride, and there were supervisors who came along—a bit like someone’s mum-in-law with a white cloth—checking under the beds and the trolleys and on top of the curtain rails. It is really important that the environment is clean.

Bed occupancy is another issue. We know that the NHS in England has been under pressure for quite a long time, because the number of beds has halved over the past 30 years. England has one of the lowest bed ratios in Europe, at 2.4 per 1,000. Bed occupancy has been more than 95% and the recommendation for a safe level is 85%. The average in Scotland in 83%. That will vary between rural and urban areas, but if there is no time to clean the bed between patients, the risk increases. If the hospital is under pressure with a queue down in A&E, people are going to cut corners.

As the hon. Member for Moray (Douglas Ross) mentioned, the fabric of the building is crucial. If something is cracked or broken or old or wooden, it is not possible to clean it properly. That is why we have the Healthcare Environment Inspectorate in Scotland, which—believe me—turns up unannounced, poking around in every nook and cranny, looking under trolleys and wheelchairs, in the toilets and the shower rooms. That also includes external unannounced observation of people washing their hands.

I will turn to staffing levels. Across the UK we face nursing workforce challenges. Although we are struggling with a 4.1% nursing vacancy rate in Scotland, in England at the moment it is more than 10%. That creates pressure on everyone else on the ward. As the hon. Member for Amber Valley (Nigel Mills) said, there is a temptation, if not to do no hand hygiene, perhaps not to spend long enough with the gel on the hands and not to take quite the same quantity.

It is important to remember that clostridium difficile is caused by the overuse of antibiotics. It may spread from patient to patient due to poor hand-washing, but the initial problem was overuse and prolonged use of broad-spectrum antibiotics. It is very important that that is controlled. We need to think about sources, such as pressure sores and intravenous access, whether it is a peripheral drip or a central line. An important one at the moment is the management of urinary catheters. How long is it left in place? Is it too long? If it needs to be in longer, is it being changed regularly?

We also need to monitor surgical site infections. In Scotland, two wounds are monitored so that we are aware of whether things are improving or worsening. Although the hon. Member for Moray complains about a 1.37% wound infection rate after C-section, that has actually decreased over many years, and for hip replacements the rate is 0.63%. Some of that is not due to hand-washing. I have been a surgeon for more than 30 years and have seen the change from big interrupted black silk sutures that allowed penetration points for infection, to subcuticular invisible mending that means that the wound seals very quickly, using better dressings and glue to seal the wound so that there is less risk of external ingress. There is also a plan to add bowel surgery and vascular surgery—a dirty operation and a clean operation—because that is how we can monitor if something more general is going wrong.

Like the rest of the UK, in Scotland since about 2000 we have been trying to tackle infections. We lost our white coats and had to wear short sleeves—I still do. We were not allowed watches—I still do not wear one—and hand-washing and hand gel were promoted. Nevertheless, in 2007-08 an appalling outbreak of clostridium difficile in the Vale of Leven Hospital affected more than 150 people and caused 34 deaths. That wake-up call made us realise that tackling healthcare-acquired infections cannot be done in isolation; it must be part of a quality improvement and safety drive.

We created Healthcare Improvement Scotland, and in 2008 we established the Scottish patient safety programme, which was based on principles from Boston but was the first national patient safety programme. It is a structure on which we can hang evidence-based practice about many of the challenges that put patients at risk. It involves not the great and the good sitting in an office, but frontline champions from all health boards and all areas. It is driven by outcome data, which is shared, published, peer reviewed and actioned. We have to make hand-washing, like patient safety, part of daily practice; it must not sit on a shelf in a folder.

The Scottish patient safety programme was started to tackle all risks. I came across it as a surgeon, because it was used to tackle surgical errors such as wrong-site surgery and drug errors—patients being given the wrong drug—but it also addressed healthcare-acquired infections and hand hygiene. We had ward champions and unannounced audits carried out by people from other wards. I agree that, unfortunately, the worst performers in every audit were the doctors. That is why we had to publish the results, put them on the doors of the ward and literally name and shame. We also did a lot of education with relatives, because they come in from outside. In recent years we have made our hospital grounds smoke-free to try to tackle the issue of staff and patients forming a mug of smoke that people have to walk through to get to the door.

All infection-control measures are brought together in one manual, the “National Infection Prevention and Control Manual”, which means that everything is in one place. If there are five or six different initiatives and guidelines, they can sometimes be slightly different and can end up causing confusion.

The hon. Member for Filton and Bradley Stoke (Jack Lopresti), who is no longer in his place, mentioned the important issue of antimicrobial resistance, which will make it harder to tackle infection. Our behaviour in healthcare is helping to drive it. We are threatened by a post-antibiotic era. Alexander Fleming came from Ayrshire, and it would be horrific to think that the antibiotic era might last less than 100 years. Antibiotic stewardship is critical, and it is part of our patient safety programme. The Scottish Government are now also working with vets, because part of the issue is the use of antibiotics in animal husbandry. It therefore comes under the title of the “one health” programme.

The purpose of the Scottish patient safety programme was to reduce deaths, and within just three years there was a 9.3% drop in hospital standardised mortality rates and a 24% drop in deaths in intensive care. The hon. Member for Moray said that there is an infection rate of 2.7% in intensive care, but we have to remember that those are the sickest, most complex patients, and they are therefore most at risk of having or bringing in an infection. There was a 90% drop in ward clostridium difficile rates within three years. Deaths from C. diff dropped by 79% between 2007 and 2015, and those from MRSA dropped by 87%.

Many hon. Members mentioned sepsis. We have all seen the horrific cases in the media, and 40,000 deaths is more than many cancers, which get a lot more attention. In Scotland we established the Sepsis Collaborative, which ran from 2012 to 2014. It focused on just one measure: the national early warning system, which was about delivering antibiotics intravenously to the patient within an hour. Every hour’s delay increases the death rate by more than 7.5%. In 2010 an audit showed that fewer than 25% of patients were getting an IV antibiotic within an hour, but by 2014 it was more than 80%. The aim was to reduce deaths by 10%, but during the time of the programme there was an almost 20% reduction.

All parts of the UK have seen a dramatic fall in C. diff and MRSA, but all have seen a rise in E. coli, which is a bug that lives in the bowel. It is largely driven by catheter infections and it concerns older patients. It is one of the challenges we face, because many of these bugs will be resistant. There is actually a higher mortality rate from E. coli than from MRSA.

One of the differences in approach is to look at healthcare-acquired infections not by themselves, but as part of patient safety. In Scotland there are no financial incentives to meet standards, either for the hospital or for the staff; it is just pure clinical competitiveness. Nurses and doctors go to work to do a good job, and if we give them the tools, the education and the training, they will do that. We also have to give them time and support. Having a more complex quality improvement structure makes it easier to share good practice. That is what we are talking about today. We want to see a change in approach, not in a protocol folder on a shelf, but in the DNA of staff.

10:26

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this extremely important debate and on his insightful contribution. He has a reputation for being one of the most prolific Members of this House, both here and in the main Chamber. He has pursued this issue assiduously during his time here, and his comments made clear his commitment to improving patient safety. His contribution was wide-ranging and fecund, and he highlighted the good timing of the debate, given that 5 May is World Hand Hygiene Day. There is a particular focus this year on sepsis, to which a number of hon. Members referred. We should reflect seriously on the staggering figures they mentioned: there are 30 million infections worldwide a year and 44,000 deaths in this country, and we could save between 5 million and 8 million lives a year through greater awareness and control. We all want to tackle sepsis very seriously.

The hon. Gentleman was right to say that there will not be any political disagreement today, as we all want the very best outcomes in this area. He was right that good progress has been made, particularly over a longer period, but it could be argued that we have plateaued. The infection rate remains too high. I am sure that we all agree that the figure of 6.4% across the NHS is far too high. He talked about the human and financial cost—he mentioned the figure of £1 billion. He made the fair point that this has downstream effects, as beds are occupied unnecessarily. It is always regrettable if any patient is in a bed because of something avoidable, particularly given that the number of beds across the NHS is at an historic low.

I was pleased to hear from the hon. Member for Morley and Outwood (Andrea Jenkyns). She has spoken on a number of occasions about this important subject, and she spoke again about the personal tragedy of her father’s death. She has been a consistent and vigorous campaigner on the issue since she came to this place. This is the first time I have heard in such detail the appalling circumstances surrounding her father’s death and the basic hygiene breaches that took place. I doubt that any member of the public, let alone any trained medical professional, would consider what happened there to be acceptable. That highlights the difficulties we sometimes face in tackling these issues.

The hon. Member for Amber Valley (Nigel Mills) made a considered and thoughtful speech about a wide range of issues. He referred to the World Health Organisation’s figures, which suggest that about half of the associated deaths in this country are preventable. He was right to say that in no other area would we be prepared not to tackle such a figure with great vigour. I agree with him that staff are not deliberately flouting hygiene standards, but the pressure of work sometimes means that standards slip. From the vacancy rates referred to by the Scottish National party spokesperson, the hon. Member for Central Ayrshire (Dr Whitford), and from regular staff surveys, we know how much pressure staff are under in the NHS. The hon. Member for Strangford highlighted accurately the difficulties with the existing audit processes and how they are not necessarily the best. He summarised perfectly the false comfort that we derive from the belief in 100% compliance rates. We know from what we have heard today that when audits are not taking place, compliance is considerably less than 100%.

The hon. Member for Moray (Douglas Ross) had clearly done a lot of important and excellent research to come up with all those statistics across a whole range of environments. He showed that there is no uniform picture in tackling infection control and suggested that the condition of the buildings might sometimes be an impediment to best practice. He rightly said that that is an area where many things can be learned from across the border, or indeed across the world—best practice should be disseminated.

The hon. Member for North East Derbyshire (Lee Rowley) talked about the need to reduce hospital admissions as one way of reducing infection rates. He mentioned anaemia in particular: apparently 4 million people have an iron deficiency and anaemia is the fourth most common cause of admission. He also mentioned sepsis and the possible gap in understanding or focus in the NHS, although we have heard today that a lot of awareness-raising is going on in that area.

It has been almost two and a half years since we last discussed this issue—January 2016—so today’s debate provides us with a useful opportunity to take stock of progress. We heard about a number of recent positive initiatives but, as the hon. Member for Strangford said, levels of healthcare-acquired infections remain stubbornly high, and in some cases they are increasing. Reductions in the rates of MRSA and C. diff are welcome, but the increase in MSSA and E. coli over the past five years is worrying. Furthermore, about one in every 16 patients will still acquire an infection while being cared for by the NHS in England, and every one of those infections requires additional NHS resources and, more importantly, leads to great patient discomfort and reduces patient safety.

According to the most recent figures from Public Health England, the fatality rate is 28.1% for MRSA cases, 19.7% for MSSA, 14.7% for E. coli and 15.1% for C. diff. We cannot overstate the seriousness of acquiring one of those infections. Furthermore, the Department of Health and Social Care reported recently that, sadly, E.coli infections led to the death of more than 5,500 patients in 2015, at an estimated cost to the NHS of £2.3 billion. The impact on patients and their families is devastating, while the growing threat of antimicrobial resistance adds to the significance of the issue.

In the US and Europe alone, antimicrobial-resistant infections are estimated to cause more than 50,000 deaths a year, and that figure is projected to increase significantly, as we have heard. A report by the World Health Organisation states that resistance is frequent among bacteria isolated in healthcare facilities, with antibiotic-resistant bacteria causing over half of all surgical site infections. We cannot overstate the importance of tackling the issue.

Healthcare of course carries inherent risks, and even if we were to take every possible preventative step, it would still be possible to acquire an infection. However, as I mentioned last time we discussed the matter, it has been estimated that about 30% of infections could be avoided by better application of existing knowledge and good practice. Much of that improvement could be realised through improved hand hygiene practices. Although we have known that for decades, the method of monitoring hand hygiene in hospitals remains outdated, inaccurate and, as we heard from the hon. Member for Morley and Outwood, flawed.

The monitoring method relies on direct observation by nurses, which leads to compliance rates being overstated and takes up hours of nursing time when staff on the wards are already overstretched. Staff naturally wash their hands much more frequently when being observed directly, which results in clearly overstated compliance rates of 90% to 100%. Academic research has found that typical compliance is actually between 18% and 40%. The international best practice to which the hon. Member for Strangford referred demonstrates that electronic monitoring of hand hygiene can decrease the risk of infection by 22%, which would not only save the NHS money, but save lives. We therefore welcomed the November 2016 commitment by the Secretary of State that staff hand hygiene indicators would be published for the first time by the end of 2017. However, as we heard, that deadline has elapsed and we seem to be no nearer to seeing implementation. Will the Minister tell us when we can expect to see the detail of that long-overdue improvement?

On 19 March, in a written response, the Minister mentioned that Public Health England had carried out some initial analysis with the available data, but that the data was incomplete, so it does not truly reflect hand gel usage. I accept that it might not provide an accurate representation of the NHS as a whole, but will the Minister set out what the analysis that he has received has found, and whether any of that information might be useful in the interim until the full dataset is available? Two ongoing pilots into the use of electronic monitoring technology within the NHS have also been mentioned. Has he made any assessment of those pilots? What plans do the Government have to look at universalising good practice, if it is shown to be as effective as early reports suggest?

As with any type of infection, healthcare-acquired infections can trigger sepsis, particularly in people who are already at risk—for example, those with chronic illnesses such as diabetes, or those who are immuno- compromised, such as those receiving chemotherapy. The majority of cases do not derive from a hospital setting, but with 150,000 cases a year and 44,000 deaths, many of them preventable, sepsis is a critical safety issue for the NHS. The challenge is to recognise it in its early stages, before multiple organ failure sets in, and to implement rapid treatment. If it is left untreated for hours, the chances of death increase rapidly. Sepsis in its early stages is often dismissed as something less serious, so I ask the Minister to advise us on what processes are in place to monitor patients at risk from sepsis. What steps will he take to ensure that treatment is started without delay?

In conclusion, around the world and in this country we spend vast sums of money on researching innovations to tackle illnesses and improve our welfare, but tackling hospital-acquired infections better would potentially put us in a position to prevent thousands of unnecessary deaths each year through the most basic of steps and the dissemination of best practice.

[Mr George Howarth (in the Chair)]

Before I call the Minister to respond to the debate, I remind him gently that it is customary to leave a short period at the end of the debate for the mover of the motion to wind up.

10:38

[The Minister for Health (Stephen Barclay)]

As always, Mr Howarth, it is a pleasure to serve under your chairmanship.

I join the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), in congratulating the hon. Member for Strangford (Jim Shannon) on securing the debate, which provides an opportunity for the House to emphasise the importance of raising standards of infection prevention and control in the NHS. He was kind to pay tribute to the Secretary of State for his work on patient safety, and on putting that front and centre in his priorities. As the hon. Members for Ellesmere Port and Neston and for Central Ayrshire (Dr Whitford) acknowledged, that is a point on which the House is united in a common cause. How we reduce infections is of real importance to our constituents, as my hon. Friend the Member for North East Derbyshire (Lee Rowley) said, and that is reflected in our surgeries, because it impacts on the lives of those we represent. There is therefore a great deal of common cause.

The debate is timely because it was World Hand Hygiene Day on 5 May, which is an initiative that the World Health Organisation started in 2010 to remind us all, including patients and family members, to practise good hand hygiene, to help reduce the spread of infections. The hon. Member for Strangford was right to challenge the Government to reinvigorate our approach to hand hygiene. A number of initiatives are under way in Government to address exactly the points that he raised. Public Health England has been raising awareness, and NHS Improvement has begun a number of initiatives, such as its NHS provider bulletin and a hand hygiene theme in its executive masterclass. Other ways of raising awareness include the Royal College of Nursing’s glove awareness week. As the hon. Member for Central Ayrshire said, that it is all about taking practice from guidance or files and embedding that into the DNA, the culture and the way people operate, who include visiting relatives and staff at all levels, including doctors as well as nursing staff.

A number of hon. Members, including my hon. Friend the Member for Amber Valley (Nigel Mills), raised technology and what more we can do. One theme of the debate was whether the Government are doing enough to drive forward the use of technology. I recognise the limits of direct observation and how behavioural change may respond to those. That is why the Government are actively looking at the extent to which technology can facilitate this area.

We have carried out an initial assessment; indeed, the NHS Improvement director of infection prevention and control, Dr Ruth May, and her team recently visited the Royal Wolverhampton NHS Trust, which has been trialling an electronic monitoring system to make an initial assessment of that. Their feedback is that the system is reliant on existing technology, and that many IT systems would not be able to support that. A number of practical issues need to be addressed before one would have a roll-out of technology. I reassure the House that Dr May and her team are actively looking at that issue. We all recognise the impact, not just on patient safety, but on the cost of infections and unnecessary deaths. We are actively looking at the issue of technology.

The hon. Member for Strangford also asked if we could publish more. To pick up on the remarks of the hon. Member for Central Ayrshire on the way information is published in NHS Scotland, dialogues are already taking place. I am happy to ask officials to ensure that, as part of the collaboration that is already under way in NHS Improvement with colleagues in the Scotland and England NHS, we look at best practice to ensure that we are working with and maximising the learning from both sets of NHS.

Public Health England has carried out some initial analysis of the available data to determine the suitability of the data available for publishing. Currently, the data is incomplete and will not truly reflect the usage of hand gel. We are exploring how to improve that data. The hon. Member for Central Ayrshire commented that transparency on what is being done and on variance in performance around infection rates is a key driver of prevention.

[Dr Whitford]

The Minister may know that as a breast cancer surgeon, I was involved in developing the breast cancer standards for Scotland. The only action was peer review—putting everyone’s performance up at an annual conference. No one wants to be at the back of the class; in actual fact, seeing genuine performance drives up quality.

[Stephen Barclay]

The hon. Lady is right that peer review is always a powerful motivator. That sort of transparency drives behaviour, so we need to ensure that we do that in an effective way that does not alarm patient families, because of the publication of data that could be misrepresented by those who have different objectives. The need to get more publication of data is an important point, which the hon. Member for Strangford and others raised, on which we need to do further work.

The hon. Member for Upper Bann (David Simpson) asked in his intervention about the specific issue of patients going outside to smoke, and whether there was an associated infection risk, for example through drips. I am advised that there is no additional risk of infection, as long as the drip is well managed. If colleagues have specific issues about the infection risk associated with that, that is the nature of the debate and helpful to know.

My hon. Friend the Member for Moray (Douglas Ross) spoke of the pain and distress to patients caused by infections, and the important link to buildings. Although that is relevant in Scotland, to which he referred, I accept that the point would also apply to the England NHS. The state of the buildings and the maintenance programme have a part to play, not just in the Scottish NHS, but in the England NHS as well.

The hon. Member for Strangford asked whether hand hygiene could be a national marker of care quality. The Department is considering how we could do that effectively. The points he raised were heard and I will ensure that they are addressed. As and when we have any update, I will be very happy to share that with him.

Overall, a great deal of progress has been made. We are committed to reducing the number of infections. Since 2010 we have made excellent progress on MRSA and C. difficile. In the 12 months ending March 2018, MRSA cases were down 54% on the 12 months ending May 2010, and C.diff infections were down 47%. Considerable progress has been made, but as the hon. Member for Central Ayrshire mentioned, although we have made progress in slowing the rate of increase of E. coli infections, there is more to be done to bring that rate down. NHS England has the challenging objective to bring that down by 20% as part of its mandate. As a result of slowing that down, there were 2,400 fewer cases of infections than there would have been with the previous trend.

Clearly, there is more to be done on E. coli and it is an area of considerable focus in the team. Those cases also have a fiscal cost of between £3,000 and £7,000 per infection, but the much more material cost is the patient safety issue and the harm that accrues as a result. NHS Improvement is leading this programme, aimed at a 20% reduction in E. coli bloodstream infections in 2018-19. It is an ambitious but important target. NHS Improvement has begun working with the medical director of NHS England, Steve Powis, on setting up pilots with local health economies across England to engage and assist in the reduction. That may be an issue that my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) wishes to pick up with me after the debate—how we can work together, given her powerful but extremely sad experience of the events that befell her father.

Colleagues recognised the considerable amount of work on antimicrobial resistance, which is an important factor in treating infections. Our latest estimate is that over five years, there could be an extra 6,000 deaths attributable to pan-antibiotic resistance. Lord O’Neill’s review on AMR said that drug-resistant infections will cost the world 10 million extra deaths a year and $100 trillion by 2050. Those are pretty scary figures, but they underline the importance of preventing infections occurring in the first place.

That brings me on to patient safety. Following the tragic events at Mid Staffordshire and the subsequent public inquiry led by Sir Robert Francis, the NHS embarked on a journey of improvement based upon three strands: better regulation, greater transparency and a culture of learning. Assessing the risk of, and preventing, detecting and controlling the spread of, infections, including those that are healthcare associated, is addressed by the fundamental standards of care, enshrined in regulations, that all Care Quality Commission registered providers are expected to meet. A number of colleagues mentioned the role of the CQC as part of the checks and balances that need to be in place.

In November 2016, the Secretary of State launched new plans to reduce infections in the NHS, including the sepsis commissioning for quality and innovation. Through that, we have incentivised hospitals to improve their sepsis care. Independent CQC inspections have focused on E. coli rates in hospitals and in the community. In addition, we have appointed a national infection prevention lead to ensure a sustained focus at national level, improved training and information sharing, so that NHS staff can cut infection rates and, through the National Institute for Health and Care Excellence’s 2017 guidelines, highlight standard principles and advice on good hygiene.

Considerable progress is being made. Data published in 2017 suggests that four in 10 of all E. coli blood infections cannot be treated with commonly used antibiotics. Infection prevention and control is a key element of tackling antimicrobial resistance, and hand hygiene plays an important part in that. We are working extensively with stakeholders, including the royal colleges, academia and the research community, industry and our expert advisory groups, to inform our next steps.

Several colleagues, including the hon. Member for Ellesmere Port and Neston, mentioned sepsis. We have made significant progress since our focus to improve sepsis practices increased in January 2015. There is new NICE guidance and a new national CQUIN measure to incentivise providers to improve the identification and timely treatment of sepsis. The hon. Member for Central Ayrshire was absolutely right about the time-critical nature of that treatment. That work is already delivering change. The most recent data, which is for the third quarter of 2017-18, shows that emergency department assessment for sepsis has increased from 52% to 92%, and in-patient assessment has increased from 62% to 84% since April 2016.

Considerable progress has been made, which reflects the renewed focus across the NHS, in England and Scotland, on the time-critical nature of sepsis treatment, but we know there is more to do, which is why a new cross-system action plan was launched in September 2017. That plan outlines a range of activities to ensure that the NHS is on the highest possible alert to tackle that devastating condition. Indeed, just recently, on 25 April, NHS Improvement issued a national early warning score 2 patient safety alert to support providers to adopt the revised NEWS2 to detect deterioration in adult patients, including better identification of patients likely to have sepsis.

My colleague the Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), hosted and gave a speech at the launch of Health Education England’s paediatric sepsis e-learning package, which, again, is about raising awareness at an early stage. That training package was informed by clinicians and by parents whose children sadly passed away from sepsis, so we can learn from those tragic events and ensure that warning signs are better picked up at an earlier stage.

As several Members recognised, hand hygiene plays a key role in infection prevention and control, in supporting patient safety and in our efforts to address antimicrobial resistance. Considerable progress has been made—MRSA has more than halved and C. difficile has reduced by just under half since 2010—but, as the hon. Member for Central Ayrshire rightly said, E. coli remains a key area for renewed focus. We have successfully slowed its growth, but we now need to reduce it significantly. Part of the challenge is that a lot of it occurs outside the hospital setting, in the community.

I look forward to working with colleagues from across the House on this shared objective in an area where shared practice, from both England and Scotland, can help. We can learn from each other and from Members’ experiences in their constituencies. We will continue to embed hand hygiene practice and promote awareness of it in the NHS, not just through World Hand Hygiene Day but through debates such as this one.

10:54

[Jim Shannon]

I thank all hon. Members for their significant and helpful contributions. The shadow Minister mentioned that everyone was on the same page and saying the same thing. I love debates of this type, because they show that we can all work in a cross-party way and make significant and helpful contributions. Let me look at the thrust of what we are trying to achieve. We are trying to bring deaths down—we have got them down to a certain level—and to implement a constructive strategy and policy to move forward with diagnosis and monitoring. Members also referred to the desire for increased public focus, and to the failure of buildings.

I am sure Members will not mind me saying that we are blessed to have the hon. Member for Central Ayrshire (Dr Whitford) here. I think we all acknowledge that she brings a wealth of knowledge to this place. I say that sincerely—I mean it, as I think we all do. We can all benefit from what she knows and from what is being done in Scotland.

The Minister told me before the debate that he was standing in for a colleague. He stood in very well, and I thank him for his constructive responses to every one of our comments. Much progress has been made. We are encouraged that a strategy is in place to try rigorously to reduce infection. Members’ contributions were all helpful, constructive and positive, and I hope that the debate leads us to where we all want to be, with disease reduced and perhaps someday done away with in all hospitals. The Minister referred to a shared objective. Yes, everyone in the House has a shared objective, and we all hope that together we can make it happen. I thank each and every Member for their contribution, and I wish them well.

Question put and agreed to.

Resolved,

That this House has considered raising standards of infection prevention and control in the NHS.

10:56

Sitting suspended.

Administration of Justice: Daniel Cresswell

Tuesday 15th May 2018 Westminster Hall

11:00

[Crispin Blunt (Reigate) (Con)]

I beg to move,

That this House has considered the administration of justice in respect of Daniel Cresswell.

I sought this debate to address a plainly wrongful conviction of my constituent, Daniel Cresswell. It is one of the most serious individual miscarriages of justice that has been brought to me about a constituent in more than two decades in Parliament. Every agency, from the investigating officer through to the Crown Prosecution Service and the legally aided defence barrister as well as the route to the Court of Appeal, the Criminal Cases Review Commission and, to some degree, the prison system, have all failed Daniel Cresswell alarmingly.

The assorted oversight systems could not produce any remedy, either. They included the then Independent Police Complaints Commission, West Yorkshire police professional standards department, West Yorkshire police’s operational and political oversight in the form of its chief constable and its police and crime commissioner, the legal ombudsman, the Bar Council and, to date, even the Government as represented by Ministers. The formal purpose of the debate is to invite the Minister, on behalf of the Government, to instruct a judge to review the whole handling of the case, as agencies and their oversight systems have collectively failed. However, I must say I have no expectation that he can or will put a review in hand. Indeed, any number of junior Ministers are responsible for some element of failure in the system that individually they oversee.

I have the highest respect for the Minister selected to reply on behalf of the Government, and I know that today he can only really listen before consulting his colleagues as to whether the Government will act further. My primary objective is for this speech to serve as a point of reference for my constituent as he embarks on his post-prison life. This speech is for him, and I know the Minister will not be too distressed if I take most of the time available.

As Daniel Cresswell seeks to provide for himself and his family, he will be able to evidence that his Member of Parliament is convinced that his conviction is wholly unsound. Any putative employer, friend or acquaintance of Daniel Cresswell should be able to use this speech to understand why any assessment of his character should not carry the burden of the state’s conviction of him for the serious offence of rape that led to a sentence of seven years in prison.

In summary, Daniel Cresswell was fitted up by the female partner of a major debtor of the company that employed him—a debt he was engaged in pursuing. He allowed himself to be manoeuvred into a position whereby the woman spent the night in his hotel room. She made an allegation of rape from what is alleged to have happened when they woke up the following morning. The investigating officer was entirely focused on obtaining a conviction, not the truth. The defending barrister chose to present a case that was fatally confused by her own view of how to achieve an acquittal, not the defendant’s own account. All avenues of appeal and accountability were either systemically closed off or wilfully obstructed by oversight systems protecting their own.

What was not established in the investigation and trial process, and should have been, was that the claimant had a motive and created the means and opportunity to make a charge against the investigating officer of a company seeking to recover a debt in excess of £80,000. Equally, having made a serious allegation against a previous employer, her character was not introduced in court.

I will not name the complainant as the law requires. However, I will name deliberately and purposefully under the protection of parliamentary privilege the investigating officer: Detective Constable Clare Barran. I am satisfied that there is a prima facie case not only that she failed in her duty in the pursuit of truth and justice but that she lied both in the signed documentation that supported her investigation and in her testimony at the trial at Leeds Crown court.

I can only headline the key issues in the time available, but they were the subject of a 29-page submission to the IPCC. All attempts to have West Yorkshire police properly review the investigation were obstructed by that force, including by its chief constable, Dee Collins, and the subsequently elected police and crime commissioner, Mark Burns-Williamson.

I had a meeting and correspondence with the then Police Minister, my right hon. Friend the Member for Great Yarmouth (Brandon Lewis), around December 2016. He encouraged the family and me to engage the police and crime commissioner as offering an improvement on the then current complaints model, which he described as in need of reform. Our experience has been that this PCC has woefully failed to hold his force to account.

The investigating officer was indolent in the extreme when it came to establishing Daniel Cresswell’s account and wholly one-eyed when investigating the complainant’s. Daniel Cresswell spent 415 days on police bail, and, after a year, the telephone records that would have supported his account, which he sought to hand over to the police—the request was declined—were deleted in the usual way by the telephone company, the police inexcusably having failed to request their protection. The only independent witness was not interviewed for 15 months and, while his recollection will plainly have degraded in that time, the police and CPS between them prevented his statement from being disclosed for a further 3.5 years. The video evidence that my constituent sought to protect as supporting his account of the evening became somehow accidentally and irreparably damaged in police protection.

There is then the issue of the central piece of forensic evidence that involves my constituent’s semen appearing on the complainant’s knickers. His account is that he awoke to find her artificially inducing it. The forensic examination made clear that,

“secondary transfer cannot be ruled out”,

but DC Barran altered that to,

“there is significantly more than mere transference”.

In the words of the forensic scientist “a trace” amount of DNA is termed by DC Barran as “a significant amount”. The complainant’s initial statement that her underwear had been “washed once” is changed by DC Barran to,

“washed a number of times”.

DC Barran signed a certification on 3 August 2013 saying that she,

“is not withholding any evidence that will support the defence”,

yet her own notes clearly show that she was aware on 28 May 2013 that the forensic science officer, having received new evidence, had concluded that either party could be telling the truth. Although that shows that DC Barran was aware the forensic science officer accepted that Mr Cresswell could be innocent, she withheld that information from the defence for 13 months, disclosing it only immediately before the trial. I happen to believe that that fatally misled the defence barrister on the strategy she should have employed for the trial. The original statement from the forensic science officer—which DC Barran knew was wrong—was submitted to the CPS and defence along with the above-mentioned certification in August 2013. It was only after 3.5 years that it emerged that she had conducted an interview with Dean Sygrove, the only first-hand witness, which was also not disclosed to the defence.

All the failures of the police investigation served to aid the prosecution and harm the defence. Had the actual evidence as to the course of events that led to my constituent and the complainant being together in the hotel room been disclosed, my constituent’s account would have been supported and the credibility of the claimant would have been undermined. What limited evidence there was from the hotel room received the same biased treatment.

We should at least understand the wider climate in which this police officer was operating: the climate in which DC Barran left my constituent on police bail for 415 days and took 15 months to interview the only first-hand witness, and where, contrastingly, she took one day to seek what she believed was confirmatory evidence for the claimant from the hotel. Ironically, I left office as the Minster for Criminal Justice in September 2012, two weeks after this alleged offence was reported to the police. I was well aware of the public policy anxiety to improve the number of convictions arising from complaints of rape to the police and indeed to support and encourage victims of rape to make those complaints to the police. This was not a climate created by Alison Saunders, the retiring Director of Public Prosecutions, but it was rocket charged under her term of office. Given today’s circumstances, with the discrediting of so many high-profile sexual offence investigations having revealed the one-sided and one-eyed way in which the police and prosecution have sought to deliver convictions and not give the defence the benefit of the information they hold, I personally think it is inconceivable that this case would now pass muster even to arrive at a decision to charge.

Alison Saunders’s recent claim that there are no people in prison today as a result of failures to disclose evidence on the part of the CPS must be nonsense. First, she cannot know, and secondly, the first-hand experience of my constituent plainly suggests otherwise. Daniel Cresswell is another victim of the enthusiasm to improve the conviction rate in rape trials. However, it is the interest of justice that has been sacrificed in the process, along with Daniel Cresswell’s liberty for three and a half years and his future reputation, which this speech is designed to at least alleviate.

Let me turn to Daniel’s representation by his legally aided defence barrister, Fiona Rowling. My review of the case is that her belief was that whatever happened in that hotel room would have been consensual. Therefore, rather than adequately challenging the complainant’s account, or advancing my constituent’s account that he had in fact been indecently assaulted, she attempted to present his account and her belief in parallel. Her performance in front of the jury was described as incoherent and disjointed, and it was muttered and mumbled so quietly and unintelligibly that the disdain and shocked disbelief on the faces of the jurors was conveyed as far as the public gallery. The transcript does not capture the shockingly poor manner of her delivery, which was seen as jaw-droppingly bad, as one member of the jury regarded her with his mouth wide open in astonishment.

Fiona Rowling’s defence strategy had shocked the family when she stated on the first day of the trial that she did not want to make the complainant out to be a liar. Advice was sought from a local Leeds solicitor about whether she could be removed from the case when she refused to follow her client’s instructions. One has sympathy for hard-pressed criminal defence barristers working on legal aid, but that quality of performance cannot be excused or form part of our justice system. Afterwards she asked her client to apologise to his family,

“who may have the impression that that didn’t go very well”.

Her performance was the subject of a complaint to her chambers— unsurprisingly that was rejected—followed by a formal complaint to the legal ombudsman, which bewilderingly found her performance “reasonable”. The legal ombudsman offered a final appeal to the Bar Council, but since the legal ombudsman was put in place because of concerns over the adequacy of the Bar Council as the regulator of professional standards, unsurprisingly that did not result in a satisfactory resolution either, and it was formally out of time. This investigation, and particularly the failure of the legal ombudsman to seek first-hand accounts of the woeful inadequacy of Fiona Rowling’s court performance, was another avenue of accountability that was closed to the family by rules and processes, and I hope that a judge reviewing the entire conduct of this case would seek to investigate that fairly.

In the wake of that one-sided investigation and incompetent defence, my constituent found himself sentenced to seven years in prison. That is when his family sought my help, given the administration of his sentence. Unsurprisingly, he maintained his innocence, and here he fell into a very difficult challenge for the prison service: what to do with myriad offenders—particularly those charged with sexual offences—who maintain their innocence? Among their numbers will be men like Daniel Cresswell, whom I believe to be innocent, yet they are now being doubly punished.

For two and a half years I had the pleasure of working with Michael Spurr, Chief Executive of the then National Offender Management Service, as his overseeing Minister. He said in a letter to me that,

“in prisons running the sex offender treatment programme, priority will be given to those who are willing to address their offending behaviour. Mr Cresswell is maintaining his innocence of the offences for which he is currently imprisoned and he is not ready to participate in a programme solely designed to address his sexual offending”.

As such, Mr Cresswell was detained in a prison much further from his home than would otherwise have been the case. His family visits were impacted as a consequence, and that also appears to have been used as a lever to try to get him to co-operate with his sentence plan—a position that to him was plainly impossible.

In my letter to Michael Spurr of 23 November 2014, I made a suggestion as to how the situation could be improved for non-compliant convicted sex offenders. Regrettably, however, given the litany of different parts of the justice system that need a reference in this time-limited speech, I cannot develop those thoughts further here. However, given the Minister’s responsibility, I am sure that he will give the matter the thought it deserves. I believe it is a growing systemic problem, given the number of sex offenders in custody, alongside our enthusiasm—understandable in many ways—to improve the conviction rate in rape trials. Given the way that such trials are now being conducted, the possibility of convictions such as that handed to Daniel Cresswell should give us pause for thought about the administration of justice.

After a wrongful conviction, the usual course would be to go to the Court of Appeal. An appeal must be made on the basis of facts and points of law, but given the circumstances of this case and the finding of facts by the jury, the family were advised—almost certainly correctly—that the chance of success at the Court of Appeal was frighteningly small. Therefore, two routes were pursued: an attempt to hold the investigation to account by seeking an investigation by the West Yorkshire police professional standards department, and what is known as a “non-appeal application” to the Criminal Cases Review Commission.

The formal complaint to West Yorkshire police was made in December 2014, and after five months of no progress, the family sought help from the Independent Police Complaints Commission and the police and crime commissioner. That eventually led to an investigating officer being appointed, and throughout 2015 and into 2016 the inquiry was prodded by Daniel Cresswell’s father-in-law, Richard Cordle, who is a retired police officer. It is entirely down to Richard Cordle, who had the expertise to understand the failures in the police investigation system and—happily for Daniel—the time and determination to bring West Yorkshire police to account, that the quality of evidence about the investigation and the rest is so convincing. Indeed, it has completely convinced me of the inadequacy of the entire investigation process.

There is an unhappily fat file on the to-ing and fro-ing between the police force, Mr Cordle and the IPCC, which was occasionally reinforced by letters from me to the chief constable, inviting her to give the matter her personal attention. Any review of the process will demonstrate that this was a police force protecting its own, given that the investigating officer could potentially be facing a trial for perverting the course of justice. That conclusion is supported by the fact that an investigation did not proceed on the basis of such seriousness; it is supported by the failure of the police to interview their officer under caution, and by the delay and obfuscation of the professional standards department and the chief constable. That was topped off by the inaction of the Independent Police Complaints Commission, which culminated in letters from me to Dame Anne Owers that even today remain unanswered.

In parallel to that was the route taken to the Criminal Cases Review Commission. Understandably, the work of the CCRC is of particular interest to those trying to reverse an injustice. Through the United Against Injustice conference, and the claims of the erudite CCRC spokesman, David James Smith, the family gained encouragement about the powers that the CCRC could employ on their behalf to gain access to undisclosed and securely held material post trial—material that they would not otherwise know about or have access to. However 16 months after embarking on the CCRC route, they were told that it would not utilise those powers on a “fishing expedition”. The family feel utterly let down by the CCRC and are left with the belief that its function is to provide closure and to protect the status quo within the justice system.

Meanwhile, the lack of progress consumed almost half of my constituent’s time in custody. Every day of delay by the CCRC, the IPCC and the PSD of West Yorkshire police made the practical benefits of a remedy —Daniel’s release from his custodial sentence—less meaningful. The family maintain that the CCRC’s failings are borne out in the statistics—in its own headline figures. I welcome the newly created all-party parliamentary group on miscarriages of justice, chaired by the hon. Member for Huddersfield (Mr Sheerman), which aims to campaign to improve the lot of the wrongly convicted, and reform the appeal system. Mr Cresswell’s family are now involved with that.

Stymied by a police force that will not investigate its own, by a police and crime commissioner who refuses to hold his own police force to account, by an Independent Police Complaints Commission that failed to get another force to investigate West Yorkshire police, by the actions of West Yorkshire police, and by the inability of the justice system as it is currently administered, my constituent has almost no effective remedy left. I understand that consideration is being given to finding out whether an out of time approach to the Court of Appeal might be possible. However, given the advice that has been received and the record of the Court of Appeal in cases such as this, personally I doubt the likelihood of success by that route.

Daniel is now out of prison and trying to rebuild his life. I am delighted that he has started so successfully. It is the purpose of this speech to be a published point of reference to my belief in my constituent’s innocence of the charge for which he was sentenced to seven years in prison. It is also my hope that those in a position to help him in future, in employment or in any other way, will pay due attention to this review of the multiple failures of our system of justice. Daniel Cresswell has been poorly served by the justice system, and I hope that this speech will help him to put the experience behind him. He has, however, been incredibly well served by the unstinting love and support of his family, who have enabled me to make this case and this speech for him today.

11:22

[The Minister of State, Ministry of Justice (Rory Stewart)]

It is a privilege to serve under your chairmanship, Mr Howarth. I pay tribute to my hon. Friend the Member for Reigate (Crispin Blunt) for a powerful and heartfelt speech. I had the opportunity to meet Mr Cresswell and his family briefly beforehand, and I join my hon. Friend in paying particular tribute to Mrs Cresswell and her parents for the extraordinary compassion, faith and energy that they have put into the case over so many years. My hon. Friend raised a number of serious issues and it is difficult for me to go through every one in turn, but serious allegations were made against the police, the lawyer, the court process and the way evidence was used, West Yorkshire police, the police and crime commissioner, the Crown Prosecution Service and, ultimately, the Prison Service.

It is, as you will be aware, Mr Howarth, a very important principle of English law that Justice Ministers do not comment on individual cases. For better or for worse, for 1,000 years the principle of this building has been that judges and juries are independent of politicians, and therefore I am not able in this case to comment on what happened in that courtroom. The grounds for appeal, as my hon. Friend pointed out, cannot be that the jury came to the wrong decision; the appeal can be made only on the basis of new evidence or a legal error. That has been central to this case.

Perhaps I may touch on the broader issue of miscarriage of justice in general and on the all-party parliamentary group on miscarriages of justice that has been set up. There is no doubt that miscarriage of justice does occur, and as the Ministry of Justice, we need to be aware of that. We have seen it in high-profile cases, such as that of the Birmingham Six. Research in the United States suggests that between 2.3% and 5% of convicted people in American prisons are in fact innocent. We need to take that very seriously, in thinking about our entire legal system. Miscarriage of justice can happen for a range of different reasons. It can happen directly through perjury. I am not in a position to comment on the present case, but we must be aware that there are cases of perjury by victims or by police officers. There can be issues to do with insufficient evidence, or with expert testimony. There can be instances of confirmation bias—people’s prejudices affecting the outcome of a case. A good, functioning legal system—and the British legal system has for 1,000 years had reason to pride itself on being one of the best legal systems in the world—has to remain ever-vigilant for these dangers of miscarriage of justice. Although Mr Cresswell has now served his term it is very important, for the sake of others who in future might go through such a situation, that we are absolutely rigorous about making sure that miscarriages of justice do not occur.

I take my hon. Friend’s speech very seriously. I will circulate it to my colleagues in both the Home Office and the Ministry of Justice, to ensure that everybody dealing with the police, with the Crown Prosecution Service, with the operation of legal aid and ultimately with the prison system, is aware of the very serious allegations that have been made today. I want to conclude with a strong tribute to Mrs Cresswell for all the energy, faith and compassion that she has shown, and to my hon. Friend for the compassion and energy that he has shown in presenting his constituent’s case.

Question put and agreed to.

11:26

Sitting suspended.

Public Legal Education

Tuesday 15th May 2018 Westminster Hall

[Mr Mark Pritchard in the Chair]

11:44

[Mr Ranil Jayawardena (North East Hampshire) (Con)]

I beg to move,

That this House has considered public legal education.

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

I rise today to open the debate on public legal education with the aim of highlighting its importance and supporting its expansion, so that it reaches as many communities across the country as possible. It is great to see the Solicitor General in his place today, knowing how passionate he is about this cause. His enthusiasm and support are especially vital, since successfully reaching as many communities as possible will take a lot of engagement on his part with the voluntary sector and the legal professions, which must themselves drive PLE. Before I get into the substance of the debate, I place on the record my thanks to voluntary organisations such as Young Citizens—formally the Citizenship Foundation—and the Legal Education Foundation, and, of course, to the House of Commons Library for the briefings with which they provided me ahead of this debate.

I believe we should start from first principles, for Her Majesty’s Government’s first duty, above all else, is to keep its citizens and our country safe from harm—safe from those who wish to do us harm, both within and outwith. To that end, just as in Burke’s unwritten social contract between the living, those who have been and those who are yet to come, the Government form an unwritten contract with the population as a whole. In that contract, in exchange for their security and safety, the public agree to follow the rule of law.

The rule of law is one of those four fundamentals, alongside democracy, individual liberty, and mutual respect and tolerance of those of all faiths or none, that are so crucial and central to our lives. It is described by the World Justice Project as,

“clear, publicised, stable and just”

laws that,

“are applied evenly; and protect fundamental rights, including the security of persons and property”.

An important part of that is the word “publicised”; not only must the great British public respect the law, but they must know it and they must understand it. They must understand their rights and, crucially, their responsibilities.

[John Howell (Henley) (Con)]

My hon. Friend makes a powerful point. Does he agree that it is not just those rights that we need to educate people about? The courts are changing. We have online courts and we have online divorces, because of changes that are occurring in the Ministry of Justice. All of that plays to the strengths of young people. I wonder whether we ought to teach them how to access that justice, as well as what that justice is.

[Mr Jayawardena]

My hon. Friend makes an important point on how the justice system continues to evolve and how young people must be taught about all facets of the legal system, some of which I will deal with later. Indeed, in today’s increasingly complex society it is more vital than ever to equip as many people as possible—young and old—with at least some basic knowledge about our legal system and their legal responsibilities as well as their rights.

[Mrs Helen Grant (Maidstone and The Weald) (Con)]

I congratulate my hon. Friend on obtaining this important debate. As a former family lawyer for 23 years—that takes me back—I recognise the arguments he is making and will make. Does he agree that a public legal education programme should also focus on our diverse communities up and down the country, where language can often be an issue and a barrier?

[Mr Jayawardena]

I thank my hon. Friend for that point. She has been a champion of greater diversity, and she is of course right that we should not exclude any community from the legal system. I will deal with those points later also. PLE, where it is implemented, provides people of all ages and backgrounds with awareness, knowledge and understanding. As a Conservative, I believe in people—the duty, desire and ability of people to look after themselves, their families and one another. PLE helps people do just that. It gives them the confidence to do it, and to gain the skills they need to deal with disputes and gain access to justice, in consequence improving the accuracy, efficacy and fairness of our justice system.

Equally important, however, is that PLE helps people to recognise when they may need support, what sort of advice is available and how to go about getting it, giving people their independence. In other words, I believe it can create less Government intervention in people’s lives, allowing them to get on with living their own good lives where they cause no harm to others.

Above all, PLE enables people to become fully participating citizens in our big society, whether through jury service or by serving as a magistrate, which I am proud to say my father has done for around 15 years, instilling in me the same example of those values of public service and participation in the legal system as colleagues here in Parliament do. PLE increases citizens’ knowledge of this mother of all Parliaments, the birthplace of parliamentary democracy, where we make the laws that others implement. It increases political engagement and, I hope, will increase representation.

Without understanding how our legal system works—without understanding actions and their consequences—people cannot live John Stuart Mill’s harm principle or understand the realist decisions that politicians must make. Without proper PLE, people vote for—dare I say—wishful thinking policies, borrowing potentially trillions of pounds more on our country’s credit card without thinking through what it really means. PLE and public financial education are similar and equally important, but I fear that PLE is often the forgotten half of that important paradigm.

One of the most important groups for us to reach with PLE is young people. Good PLE in schools will develop, by extension, fully participating citizens, who have the tools to confidently engage in our democratic parliamentary system under the rule of law, and therefore citizens who do not respond to views different from their own with violence such as we saw in the 2011 London riots, or by potentially no-platforming public speech as others do, or indeed by demanding a second referendum to overthrow the democratically expressed will of the British people without any consideration for the other side of the argument. Who knows? Some might even be encouraged to pursue law as a career—I should say that my wife is a non-practising solicitor—helping to expand the capacity of the UK’s world-leading services industry and, consequently, our economy.

Organisations such as the Citizenship Foundation have been working in hundreds of schools and colleges for almost 30 years to help deliver an important part of citizenship education. By helping legal professionals to partner with schools and young people and helping teachers to deliver engaging citizenship education, they aim to help

“young people to understand their rights and responsibilities as active citizens”.

Pupils at schools in my North East Hampshire constituency benefit, too. One of the Citizenship Foundation’s PLE initiatives is an annual mock trial competition, run in conjunction with Her Majesty’s Courts and Tribunals Service, with Hampshire heats, including a magistrates mock trial at Winchester Crown court, a Southampton heat and Bar mock trials at nearby Reading and Guildford. Thousands of pupils take on the various roles involved in criminal cases, such as prosecutors, witnesses, defendants, court clerks and jurors, and learn skills such as advocacy, public speaking, cross-examination and critical thinking, as well as understanding how the court system works.

[Jessica Morden (Newport East) (Lab)]

The hon. Gentleman makes a good point about the experiences of his constituents, but does he agree that while it is a very good thing for people to know their rights, being able to enforce them in a real court is what really matters, and that the Government’s cuts to legal aid and court closures have cut people’s ability to do that?

[Mr Jayawardena]

It is a shame that some people have to play politics on a day when we can commend the work of outside organisations that are doing much good work in schools, in my constituency and others. Indeed, by encouraging more young people to understand their legal position, I hope—I have mentioned it already and I mention it again—that more people will be able to take the right action, so that they need not face action in the courts. I think we can actually help people to help themselves to better understand their position in the legal system, and to find where they can get the advice they need.

If the hon. Lady will allow me to continue, I think it is absolutely fantastic that legal professionals, who are the experts in this area, are so involved. The cases in those mock trials are heard in front of real judges and magistrates, who give feedback to the teams. Some 2,000 legal professionals, including solicitors and barristers, volunteer their time to support these events. As Members of Parliament, I think we have a platform to encourage more dedicated legal professionals to get involved and to support those initiatives—indeed, to commend those initiatives and thank them for what they do.

Another example of a great PLE initiative that we need to see more of, and which might help to address the point raised by the hon. Member for Newport East (Jessica Morden), is the legal branch of the Experts in Schools scheme. The scheme trains volunteer professionals from the Citizenship Foundation’s 40 corporate legal partners and matches them with schools, where they deliver sessions on subjects relevant to young people, such as social media or consumer rights.

As well as providing classroom resources for topical legal issues and immersion conferences led by leading barristers, the Citizenship Foundation wants to reach young people directly. It produces a pocket-sized guide to the law—“Young Citizen’s Passport”—which is now on its 17th edition. Millions of copies have been distributed. I put a call out here and now to fellow Members to encourage our generous and fantastically civic-minded law firms up and down the country, and indeed the wider voluntary sector, to consider whether they can help with this in the years ahead.

Other organisations also have worthy PLE initiatives, such as BPP University’s Streetlaw programme. Showing the potential for everyone to succeed, BPP University law students research, design, draft and deliver interactive presentations on the law to community groups that might not have access to legal information or education, or to those groups that may have a negative perspective of the legal system. Those can include basic presentations on civil and criminal rights to primary and secondary school classes in disadvantaged communities, helping children to learn about the legal system, the courts and the people who appear in them in an interesting and enjoyable way, as the group is currently doing across London. At the other end of the spectrum, I would contend, they can be presentations to enhance prisoners’ understanding of the role that law plays in civic society while imparting general legal information, with the aim of equipping prisoners with the skills and knowledge that will facilitate their reintegration into society upon their release. Those are absolutely critical in ensuring that no one is left behind.

BPP University also has a third branch of the scheme that works with several shelters and charities to provide highly practical presentations to homeless people, who are sadly part of the group of people who are largely sceptical of the English legal system. That takes us back to the principles that I voiced at the start: helping people to help themselves, empowering people to become fully participating members of society and allowing people to live their own lives within the law.

These smart initiatives I have highlighted make a great start, but we must do more to provide a legal foundation that stays with people throughout their lives. That is why I regularly speak to pupils at my own local schools about democratic engagement, and why I participate in schools’ citizenship events, such as the model United Nations. I know that many Members do likewise, and I encourage all Members to do so. I also regularly speak to the headteachers of my local schools, and I will raise PLE with them in the months and years ahead to encourage participation in all the great schemes that I have highlighted.

However, I believe that Members of Parliament can go further. We should strongly encourage local schools to make time for initiatives from local charities, even if they do not have time to teach the full citizenship course. Academy trusts, for example, could create the resources to provide such PLE and other citizenship education centrally and then alternate between which of their schools they direct that resource to. Indeed, they could share those resources with neighbours and vice versa.

Further, the Lords Select Committee on Citizenship and Civic Engagement recommended a statutory entitlement to citizenship education from primary education to the end of secondary education, inspected by Ofsted. I am not here to make the argument that statutory involvement by the state is the way forward, although, as with any instance of major market failure, if the teaching of PLE, citizenship and fundamental British values should fade, the Government should rightly consider the good that they could do by stepping in.

However, we miss the point if we talk only about schools. PLE is not just about schools. It can be, and is being, delivered in all sorts of community settings to interested groups by members of the legal profession, but we must not reach interested groups only. There are a range of vulnerable or at-risk communities for whom a greater understanding of their rights, responsibilities and risks is really important.

For example, with our ever-aging population, the elderly are vulnerable to doorstep, phone or online scams, as are we all. In Hampshire in January, a fake detective sergeant, allegedly from the Met, conned a lady in her 70s out of more than £10,000 after phoning her continuously—harassing her, in effect—and sending a courier to her house to supposedly investigate counterfeit money.

There exist phishing, smishing and vishing, and we expect our vulnerable communities to keep up without providing them with PLE? We can do more. The disabled, those with mental health problems, the isolated and lonely and other vulnerable groups also face risks. We are seeing more instances of cuckooing, where gangs travel to towns and befriend vulnerable people, only to take over their homes. That is not good enough. We must do more.

Educating people and their friends, family and neighbours in the signs to look out for and their responsibilities to help one another would help to protect people and help fulfil the duty I talked about earlier—people looking after themselves, their families and their communities. As Sir Robert Peel said when he founded the Metropolitan Police in 1829, as a Conservative, the founding principles of policing a democracy are that,

“the police are the public and the public are the police”.

Everyone has a role.

I have highlighted a whole range of great voluntary sector PLE initiatives and great engagement from the legal professions—both as part of and in addition to their pro bono community work. PLE has links with the school curriculum, police engagement and scam-awareness initiatives, and I commend the Solicitor General for spearheading important work to co-ordinate and focus PLE, so that it reaches as many communities as possible. I am not alone in doing so; his efforts have been commended by the voluntary organisations that I have heard from. Clearly, better co-ordination of PLE initiatives and goals will ensure that everyone works together more effectively. His working group of professional and voluntary organisations does just that. He is doing good work, and may it continue.

Just as with health education or financial education, the long-term effects of public legal education include: fully participating, responsible and engaged citizens; better-functioning public services which are under less pressure and are better able to target resources; and potential savings for the public purse. The British justice system is held up as a shining example across the world. If that alone was not a reason to shout about it from the rooftops—educating the public about its benefits—then improving the accuracy and the fairness of its outcomes must be.

Greater PLE would improve our legal system by ensuring better educated and engaged jurors. It would improve our legal system by creating confident witnesses, aware of the importance of their testimony and often supported factually and emotionally by the Citizens Advice witness service. It would improve our legal system by bringing about the wider participation, and therefore better representation, of communities, as a result of citizens acting as magistrates, for example. It would improve our legal system by helping victims to recognise that they need support and enabling them to seek it in the right places, rather than their circumstances going unreported and unresolved. It would also improve our legal system in many, many other ways.

I am very pleased that we have been granted the opportunity to discuss the excellent PLE already going on in our country. However, I believe that it is more important than ever to equip as many people as possible with knowledge about their legal responsibilities—as well as their rights—under our great British legal system.

14:49

[Eddie Hughes (Walsall North) (Con)]

It is a pleasure to speak under your chairmanship, Mr Pritchard. I congratulate my hon. Friend the Member for North East Hampshire (Mr Jayawardena), partly because this debate has been an education for me. When I was growing up, as the son of a bus driver, in a typical Irish community in Birmingham, I aspired to be a JCB driver, largely because the people I saw around me were involved in construction of some sort and it is easy to aspire to be something that we can see.

I managed to spend a considerable portion of my life without interacting with lawyers of any sort, and when I did, I saw that largely as a negative thing. When I was purchasing a house, I clearly needed to use the services of a conveyancing solicitor. Once we have settled on a house that we think we can afford to buy, all of a sudden there are additional costs that need to be built into that model, so the cost increases and I think, “Oh my god, I have had to pay for this service that I didn’t think I needed and I have paid what felt like an unreasonable fee for it, and these posh lawyers are the people who benefit from it.” Little did I know that although good legal advice is expensive, bad legal advice can be very expensive. Only later did I come to appreciate just how brilliant some people in the legal profession can be, and just how necessary.

The next time that I engaged with solicitors was perhaps even less fortunate—it was when I was getting divorced. Again, the process seemed to cost me considerably more money than I had thought it would. It was an already perilous position to be in, but I needed to engage lawyers at least to mitigate the loss that I was experiencing. My point is that, clearly, if people do not engage with the law and solicitors except at a time when they are absolutely necessary to them in order to navigate life, their experience of them might be fairly negative.

Why do I make this introduction? I do so because I believe that I am the Conservative MP who represents the most deprived constituency represented by a Conservative MP. I believe that approximately 25% of my constituents do not have a passport. They certainly do not have high levels of education and they will definitely not be meeting solicitors or other legal professionals as a matter of course, so the law is, I imagine, probably something for them to fear. If people do not know it, do not understand it and are not aware of what their obligations are under it, life is likely to be all the more difficult, so for me, part of the reason for being excited about the concept of public legal education is the opportunity that it will give me, as an MP, to enhance my engagement with schools in my constituency and also, hopefully, to engage with legal practices in Walsall and give them the opportunity to come into schools and educate young people.

The reason for that is twofold. First, if people are introduced to the law and legal professionals and become more familiar with them, their greater understanding will allow them, I hope, to navigate the law more easily on their own and, should they need to engage professional legal services, they are likely to be better informed as to where to find them. Secondly, and perhaps more importantly, is the idea that schools interacting with legal firms will give young people, particularly those in my constituency, the opportunity to aspire to be something brilliant.

Since I have become more engaged with lawyers—let us face it: an awful lot of them end up becoming MPs—I have developed greater respect for the profession. We do not see them as people who are just going to take our money off us; they are actually nice people, deep down inside, and very useful. Many of them have great careers. What a unique thing for people in my constituency to aspire to.

Before I came to the Chamber this afternoon, I was speaking to some people from Lloyds Banking Group about a programme called Women in the Real Economy. The idea is that 10 MPs will be mentoring young people —young women—who otherwise would not have access to the networks and opportunities that might be naturally available to more middle-class families. What a great programme that is. We will be working in pairs—it will be me and a representative from Lloyds bank—to help those young women to develop skills and talents that they might not otherwise have the opportunity to develop. How great, then, that the timely arrival of this debate means that I have learned from my hon. Friend the Member for North East Hampshire about a number of the programmes that are available to schools and that I can engage some of those young women in them, so that they not only can aspire to great careers in professional commerce—as they might do through Lloyds Banking Group—but can be given some introduction to the law and perhaps, therefore, go on to pursue a career in law in future.

I wholly endorse the concept of the programme under discussion—the idea that we might educate people sooner and quicker. Young people will not be frightened of the law, but will have a grounding in it and a basic understanding of it and their obligations under it, but more importantly for me, the idea that some of them may go on to aspire to become legal professionals in the future is a great endorsement of this programme.

14:56

[Mrs Maria Miller (Basingstoke) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Pritchard; I am not entirely sure that I have done so before. It is wonderful to see you in the Chair today.

I thank my geographical neighbour, my hon. Friend the Member for North East Hampshire (Mr Jayawardena), for calling the debate, because it has given me, like my hon. Friend the Member for Walsall North (Eddie Hughes), an opportunity to look more closely at the work that the Solicitor General has been driving forward in this sphere. I shall speak particularly from the experience that I have had over recent years chairing the Women and Equalities Committee, which has given me an insight into things that I would like to draw on today. Of course, with the Solicitor General in his place, I pay tribute to my right hon. and learned Friend—[Interruption.] My hon. and learned Friend—soon to be right hon., I am sure. I pay tribute to him for the work that he has done in this area. As a solicitor, he might be forgiven for thinking that all of us know about these things. He has spent years—[Interruption.] Sorry, he is a barrister. Apologies; I will get into trouble with the Solicitor General! He has spent years honing his craft and knowing everything there is to know about the law. Then there are mere mortals, such as my hon. Friend the Member for North East Hampshire and me, who have not had that opportunity, although we did have the opportunity to go to the same wonderful university, the London School of Economics; that is something that we share.

Law shapes our lives. We know here, in the seat of democracy, that laws are an important part of the fabric of British society. We also know that the rule of law is integral to the way in which the British system of democracy works. We need look no further than north Hampshire to see the different ways in which we can make the rule of law work to underpin a better understanding of law are working in our community courts. We can look at the peer courts that have been set up. In those, young people sit and look themselves at community cases involving people of their own age, so that they can gain a better understanding of how the legal system works. We should applaud that and certainly applaud the Hampshire community court for pressing forward with it and rolling it out to ensure that young people understand that laws are not something that sits on a dusty shelf, but are put into practice through our courts and the rule of law.

The other critical part of the law is the political will to ensure that laws have the intended effect. Having been a Minister and been privileged enough to take laws through this place, I know only too well how they can sometimes not have the impact that we want them to have. One law that I believe has had a significant impact, although it probably still needs to go further, is the Equality Act 2010. It has had a significant impact, but we need to do much more to ensure that it has the political effect that was intended at the time. I think this is where public legal education can come into play.

I note the admirable words of my hon. Friend the Member for North East Hampshire, who talked about the importance of young people understanding the law: it should be part of the national curriculum and we should embed an understanding of the rule of law, hopefully to ensure that people can be good and upstanding citizens, who live their lives within the law. I gently suggest that that needs to go further and embrace those of us who are older, too. The lack of understanding, particularly of equality rights and our equality laws, is quite alarming. I will give a few instances where public legal education can focus in the future.

The first issue is maternity discrimination. Every year, tens of thousands of women feel that they have no choice but to leave their job because of the way in which they are treated in the workplace when they are pregnant or have new children. The Women and Equalities Committee, which I chair, has done an excellent report on maternity discrimination and has proposed some persuasive ways in which we could deal with this, including adopting a model that is in place in Germany, where women are not allowed to be made redundant when they are pregnant or have had small children. I hope the Government will eventually warm to that. As we will perhaps have a shortage of labour in future, we need to ensure that every single person in this country is able to play their part and not be excluded from the workplace for unlawful reasons. Few women understand maternity discrimination; they do not realise that what they might be enduring is maternity discrimination. I hope that the hon. and learned Friend the Solicitor General can talk a bit about some of the work—I believe that his office or the Legal Education Forum may be involved in it—to help women to understand their maternity rights. I think it is critical that any programme he undertakes in future should try to include these equality issues. Perhaps his panel will take some evidence from or listen to some of the organisations that are dealing with these particular issues of equality discrimination.

Secondly, I will briefly draw on some of the issues behind the #MeToo campaign. Again, demonstrating an absolute ignorance of the law, people have perhaps been coerced into signing severance agreements that include gagging agreements—we call them lots of different things and I get into all sorts of trouble for calling them non-disclosure agreements, but we will call them gagging clauses—to stop people speaking out against wrongdoing. The Solicitor General, who is a learned gentleman, knows that these things are completely unenforceable, but the average person, such as me or perhaps my hon. Friend the Member for North East Hampshire, would not be in that position and may believe that draconian measures to keep us quiet are entirely lawful. If the Solicitor General considered how he might use his excellent education programme to look into this further, he would be doing this country a great service indeed.

I could draw on many other areas in equality law, where the lack of understanding is hampering the original intention of the law. Hate crime, disability discrimination, maternity discrimination, which I have discussed, and tackling sexual harassment—the list goes on. I suggest to the Solicitor General that he look at the list of reports that the Women and Equalities Committee has published to see where his topics might lie, because this is a theme that comes up time and time again. I believe that the Equality Act 2010 needs some significant reform to make it work properly, but we also need people to understand it. That is where his programme of legal education comes in.

I wholeheartedly welcome this debate, the concept of public legal education and the excellent work that the Solicitor General is doing. Will he explain how what he is doing sits alongside the role of regulators, such as the Solicitors Regulation Authority, which has a statutory duty to promote the public understanding of citizens’ legal rights and duties? We recently had an opportunity to hear from the Solicitors Regulation Authority in one of our Select Committee hearings. I hope that the SRA will look more closely at this area in the future, particularly given the problems that many people are having with the way in which their employers may be using the law, which is not always as transparent as it should be. Many laws require people to know that they exist before they can come into effect, nowhere more so than when it comes to equality rights. I applaud my hon. Friend the Member for North East Hampshire for bringing this issue to the attention of the House. I will listen carefully to the Solicitor General’s response, to hear whether he feels there is more he could do when it comes to the understanding of equality law as well.

15:05

[David Morris (Morecambe and Lunesdale) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Pritchard. I thank my hon. Friend the Member for North East Hampshire (Mr Jayawardena) for introducing this pertinent debate. When I was asked to speak on this yesterday, not having a legal background, I must admit that I found the issue a bit daunting, until I looked into what it was actually about. It is very simple indeed. It is about citizens’ awareness of public legal procedures. It turned out—quite remarkably—that I am actually a patron of a public legal education entity, the Mason Hayes Charitable Trust, which is run by Marcus Hayes of Mason Hayes Solicitors. We work with the University of Sussex, placing law students and lawyers in primary and secondary schools, mainly in the midlands. We bring some of the law students into Parliament to learn about how the laws are made in this place and the ways in which we can enhance parliamentary process. We bring them in to show them exactly how laws are made here. We are linked to this issue. It is important that we reach out to the public to show them that the law is not something to be frightened of. The law plays into our everyday lives. All of us will have to use the services of a lawyer at one time or another. It is important that we teach our citizens how to access that market and that part of our society.

My son, Thomas, who is a postgraduate law student at BPP, participates in the StreetLaw programme, run by BPP’s pro bono centre. He goes out to schools and teaches young people how to access the law, what the law is about and how it functions in our everyday lives. These are important issues that we have to cover. In my Morecambe constituency, we have many fine law firms—too many to list, and it would be inappropriate to single out any one of them—that do the same thing. It is good to know that the law profession is giving something back to the citizens who support and use them. I ask the Minister, how can we enhance this going forward? It should not be seen as a scary subject, as I thought it was when my colleague approached me to talk about it. It is not a scary subject, as I have explained. I am involved in it and I did not even know I was involved in it, not only as a Member of Parliament, but as a citizen. I wholeheartedly endorse public legal education. We should do this in a fashion that helps the society we are making in this great country.

15:09

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate my hon. Friend the Member for North East Hampshire (Mr Jayawardena) on securing this important debate. I am fortunate indeed to have been surrounded by the law for the past 30 years, from studying it as a 16-year-old for A-level and going on to study at degree level to becoming a barrister and spending 18 years as a lawyer, and then in the past three years trying to help make the law in this place. In a way, this debate is about how we can help young people ensure that they never have to come across somebody like me. I believe absolutely passionately that young people should be put in a position where they can understand rights and wrongs, rights and responsibilities and the way to settle disputes without the need for them to escalate. That is why I am passionate about the concept of public legal education in our schools. I feel to a certain extent that we are almost there, and this is the bit I want to reference with respect to the Minister.

A year or so ago, I served on the Children and Social Work Bill Committee, and a big discussion was held on personal, social and health and economic education. It came up in a narrow fashion because the discussion was about sex and relationship education and whether that should be a compulsory curriculum subject. In my mind, there was a great opportunity to go broader than that to teach our young people something wider than the citizenship curriculum subject that we have at the moment.

Citizenship is a hugely important subject that covers the rule of law, the ability to articulate debate, volunteering, and how to plan one’s life in future, but it could be so much more, and public legal education could easily fold into that. Although it has been confirmed for primary schools that compulsory relationship education will come in—and for secondary schools, sex and relationship education—by September 2019, I think we are somewhat in the dark as to what will occur to the concept of PSHE on a wider basis. I would like to see PSHE established on a compulsory footing, but I would also want to make sure that we do not overload our schools with yet another subject in the curriculum.

[Mrs Miller]

My hon. Friend is making an extremely important speech. The law is already there; the Secretary of State has put in place a law that can make PSHE compulsory. It just needs to be enacted. I hope my hon. Friend welcomes that, because the Government have actually done something that had been not done for 17 years by Governments of successive colours.

[Huw Merriman]

It will be down to the Minister to confirm this, but my understanding is that although there has been some form of commitment—we are absolutely clear as to what has been brought in for primaries and secondaries with regard to compulsory relationship education—so far that clarity has not been given for the wider PSHE. I look to the Minister to confirm that, but my research, certainly from February, tells me that that was indeed the case, and that is the commitment I want to see from the Government.

On the current challenges for teachers, I have long taken the view that while it is essential to get the basics of English and maths right in our primary schools—we have known for many years that they have failed in that regard—I feel that there is a strong emphasis on those two subjects and they lead to the exclusion in some schools or a lack of attention in others regarding the wider curriculum subjects that will give our young children and pupils the ability to navigate their way through the challenges of life, which is as essential as giving them the basics in English and maths.

I will not delay any further. I know that the hon. and learned Member for Edinburgh South West (Joanna Cherry), who speaks with great knowledge on this matter, has had to cross out part of her speech, so I hope she will get some time back. I look forward to hearing from the Minister as to whether PSHE will be introduced and whether that gives us a golden opportunity to advance public legal education within that sphere.

15:14

[Rachel Maclean (Redditch) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Pritchard, and to follow my hon. Friends, particularly my hon. Friend the Member for North East Hampshire (Mr Jayawardena), who secured this debate. Like others who have spoken, I too had to educate myself on this subject before I came to speak in this debate. It is really important to welcome the work that the Government are doing in setting up a public legal education panel because the law can appear very complex and intimidating, particularly for those from disadvantaged backgrounds who are not as lucky to be as educated as we in this Chamber are.

The trouble with the law, as my hon. Friend the Member for Walsall North (Eddie Hughes) has referenced, is that it tends to affect us at the times in our lives when we are undergoing a lot of stress because of life events that come at us out of the blue, such as divorce or bereavement. It has touched me recently in the case of my mother, who is a dementia sufferer. I have had to apply for a lasting power of attorney and go through an entire process, which has been extremely difficult and complicated. There has been help for me, which I have welcomed, but I think a lot of people struggle with such concepts at difficult times in their lives.

We live in a society where there are still a lot of myths around the law. One area is very important. Women still sometimes believe in the concept of common law marriage, which is a concept with nothing behind it, yet sometimes people believe that they have some rights and protections in a relationship. They find out when it is much too late that they do not have protections and are left in a devastating financial position, sometimes losing access to their property or their children. I very much hope that the concept of public legal education can reach out to all areas of society and help people when they have tragic and difficult life events.

I am delighted, like other hon. Members, to mention some of the organisations that do an excellent job. I have been made aware of one organisation called Big Voice London. One of my daughter’s friends has done some work for that organisation, which focuses on the diversity aspect because, when we look at the legal profession, it is still very limited in terms of who comes into it. Unfortunately, social mobility is a real problem. In 2017, despite only 7% of school pupils attending private schools, according to the Sutton Trust 32% of law firm partners, 71% of QCs and 74% of judges attended private schools. As someone who went to a comprehensive, I do not think that is good enough, so I am delighted that there are organisations such as Big Voice. My friend, who came from a non-traditional background, said that it really helped him in his journey. He has just started as a young barrister and is doing very well. I hope that such organisations can continue to be supported.

I will touch on three issues—I do not think they have been mentioned—where public legal education is critical. The first is social media for young people in our schools. They sometimes do not realise the impact on their future careers of what they post on social media.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that it is imperative that, in a world that is increasingly litigious, people are educated from a young age to understand how systems work and, more importantly, understand where they can seek help from appropriate sources without the worry of feeling isolated, uncertain, overwhelmed and vulnerable?

[Rachel Maclean]

I thank the hon. Gentleman for that intervention; I agree with the point he has made. Social media can sometimes combat isolation, but it can also lead to isolation in and of itself.

Social media is one area where young people need to be more aware of the law and how what they post can affect their future job prospects. The other area is housing, which comes up all the time with constituents in my surgery. Unfortunately, there are very bad landlords out there. The Government have done a lot to protect tenants, but sometimes people lack awareness of their rights and responsibilities and they end up living in absolutely horrific housing conditions that none of us would want to see.

The final area is around employment law, which my right hon. Friend the Member for Basingstoke (Mrs Miller) has mentioned, and she was right to do so. There are many small business employers—I was one myself—who feel terrified of battling with employment law, and better awareness in that regard would help them as well as the employees whom she talked about in detail. I will conclude so that others can speak, and I thank my hon. Friend the Member for North East Hampshire for securing the debate.

15:19

[Joanna Cherry (Edinburgh South West) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate the hon. Member for North East Hampshire (Mr Jayawardena) on securing this important debate and on speaking so well in it. I do not want to be a churl, but I have to correct something that he said when he referred to the British legal system. It is not a nationalist point I am making. I can assure him that many of my colleagues at the Scottish Bar who are members of the Conservative and Unionist party would be just as anxious to say that there is of course a separate legal system in Scotland.

[Mr Jayawardena]

I was, of course, simply waiting for the hon. and learned Lady to call me out on that point.

[Joanna Cherry]

I should nevertheless declare an interest as a member of the Scottish Bar of some 20-odd years’ standing, although I have not practised since I was elected, almost three years ago. Since I have been in Westminster I have been touched by the friendship and hospitality of colleagues of all parties from the English Bar, and indeed from the Law Society of England and Wales. They have made me very welcome and invited me to many of their enjoyable dinners, which I was pleased to see are just as boozy as the Scottish ones; although perhaps, as I am from a country that has introduced minimum pricing for alcohol, I should not say that.

I am very proud that in Scotland I benefited from a free legal education. That was back in the 1980s, but law students in Scotland still benefit from the fact that there are no tuition fees there. It makes law more readily accessible to people from poorer backgrounds, although there is a lot of work to be done on that. I want to come on to discuss what my profession is doing, in the Faculty of Advocates and the Law Society of Scotland, to encourage people from more diverse backgrounds to enter the profession. In Scotland, public legal education starts at an early age because the study of human rights is part of the curriculum for excellence in Scottish schools. It is part of the core element.

15:21

Sitting suspended for a Division in the House.

15:38

On resuming—

[Mark Pritchard (in the Chair)]

For the sake of clarity, this debate may now run until 4.17 pm, and the sitting as late as 5.50 pm, unless there are more Divisions in the House—that is not currently anticipated, but who knows?

[Joanna Cherry]

As I was saying, public legal education in Scotland begins at an early stage. Human rights is part of the curriculum for excellence that is taught in Scottish schools, and it is a core element of the health and wellbeing module of that curriculum. Schools in Scotland work in collaboration with organisations such as Amnesty International to deliver the human rights element of the curriculum.

I am a member of the Joint Committee on Human Rights, which is carrying out an inquiry into the enforcement of human rights and attitudes towards them. Last week, we heard evidence from a number of witnesses who said that there is a demonstrably different discourse about human rights in Scotland. They put that down to the teaching of human rights in Scottish schools, as well as to media in Scotland, which are less hostile to the concept of human rights.

Good human rights practice in Scotland flows from that less hostile environment towards human rights. The witnesses giving evidence to our Joint Committee last week gave as an example of that the embedding of human rights in the new Social Security (Scotland) Bill, which I am proud was introduced by my good friend and colleague Jeane Freeman, the Minister for Social Security in Scotland.

The witnesses also spoke of the wonderful work done by the Scottish Youth Parliament on legal education and rights. The Scottish Youth Parliament is a grassroots project—run in conjunction with the Scottish Parliament—that does a lot of good work in the area of human rights principles and children’s rights.

I am sure that other hon. Members present will, like me, have in their constituencies schools that are part of the UNICEF Rights Respecting Schools project. I am advised that 1.5 million children across the United Kingdom go to a rights respecting school. I am proud that I have worked with two schools in my constituency, Redhall School and Oxgangs Primary School, on rights respecting. The children were particularly interested in the importance of respecting the rights of child refugees.

Why teach human rights, and indeed legal education, in school? Scotland’s curriculum for excellence aims to enable students to become responsible citizens. As other hon. Members have said, learning about the law, rights, respect for others, and a commitment to participate in all aspects of public life helps children to grow up and aspire to be good citizens.

Students across Scotland, particularly law students, are involved in the delivery of public legal education through the Scottish Universities Law Clinic network. A number of universities in Scotland run free legal advice clinics for members of the public.

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

The hon. and learned Lady is making some good points. She is absolutely right that a lot of law students can give their free time to such projects, but is there not a real problem in that some of the bigger law firms do not sign up to pro bono work and do not free up their solicitors to spend time in schools or to do other important pro bono work? What are her thoughts on dealing with that?

[Joanna Cherry]

I very much encourage those who have benefited from a free legal education in Scotland and beyond, and who are now doing well out of being lawyers, to engage in pro bono work. I am proud that the Faculty of Advocates and the Law Society of Scotland do that and encourage firms and individual advocates in Scotland to do it too. I will return to that in a moment.

The Edinburgh Napier law clinic is in my constituency. Edinburgh Napier University is a relatively recent deliverer of legal education in Scotland, but I am proud to say that staff and students have set up a voluntary clinic to provide free legal advice and assistance. We have a considerably more generous legal aid scheme in Scotland than in England and Wales, but nevertheless people fall through the cracks, and they can benefit from law clinics such as the one established by Edinburgh Napier University. One of the clinic’s main objectives is to broaden the concept of access to justice, and that is really what this debate is about, at least in part. Public legal education is about educating people and giving them access to justice.

I am also proud that Edinburgh University, which is not in my constituency but is my alma mater, has a free legal advice clinic, as does Glasgow Caledonian University, the University of Strathclyde, Aberdeen University, Robert Gordon University in Aberdeen and the University of the West of Scotland. Those law clinics are thriving. Many MPs and Members of the Scottish Parliament refer their constituents to them from time to time.

The Faculty of Advocates, which is the Scottish Bar, of which I am a member, also runs a law clinic or a free legal services unit, which is part of its commitment to promote access to justice. That means that members of the public can be referred through certain organisations, such as citizens advice bureaux, to get free advice and representation from practising advocates in Scotland.

[Jim Shannon]

Has the hon. and learned Lady experienced the issue of local citizens advice bureaux being deluged with personal independence payment and employment and support allowance forms? In a great many cases, they find themselves unable to give that legal advice because of the change in the benefits system.

[Joanna Cherry]

Yes, I have. My constituency office in Edinburgh South West, on Dundee Street in Fountainbridge, is next door to the local citizens advice bureau in Fountainbridge library. We work closely together on this sort of issue. Citizens Advice provides an amazing service. In my experience, Members of Parliament who work in conjunction with it can have successful outcomes in fighting issues of administrative justice in the UK social security system. That is a much-neglected area; we need to look at how the social security system is functioning or, in my experience, not functioning, and failing to properly respect people’s rights. We need to look at all the facts of the case. As in the immigration field, there seems to be a considerable amount of capricious decision making, which is why it is important for people to have access to legal assistance in facing down that unfair decision making.

I am happy to say that on a number of occasions, I have referred constituents to the free legal services unit at the Faculty of Advocates with good outcomes. The Faculty of Advocates also arranges open days to encourage students from schools across Scotland to come and see what life as an advocate is really like.

I am proud that the Faculty of Advocates has done much to increase its diversity since I was called to the Bar in 1995, when I was one of a small number of women advocates in Scotland and there were no female judges on the senior Scottish bench. Now, our second most senior judge is a woman and we have many women on the senior judicial bench in Scotland, but there is still quite a long way to go before we achieve parity with the men.

There is also the issue of trying to encourage more people from working-class backgrounds and from diverse and BAME communities to come into the law. As well as holding open days, the Faculty of Advocates runs a couple of mini trials—or mock trials—initiatives, which are particularly directed at kids from schools and backgrounds from which people would not normally be expected to end up at the Bar, to try to break down the barriers and to show that—if I am allowed to say this—the law can sometimes be fun, and that it is not just for posh people who went to a private school. I hope that my former colleagues are making some progress in that area. They run the mock trials as part of the Citizenship Foundation, which has been mentioned. It is a cross-UK foundation that is supported north of the border by the Faculty of Advocates.

Another way that legal professionals can contribute to legal education is by providing briefings to parliamentarians working on Bills. In the three years that I have been here, I have had invaluable assistance from briefings provided by the likes of the Law Society of Scotland, the Law Society of England and Wales, the Bars of Scotland and of England and Wales, and organisations such as Liberty, and Justice. I am proud that the Faculty of Advocates actively contributes to law reform north and south of the border under the excellent chairmanship of Laura Dunlop, QC, who was my pupil master, although she is not responsible for any of my mistakes—only for the good parts.

The Law Society of Scotland also provides fantastic briefings. I could not have done my job as an MP properly without its assistance in the last few years, particularly the assistance of Michael Clancy, who is the head of law reform there and is well known to parliamentarians from all political parties. In more general terms, it has also engaged in significant activity in the area of public legal education.

The hon. Member for Morecambe and Lunesdale (David Morris) mentioned StreetLaw. The Law Society of Scotland participates in the StreetLaw project. That involves sending out StreetLaw trainers to teach students and schoolchildren about the law, the legal process and the sort of knowledge and skills that students can use to recognise and prevent legal problems in their lives, and perhaps also to prompt them to consider participating as legal professionals in later life.

All the Law Society of Scotland’s StreetLaw trainers are law students studying in Scotland who undertake this work on a voluntary basis. I am very proud to say that they are supported by two major international law firms in doing so—CMS Cameron McKenna Nabarro Olswang, and Pinsent Masons. They have also had support from the Law Society of Ireland and from international leaders in public legal aid education, such as Harvard University, Georgetown University and Penn State University.

As well as participating in the StreetLaw project, the Law Society of Scotland participates in a charitable foundation, which was set up to give bursaries to students and to support summer schools, schools programmes, visits and events. The Law Society of Scotland is also playing an active role in a campaign to increase diversity in professional services in Scotland.

Just before I draw to a close, I will add a note of caution. An awful lot has been said today about the importance of public legal education, but public legal education should never be viewed as an easy way to plug the gaps left by legal aid cuts. Access to justice should always be our paramount concern. Public legal education should be more about developing capacity and not really about answering specific legal problems because of unmet needs due to gaps in the legal aid system.

Recently we saw a leaked Ministry of Justice report that revealed judges in England and Wales are concerned that legal aid cuts are leading to an increase in the number of defendants without legal representation. I think it is fair to say that the extent to which legal aid has been cut in England and Wales has pushed many people out of eligibility for it in crucial areas of justice, meaning that vulnerable people are often left without legal aid and appear in court or before a tribunal without a lawyer. That is not just my view; it is also the view of many of the witnesses who have given evidence to the inquiry by the Joint Committee on Human Rights into the enforcement of rights. It is also the view of Amnesty International, which has said that the cuts included in LASPO—the Legal Aid, Sentencing and Punishment of Offenders Act 2012—have created a two-tier justice system in England and Wales.

Recently in Scotland, we had an independent review of our legal aid system. It highlighted that, despite the fact that we spend less per capita in Scotland on legal aid than is spent in England and Wales, legal aid is far more widely available in Scotland and covers a wider scope of categories than it does south of the border. As I say, that was not a Scottish Government review but an independent review, chaired by Martyn Evans, the chief executive of the Carnegie UK Trust. It shows that it is possible to have legal aid that is more widely available without actually spending any more money. So, where there’s a will, there’s a way.

I end by urging the Solicitor General to be cautious about letting public legal education plug the gaps that legal aid should fill, and I urge the UK Government—as I have done on previous occasions—to carry out an independent review of the legal aid system in England and Wales, rather than the in-house Government review that is going on at the moment.

15:53

[Nick Thomas-Symonds (Torfaen) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Pritchard, and I draw attention to my relevant entry in the Register of Members’ Financial Interests. I am a non-practising barrister at Civitas Law in Cardiff. Indeed, I practised as a barrister for some years before entering Parliament in 2015.

I begin by congratulating the hon. Member for North East Hampshire (Mr Jayawardena) on securing this debate on a very important subject and I join him in congratulating the many organisations that contribute to public legal education, which includes professional bodies such as the Law Society and the Bar Council, but also many other organisations, within our communities all around the country.

I share the hon. Gentleman’s passion for citizenship education, not only as taught in our schools but as part of lifelong citizenship education. He spoke very powerfully about scams and other matters when, of course, knowing your rights is important, whether that is at the age of 20 or much later in life. The hon. Member for Walsall North (Eddie Hughes) spoke very powerfully about a really important point to take from this debate, which is that nobody should ever feel that the legal profession is not for them. We want anyone to aspire to be in the legal profession on merit and not because of background.

[Mr Gary Streeter in the Chair]

The hon. Member for Morecambe and Lunesdale (David Morris) raised another important issue, namely the fact that public legal education really should not be an intimidating subject; it should be something that we can all speak about and access. I share the passion of the hon. Member for Bexhill and Battle (Huw Merriman) about public legal education in schools. Giving people the skills to go through life is indeed very important. I thank the hon. Member for Redditch (Rachel Maclean), who drew, in a moving way, on her own personal experience of dealing with her mother’s dementia and applying for a lasting power of attorney which, with our ageing society, is something that more and more people will have to apply for in the years ahead.

The right hon. Member for Basingstoke (Mrs Miller) set out well how law shapes our lives and she spoke very powerfully about the issue of maternity discrimination. The only thing that I will say about that is that we all need to be grateful to the Supreme Court for declaring tribunal fees unlawful, because I am sure the right hon. Lady will appreciate that between the introduction of the fees in July 2013 and the date on which they were declared unlawful by the Supreme Court the number of maternity discrimination cases fell significantly.

[Mrs Miller]

My point was much broader than that. Far more people are affected by maternity discrimination than bring maternity discrimination cases. Although the point that the hon. Gentleman has made is factually correct, I hope he agrees that it is important to think about those women who would never even have understood that they had been discriminated against. That is the point I was making.

[Nick Thomas-Symonds]

I do not disagree with the right hon. Lady, and she is absolutely right to say that the problem is broader. However, she will appreciate that there must be an ability to enforce the right before a tribunal; otherwise, of course, the right loses its meaning. I think that we all hope that, now those fees are gone, we will get back to a position where everyone who wants to bring such a case is able to do so.

I do not doubt for a moment the Solicitor General’s commitment, and I know that he has been at the forefront of efforts to set up a panel that will co-ordinate work in this area. I will quote what he said when he set up the panel, because I agree with it:

“Teaching people about their legal rights and responsibilities, together with helping them gain the confidence and skills to get access to justice, can really make a difference to people’s lives—as well as our legal system.

The new Panel will help drive forward Public Legal Education, so more people can reap the benefits.”

That is all absolutely right.

Similarly, I do not disagree with what the hon. Member for North East Hampshire said when he maintained that one of the benefits of public legal education might be that more people can settle disputes outside court. That is absolutely right, as well. Of course we all want to see that; we do not want to see unnecessary litigation.

At the same time, although it is not my intention to be unduly partisan in a Westminster Hall debate, I have to record the concern that exists about the ability of people to enforce their rights before a court irrespective of their wealth. “Our system of justice has become unaffordable to most”—those are not my words, but those of the previous Lord Chief Justice, Lord Thomas, who said them in January 2016 in his annual report to Parliament. There is concern that we have to put alongside an absolutely correct drive towards greater public legal education a similar ability for people to enforce their rights before our courts if they need to do so.

The hon. and learned Member for Edinburgh South West (Joanna Cherry) mentioned a concern that exists about people in a very vulnerable position not having access to legal aid to enforce their rights. A very good example of that is state help in benefits cases, when people are indeed in a very vulnerable position and looking for advice as to how they can best enforce their rights and ensure the continuation of their income. The statistics on this are stark. In 2012-13, 83,000 people had the benefit of state help in those circumstances; by 2016-17, the figure was 440. That is a swingeing cut in help and assistance for those people to enforce their rights, and it is a great concern.

The hon. Member for Henley (John Howell), who is not in his place at the moment, rightly made the point that with the changing dynamics of our courts, with virtual courts and online courts, the idea of public legal education is becoming more important than ever. Far more people are representing themselves before the courts. In one sense, that reinforces the point about more public legal education, but there is a concern about the family courts in that regard. There has been a leap in those representing themselves from 45,000 people in 2012-13 to 64,000 in 2016-17, and the worry is that there is no protection in family courts for perpetrators of domestic violence to cross-examine their victims. Such a measure was included in the Prisons and Courts Bill, which was lost just before the general election of last year—I served on the Public Bill Committee. When will that provision be brought back? It would command wide support across the House, and the sooner it can be brought back and put into effect, the better for everyone concerned.

Legal aid is a huge concern across a number of areas, whether that is immigration, civil legal aid or criminal legal aid. I have looked at the figures, and between 2010-11 and 2016-17 there was a £950 million cut in legal aid. No wonder the legal profession has been driven to take the action it has, but it is about far more than figures; it is also about the idea that early legal advice can save money. I commend to the Solicitor General my noble Friend Lord Bach’s report, published in the past 12 months, in which precisely that issue of early legal advice is proposed as something that should be absolutely central in our justice system.

I think there is consensus about the importance of public legal education, and I am grateful to all those who do work in that area. I do not doubt for a moment the Solicitor General’s commitment and I am sure that progress will continue, but the means by which people can enforce their rights before the court should not be based on their personal wealth. At the same time as enhancing our public legal education, let us put legal aid back to where it was meant to be when it was introduced in 1949 as the fourth pillar of the welfare state.

[Mr Gary Streeter (in the Chair)]

Order. I remind Members that the debate closes at 4.17 pm. If the mover of the motion were given two minutes to have the final word that would be wonderful.

14:00

[The Solicitor General (Robert Buckland)]

I will do that, Mr Streeter. It is a pleasure to serve under your chairmanship, as it was under Mr Pritchard’s. It is almost a challenge for me to fit into the few minutes I have, everything I want to say on a subject I have a long interest in and passion for.

I thank my hon. Friend the Member for North East Hampshire (Mr Jayawardena) for reminding us clearly and comprehensively about the unwritten contract, the Burkean principle that is so important to many of us, and for reaching into the present day by illustrating some of the excellent initiatives going on around the country. I will come back, if I may, to some of the observations made by the shadow Solicitor General and the hon. and learned Member for Edinburgh South West (Joanna Cherry), but I will begin by reminding everyone what public legal education, or PLE, is.

PLE provides people with vital awareness, knowledge and understanding of their rights and those of their fellow citizens. It builds their confidence and the skills that are needed to deal with the disputes that no doubt encroach on the lives of many of us, and it ensures effective access to justice. I was at the independent Bar for many years before I was elected to this place, and I played my part in the delivery of public legal education in schools and colleges in south Wales. I wanted to bring that experience with me into my role as Solicitor General. It is ever more important to ensure that the people of our country understand the law and their rights and responsibilities within it. Public legal education breaks down barriers of knowledge, circumstance and access. As we have heard, PLE is provided by myriad community-based organisations—youth workers and health workers, for example, and legal professionals themselves—all doing their part to ensure that particularly those people with social and economic disadvantages can still get the support they need.

The shadow Solicitor General made the observation that legal aid is a pillar of the welfare state. It is more than that; it is about access to justice. Both he and I, as practitioners, have seen Governments of various colours take legal aid measures that have resulted in reductions in overall eligibility, and the remarks of the hon. and learned Member for Edinburgh South West were particularly interesting in that regard. Frankly, I do not think that any Government have got it absolutely right. I could go into a long history lesson about how in 1949 only High Court family cases were eligible for legal assistance and that under successive Governments that assistance was enlarged to a point at which under the Thatcher Government—some would think this almost ironic—84% of the population of England and Wales had some form of eligibility for legal aid.

[Joanna Cherry]

An independent report published just a couple of months ago shows that 70% of the population of Scotland is eligible for legal aid, yet less is spent per capita on that aid than in England. With a bit of imagination, there could be wider availability of legal aid in England. Scotland shows that it can be done.

[The Solicitor General]

I am always interested in the hon. and learned Lady’s observations, but I am not sure whether 70% coverage is the right balance. I will consider with interest what she has said and study the issue more carefully, rather than making remarks that are not based on a full study of the evidence. I will, however, concede the point that public legal education is not some substitute or easy fix for eligibility for legal aid. It is a much more long-term approach, which focuses naturally on children and young people and is designed, above all, to give people the knowledge and the wherewithal to avoid the pitfalls of litigation and court proceedings in the first place. We have a very different aim in mind when it comes to spreading the provision of PLE. I pay tribute to all the organisations in Scotland that do so much work, the law clinics in particular, which the hon. and learned Lady mentioned—we have those in great measure too south of the border.

It is not just motherhood and apple pie; there is a statutory underpinning to public legal education in the Legal Services Act 2007 which, among its regulatory objectives refers to

“increasing public understanding of the citizen’s legal rights and duties”

and

“improving access to justice”.

It is not an option for the Government, or indeed any of the regulatory bodies, to neglect those objectives. I am glad that the Law Society, the General Council of the Bar and the Chartered Institute of Legal Executives here in England and Wales play their part in ensuring that PLE is spread as far and wide as possible within the professions. Both the Attorney General and I, as the pro bono champions of the Government, work closely with those involved in PLE and support initiatives to increase its profile and reach more members of the public.

[Dr Poulter]

I come back to my earlier intervention, and put the same question to my hon. and learned Friend. There is a challenge, despite the best efforts of the Law Society and the Bar Council in encouraging pro bono work, as some of the big law firms, which are all about billable hours, do not free up enough of their solicitors to do important pro bono work. What does my hon. and learned Friend think the Government or the Law Society could do to encourage a more responsible approach from some of those firms?

[The Solicitor General]

My hon. Friend makes an important point. For those of us who were in the full throes of private practice, very often the delivery of PLE was a better use of our time than our having to immerse ourselves in often very unfamiliar areas of law, with all the concomitant risks. My message to the big firms is: where there is an issue about availability, allow members of the team to go into schools first thing in the morning. I have seen that in several state schools in London. I have joined employed barristers and solicitors helping to deliver citizenship foundation courses, for example in social media law. To see the engagement and sense of ownership that young people have when talking about issues so close to their everyday lives—when they suddenly understand that law is not some remote, dusty concept, but reaches into their existence and everyday experience—is quite a sight to behold.

I want to outline and underline the work that we are doing with the public legal education panel, which has been formed from leading organisations in the field to promote the importance of that work. It was convened by me last year. It involves the professions and organisations such as the Citizenship Foundation and Law for Life. We are bringing together organisations in a joined-up way to help work out where the need is and what the provision is currently. I have two sub-groups working on those issues.

There are two types of PLE. “Just in case” PLE is all about ensuring that people have skills, information and knowledge about their rights. “Just in time” PLE is all about giving people knowledge and support when a legal issue happens to arise. Both types of provision are equally important, and we are working our way towards getting a better understanding.

Through organisations and such events as National Pro Bono Week, I can champion the importance of PLE through the community, whether it is delivered in schools, to people who are homeless or those in prison, who really need to understand their rights and, most importantly, their responsibilities. Last year during Pro Bono Week, I took part in a session on social media and the law being delivered by university students to local secondary school pupils in Chester. It gave young people a chance to learn about their rights and the surrounding law. One issue that arose was the increasing problem in schools of young people taking videos of fights and other incidents in the playground. The session was about understanding what the sharing of those videos meant for privacy, the rights of the individuals involved and the problems that we are all familiar with here, but which all too often young people sadly only learn about to their expense after the event. I was proud of and impressed by the commitment of the university students delivering the sessions. That has been backed up in recent months by my experience at the Kent law clinic at the University of Kent in Canterbury. Law students there are not only delivering support and advice to members of the public; they are also helping to spread public legal education more widely.

We have some shining examples of the work that is going on, and I pray in aid the work of His Honour Judge Wildblood, QC at the Bristol family court. He is allowing his court to be used for public debates about the law. He is even using local drama groups to help to educate young people. He is bringing together the legal community in Bristol and the surrounding area in a most effective way. With that sort of leadership, many great things can be achieved but here, Mr Streeter, is where you and other colleagues come into play. As has been said by many Members, including my hon. Friends the Members for Walsall North (Eddie Hughes) and for Redditch (Rachel Maclean), there are opportunities for colleagues to take a lead in their local communities and work with local firms of solicitors or legal practitioners to help to deliver public legal education in our schools.

[Nick Thomas-Symonds]

I know the Solicitor General has done his fair share of school visits over the years. Does he agree that there is still work to be done on diversity and encouraging more people to apply to the profession? We can all make a difference by visiting our local schools and speaking about these matters.

[The Solicitor General]

The hon. Gentleman is absolutely right. Only last Friday I was doing that at a school in my constituency, the Ridgeway. I was talking to young people in the sixth form who did not have a background in the law about what opportunity there was for them. Like me, he no doubt has taken on youngsters in chambers deliberately with the knowledge that they did not have a background in law. In fact, I would not take people who had any connection with the law because I wanted to empower young people and give them a chance.

I want to deal with some of the points raised by my hon. Friend the Member for Bexhill and Battle (Huw Merriman) about the curriculum. The position has yet to be clarified because more work is being done, particularly on sex education in schools and the issue of consent and withdrawal. That is not yet a statutory part of the curriculum. Citizenship remains compulsory at key stage 3. We are talking about youngsters in years 7, 8 and 9 who can access that education in school, and it must include PLE. It is a matter for schools to determine how to deliver it, but by working collaboratively with professionals, a lot can be achieved.

My right hon. Friend the Member for Basingstoke (Mrs Miller) made some important points about access in the workplace, particularly for women who have no knowledge—I say that with respect; it is not their fault—about their rights. That is why the regulatory objective in the 2007 Act is important. More has to be done to deal with the question of empowerment of our citizens via the regulatory bodies. That would not just include lawyers, even though the 2007 Act has that remit. I will go away and think about her point very carefully. Perhaps we can use it as the start of an important discussion. I thank all hon. and right hon. Friends and Members for taking part today. The law is not some mystical holy of holies and lawyers are not the high priests. We should demystify it, and that is where public legal education is so important.

[Mr Gary Streeter (in the Chair)]

Mr Jayawardena has 20 seconds to wind up.

16:16

[Mr Jayawardena]

It is a pleasure to serve under your chairmanship, Mr Streeter. I thank all my right hon. and hon. Friends and all Members for taking part. My lasting memory of this debate will be my right hon. Friend the Member for Basingstoke (Mrs Miller) outing me as a mere mortal for not having been a lawyer and for only having gone to the LSE. Sir Arnold from “Yes, Minister” would have said, “Oh, I am sorry.” I am not.

Motion lapsed (Standing Order No. 10(6)).

ADHD Diagnosis and Treatment

Tuesday 15th May 2018 Westminster Hall

16:17

[Jo Platt (Leigh) (Lab/Co-op)]

I beg to move,

That this House has considered the diagnosis and treatment of ADHD.

It is a great honour to serve under your chairmanship, Mr Streeter. A few months ago the enormousness of the struggles and barriers that those with attention deficit hyperactive disorder face on a daily basis was brought to my attention by an inspirational woman who approached me in the hope that we could establish an all-party parliamentary group for ADHD. Seven months later, I proudly chair that APPG, along with the hon. Member for Faversham and Mid Kent (Helen Whately). We have held our launch and our first meeting, which was on the economic impact of ADHD, and today we have our first parliamentary debate on the diagnosis and treatment of ADHD.

That inspirational woman is Michelle Beckett, the founder and CEO of ADHD Action, an incredible charity set up to support and offer advice to people struggling with their condition. Everyone on the APPG, some of whom are here today, would agree that we would not be here today without Michelle’s work and dedication to the issue. I would therefore like to place on the record my thanks, and those of the APPG, to Michelle for the incredible work she does.

In the months since we created the APPG, I have become ever more shocked by the stories and experiences shared with us about the diagnosis and treatment process that has been letting people down. It has been doing so in three ways. The first is stigma and attitudes. That is true of mental health more generally, and I am pleased that this debate is during Mental Health Awareness Week, which is a yearly reminder of the progress yet to be made in treating mental health in parity with physical health.

Looking at societal attitudes to ADHD in particular, we see a variety of misconceptions and stigmas. ADHD is often seen as a condition that only affects boys. It is sometimes interpreted as the product of poor parenting or just excused as naughty children playing up. All those ideas are false, but the impact of those misconceptions is enormous. Children may not be offered the correct support, and adults with the condition are often undiagnosed or even unaware that they might have ADHD.

An undiagnosed child in school, without the support they need, will in all likelihood fall behind their classmates and struggle to obtain top grades. Almost half of all school exclusions involve pupils with special educational needs. That is a truly shocking statistic, and it underlines the importance of exploring further ADHD-specific policies, perhaps in the mental health Green Paper or as part of the special educational needs and disability code of practice.

[Mike Hill (Hartlepool) (Lab)]

As my hon. Friend knows, ADHD can continue into adulthood. A constituent of mine is lobbying for it to be given the recognition it deserves. Does my hon. Friend agree that ADHD should be classed as a disability for the purposes of the law, including accessing benefits?

[Jo Platt]

I thank my hon. Friend for that intervention. He is right that we need more awareness of ADHD. I know that people who suffer with ADHD have called for their own Act—something similar to the Autism Act 2009.

In the midst of cuts to school nursing provision, and a school funding and teacher recruitment and retention crisis, the number of school exclusions of pupils with special educational needs is no fault of our hard-working, dedicated and professional healthcare workers and teachers; it is the product of an underfunded and under-resourced health and education system. We cannot go on treating children with ADHD simply as naughty kids, and being unable to afford the time or resources to help them. Instead, we must support those young people and focus their education around their skill set.

The second way we are letting people with ADHD down is through diagnosis. A recent survey with more than 800 responses revealed that 70% of respondents had waited 18 months or more for an ADHD diagnosis, 9% of whom were, shockingly, waiting for more than three years.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I recently asked three parliamentary questions on waiting times for assessments for ADHD, and for all three the response was that those figures were not collated. We cannot do anything about it until we have accurate data. Does my hon. Friend agree that the Minister and the Department should be collating that data?

[Jo Platt]

I thank my hon. Friend, the vice-chair of the all-party parliamentary group for ADHD, for that intervention. He is absolutely right to mention that the lack of data causes a mismatch and a bit of a postcode lottery, which I will address later.

At a recent APPG meeting, we heard stories of people waiting years for a diagnosis—years battling without the support or guidance they need, falling behind in school, or struggling in their occupation. We heard stories like that of my constituent Mick, whose son has suffered enormously, falling into crime before he was diagnosed, which unfortunately is all too common. About 25% of male prisoners are thought to have ADHD.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I congratulate my hon. Friend on securing this important debate. She mentioned that about 25% of male prisoners are thought to have ADHD. Does she agree that early intervention and diagnosis of ADHD would not only reduce crime and save money, but improve the life chances of people with ADHD who fall into the criminal justice system?

[Jo Platt]

I completely agree. ADHD in the criminal justice system is an area that evidently needs a lot more investigation. The simple fact that an estimated 24% of the prison population are thought to have ADHD is a cause for concern.

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

I congratulate the hon. Lady on securing the debate, and I draw attention to my declarations in the Register of Members’ Financial Interests. To enable early diagnosis, or any diagnosis at all, having the workforce in place is key. Recruitment of specialist child and adolescent mental health services doctors is a real problem. Unless we get that right, we will not deliver the service that patients and their families deserve.

[Jo Platt]

I thank the hon. Gentleman for that intervention. I completely agree that we need to highlight the workforce, but before we do that we need the data to see how many people we need in all workforces. Again, I will come to that point later.

[Martin Docherty-Hughes (West Dunbartonshire) (SNP)]

I congratulate the hon. Lady on introducing today’s debate. Do they agree that one of the additional complexities in the workplace is the bureaucracy of the workplace assessment? If the Minister takes anything away from today regarding those living with ADHD in adulthood, it should be that that process urgently needs review in terms of its effectiveness and the impact on those with ADHD in the workplace.

[Jo Platt]

I completely agree. We have focused on young people in school settings, but that affects adults enormously.

I received a message from a constituent, Diane, who felt that she was different at school. Diane’s story speaks to the point, made by the hon. Member for West Dunbartonshire (Martin Docherty-Hughes), that adults are affected too. Diane went under the radar as she was high-functioning. She passed her GCSEs but failed at university as she felt that she could not concentrate. Diane developed mental health issues and has spent most of her life on anti-depressants, which she found did not work. She was unable to keep a job or a relationship, and in her 30s she tried to take her own life. It was only when her doctor advised her to be tested for ADHD and she was treated appropriately that her life turned around. That is not an uncommon story.

Since the debate was publicised on the House of Commons Facebook page last week, it has become clear that the scale of the diagnosis crisis is even greater than I could have imagined. The post was seen by 37,000 people and was engaged with by more than 1,000 people, shared right across the country. We saw stories of five-year waits and longer, of people forced to get a private diagnosis costing up to £1,000, and of children in school without the support they need. I urge the Minister to head to the Commons Facebook page and read some of the powerful stories.

After reading those stories, I could not help but wonder how in 2018 our healthcare provision can be so unresponsive to a condition that affects so much of the population. Earlier I quoted from a survey but did not state what the average waiting time is for a diagnosis across the country. That is because such information is not collected by the NHS or the Department of Health and Social Care. We have no idea what the average wait for diagnosis is, and therefore there are no target times.

From the unofficial data that is collected, it seems that we are likely encountering a vast postcode lottery that is unfairly dictating the speed of a diagnosis and the support available. Just take the comment of Sian on Facebook. Her son in Wigan has received excellent care, which she described as “life changing”. However, she teaches in a neighbouring constituency where children are waiting more than a year for diagnosis and encounter a far more confusing process. Without the diagnosis data, we have no way of either assessing the effectiveness of the current diagnosis process or identifying areas of good practice. That data must be collected before we can begin to assess our treatment strategies.

The third way we are letting people down is through the lack of an integrated support strategy for those with ADHD. By looking at each impact of ADHD in isolation—at just the medical impact, just the impact in educational settings, or just the behavioural impact and the social implications of the condition—we, as a society, are failing to offer the whole-system approach to ADHD, and to mental health more generally, that is needed. Tackling ADHD should be about transforming lives; not just responding to symptoms, but working to unlock the full potential of the incredibly creative minds that those with the condition possess.

The current approach to ADHD is not fit for purpose. Too many are falling through the net; too many are still waiting for a diagnosis after years on a waiting list; too many are without the right support; and too many are living undiagnosed with a condition that can have a severe impact on their daily life. I introduced today’s debate because of stories such as Becky’s, Sam’s, Hugh’s, Sarah’s, Claire’s, and the countless others who got in contact with me out of desperation, and who I know will be watching today.

What changes do we need? First, there needs to be more research. A recent Demos report highlighted that ADHD is under-researched, particularly its social and economic impacts. There also needs to be research into the difference made by early access to diagnosis and treatment to the long-term outcomes and costs of people with ADHD.

Secondly, the NHS and the Department of Health and Social Care need to collect data on waiting times. As we have seen, there is a vast postcode lottery across the country that determines the speed of diagnosis and the level of support. The system is grossly unfair and is reducing the life chances of people, based purely on where they live.

Thirdly, we need a streamlined and integrated approach to the support process we offer to children and adults with ADHD. As I have mentioned, those living with the condition are no less able but are often not suited to traditional methods of learning. We must implement a strategy that diagnoses an individual with ADHD speedily and then, crucially, signposts and tracks that individual through a system that promotes educational or employment opportunities suited to their skill set. More broadly, that means that as a society we must be unafraid to promote the untraditional or unconventional routes to success, to promote the creative industries, and to destroy the social stigma that too often forces individuals down the academic route.

In my own borough of Wigan, we have seen the beginnings of such an approach. The local clinical commissioning group has implemented a new joint mental health strategy that is designed to facilitate the seamless interaction of healthcare professionals with support services and education providers. The early signs are promising. Already we have seen the average local wait down from 15 weeks to six weeks, which will help numerous local young people to thrive. However, there is still a long way to go. The strategy addresses ADHD only in children and its implementation is too recent to see the long-term local impact. The local nature of the strategy also highlights yet again the importance of a national framework to achieve equality of provision across the country.

[Bambos Charalambous]

Is my hon. Friend aware of the Government’s mental health Green Paper? Does it contain anything of substance in relation to ADHD? Is there any strategy? If it does not, does she think it should?

[Jo Platt]

The Green Paper is a step in the right direction, but it does not go nearly far enough to confront the enormous scale of the challenges we face. In the case of ADHD, it is important to remember that the condition is neuro-developmental and not a mental health issue.

I have a final ask of the Minister: I invite her to a meeting of the APPG to listen to some of the experiences of people with the condition and to understand the barriers they face. ADHD is highly treatable and is, in many ways, a great asset, but only if it harnessed correctly. I hope that in this Mental Health Awareness Week we can commit to the beginning of a fundamental transformation in our approach to ADHD. No longer can people be waiting years, if not decades, for diagnosis; no longer can social stigma form a barrier against success; and no longer can we leave such enormous talent locked, restricted and hidden away in society. Now is the time to act. I hope that we will see from the Government the strategy and the leadership needed to support those with ADHD and break down the barriers to success that thousands across the country face today.

16:33

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I congratulate the hon. Member for Leigh (Jo Platt) not just on the passionate and articulate way in which she has introduced this important subject, but also on setting up the all-party parliamentary group. I am delighted to accept her invitation to come to a meeting and to hear some of the stories. I would also, through her, extend my congratulations to Michelle Beckett for her work in raising awareness.

The hon. Lady has highlighted that this group of people face quite intense, if unconscious, discrimination, because the way that our education system is set up does not really address their needs. That is something we should all wish to tackle. There are similarities with the way that autism and conditions such as dyslexia were treated in the past. If the abilities to learn are not there, people can fall out of the system. The truth is that they have a very different skill set and we should all be endeavouring to draw that out and, at the very least, not make them feel marginalised or discriminated against. As we have heard from other hon. Members, it is that sort of discrimination that leads them to fall out of the mainstream and perhaps fall into the criminal justice system, which is something that could easily be avoided if we were all more sensitive to it.

The hon. Lady mentioned data. I will take that away and look at it. It is fair to say that it is only very recently that the NHS has started to collect data regarding autism, for exactly the reasons highlighted today—the postcode lottery in terms of how different areas treat the condition. Quite often, it depends on having somebody in the area who gives a damn to give some leadership on the issue. Clearly, that is not good enough, as it will fail far too many people. I will go away and look at that. We have just introduced a new dataset for autism and I do not see any reason why we cannot extrapolate that methodology to look at ADHD. There is no doubt that we will continue our dialogue on these issues.

[Dr Poulter]

The Minister is absolutely right to highlight the issue of data, or the lack of it. In the interests of parity of esteem, is it also worth looking at introducing access targets in mental health for access to child and adolescent mental health services, which do a lot of the assessment of people with ADHD? Would that help drive better data collection in the NHS? Measuring against a target forces local healthcare providers to collect the data that is necessary to drive improvements.

[Jackie Doyle-Price]

I am just about to come on to issues about waiting times. The methodology that my hon. Friend suggests is absolutely right. Although it is Mental Health Awareness Week and we are looking at the issue through that prism, this is not just about mental health; it is about a learning disorder, and goes beyond that. Compartmentalising people who fall out of the mainstream as those with mental health issues is equally discriminatory, but we do have to ensure that we have the right care pathways for them to meet their needs.

[Dr Poulter]

I did not intend to come across as discriminatory in the point that I made; it is CAMHS professionals—mental health professionals—who tend to do the assessments for ADHD in children. What is the Minister going to do about the recruitment crisis in CAMHS? Without those CAMHS professionals, we shall not be able to provide the diagnosis and delivery of care.

[Jackie Doyle-Price]

My hon. Friend will be aware that we have addressed those issues in the Green Paper. We are investing in a whole new workforce in support of CAMHS, which will have a direct relationship with schools, where it will be possible for a lot of the wraparound help to take place.

I would like to make some progress on the specifics of ADHD and move on from CAMHS. The hon. Member for Leigh highlighted the massive variation in services across the country. I fully acknowledge that there are long delays for some to see a specialist and secure a diagnosis. That will clearly have a negative impact on those living with ADHD and their families, who can also find the experience confusing.

We are determined to see improvements in the patient journey. There are NICE guidelines. The earlier the diagnosis the better, and the better the chance of getting the right support and better outcomes for the individual. The NICE guidelines were published in 2016 and set out the process for managing ADHD for people aged three years and above. The guidelines aim to improve the diagnosis of ADHD, as well as the quality of care and support for people with an ADHD diagnosis.

An updated guideline was published in March this year, which particularly addresses under-diagnosis and misdiagnosis of ADHD in girls. People think it is just about behaviour, but in girls it does not play out in exactly that way; there is a lot to be done in education on exactly what this condition is. As the hon. Lady said, people think it is about bad parenting or bad behaviour when it is much more complex. The guidelines advise practitioners to be alert in such circumstances to the possibility of ADHD. We will be failing girls if we do not raise awareness of how that might be playing out.

The guidelines also recommend that people with ADHD would benefit from improved organisation of care and better integration of child health services, CAMHS and adult mental health services. Although NICE clinical guidelines are not mandatory, we expect health and care professionals and commissioners to take them into account fully as they design and put in place services to meet the needs of their local populations. NICE has published a range of tools to help local areas put the guidance into practice, but that is clearly not happening everywhere. I always find that sunlight is the best disinfectant, so the more we can do to ensure transparency, the better. That is why data is so important, as the hon. Member for Leigh said.

The NICE guidelines do not at this time recommend a waiting time for seeing a specialist for diagnosis, but they do recommend that parents of children whose behaviour is suggestive of ADHD should be offered a referral to group-based ADHD-focused support without waiting for a formal diagnosis. That will clearly be helpful, but we should also look at the waiting times.

An issue that I am particularly concerned about—I look forward to engaging with the APPG on this—is support for schools, which the hon. Lady mentioned. Getting the right support package for children with ADHD can be challenging for some institutions. I am concerned that anecdotal evidence suggests that people are being excluded disproportionately, so we really need to tackle that discrimination. Perhaps I can ask the APPG what we can do together to give schools extra support and better advice about how to support children with this condition, rather than simply marginalise them.

The Children and Families Act 2014 and the special needs code of practice set out ways in which care services should join up, and we need to hold them to account. We expect CCGs and local authorities to work together to support children with special educational needs or disabilities, including ADHD. That includes co-ordinating assessments of individual needs and, for those with the greatest needs, providing an individual education, health and care plan. I am interested in hearing evidence from the APPG about how many children are not receiving such plans.

I am not going to stand here and pretend that everything is perfect, because I know perfectly well that it is not, but we have the opportunity to highlight good practice, help local authorities and CCGs to learn from it, and highlight when people are being failed.

[Martin Docherty-Hughes]

On best practice, I asked the hon. Member for Leigh (Jo Platt) about the Department for Work and Pensions’ workplace assessments. Will the Minister speak to her colleagues in the DWP about how effective they are for adults with ADHD in the workplace?

[Jackie Doyle-Price]

I will be happy to look into that in response to the hon. Gentleman’s question. The Government are trying to encourage as many people into work as possible, and we want to get an additional 1 million people with disabilities into work. Employers should treat people sensitively, and people with ADHD can be valuable members of the workforce. I will be happy to have a conversation with my colleagues in the DWP to encourage that. Those people have a skill set that can be extremely productive for enlightened employers who are prepared to make concessions and work with them effectively.

I acknowledge that data is an issue. Without robust and comparable data about waiting times, we do not have the tools with which to challenge local areas, but hon. Members can raise anecdotal evidence in advance of our being able to put together a suitable dataset. I have asked my officials to explore with NHS Digital what data can be made accessible via the mental health dataset. We also need to work alongside the Department for Education, because people with ADHD start manifesting issues in school.

A number of hon. Members said that it is important for employers to improve outcomes for people with ADHD. Unless we get people with ADHD into meaningful employment, there is a risk that they will fall into the criminal justice system, quite unnecessarily. Work is not just about earning a living; it contributes to people’s psychological wellbeing and gives them a sense of belonging, purpose, confidence and self-esteem. As I have said many, many times before, work is good for people’s health, so we need to ensure that nobody is excluded.

People with ADHD can be well skilled, highly qualified and employable individuals, with exceptional and unique talents, who can bring real benefits to businesses. I am more than happy to bang the drum to encourage more employers to be sensitive to people with ADHD, as they should for people with autism, who also have big skill sets that they can offer to employers.

I do not have much time left. I thank hon. Members for their contributions. This group of people has been poorly served for a very long time. I therefore welcome the establishment of the all-party group and I look forward to having ongoing dialogue with all its members. I hope that, before long, we can achieve some material differences and improved outcomes for all those people.

Question put and agreed to.

Historic Allegations against Veterans

Tuesday 15th May 2018 Westminster Hall

[Mr Gary Streeter (in the Chair)]

We will move directly on to our next debate, which is extremely popular. There will be 20 minutes for the winding-up speeches. After Sir Henry Bellingham has spoken for a smart 10 minutes, that leaves about 30 minutes for eight Back-Bench contributions. My maths tells me that that is just over three minutes each. I will not impose a time limit, but if hon. Members have a voluntary time limit of about three minutes each, let us see how we get on. Let us not have too many interventions in this important debate.

16:47

[Sir Henry Bellingham (North West Norfolk) (Con)]

I beg to move,

That this House has considered historic allegations against veterans.

It is a pleasure to serve under your chairmanship, Mr Streeter. The first and foremost duty of any Government is to protect and defend their citizens from internal threats and threats from abroad—away from the UK. Young servicemen and women put their lives on the line. Parliament and the Government have a duty of care to them at the time and a subsequent duty of care when they become veterans. I will talk mainly about Operation Banner in Northern Ireland, but other hon. Members may well talk about other theatres.

We know that 3,500 people were killed in the so-called troubles. Of that number, 2,000 were killed by republican terrorists, 1,000 were killed by loyalist paramilitaries and 370 were killed by security forces. In total, 722 members of the security services, which mainly comprised serving British soldiers, were killed. No other army in the world would have shown the sort of restraint that our Army showed in Northern Ireland. The very fact that twice as many soldiers were killed by terrorists as terrorists were killed by soldiers illustrates that point.

All those cases have been investigated fully, but there are a few outstanding terrorist cases. I entirely understand and accept the need for closure. I also understand the implications of the Good Friday agreement and the legacy issues, and I feel for the families and loved ones who want some sort of closure. Of course, matters are complicated by the 365 Royal pardons that were granted, by the on-the-run letters and by the 500-plus prisoners who were released on licence between 1998 and 2000. So far, everything has been weighing much more heavily against the former servicemen and in favour of the terrorists. There cannot be any parity or moral equivalence between terrorists and paramilitaries on the one hand and the police and armed forces on the other.

[Ian Paisley (North Antrim) (DUP)]

How can soldiers on duty be equated with terrorists and death squads? That appears to be what is happening here. There is a confusion and a bringing together of those two groups. They are being dealt with as one single group, and we therefore have an amnesty for all. That is, of course, abhorrent and immoral. How do we deal with that?

[Sir Henry Bellingham]

We have to draw a distinction: the police and armed forces were acting under statute. They showed immense bravery, professionalism and courage, and they were acting in support of the civil code and authorities. They were also acting under the Yellow Book—which the colonel, my hon. Friend the Member for Beckenham (Bob Stewart), knows only too well—and if they deviated from it, they were dealt with severely.

A number of colleagues present will remember the case involving the four soldiers from the Argyll and Sutherland Highlanders. A farmhouse was broken into and two civil rights campaigners, Michael Naan and Andrew Murray, were shot. There was an investigation; two sergeants were charged with and convicted of murder and another was convicted of attempted manslaughter. All three were sentenced to long prison terms. The officer in charge, who was not actually present—though, to be fair to what happened afterwards, he covered up—was charged and given a suspended sentence, and he resigned his commission. It is fair to say, therefore, that events and incidents such as that were dealt with incredibly firmly.

[Dr Julian Lewis (New Forest East) (Con)]

I would like my hon. Friend to address the point that was raised in the earlier intervention. There is a natural repulsion that one feels about equating the treatment of soldiers with that of terrorists, but that pass, surely, has already been sold because the Northern Ireland (Sentences) Act 1998 provides that anyone—whether soldier or terrorist—convicted of having killed someone unlawfully cannot be sentenced to more than two years in jail. If the price of protecting soldiers against trials so long after the event is that we also have to protect everyone else, is not that a price that we ought to be willing to pay?

[Sir Henry Bellingham]

My right hon. Friend has done a lot of work on this, and I pay tribute to his work and that of his Committee. I have a way forward, which involves the statute of limitations, which covers the whole of the UK, but I shall come on to that.

Let us look at what the Police Service of Northern Ireland is doing, because that is relevant to the Dennis Hutchings case, which I am coming on to. In 2010 the PSNI set up the Historical Enquiries Team which, as colleagues know, completed investigations into nearly 1,600 cases. The PSNI then set up its legacy investigation branch which, as I understand it from the consultation issued by the Secretary of State for Northern Ireland, will morph into an historical investigations unit.

That unit, I believe, will look at the remaining 923 cases, of which 283 involve members of the security forces. So far, five cases involving them have been or are being investigated, leaving another 278. The cost so far has been £35 million, so if every one of those cases is investigated, we are talking about hundreds of millions of pounds. A number of former members of the security forces have been investigated and charged, as I said, including two retired veterans of the Parachute Regiment now aged 68 and 65, who have been charged with the 1972 murder of the infamous IRA commander Joe McCann.

Another such case is that of Dennis Hutchings. I declare an interest, because I know Dennis and I have had long discussions and meetings with him. However, it is important to look at his case in a bit more detail. The incident took place in 1974, which was an incredibly tough, difficult year in the Province. More than 300 people were killed. There were numerous bomb attacks on the mainland, too. On the day in question, 6 June, Dennis Hutchings was leading a four-man patrol in an area where firearms and bomb-making equipment had been found two days before. There had been an exchange of fire two days before. Dennis Hutchings had been commended for his bravery and was subsequently mentioned in dispatches for the way in which he had controlled the patrol two days before, when one of his patrol was hit and badly wounded.

On the day in question, Dennis Hutchings and his patrol went back to a village called Benburb. They chanced on John Pat Cunningham, who was challenged to give himself up. He was behaving in a suspicious manner; he had a suspicious piece of equipment on him. He did not answer the challenge. He moved away from the patrol. They thought they were threatened. They opened fire. It was a tragic case of mistaken identity. It was an innocent civilian that was killed.

I want to stress that the case was fully investigated at the time by the regiment, the military police and the Royal Ulster Constabulary. It was investigated over a period of months. All the forensic evidence was looked at, the rifles were looked at, the bullets that were fired were examined in forensic laboratories, and witness statements were made. The men of the patrol were told by the Army legal service that that was the end of the case and they would have no more to fear.

Fast forward to 2011 and Dennis Hutchings was called before the Historical Enquiries Team. He was asked to go to Northern Ireland, where he was questioned over a period of time about the incidents that took place. He co-operated fully. When it became apparent that there was no evidence that would stand up in court, and that obviously no fair trial could take place, he was told by the PSNI investigators that that was the end of the matter—in 2011. He was told it was totally the end of the matter—that he could go back to his grandchildren, back to the constituency of my hon. Friend the Member for South East Cornwall (Mrs Murray), and enjoy the rest of his life, get on with the rest of his life. And that is what Dennis did.

We move forward to April 2015—four years on. There is a dawn raid on Corporal Major Hutchings’s home in Cornwall. He is in extremely bad health. He is arrested in a pretty high-handed manner, taken to Northern Ireland for four days’ questioning and then charged with attempted murder. The case is ongoing.

[Mr Alister Jack (Dumfries and Galloway) (Con)]

I thank my hon. Friend for securing this important debate. Does he agree these that historical allegations cases against veterans, particularly from the troubles in Northern Ireland, and particularly that of Dennis Hutchings, give little confidence to our school and university leavers when they think about a career in the armed services?

[Sir Henry Bellingham]

I could not agree more with my hon. Friend. I do not think that any other country in the world would treat its veterans in this way. It is a straightforward breach of the armed forces covenant and is bound to have an impact on morale and, as he points out, on recruitment.

We have heard a number of very encouraging quotes from the Prime Minister and other Ministers. In 2017 the Prime Minister said that,

“we will never again in any future conflict let those activist, left-wing human rights lawyers harangue and harass the bravest of the brave, the men and women of our Armed Forces.”

[Leo Docherty (Aldershot) (Con)]

Does my hon. Friend believe, as I do, that if a statute of limitations is introduced, it should cover all theatres, so that veterans who have served honourably in Iraq and Afghanistan—even those who have faced disciplinary action but been cleared of any charge or wrongdoing—can get on with their lives? Also, does he know anything about the case of Major Robert Campbell, which is an exemplar of the bad justice meted out by the Iraq Historic Allegations Team? Does he agree that a statute of limitations should not be limited to Northern Ireland?

[Sir Henry Bellingham]

I shall come on to the statute of limitations point in a moment—I shall close my remarks shortly—but my hon. Friend makes an incredibly important point.

As we know, my right hon. Friend the Member for Sevenoaks (Sir Michael Fallon) took action when he was Secretary of State for Defence. He wound up the Iraq Historic Allegations Team, which had cost roughly £40 million, but that has not solved the problem. Yesterday I saw that Leigh Day is looking at up to 200 cases involving Iraqi veterans. Indeed, any solicitor anywhere can raise a case against a veteran if they feel like doing so and feel there is enough evidence. This problem will simply not go away.

I believe very strongly that the Ministry of Defence and the Government have that duty of care that I mentioned earlier. They have to draw a line under this situation. The only way I see for us to do so is to deal with all veterans on an equal basis across the UK, across all campaigns and across all theatres. There should be a statute of limitations on that basis, with an override whereby compelling new evidence that became available could be looked at; but otherwise, after five or 10 years or some clear limit—the Armed Forces (Statute of Limitations) Bill, a private Member’s Bill introduced by my right hon. Friend the Member for Newbury (Richard Benyon), mentions 10 years—those veterans could at least get on and enjoy the rest of their lives.

In conclusion, I am giving the Minister a way forward. If we do not take that way forward, I think we will have really serious problems. The Secretary of State for Northern Ireland, in her consultation, has made it clear that she will not consider a statute of limitations in the context of Northern Ireland. Therefore, let us have a statute of limitations covering the whole of the UK.

I have given the Minister a way forward but, as I said, our Northern Ireland veterans were sent there when they were young men and women, and they are now a good deal older than most of us. They risked everything. Many of their friends were killed; many were injured. Many suffered the most appalling mental illnesses. What the Government, and this Department in particular, owe to them now is no ordinary duty of care. It is something much more fundamental and profound. In some ways, the duty of care that we owe to current servicemen and women is perhaps more sacred than the duty of care we owe to people who fight in a world war, because the people who fought in Northern Ireland, or who went to various theatres such as Kosovo, Iraq and Afghanistan, had a choice. They could, like Dennis Hutchings, have gone into the Army and risked their lives, or they could have had the easy way out—an easy life in civvy street. They could have had a very different life. But they did not. They risked their lives.

They are not asking for a great deal. They are not asking for an increase in their pension, or for any monetary handouts or further recognition. All they are asking for is not to be betrayed by the Government who they put their lives at risk for.

[Chris Davies (Brecon and Radnorshire) (Con)]

I thank my hon. Friend for obtaining the debate. Only last year I met a constituent who is, sadly, fearful of a knock on the door, or a letter, calling him to court. He served his country and had been retired for nearly 30 years. He put his life on the line for his country; he had taken lives for his country, yet he now feels that his country is not supporting him. Does my hon. Friend agree that that is not right at all?

[Sir Henry Bellingham]

I am grateful for that intervention.

I shall now conclude. The point is that these veterans are not asking for a great deal; they are simply making a request of this Government of all Governments—a Conservative Government who, at every possible opportunity, stand up and say that they support veterans. I have given the Minister and the Government a way forward. I hope that they will take it. I hope that all these veterans can then get on with the rest of their lives. They deserve a retirement free of the fear of a knock at the door.

[Richard Drax (South Dorset) (Con)]

I shall intervene once, as I know that many Members want to speak, but I need to speak up on behalf of a sergeant-major who served 22 years, including in Aden, Cyprus and Northern Ireland. He sent me an email today in which he said:

“From my side of the fence, it is fair to say that ex-service personnel feel betrayed beyond belief by the fact that the Government has not only failed to stamp this out immediately but has actually pursued the policy of opening even more doors for those who would wish to investigate incidents so that they can lay some form of blame on those who were, quite simply, carrying out orders.”

Does my hon. Friend agree that what is happening is completely wrong?

[Sir Henry Bellingham]

This problem—this challenge, this crisis—facing these veterans can be solved. We look to the Minister to come up with solutions and give the House this afternoon some hope for the future.

[Several hon. Members rose—]

[Mr Gary Streeter (in the Chair)]

Order. Winding-up speeches will begin at 27 minutes past 5. There are three minutes for each speech.

17:02

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for North West Norfolk (Sir Henry Bellingham) on bringing the matter forward.

Increasingly, what is to all intents and purposes a private vendetta against the security forces is becoming a witch hunt funded by the public purse, at massive emotional and physical cost. What a world we now live in—while someone like Gerry Adams is taking a legal case attempting to overturn his conviction, the Democratic Unionist party will stand by the men and women in question as individuals who have been attacked merely because they dared to wear a British uniform in Northern Ireland. I declare an interest as one of those who served in the Army and was privileged to wear that uniform.

[Emma Little Pengelly (Belfast South) (DUP)]

Does my hon. Friend agree that, if the country and Parliament put our young men and women in an incredibly dangerous position and, as part of their operational duties, they must make very difficult operational decisions, sometimes with tragic outcomes, it is appalling that they should then be subject to the full rigour of the criminal law, instead of the events being looked at in the light of the context in which they happened?

[Jim Shannon]

I agree wholeheartedly with my hon. Friend.

General Lord Dannatt, the former Chief of the General Staff, said this week:

“There should be no obligation on soldiers to co-operate because they have previously given evidence on the assurance of no further action being taken when this has proved a false promise.

I think this is an extremely unwelcome, worrying move. I served in Belfast in 1971 and had 25 to 35-year-old soldiers in my platoon who would now be in their 70s and 80s. Asking them to recall shootings from back then is outrageous.”

Hear, hear, I say.

I ask Members to picture a 75-year-old gentleman who served his days in Northern Ireland. He lost his friends and saw the unthinkable. Meanwhile, those who literally know where the bodies are buried are the ones pulling the strings, involving themselves in political life and pointing the finger at men and women whom they hate with a passion, as they are British. The man who murdered Ulster Defence Regiment soldier Lexie Cummings in Strabane walked freely around his home town wearing a mayor’s chain. Yet a 75-year-old whose only crime was to decide to serve Queen and country is being interrogated. Every single person who voted no to the Belfast agreement on the principle that it was unfair that those convicted of murder were released are now seeing those murderers with a vendetta being validated and having precious funding thrown at them, to seek the prosecution of soldiers. Those who honey-trapped three young soldiers and those who dragged soldiers out of a car and literally beat them to death have the so-called high moral ground about what happened some 40 years ago.

This witch hunt must not be tolerated. The Democratic Unionist party stands for our innocent armed forces and will continue to oppose every media post, newspaper article and motion that seeks to paint the troubles as a freedom fight. It was no freedom fight; it was terrorism no more shocking than 9/11 or the 7/7 attacks. IRA terrorism is no different from ISIS terrorism. In the same way that I stand with our current personnel, I stand with our veterans. I will defend them in this place against the hatred until the very last breath in my body.

17:05

[Sir Michael Fallon (Sevenoaks) (Con)]

In addition to the excellent speech of my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham), I would like to make just three points. First, an amnesty involves difficult issues. It is right that they should be debated here. If there is a line to be drawn, when exactly in time should we draw it? How do we properly distinguish between those who were in the service of the state and those who were trying to undermine the state? That should be debated not only here but in the province. That is why I wanted this issue included in the consultation paper, and I am very disappointed that it has not been.

Secondly, as my hon. Friend said, we should not reopen cases that have not only been investigated previously, but where the suspects have been told that the case has been concluded and that the investigation is over. It is morally wrong that people should have these cases reopened all over again. Thirdly, a number of the potential suspects and interviewees are elderly. They are fearful. They need and deserve the full support not just of the Ministry but of the chain of command. These were people doing their duty: carrying out the orders of others and the guidance that had been given to them by their superior officers. They deserve the full legal, financial and moral support of the current Army chain of command.

[Several hon. Members rose—]

[Mr Gary Streeter (in the Chair)]

Thank you very much for setting a good example. I call Bob Stewart.

17:06

[Bob Stewart (Beckenham) (Con)]

The Government will maintain that they have no choice but to follow the rule of law with regard to prosecuting historic allegations against veteran soldiers who fought in Northern Ireland. What total twaddle! If so, which rule of law was followed when PIRA terrorists who killed so many people were released, pardoned and given promises that they would not be further prosecuted after the Good Friday agreement and other deals? I afraid I am coming to the view that the Government are resorting to craven appeasement of Sinn Féin. They are scapegoating a few old soldiers. Is that a price worth paying? My God, it is not. How can our Government mollify Sinn Féin using old men who ran huge risks for all of us, as collateral? Have we lost our sense of decency?

Not one member of the Cabinet has seen operational service for their country. Not one of them has had to make a split-second decision to open fire when his or her life was threatened, as so many soldiers did. May I mention that the Minister for the Armed Forces, the right hon. and gallant Member for Milton Keynes North (Mark Lancaster), is not a member of the Cabinet—yet?

This seemingly vindictive persecution of veteran soldiers has gone unresolved for too long. Successive Governments’ lack of leadership on the matter is appalling. I am very angry about the betrayal of our service personnel. This matter is fixable. I call on the Secretary of State for Northern Ireland, the Secretary of State for Defence, the Secretary of State for Justice and, indeed, the whole Cabinet and the Prime Minister—because we have collective Cabinet responsibility—to grip this and sort it out.

17:09

[James Heappey (Wells) (Con)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) on securing the debate.

I served in Northern Ireland at the end of Operation Banner, so I know very well just how politically sensitive these issues are out there. However, the current situation, with ex-soldiers still under investigation, cannot endure. The equivalency being made between the service of members of the British armed forces and terrorists is immoral, and public outrage is entirely understandable.

[Ian Paisley]

These issues are only sensitive among a very narrow band of people who did not give a toss about the life of any soldier in Northern Ireland.

[James Heappey]

That may be the case. I will talk about something slightly different in the short time I have available, drawing on my own experiences in Iraq and Afghanistan, rather than getting into the intricacies of Northern Irish politics.

I served in Afghanistan twice, as a platoon commander and then, latterly, as the adjutant of 2 Rifles in 2009, with a tour to Iraq in between. As a platoon commander, I was only too aware that I was training my soldiers to go out on operations in Iraq and Afghanistan, to remove the safety catch and open fire, acting entirely on instinct in the heat of the moment, drawing on everything they had learned in their pre-deployment training and everything they had seen on the tour hitherto. We have to give soldiers the confidence that, on the rare occasions on which they take those decisions—on operations in hugely dangerous situations—and get them wrong, the system will back them up and will agree that they followed the rules of engagement, and that, once all the investigations in theatre are complete, that is them done.

When I was the adjutant of 2 Rifles in Sangin in 2009, arguably on the most kinetic of the Operation Herrick tours, there were lots. Every day I would start shooting incident reports and other sorts of incident report that would go on up to the Herrick taskforce at brigade and would be immediately looked over by lawyers and the Royal Military Police. That process was robust, and when there was any doubt in investigators’ minds, the investigation continued beyond the brigade, up to division, and was looked at thoroughly.

Soldiers have to know that that process is complete, and that when it is done the nation will stand behind them. Otherwise, in that split second when the safety catch has to be removed and lethal force has to be applied, they will hesitate. That could cost them their life.

17:09

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

I will briefly make three principal points. First, without the bravery and sacrifice of British troops—supported by the Ulster Defence Regiment and the Royal Ulster Constabulary, GC—there would never have been a peace process in Northern Ireland.

[Stephen Pound (Ealing North) (Lab)]

The right hon. Gentleman is a most distinguished Minister, and I respect him for that. He talks about bravery and sacrifice. He should also refer to discipline. I have never met anyone in the armed forces who ever felt that every single soldier, sailor and airman always acted with total and complete probity. There are some people who breach the code. Does he honestly think that an amnesty, which would exclude every single person, should be allowed? Should he not listen to the words of David Cameron following the Saville report, maybe study Ballymurphy and have a look at some of the incidents that quite clearly have to be investigated? By all means do not penalise the elderly, but also do not try to put everybody into the same category.

[Mr Francois]

All these cases were investigated at the time. That is exactly the point. They have already been looked into, and the people concerned have already been cleared.

Tony Blair said, “This is not a time for clichés, but the hand of history is upon us”. Well, that hand of history, if it were there, was only there because of the tremendous bravery and sacrifice of all those British Army personnel on Operation Banner for three decades in the run-up to 1998.

[Gavin Robinson (Belfast East) (DUP)]

Will the right hon. Gentleman give way?

[Mr Francois]

I am afraid I will not.

Secondly, the Government consultation was originally going to include an option for a statute of limitations, but that was pulled at the eleventh hour. Why? Was it because of political pressure from Sinn Féin? Why did the Northern Ireland Office suddenly buckle and take that out of the consultation, so that it was no longer a formal option to be considered?

Thirdly, we all want to see the power-sharing Executive restored in Northern Ireland, but not at any price. There will be no equivalence in this system. There is no point in saying, “Oh, but the terrorists will be investigated as well,” because they have been given letters of comfort by Blair—they are off the hook. But the letters received by British servicemen who were investigated and told they were in the clear do not count, do they? They are still being investigated by the PSNI. We saw what a farce the Iraq Historic Allegations Team was. It was so bad that it had to be closed down by my right hon. Friend the Member for Sevenoaks (Sir Michael Fallon) when he was Defence Secretary.

The proposals from the NIO are morally disgraceful. I have never been so annoyed with my own Government. We need a statute of limitations for Northern Ireland, Iraq and Afghanistan, and we need it soon.

17:15

[Richard Benyon (Newbury) (Con)]

I am delighted to see my right hon. Friend the Minister here—as a Defence Minister, he can reflect this issue right across the Government. As a veteran of Operation Banner who has been involved in this issue for many years, I am angry. We want to hold the NIO to account. I strongly believe that there is a cadre of officials in that Department who can think up a thousand reasons why they should not do something. Just occasionally, they should be encouraged to think about how they can solve a problem that is an affront to every decent person in this country.

I have a solution, which builds on what my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) proposed. It will come before the House on 15 June. Okay, it is a ten-minute rule Bill and it has got to the bottom of the list—we all know how this place works—but the Government should pick it up and run with it. I suggest that there should be a 10-year statute of limitations for all servicemen who serve on operations. I agree entirely that there can be overrides and caveats, and I am happy to talk about the time—I am happy to talk about anything—but we must get the principle in law so that the young men and women currently training with my son in the British Army know that the system in this country will stand by them when they make the awful decision to take somebody’s life, under all the constraints we impose on them.

We are in a situation in which a 78-year-old man with kidney failure—a constituent of my hon. Friend the Member for South East Cornwall (Mrs Murray)—is being taken to court. What other country would do that? Why are we so shaming? I know that we have a devolved justice system in Northern Ireland, and that the people who take that case forward will have to be held to account for that, but we have reached the point where we as a society must ask, “Is it right to take an old man who is in poor health away from his family and put him through this?”

I believe that we have a solution. I am desperately keen that we should work constructively with all elements of the Government. If we start from the basis that it is all too difficult, nothing will happen, but we have to find solutions.

17:17

[Mrs Sheryll Murray (South East Cornwall) (Con)]

I will start by reading a message from another of my constituents, a Mr Dennis Blagdon. He wrote to me this weekend:

“I feel ashamed to be British that the government would let this serious lack of justice happen”

to Dennis Hutchings. Mr Blagdon continued:

“He is a man who is ill, who is being hounded for a job which he was employed by the government at the time to do. It was war.”

We cannot put it any simpler than that. Northern Ireland was war. Mr Blagdon added that,

“a shot was fired which, unfortunately, killed a person. TO THIS DAY, NO ONE KNOWS WHO FIRED THAT FATEFUL SHOT. Why should this poor man, who is dying, be held responsible? This guy is a lovely man, who I have met on many occasions. Please just let him live his last days in peace.”

[Mr Laurence Robertson (Tewkesbury) (Con)]

Has my hon. Friend not put her finger on the very problem—that one side, the IRA, called it a war and behaved as if it were a war, whereas the soldiers were expected to work by the book?

[Mrs Murray]

My hon. Friend is quite right.

I will not take much time to repeat what has already been said, but the Department of Justice in Northern Ireland was originally formed from the Northern Ireland Office and the Ministry of Justice. We do not have an Executive in Northern Ireland at the moment. I am calling on the Secretary of State for Northern Ireland to address this immediately by announcing the consultation paper. As far as I am concerned, my constituent, Dennis Hutchings, has suffered enough. I have been informed that he has been cleared twice and, to be honest, the evidence has since been destroyed—evidence that he could have used in his defence. I agree with the Government when they say that the current process is flawed, and I call on them to do something about it and let Dennis Hutchings, my constituent, go free now. He is a hero who did his job. Let him go free.

17:20

[Leo Docherty (Aldershot) (Con)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I am grateful to my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) for securing this important debate. I will speak very briefly.

The issue is very pertinent to my constituency. Generations of Aldershot soldiers served in the Province and still live in and around the Aldershot area and in the borough of Rushmoor. The savagery and brutality of the troubles were brought home to Aldershot in February 1972 when, through an IRA atrocity, a bomb was exploded outside the headquarters of 16th Parachute Brigade. Seven civilian staff were killed and 19 were wounded. The treatment of Dennis Hutchings has aroused some very strong feelings in and around my constituency. I share that sense of moral outrage. I clearly put on the record my support for the statute of limitations proposed by my right hon. Friend the Member for Newbury (Richard Benyon), and I would like the Ministry of Defence to legislate for that, possibly for 10 years, to cover veterans.

It is important to point out that soldiers do not expect to be above the law. Any legislation would cover those who had already been investigated, just as Dennis Hutchings has been investigated. They expect only natural justice, and that is what we should seek to provide for them.

It is important that the statute covers theatres other than Northern Ireland. Several veterans have been treated very badly in their experience of dealing with the Iraq Historic Allegations Team, and I draw attention to Major Robert Campbell, who has experienced eight different investigations. He has been cleared of wrongdoing and has been abysmally treated by the IHAT process. Although IHAT has been closed down, the danger is that its legacy unit, the Iraq fatality investigations unit, is still prosecuting individuals. That is why those individuals need to be covered by a possible statute of limitations.

The contract between the military and the Government depends on trust. The Government have to deliver on that. That is what Dennis Hutchings, Major Robert Campbell and the veterans of Iraq and Afghanistan deserve, and it is what we in our community and in our society should demand. We should demand natural justice for our veterans.

[Several hon. Members rose—]

[Mr Gary Streeter (in the Chair)]

There are two more Back Benchers to go. They have two and a half minutes each, please.

17:23

[Robert Courts (Witney) (Con)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I rise to speak with a great deal of humility, having heard the distinguished speakers who have gone before me, who have served and who have great experience in such matters. I rise only because I would like to add something from a slightly different perspective. I have not served; I am a lawyer and I approach the debate from a legal perspective, because there is a legal as well as a moral element to it.

By nature, I am very cautious about the increasing role of law in warfare, simply because the mindset of a lawyer is so different from that of a soldier, by necessity. Lawyers are cautious and risk-averse. They explore every option. That avenue simply is not available in circumstances such as those described by my hon. Friend the Member for Wells (James Heappey). The military are all about the can-do attitude that was described by my right hon. Friend the Member for Newbury (Richard Benyon). That is even more the case when we look at cases in retrospect.

As my hon. Friend the Member for Aldershot (Leo Docherty) has just said, nobody is suggesting that the military should be able to act with impunity; all that is expected is natural justice and fairness. If laws of war or engagement are broken, of course they should be held to account, but not years and years after the event. The spectacle of repeated historical allegations is absolutely deplorable, and set against a set of standards that were often simply not available at the time. IHAT is a classic example of that, and Northern Ireland much more recently.

I would like to add one thought on a limitation Act, from a civil law perspective. I used to practise in an area of industrial disease, representing people who had suffered from horrible illnesses such as mesothelioma. In those circumstances there is a statute of limitations—the Limitation Act 1980—so after a certain amount of time companies can expect not to be pursued. There are good reasons for that: memories fade, documents get lost, standards change, and knowledge and attitudes change. Therefore, after a reasonable amount of time, they have a reasonable expectation that they will not continue to be pursued.

Here there is a clear imbalance. For example, the IRA did not keep records, while the British Army does. In civil law we would look at things very differently. I entirely support the suggestion for a statute of limitations simply because we have a similar thing in civil law. We are currently providing assistance and protection to historical industrial companies that are facing only civil claims and not soldiers, who may face serious matters that would turn their lives upside down.

Our veterans should be entitled to know that when they serve, they can go home with gratitude and not have to look over their shoulders for the rest of their lives. The Government should be clear. The public view the spectacle of Britain turning on its own with absolute disgust. We must bring peace to veterans who have worked so hard to bring peace to us.

17:25

[Gavin Robinson (Belfast East) (DUP)]

Thank you for including me in the debate, Mr Streeter. All the contributions have been incredibly thoughtful, not least that from the leader of the debate, the hon. Member for North West Norfolk (Sir Henry Bellingham). There are two aspects to this: can it be done, and should it be done? The lawyers are debating whether it can be done, but those who focus on the negativity of one legal academic who gave evidence to the Defence Committee and on his aspiration that it should apply to terrorists and those who engage in paramilitarism in Northern Ireland are wrong. It can be done. Much more thoughtful legal evidence was given to the Defence Committee as part of the report we prepared seeking a statute of limitations. There has not been enough focus on that.

There has been focus on the rule of law. We set the rule of law in this country. Releasing prisoners in 1998 or in 2000 in Northern Ireland was anathema to at least the 30% of the population who voted against the Belfast agreement, but it was passed in this House and it became the rule of law. When Tony Blair signed comfort letters secretly and quietly and told individual IRA paramilitaries that they would not be pursued for the crimes they committed in this country against this state, that was notionally against the rule of law, but he did it.

There were no hang-ups in the Northern Ireland Office about the on-the-runs procedure. What happened to John Downey, the person responsible for the Hyde Park bombing here in London? He went to court and the prosecution stalled on the basis of an on-the-runs letter. Therefore, when we hear about the rule of law and practical implications, we should remember that we are sovereign in this country—we set the rule of law and the tone—and having appraised ourselves of the moral implications and the moral imperative that, after 20 years of appeasing those involved in paramilitarism and trying to destroy this country, there is a greater prize in protecting those who serve to defend the principles of this country, it can be done, and it should be done.

[Mr Gary Streeter (in the Chair)]

We come to the Front-Bench speeches. The Scottish National party and Labour party spokespeople have five minutes each and the Minister has 10 minutes.

17:28

[Carol Monaghan (Glasgow North West) (SNP)]

I congratulate the hon. Member for North West Norfolk (Sir Henry Bellingham) on bringing forward the debate. All of us in the Chamber are proud of our armed forces. Our veterans are an asset to our society, deserving of our thanks, respect and support. We support them because we are proud of them, because we know they have been trained to the highest standards and conduct themselves with the utmost integrity and because they operate to bring peace to areas of conflict.

That confidence in the behaviour of our military personnel enables them to continue carrying out their duties with full public support in every theatre of war. However, when the actions of individuals call into question the integrity of our armed forces, we must address that. That is not to say we should not protect ex-service personnel from bogus legacy cases. Members and former members of our armed forces must be treated fairly when accusations of wrongdoing are made. We know about the huge backlog of cases in the Iraq Historic Allegations Team, which means that serving members and former personnel face extended periods of uncertainty over accusations that have been made. The case of Major Robert Campbell has been mentioned today, and I think we would all agree that that is not acceptable.

We must also have confidence in the institutions of the police and judiciary in Northern Ireland to serve the people. Responsibility for policing and justice matters in Northern Ireland is devolved and should be respected as such. The PSNI legacy investigations branch should be given adequate resources for such investigations so that they are not prolonged unnecessarily. In the north of Ireland, we know that few families escaped the suffering and the violence.

This debate is timely, given the actions we saw yesterday from the Israeli military. The callous manner in which civilians, including children, were mowed down, demonstrated to the world a military not operating in a manner that we would consider exemplary, but we cannot brush over our own past. Events such as the Ballymurphy massacre, into which an inquest is currently taking place, or the Bloody Sunday murders, are a stain.

[James Heappey]

I am sure that the hon. Lady will want to clarify that. I am sure she is not, but she seems to be saying that whatever happened on the border of Gaza yesterday has perhaps some equivalency with the behaviour of the British armed forces during their service in Northern Ireland, Iraq or Afghanistan.

[Carol Monaghan]

That is absolutely not what I said. I said that that was a military behaving in a manner that was not exemplary.

We know there were terrorists on both sides in Northern Ireland, but the idea that people can murder with impunity cannot be tolerated. Those carrying out the atrocities we are talking about today were not terrorists. They were sent to Northern Ireland to keep the peace, not to enflame an already volatile situation. We expect the highest standards from our armed forces and that requires them to operate within, not outwith, the rule of law. The actions of a few individual members of the armed forces during those events brought them down to the level of the terrorists. That is something that should cause us all shame.

[Several hon. Members rose—]

[Carol Monaghan]

Our service personnel should rightly be held to the highest standards of behaviour, but they should also be supported fully by the Ministry of Defence when allegations are made. That certainly means being offered proper legal representation and support. Our armed forces have our gratitude for the difficult work they do on our behalf, in defending us and our values, sometimes in traumatic and highly stressful situations. The hon. Member for Wells (James Heappey) talked of his own experience. He described the very best practice, where he was aware of what was going on.

[Several hon. Members rose—]

[Mr Gary Streeter (in the Chair)]

Order. The hon. Lady is not giving way.

[Carol Monaghan]

For the public to have full confidence in our military, there must be some accountability when they operate outwith the rule of law, and there must be due process.

17:33

[Wayne David (Caerphilly) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I will confine my remarks to Northern Ireland, as the hon. Member for North West Norfolk (Sir Henry Bellingham) did. I congratulate him on securing this extremely important debate. As a young man, I well remember the horrific reports on the television about the troubles in Northern Ireland. At the height of the troubles, there were more than 27,000 military personnel, in more than 100 locations. They were there as part of Operation Banner, the longest continuous campaign in the history of the British Army. Let me place on record my appreciation and my highest possible regard for the professionalism and the commitment of our armed forces personnel in the most difficult of conflicts.

[Ian Paisley]

I think the point that the hon. Gentleman is emphasising is that so many armed service personnel in Northern Ireland acted to the highest standards and showed massive restraint in the face of being terrorised, whether at Warrenpoint, Ballykelly or Narrow Water. We should look up to our soldiers and be extremely proud of the way in which they conducted themselves over decades of service.

[Wayne David]

The hon. Gentleman is obviously better aware of the situation in Northern Ireland than just about any Member here. I certainly concur with his remarks, and I hold in the highest possible esteem, as I said, the personnel of our armed forces and the commitment they showed.

There were 3,260 deaths during the troubles. In 2006, the then Government established the Historical Enquiries Team to examine all deaths attributable to the security situation. In September 2014, the Historical Enquiries Team was disbanded, and in its place PSNI set up the legacy investigations branch. As we are only too aware, there have been significant criticisms of the process by which legacy investigations are currently undertaken. The Prime Minister’s comments last week are a clear indication of that.

However, it is worth noting that it has been argued that PSNI’s statistics indicate that more of its legacy resources are deployed investigating former paramilitaries, and the Public Prosecution Service in Northern Ireland argues that more effort has gone into investigating former republican and loyalist paramilitaries. There are clearly differences of opinion on this, but we should have respect for all opinions that have been expressed on this very emotive issue.

Addressing legacy issues was a key part of the Stormont House agreement of December 2014. It was agreed that principles including the promotion of reconciliation and the rule of law should be upheld, that the suffering of victims and survivors should be acknowledged and addressed, and that there should be a facilitation of the pursuit of justice and information recovery. It was also argued that human rights should be respected, and that all investigations should be balanced, proportionate, transparent, fair and equitable. To that end, the agreement set out the establishment of a new, independent Historical Investigations Unit. I understand that the Government have now produced a consultation document, and that there will soon be a public consultation exercise on the new mechanisms for handling outstanding legacy issues.

The Defence Committee argued in its April 2017 report that there should be a statute of limitations protecting both former members of the security forces and paramilitaries. It was recognised that such a statute had to be equally applicable to all those involved in the conflict, and that there ought to be a truth-recovery process. That was the argument put forward.

At the end of last year, the British Government indicated that a statute of limitations might be included in the consultation. I understand from press reports that that will not now be the case. Personally, I am not persuaded that such a statute is the best way forward. However, I would like to know from the Minister why the Government have seen fit to exclude the suggestion from the public consultation. While I realise that the consultation will be in the hands of the Secretary of State for Northern Ireland, the Government operate on a collective basis, and I would like to know who, and what organisations and bodies, will be consulted. Will the views of the veterans’ organisations be sought? I certainly hope that that will be the case.

Finally, I emphasise the need for progress to be made in this difficult area on the basis of consensus. Only by working together, in a spirit of reconciliation and co-operation, will we ensure that Northern Ireland can enjoy a lasting peace.

17:38

[The Minister for the Armed Forces (Mark Lancaster)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) on securing the debate. I had the opportunity as recently as January to make a speech on this matter. That another debate has been secured so soon speaks volumes about the commitment of the House to the welfare of both serving and former members of our armed forces. I declare my interest as a serving member of the Army Reserve.

I am troubled that my hon. Friend the Member for Beckenham (Bob Stewart) feels that the Government are simply not interested in our veterans. He is probably right that there is no serving Cabinet Minister who has seen operational service—there is, of course, one who serves in the Royal Naval Reserve. Although my own very modest experiences in Bosnia, Kosovo and Afghanistan pale into insignificance compared with those of many who served in Northern Ireland and elsewhere, several Ministers have served. I assure my hon. Friend that many of us in Government have our veterans’ interests at the forefront of our minds and are determined to do what we can to support them. I will move on in a moment to underline some of the things that the MOD is doing to support our veterans.

I am second to none in my admiration for our armed forces. They do an exceptionally difficult job in the most challenging circumstances, and we rightly hold them to the highest standards. However, although the overwhelming majority of service personnel conduct themselves professionally and in accordance with legal obligations, a few do not. In such circumstances, domestic and international law requires us to investigate serious allegations, and it is right that we do. We live in a democracy that values the rule of law, and no one, including those in the armed forces, should be above the law. However, let me be clear that that does not mean we should accept lengthy investigations and reinvestigations many years after the event.

Let me turn first to Northern Ireland. It is due only to the courageous efforts of our security forces that we have the relative peace and stability that Northern Ireland enjoys today. The Government are sincere and unstinting in their gratitude to all those who served throughout the long years of the troubles, many hundreds of whom paid a very high price for doing so. We will always salute the heroism and courage they displayed in upholding democracy and the rule of law in Northern Ireland, and we will not tolerate the rewriting of Northern Ireland’s history by those who wish to legitimise the actions of terrorists who sought to kill and destroy.

Historical investigations in Northern Ireland currently involve numerous inquests and investigations into the small minority of deaths attributed to the state. Meanwhile, many terrorist murders go uninvestigated. All those involved, not least the victims and survivors of terrorism, along with former members of the security services, deserve a better approach than the current flawed system, which is not working well for anyone. The Government are committed to putting this unacceptable situation right.

The Government believe that the institutions proposed in the 2014 Stormont House agreement are the best way to ensure a fair, balanced and, crucially, proportionate approach to addressing the legacy of the past in Northern Ireland. On Friday the Government published a consultation and draft Bill that set out in detail how the Stormont House agreement institutions could be implemented.

The key institution in the context of today’s debate is the proposed historic investigations unit, or HIU. The HIU would be responsible for completing outstanding investigations into troubles-related deaths within five years. Critically, that would include around 700 murders by terrorists that are not currently being investigated. In addition, the HIU would be required to act in a manner that is fair, impartial, proportionate, effective, efficient and designed to secure public confidence.

[Mrs Murray]

Can the Minister explain to me how this new unit will prevent my constituent, Dennis Hutchings, from being prosecuted, because I do not think that it will?

[Mark Lancaster]

My hon. Friend is aware that that is an ongoing process. She and I met, at her request, the last time we had such a debate to discuss her constituent in detail, and the ongoing support that he is receiving from the Ministry of Defence.

In delivering our manifesto commitment to consult on how the Stormont House agreement could be implemented, the Government are clear that they will not take forward any measure that could have the effect of targeting, discriminating against or otherwise putting at a disadvantage our veterans. As part of that commitment, the Defence Secretary has asked the Defence Committee to play a role in scrutinising the detail that has been proposed. In particular, he has asked the Committee for its views on whether what has been put forward will meet the Government’s aim that any future investigations will be conducted in a way that is balanced, proportionate, transparent, fair and equitable, with no prospect that veterans will be targeted or discriminated against.

[Emma Little Pengelly]

Is the Minister aware that the issue emerged in parallel with and subsequent to the Stormont House agreement through a decision by the chief constable to refer all state-related deaths to the case load of PSNI’s legacy unit, ergo it will go into the historical investigations unit? This is a new and emerging issue since the discussions on the Stormont House agreement.

[Mark Lancaster]

Of course, there are a number of emerging issues, and this is proving to be one of the difficulties in trying to get consensus on how we move forward. Members will also be aware of last year’s Defence Committee report recommending that a statute of limitations covering all troubles-related deaths involving the armed forces should be established, alongside a non-criminal mechanism for ascertaining the facts surrounding the deaths. That report, and indeed today’s debate, demonstrate that there is support for an alternative approach to dealing with the legacy of the past.

In the limited time I have, let me say that Members do not have to take the Government’s word on this. I am sorry that the Chair of the Defence Committee is not here, but I encourage all Members to look at that report and the legal evidence given to it over the challenges—that is probably the best way of describing them—about moving forward under the statute of limitations approach. That said, the whole purpose of the consultation is to try to move the issue forward. There is an open question as to how we move forward, and the suggestion of the hon. Member for North West Norfolk is a perfectly reasonable one to be put forward into the consultation. As we have just launched a consultation, it would be premature for me to commit to what that way forward will be. That is why I encourage everybody, particularly veterans and Members, to contribute to that consultation so that we can attempt to find a sensible way forward.

[Leo Docherty]

I am grateful to my right hon. and gallant Friend for giving way. Does he agree that theatres other than Northern Ireland, such as Iraq and Afghanistan, should be included in the consultation?

[Mark Lancaster]

The consultation, as published, is specific to Northern Ireland. However, this is a wider issue that impacts operations in other theatres. I take this opportunity, in the 20 seconds I have left, to pay tribute to my right hon. Friend the Member for Sevenoaks (Sir Michael Fallon), who did so much in his tenure as the Secretary of State for Defence to move these issues forward—not least when it comes to other theatres—by closing down IHAT from 30 June last year.

17:47

Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).