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Nursing Workforce Shortage: England
(4 years, 9 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mohammad Yasin (Bedford) (Lab)
I beg to move,
That this House has considered the nursing workforce shortage in England.
It is a genuine pleasure to serve under your chairmanship, Ms McDonagh. I start by recognising the skills and expertise that nurses bring. Nursing shortages impact on patient care and staff wellbeing. Wherever there are people, there are nursing staff. They work in public services, across the NHS, social care, public health and the independent sector. They are with us at every stage in life, from birth to death. I am grateful for all that health and care staff do in my constituency and across the country.
This debate was secured in response to petitions handed in by nurses from the Royal College of Nursing, calling on the Government to fix the workforce crisis. I am pleased to be their voice—and that of everyone who works in the health profession—in Westminster today, and call on the Government to do all they can to tackle nursing shortages, which have huge knock-on effects on our NHS and wider health and care system, as well as on patient safety and staff wellbeing.
There are about 40,000 nursing vacancies in health and care services in England. In my region, the east of England, the nurse vacancy rate is 10.7%, which amounts to more than 3,600 nurses. Worryingly, the vacancy rate for mental health nurses in my region is even higher, at 15.3%. Nurses are crucial in health promotion and improving population health, yet the numbers of health visitors, school nurses, community nurses and district nurses have dropped at a rapid rate and are in long-term decline. We need to see significant growth in the NHS cancer workforce as well.
I expect that the Minister will tell me that almost 8,000 more nurses work in the NHS since this time last year. Although that figure is correct, it must, as with all stats, be viewed in the relevant context. That is a growth rate of just 0.4%, which is nowhere near the scale needed to provide enough nurses now or in the future. The pace of growth is not sufficient to reassure patients that we have a workforce ready to meet their needs, and it is nowhere near the rate needed to cope with the increasing demands that are predicted to be placed on the NHS by our ageing population.
For every NHS nurse employed in hospitals last year, there was an equivalent of 214 admissions. Patient need is rising faster than the growth in our nursing workforce. Social care and public health are also without thousands more nurses. It is difficult to calculate the number of vacancies in those settings because the data is incomplete. We have no understanding of plans to support and fund social care, which I hope the new Minister will confirm are a priority.
Nursing shortages directly impact on patient safety. Even with the small increase in staff numbers, hospitals and other services are struggling more than ever. Last week, the RCN published findings from a survey of emergency care nurses, who are increasingly forced to provide care in corridors. Some 95% of survey respondents said that patient dignity is compromised, and 92% worry that patients may be receiving unsafe care. December saw the worst performances on record for A&E departments in England, with every single department failing to meet the four-hour waiting time target. Those stats should alarm us all. Chronic underfunding has led us to this point.
Trust papers from Bedford Hospital, a district general in my area, show just how intense the pressures are on our frontline workers. Staff are doing as much as they can to keep patients safe and to provide high-quality care, but the situation is outside their control. Staffing shortages are systemic, and addressing them requires political will and action.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
The hon. Gentleman mentions staffing shortages. My vast and remote constituency, which has a large and ageing population and is the most remote mainland constituency in the UK, has problems not only with recruitment but particularly with retention. Health is devolved to the Scottish Parliament and Scottish Government, but as and when the UK Government develop an approach to keeping people in the most remote and rural areas, where they are needed most, I hope that that intelligence will be shared with the Scottish Government.
Mohammad Yasin
The hon. Gentleman is absolutely right. There are nursing shortages in every part of the country, and nurses are struggling to provide good care. I will come to that point in a moment.
Nursing shortages also impact on staff wellbeing. One testimony from an emergency nurse describes the realities of working in the profession:
“When I witnessed elderly patients being assisted onto bed pans while on ambulance trolleys, surrounded by paramedics, other patients on trolleys, and relatives all squashed in a freezing corridor…I realised that I can no longer preserve or protect my patient’s dignity, and that I am failing them as a nurse. Dignity is the first thing that the patients are stripped of when in a queue in a dark, cold corridor, closely followed by safety.”
Sharon, a community nurse who recently responded to a House of Commons digital debate on this Westminster Hall debate, said:
“I have worked in my locality for four and a half years. In that time, we have never been fully staffed. This puts enormous pressure on the whole team and many people have left because of it. Often, we are rushed, we forget things, and we cannot give the quality of care that we would like as we are just too thinly spread. Many of us end catching up on our notes or management at home, working way over our contracted hours. We are exhausted, frustrated and disappointed.”
This is an appalling situation for all concerned, and I know from these responses that this happens daily in hospitals up and down the country. Talk of a winter crisis is meaningless when staff and patients experience crisis every day, all year round. We must all focus on fixing this.
There is a long-term plan for the NHS, but its ambitions are dependent on having enough nurses. We have no funded workforce plan, even though it was promised by the Government when they announced the funding allocations back in the summer of 2018. Will the Minister tell us when the long-promised NHS people plan will be published, and whether it will include bold and funded policies to recruit, train and retain vital nursing staff to meet the needs of our population?
Nursing students in England can receive grants of up to £5,000 a year, and for some they can go up to £8,000. However, these do not reflect the true cost of living. Just as importantly, tuition fees are also a huge burden on nursing students, and it is important that this is addressed in the forthcoming Budget. As a father of four, I believe that financial barriers to education must be removed.
Chris Elmore (Ogmore) (Lab)
My hon. Friend makes some important points about the pressures facing nursing in England and the cost of living. Does he agree that one way that this could be resolved is by supporting bursaries and offering more financial support to student nurses? The Welsh Labour Government have kept those throughout this entire period, ensuring that the bursary was not scrapped in Wales.
Mohammad Yasin
My hon. Friend is right. Cuts to bursaries have impacted hugely on the recruitment of new staff. The Welsh Government did the right thing in a difficult situation. If we do not look after our staff, it will be hard for them to stay in the profession. That is why we have a shortage of nurses.
As a father of four children, I believe that financial barriers to education must be removed so that everyone who wants to go to university can do so, particularly those who want to become nurses. We should encourage young people to train in these critical professions. Why are the Government putting up barriers to young people who will go on to contribute such vital services to society and saddling them with huge debts before they have begun working?
This problem has been years in the making. Such stark shortages do not occur out of the blue. In England these shortages are due to the complexities of political decisions and structural issues.
Scott Mann (North Cornwall) (Con)
As has been mentioned, these issues are compounded in rural areas, where we have problems with recruitment and retention. A cottage hospital called Stratton in my constituency has just had its minor injuries unit closed overnight due to nurse shortages. What more can we do to promote staff retention across the whole of the UK?
Mohammad Yasin
The Government must listen to nurses and the Royal College of Nursing. They are pleading for the Government to act now. Getting nursing bursaries back in action might help, but the problem is now so deep that we must take urgent action to tackle it.
This problem has been around for a long time. It is not a short-term problem. It will affect us in the long term unless we act now. Who is responsible for the health and care workforce? It is shocking that no one is. There is no clarity in law on the role of and responsibility and accountability for growing and developing our health and care workforce, or the various layers that drive our health and care services.
A nurse walking on to a short-staffed shift has no option but to carry on. The buck stops with them. They carry the professional, physical and emotional impact. Nurses have no power to recruit more staff. That is true of all professionals in our taxpayer-funded health and care services, including nurses, medics, physiotherapists, psychologists, social workers, support workers and many others. The Government should be accountable for the provision of the labour market that staffs our health and care services. The taxpayer must be assured that the services they have paid for are safe and effective.
The former MP for Wolverhampton South West, Eleanor Smith, who is also a nurse, was here last summer setting out the same concerns. This is the 37th debate on workforce issues in health and care services since 2017, and it will not be the last. In recent responses to parliamentary questions, the Government have considered the merits of safe staffing legislation and ways to close the workforce accountability gap. The Royal College of Nursing has been campaigning, along with several other health organisations, for accountability to be secured in legislation, so the Government’s consideration is welcome.
The long-term plan Bill is the way to make progress on that agenda, but it must include an explicit framework for the role of and responsibility and accountability for workforce supply and planning at all levels at which decisions are made across the system, including the Government. Achieving accountability in law provides an opportunity to safely staff our health and care services in the future. I hope the Minister will commit to safe staffing legislation for England and update us on what her Department is doing to ensure that the NHS long-term plan Bill is forthcoming. Will that Bill explicitly provide for accountability for workforce provision?
I suspect the Minister will want to discuss the Government’s promise of 50,000 more nurses over five years. We have heard a lot about that commitment but not in detail. How will 50,000 more nurses be recruited, especially when the Government appear to be ramping up the hostile environment rhetoric and making the UK as unattractive a place as possible to come and work? The loss of many NHS workers from the EU is a tragedy.
Bedford Hospital had to recruit 237 nurses from Australia, India and elsewhere to fill vacancies left largely by EU nurses who left because of their fears for the future and the ill treatment they received in the UK. It is a testament to the hard work of the hospital’s chief executive, Stephen Conroy, that, despite those staffing difficulties, the hospital is projected to reach full recruitment of band 5 nurses for the first time in many years, but that will be achieved only by recruiting nurses from overseas.
We also need to increase capacity in clinical placements, to support nursing students at universities. How will the Government achieve that? How many nurses do the Government expect to retain? When will the Government publish their plan in full? Will the Secretary of State report on progress made in this Parliament?
This year, the World Health Organisation is celebrating the first ever year of the nurse and the midwife, at a time when the spotlight is on the nursing profession across the globe. As their elected representatives, we must stand with them and celebrate this diverse and dynamic profession. I will do everything possible to ensure that our health services are staffed safely. It must be a priority for us all. The problems are well known. The evidence continues to mount. We need decisive action, but we are not getting it from a Government drowning in Brexit uncertainty. Nursing staff need action now, as do their patients. We cannot wait any longer.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. Although this debate is about nursing shortages in England and health is a devolved matter in Northern Ireland, I believe we are experiencing the same problems in Northern Ireland that exist in Wales, Scotland—as mentioned by the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone)—and the whole of the United Kingdom. The solution must be UK-wide.
The Minister has responsibility for England, but I want to refer to things that are happening in Northern Ireland, which I believe the UK Government can change to the benefit of the devolved Administrations. We are currently facing a crisis in nursing care. Although nurses in Northern Ireland have received a pay increase, which they deserve, that does not ease the conditions in which we are asking them to work. Those conditions are the same as in England, Scotland and Wales.
During the election, nursing was perhaps the largest issue I was confronted with on the doorstep, along with the dysfunction of the Northern Ireland Assembly, which, although we are not directly responsible for it, people still wanted to talk to us about. When we got past the misinformation that had been fed to people in a deliberate attempt to skew the vote, it was clear from speaking to nurses that, although the pay issue had been an insult to them, they had genuine concerns about staffing levels—the subject of this debate. The concerns I heard on the doorstep were clear to me, as I am sure they were to all hon. Members from across the United Kingdom of Great Britain and Northern Ireland. There was a genuine concern that the everyday nurse felt guilty about taking annual leave; they felt that they were letting people down by having their hard-earned time off. That should not be so.
The health service in Northern Ireland has a registered nurse vacancy rate of 11.6%, equating to precisely 2,103 empty posts, as well as a shortage of 421 nursing assistants. The cost of employing nurses via agencies has increased from £10 million in 2012-13 to £32 million in 2017-18. I know that the last few years, with a non-functioning Assembly, were an issue regarding the employment of agency staff.
I had a meeting with the Royal College of Nursing some six weeks ago in my office, and I welcome the fact that the Northern Ireland Assembly is up and running. I also welcome the fact that the Minister who has responsibility for the Health Department in Northern Ireland, Robin Swann, has committed to recruiting more nurses. I understand that 700 nurses will be recruited, which will go a long way to addressing some of the empty posts. However, that will still be only a third of the way to filling all the vacancies that exist; the other two thirds of vacancies also have to be filled.
Jamie Stone
The hon. Member makes an extremely interesting point. At the last election, constituents and voters said to me on the doors that they would prefer that nurses were employed by the public purse—by the Government—rather than via an agency, which, by definition, makes a profit on the salaries for those nurses. I suggest that the general public does not like that and, if I am reading him correctly, he does not like it either.
Jim Shannon
I thank the hon. Gentleman for his intervention, and that is exactly what I am saying. I know that the Health Department in Westminster does not have responsibility for recruiting nurses in Northern Ireland. The Minister in Northern Ireland now has, and he has made the first step towards addressing that issue. It is hoped that over the next couple of years the number of vacancies—over 2,100 nursing posts, as well as 400-odd nursing assistant posts, making about 2,500 vacancies in total—will be addressed. We hope that the cost of agency staff and the extra financial burden created by the fact that agencies are profit-making organisations—this is how they make their money—will be addressed in a way that helps to reduce the shortcomings.
This situation means that nurses cannot simply work their 37.5-hour working week. They are called in on days off and asked, “Can you do the twilight shift? Can you give me a couple of hours?” That is not the fault of the ward sisters; they need the floors covered and are under pressure. It is simply that we do not have enough full-time working nurses in the NHS. That means that conscientious nurses, who do not want to leave the ward or the district short, are working additional hours themselves, and not in the short term to save money for a holiday or a renovation of their house. Instead, they are consistently working overtime to help on the wards, and so they are not getting their family time, their social time and—more importantly—their rest time
I have had glimpses of this situation. Some 6,500 nurses live in my constituency, so I have regular contact with them. I got a brief glimpse of the work of a nurse during my surgery and was in awe of how they stayed on their feet, and remained both sharp and compassionate —as they do. Doing all that with no rest is simply unsustainable. So, for a better system and a better caring system with better nurses, who are more able to work within that system, we need to address the shortage of nurses.
It used to be the case that bank nurses were only used in an emergency, but now they are used ever more frequently and their use is becoming the norm. They are no longer just used in the emergency. Using them is now just the fall-back position: “Let’s just do it”. That is not good either for morale or for finances—the current finances clearly indicate that it is not. It is more costly to have agency staff in than it is to have nurses on full-time pay.
I will give another example, of a nurse who approached me in my office and asked me to clear up rumours about nurses, their employment and so on. She is a young nurse in her early 20s who has been working at the Ulster Hospital in Dundonald—the main hospital in my constituency—but she has been left as a staff nurse in charge at night on numerous occasions. What she said to me was simple; she just said to me, “Jim, keep the pay rise and please give me an extra nurse per shift.” That was her initial reaction, because she can feel the pressures of delivering this system, and was saying, “I physically can’t do it all for much longer”.
This is a lovely young girl who is dedicated and good at her job, but who knows that when she has kids she will not be able to work 60 hours a week. She is asking me to do something about that, and today I am on the path towards doing something; I am highlighting this issue. I am very happy to do so.
Scott Mann
The hon. Gentleman is making an excellent point about that young lady. There is one way that the NHS might be able to support her. NHS Property Services owns huge amounts of land around the country on the public estate, and I know that the Government are putting together a key worker policy, for there to be a 30% discount for local people in the housing policy, like a local homes discount. Does he think that if we included nurses within that category that we might be able to address some of the challenges that we face, by giving people discounts and getting them into the profession?
Jim Shannon
I thank the hon. Gentleman for that intervention. I was not aware of that proposal until now, but it certainly seems like a way of incentivising people—for some people. Let us be honest; it will not suit everybody’s circumstances, but it will suit some people’s. Whatever we can do to incentivise nurses to stay in the profession is good. I will give a third example, if I may, of the reasons why nurses are not staying in the profession, but some of the things that the hon. Gentleman referred to would be helpful.
I met one woman in her 30s in my office who wanted to go into nursing, but she could not do so because her tax credits would not allow to stop work while she got her national vocational qualifications and other qualifications. So, reluctantly, she gave up and we lost her. She is not the only one we have lost; we have lost many more than that.
I know that in Northern Ireland this issue is not the responsibility of the Minister who is here today, the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately); I understand that. However, will she ask the Minister who has the portfolio for tax credits to review the circumstances around tax credits and the circumstances of those nurses who are trying to get their NVQs, and have to stop work to do so? If we are losing nurses because of an anomaly in the system, let us try to address that anomaly, to allow us to retain the nurses who want to be retained.
My mother was a nurse. That was a long time ago; my mother is coming up to 89 now. I know that for her nursing was a vocation, as it is for many other people. In today’s busy life, it is important that we try to help those who want to be in nursing for the rest of their lives to retain their position. However, that was a young girl in her thirties in my office who wanted to go into nursing and unfortunately we lost her.
We lost someone who wanted to train as an intensive care unit nurse, because the current system could not work with her and her four children. Can we do better in helping mature people to come out of retail and enter education, while still having their children cared for? There are many such people across the nation and across my constituency. There are also a great many people who are former nurses, and we should try to recruit them back into the system as well. There comes a time in their life, perhaps when their children are a bit older and they find themselves with a bit more time on their hands, so what are we doing to attract the more mature nurse into the profession that they once wished they were in?
There must be a way of doing that. I believe that it is up to us in this House to address these two issues, which are so closely linked: getting more nurses; and making a clear way forward to allow mature people to choose nursing, not simply as their job but as their vocation and their calling.
Tonia Antoniazzi (Gower) (Lab)
I congratulate my hon. Friend the Member for Bedford (Mohammad Yasin) on securing this excellent and timely debate.
I speak today as the newly elected chair of the all-party parliamentary group on cancer. Currently, there are 3 million people in the UK living with cancer, and that number is set to rise to 4 million by 2030. In a survey conducted by Macmillan Cancer Support, more than two thirds of cancer patients said that they are not getting the support they need from the NHS in England, and that is because the NHS is buckling under increased workforce pressure.
The healthcare system is facing a staffing crisis that is crippling frontline services and affecting the care that patients receive. There are more than 40,000 nursing vacancies in the NHS workforce, and Government figures show that waiting times for cancer treatment and diagnosis are at record high levels.
Every day across England, NHS professionals work tirelessly to give people living with cancer as full a life as they can. They are stretching themselves and working harder every day to meet rising demand, but the harsh truth is that there simply are not enough professionals with the right skills to meet the needs of the growing cancer population. That is why I support Macmillan’s “Save our support” campaign. I was delighted to attend its parliamentary reception in January, along with nearly 140 parliamentarians who came to speak to frontline healthcare professionals and people with lived experience of cancer.
The NHS played a key role in the general election debate. Although the pledges on nursing numbers in the Tory party manifesto were welcome, it is imperative that we see the full NHS people plan for England published so that we can see how the Government intend to deliver on their commitment to grow and support the NHS workforce. Overall, we need a Government that get their numbers right and deliver on their promises.
I have concerns that the interim NHS people plan published last year contained no specific actions for cancer services. Without a clear plan for cancer, the NHS will not be able to cope with the demand caused by the rising numbers of people living with it. There are concerns that the NHS people plan will not be as ambitious and will not have the committed funding made available to ensure that it delivers for the 4 million people likely to be living with cancer by 2030.
According to a recent Health Service Journal, 20 of the UK’s largest cancer charities recently wrote to the Secretary of State to raise their strong concerns that the NHS people plan falls far short of what is needed to support the welcome ambitions within the NHS long-term plan on cancer survival and care across England. Will the Minister please confirm when the NHS people plan will be published, and will she provide assurances that the Government will provide the necessary funding and resources to ensure that it can meet its ambitious targets on cancer?
The Government’s target to have an additional 50,000 nurses in the NHS relies heavily on increasing staff retention. Macmillan Cancer Support published a report last year, “Voices from the frontline”, which underlines the important role that continuing professional development can play in supporting and retaining staff. The report reflects the views of lead cancer nurses from across England, focusing on the challenges that they and specialist cancer nurses face in accessing CPD opportunities and the impact of that on cancer care. Some 44% of lead nurses felt that their workload negatively affects the quality of care that they can give to cancer patients; 39% said that their current workload is unmanageable; and 44% say that the strain negatively affects their morale.
Macmillan professionals said that they had faced three main barriers to accessing CPD: a lack of protected time, funding, and locally available courses. Only a third of the specialist cancer nurses surveyed had protected study time to access and attend CPD training. A quarter of survey respondents reported that the availability of CPD training has worsened over the past two years.
Cancer clinical nurse specialists report that CPD is essential to the delivery of high-quality personalised care for people living with cancer. More than three quarters of respondents to the Macmillan survey were clear that having more time for CPD would help them improve care for people living with cancer. To address that, the Government should immediately return the CPD budget to at least £205 million, the level it peaked at in 2015-16 before budgets were cut, and not by 2024, which is the Government’s current plan. To ensure that the NHS has the well-trained and motivated cancer workforce it needs, will the Minister therefore please provide reassurances that the Government will return the CPD budget to at least £205 million to support the NHS people plan?
It would be remiss of me to stand here as a Welsh MP and not mention that the budget challenges we have spoken about are, as the hon. Member for Strangford (Jim Shannon) has highlighted, pan-UK issues. I understand how health services are devolved and that the challenges are ones we deal with every day, but we are losing experienced nurses quicker than we recruit them. We are on the edge of a full-blown crisis. I am very happy to stand here and say that the Welsh Government have an ambitious NHS workforce plan to train and recruit, and they have kept the nursing bursary. We need a positive action plan that will move quickly. In Wales we are moving quicker than the UK Government, so what are the UK Government doing?
As a former teacher I know what it is like to inspire young people to go into the teaching or nursing profession. What are the Government’s commitments? We need to work with our young people. Once they start on their journey into a profession, we need to highlight the benefits of working in the healthcare system. It could be a 12-year journey to become a senior nurse. By that time it is a little too late, because we have not trained them up in time to deal with the current crisis. What are the UK Government’s plans to recruit from overseas? We need to deal with that.
Lastly, it is important to dispel the myth around the funding that has been made available to the NHS in England. The NHS Funding Bill, which recently passed through both Houses, does not represent new money. It was first announced by the right hon. Member for Maidenhead (Mrs May) in June 2018 and does not cover the budgets for Health Education England, which include education and training for the extra nurses that the NHS in England desperately needs.
As part of the Budget next week and the comprehensive spending review later this year, it is crucial that the Chancellor supports people living with cancer across the country and ensures that the NHS people plan and Health Education England get the funding that they need to deliver the ambitious cancer care targets in the NHS people plan.
Martyn Day (Linlithgow and East Falkirk) (SNP)
It is a pleasure to serve under your chairmanship, Ms McDonagh. I am grateful to the hon. Member for Bedford (Mohammad Yasin) for securing this debate today, and also grateful for his summary of the issue. He is correct to say that the growth in nursing numbers is nowhere near enough. I agree with him on the importance of investing in the NHS and the nursing workforce.
I am also grateful for the work of the Royal College of Nursing in highlighting the issue, including the recent petition with more than 200,000 signatures that was presented to the Prime Minister in February and called for action to remedy the staffing shortages as a priority. We know that there are some 40,000 nursing vacancies in England, and one in three nurses are due to retire within the next 10 years. In Scotland, of course, this issue is devolved, and in normal circumstances I would not interfere in a debate focused on the issue in England. However, devolved Administrations do not operate in a policy vacuum. UK policies, such as those on Brexit and immigration, affect all parts of the UK, so I will contribute to the debate today. Nor do I feel alone in this matter as several of my Celtic cousins have already spoken in the debate, and the issue benefits from hearing about what happens in Northern Ireland, Wales and Scotland.
NHS Improvement reported in September last year that the latest nursing vacancy rate in England stood at 12.1%. Information Services Division statistics show that NHS Scotland’s nursing and midwifery staff vacancy rate was 6% in the same month. Qualified NHS nursing levels per head are already 46% higher in Scotland than in England. For nursing levels in England to match Scotland’s, they would need to increase nursing numbers by more than 130,000. That puts the 50,000 nurses that were promised for England into a certain context. Consequently, there may be lessons we can learn from how each of the four national health services operate, and I hope my observations on the differences between the two countries’ nursing numbers are seen as constructive and helpful.
NHS staffing per head is 26 staff per 1,000 people in Scotland, whereas England’s is 19.7. Those figures are from September and August last year—I could not get the months to match, but it sets the pattern. There are more qualified nurses and midwives per 1,000 of the population, with 8.1 whole time equivalents in Scotland versus 5.5 in England. Why is that? The number of people in Scotland choosing a career in nursing is increasing, and bursaries are undoubtedly one reason for that. Bursaries for student nurses in England were scrapped as part of the Tories’ austerity measures, a policy that led to a drop of more than 30% in nursing applications. In stark contrast, those bursaries were protected and increased in Scotland by the SNP Scottish Government, and nursing student numbers in Scotland have increased for seven years in a row. One of the big differences is that in Scotland, nurses will receive a bursary of £10,000 a year from next September, and already benefit from free tuition. The UK Government pledged a £5,000 annual grant for student nurses from this year—only half of what we are offering in Scotland—and still expect nursing students who train on the job to pay thousands in tuition fees. I believe that figure in England is around £27,750, a stark contrast to the figure in Scotland, which is zero.
Nurses in Scotland across all bands are better paid than elsewhere in the UK, which also helps to make nursing a career choice and benefits retention. Training more nurses is key to addressing this issue. The latest UCAS figures show a 2% increase in people from Scotland choosing nursing as a career, but a decrease of 4% in the English figures. Meanwhile, a report last year by the Nuffield Trust, the Health Foundation and The King’s Fund concluded that the NHS in England has no chance of training enough GPs and nurses to solve the shortages it faces. This suggests that in order to address the current and future shortages, we need to look elsewhere.
That leads me on to the topic of immigration. EU nationals make up 10% of the medical workforce, and we should be concerned about the insight into their mindset provided by the 2018 British Medical Association survey of 1,527 EEA-trained doctors across the UK, which found that 35% were considering moving abroad. Of course, only time will tell what actually comes to pass. However, immigration to the UK has fallen to its lowest level in six years according to the Office for National Statistics, and Cambridge Econometrics’ analysis states that leaving the single market will see the working-age population fall by nearly 2% by 2030, which is equivalent to 790,000 people.
The challenges with recruitment are not going to get any easier. On 15 November, the King’s Fund, the Health Foundation and the Nuffield Trust predicted that NHS England staff shortages will rise to over one in six health service posts by 2030. Clearly, we must attract skilled workers from abroad, but the UK Government’s regressive immigration plans look set to make the situation worse. At this time, details of a UK NHS fast-track visa scheme remain unclear, and I look forward to hearing those details; perhaps the Minister will enlighten us. With regard to the proposed points-based immigration system, I assume that nursing will be classed as a shortage occupation, which would require a £20,480 minimum salary. I believe it must be on the shortage occupation list, but also that it should be exempt from any salary threshold. The Library briefing for today’s debate gives us the RCN’s opinion of the points-based system:
“We are concerned that these proposals from the Government will not meet the health and care needs of the population. They close the door to lower-paid healthcare support workers and care assistants from overseas, who currently fill significant numbers of posts in the health and care workforce.”
I also echo their calls for the introduction of an immigration system that supports nursing, and to exempt nursing staff from the immigration health surcharge, which seems an unnecessary burden to put on people coming here to relieve our own health crisis.
I will finish with a quote from the RCN’s general secretary, Dame Donna Kinnair, who has said that there are
“43,000 vacancies in the NHS in England alone. Yet failure to increase nurse numbers isn’t inevitable, but a political choice. We need proper financial help for nursing students in every nation of the UK in order to ensure the supply of nurses in the future, and clear legal duties for governments and NHS leaders across the UK to ensure there are enough nurses to provide safe care to patients.”
It is indeed a choice, and I hope that my Scottish comparisons and views on immigration help to inform the choices facing NHS England.
Justin Madders (Ellesmere Port and Neston) (Lab)
It is a pleasure to see you in the Chair, Ms McDonagh. I congratulate my hon. Friend the Member for Bedford (Mohammad Yasin) on having secured this important debate, and on the thoughtful and knowledgeable speech he has given about the challenges currently facing the nursing workforce. He made some very interesting points: the reference to nurses being there at our birth, at our death and throughout our lives was an important and moving reference to how much we all rely on nurses. He mentioned the 10.7% nursing vacancy rate in his region, which is a staggering statistic; there are actually some variations within that, because the vacancy rate for mental health is even higher, at 15.3%. Those huge variations across disciplines need to be addressed by the Government.
My hon. Friend also referred to the RCN’s survey of its members, in which a staggering 95% of nurses said that patient dignity is compromised and 92% felt worried that patients may be receiving unsafe care. That should be a red-light warning for us all about what is going on in our NHS. What he said about the professional attitude and sense of duty that nurses feel was particularly important: when a nurse is at the end of their shift but sees something that needs to be done, they carry on. They are professional, but they carry the impact of that with them, and we have been relying on their good will to keep the NHS going for far too long. Finally, my hon. Friend referred to this being the year of the nurse and the midwife, and was absolutely right to say that we should celebrate this diverse and dynamic profession.
We heard from the hon. Member for Strangford (Jim Shannon), as we often do in these debates, who gave his own perspective from Northern Ireland. He referred to the recent dispute there, and it was clear from what he said that the concern was as much about working practices as it was about pay. He was right to say that workforce challenges there are often mirrored here. The hon. Gentleman also referred to a worrying increase in the agency bill in Northern Ireland, which may well be partly related to the greater flexibility that agency work can sometimes provide to nurses. That is something we need to reflect on when we consider working practices.
As always, it was a pleasure to hear from my hon. Friend the Member for Gower (Tonia Antoniazzi), who I congratulate on her appointment as chair of the all-party parliamentary group on cancer. She was right to highlight patients’ concerns that they are not getting the care they need, the reason for which is inextricably linked with the staffing shortfall. She was also right that it is vital that the full people plan be published as soon as possible, and to raise the concern that the plan will not include the funding it needs to meet our ambitions. Only last month, the Government introduced the NHS Funding Bill 2019-21, so we already have the parameters for funding the healthcare system over the next three to four years. Really, it should have been the other way around; we should have established what the staffing need was before we put a financial envelope around it.
My hon. Friend also referred to the excellent Macmillan report, “Voices from the frontline”, and the concerns it expresses about the lack of ability to access continuing professional development. She highlighted the impact on retention caused by cuts to the CPD budget, and the report’s references to many nurses feeling that their current workloads are unmanageable. My hon. Friend has said that we are on the edge of a full-blown crisis; I could not agree more.
I pay tribute to the 1.9 million or so dedicated and hard-working people who work across both the health and the social care sectors; it is always an honour to speak up on their behalf. Our NHS is built on its staff, and in particular our nurses and midwives who, as we have heard, go the extra mile day in and day out, despite too often finding themselves under intolerable levels of pressure. It is a damning indictment of this Government’s record that despite this being the 37th debate in this place over the past three years on workforce shortages in health and care settings, there is still no plan to address this crisis. It is not over-dramatising matters to describe it as an existential crisis, because following nearly a decade of mismanagement and underfunding, we are facing a very real recruitment and retention crisis in the NHS. Years of pay restraint, cuts to training budgets and growing pressures have left us with a chronic shortage of over 100,000 staff.
Those shortages affect patient care every single day. They manifest themselves in the NHS performance data, which month after month show hospitals with the worst performance data on record. That will not change unless the workforce shortages are acknowledged and addressed. The proportion of people being seen within four hours in A&Es is the lowest on record, and the number of people waiting four hours or more on hospital trolleys is the highest on record, as is the number of people waiting 12 hours to be admitted and the total number of people on the waiting list in England. Targets for patients to receive treatment within 18 weeks have not been met for four years now, and there is no sign that that situation will improve any time soon.
The Government need to take seriously the growing gap between the number of nursing staff and the number of people who need healthcare. As we know, the Royal College of Nursing estimates that there are about 43,000 nursing vacancies in the NHS in England alone and warns that the nursing shortfall will rise to almost 48,000 by 2023 and a mind-boggling 108,000 by the end of the decade. That is a staggering figure. To put that in context, it is more than every man, woman and child living in the Minister’s constituency—picture that. That is how much of a shortfall we could face by the end of the decade, if action is not taken.
The effect of staffing shortfalls on patients must never be underestimated, but they also have an effect on staff. NHS staff are consistently asked to take on additional responsibilities, to work harder, to do more intense shifts and to take on excessive numbers of patients. All the surveys show the effect that that has on them. It is worrying, but not surprising, that only a quarter of respondents to the NHS staff survey published last month agreed that there were enough staff for them to do their job, and that more than two thirds per week worked additional unpaid overtime. As we heard, higher numbers of emergency care nurses—more than nine in 10—are worried that patient dignity is being compromised and that patients may be receiving unsafe care.
I am sure that all hon. Members were moved by the testimony that my hon. Friend the Member for Bedford quoted. No one, patient or staff, should be in that situation. The testimony used the word “dignity” repeatedly, which should cause us to reflect on the situation that we are putting people in. I am sure that we would not want that for our family.
Staff are working in a high-pressure environment without adequate resources or support, which not only puts patients at risk but damages the mental health of staff and leads to low morale, poor wellbeing and a poor work-life balance. It is no surprise that conditions are becoming intolerable for some staff. More than 40% of NHS staff were unwell as a result of work-related stress in the last year—that is an unsustainable figure.
An analysis of NHS Digital data finds that more than 200,000 nurses have left the NHS since 2010-11; there has been a 55% increase in voluntary resignations from the NHS with staff citing a poor work-life balance as the primary reason; and the number of voluntary resignations for health reasons has increased threefold in the past 10 years. It is no wonder that the recent “Interim NHS People Plan” states that hard-pressed staff are “overstretched” and admits that people no longer want to work in the NHS. It is our pride and joy. People should positively want to go to work every day full of joy about what they are delivering for the people of this country, but the pressure is becoming too great.
It is damning that we still have no funded workforce plan, despite the Government’s promise of one when the funding settlement was first announced in summer 2018. We also still have no framework that sets out the roles, responsibilities and accountabilities for workforce supply and planning.
As has been mentioned, last month’s NHS Funding Bill was an opportunity for the Government to show their commitment and set out plans for a proper costed strategy for the workforce but, frankly, it was a publicity stunt. Despite every trust chief executive reporting that understaffing is their biggest challenge and a hindrance to delivering safe care, there was nothing in the Bill on protecting and enhancing training budgets. I acknowledge that staffing shortages are the responsibility of multiple decision-makers across all levels of the health and social care system, but ultimately, they are outside the control of frontline staff and trusts. The Government need to act to ensure that there are enough skilled staff to ensure safe and effective care.
The standards of protection and safety that are rightly expected by staff and enshrined in the NHS constitution appear to have been abandoned by the Government. Things have become so bad that NHS England has recommended that the Government review
“whether national responsibilities and duties in relation to workforce functions are sufficiently clear.”
The public are concerned and want action too. In a recent YouGov poll, 80% of respondents in England agreed that
“the Government should have a legal responsibility to ensure there are enough nursing staff to meet the country’s needs”.
The Royal College of Nursing, other royal colleges and health organisations are all calling on the Government to take action to ensure clear workforce accountability in law. Unfortunately, there has been a continued failure of leadership to bring forward the required legislation to guarantee and enshrine safe staffing levels in the NHS in England. That has left us lagging behind Scotland and Wales, which have already established explicit accountability for workforce provision.
It is vital that, as the royal colleges are calling for, an NHS long-term plan Bill for England sets out a framework of explicit roles, responsibilities and accountabilities for workforce supply and planning, through all levels of decision-making. Like other hon. Members, I am keen to see the detail of the Bill and whether it will contain the long-awaited commitment to safe staffing, in addition to a bold and fully funded workforce strategy. I welcome the Minister to her place; perhaps she will indicate when that Bill might be introduced when she responds.
The election promise of 50,000 more nurses in five years is all well and good, but without a plan for how that will be delivered and maintained in the long term it is pie in the sky. As it is British Pie Week, I cannot think of a more apposite metaphor. We all know that that figure does not stand up to even the most cursory inspection. It is not 50,000 extra nurses, but the retention of 19,000 existing nurses and the recruitment of an additional 31,000. As has already been clearly set out, retention is a huge challenge that the Government are failing on.
The Minister will no doubt tell us there has been an increase in the number of nursing staff in the last year. Of course, in such desperate times, any increase is welcome, but as my hon. Friend the Member for Bedford said, it is a miniscule 0.4%. Let us be honest: the scale and pace of the increase is not happening fast enough. There are also concerns that the figures do not reflect what is really happening on the ground, because they were taken at the optimum time to capture the new registrations before the impact of annual departures is felt.
The Government’s failure to train enough nurses will not be reversed by the recent announcement of maintenance grants for nursing students, as the grants will cover only living costs, not tuition fees. Many student nurses are slightly older and may have family responsibilities, yet the sum on offer from the Government to support them through their training is slightly less than £100 a week.
Evidence shows that, since the Government scrapped the bursary scheme in 2016, applications to study nursing have dropped by 25% in England. As we and many others repeatedly warned at the time, that was bound to happen. Adequate funding for nursing students is crucial to attract more people to study nursing. I hope, again, that the Government listen to us when we say that the U-turn is only partial and not enough to undo the damage done. It is still the case that the prospect of accruing large debts is a huge disincentive for those who want to train in nursing, especially prospective mature students who may already shoulder debt from a previous degree in another subject.
With Labour’s analysis showing that the first cohort of students who started their nursing degrees in 2017 will graduate with £1 billion in tuition fee debt, everything possible must be done to remove the financial burden for prospective students. If the Government are serious about recruiting more nurses, they need to match our commitment to bring back the nursing bursary in full, including the abolition of tuition fees.
I agree with my hon. Friend the Member for Bedford that the new maintenance grants must be increased to cover actual living costs. Given that the Government have admitted the error of their ways in removing the bursary in 2016, I hope that the Minister will set out whether any maintenance loan debt incurred by students between 2017 and 2019 will be written off.
I cannot end without mentioning immigration. The NHS plans to increase the international recruitment of nurses to reduce workforce pressures, but, at the same time, the Government are planning to raise the health surcharge that those staff have to pay. Unison and the RCN are calling for nursing staff to be exempt from the immigration health surcharge. Those staff already make their contribution to the NHS by working in it. Alongside their colleagues, they often go beyond their contractual hours to keep the service from crumbling under the pressure. It is indefensible to continue to apply the surcharge to them.
The RCN also calls for nursing to remain on the shortage occupation list and for nurses to be exempt from the salary threshold when the points-based immigration system comes into force. Given the challenges outlined today, could the Minister set out when responding what representations she has made to the Home Office about bolstering the workforce and ending the uncertainty and red tape in international recruitment? Nursing is a global recruitment market, and a challenging one at that. If the Government’s workforce strategy is over-reliant on international recruitment, it will fail, particularly when barriers are put in the way of recruitment. The myriad of reasons that have been set out about failing to improve retention rates will not lead us to a better place.
The Minister for Care (Helen Whately)
I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. I thank him for his tone and his constructive approach to the challenges. I also thank him for giving me this opportunity to speak about a subject that I am truly delighted to have as my responsibility as a new Minister in the Department of Health and Social Care, and about which I feel very strongly—namely, the NHS workforce.
Our NHS is truly fantastic and we as a nation are proud of it. However, as we know, the NHS is really its people. The people of the NHS are the NHS—from the most senior doctor, to the newest healthcare assistant and everything in between. That is particularly true of nurses, who make up nearly one quarter of the NHS workforce, and good healthcare depends absolutely on good nurses.
The NHS should be looking after its nurses, but over many years visiting hospitals and community services—this goes back a long time—I have had too many conversations with nurses who feel that the NHS, or their employer, has not been looking after them. The biggest problem that comes up, going back over many years, is that of staff shortages.
I completely agree with the hon. Member for Bedford that the vacancy rates among NHS nursing teams are too high. They are particularly high for some specialties, such as mental health. There are variations across regions. For instance, in the north-east, Yorkshire and the north-west, the highest vacancies are in ambulance trusts. We also know that there are particular challenges in rural areas, as mentioned by my hon. Friend the Member for North Cornwall (Scott Mann), and across the nations of the UK. As we heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), there are challenges in rural parts of Scotland. We heard from the hon. Member for Strangford (Jim Shannon) about the challenges in Northern Ireland, and there are also parts of Wales that are struggling. This is not just a problem in England, but nevertheless I recognise the problem in England. We need plans to address that, and we have plans, which I will come to.
The hon. Member for Bedford also flagged up the importance of safe staffing in the NHS. I absolutely agree that our first priority must be that the NHS is a safe place for patients, and that care is safe. As he will know, trusts call on bank and agency staff, to make sure that they have enough staff to make wards safe. We must appreciate the work of those staff, who do a really important job of stepping in, but, as I have heard from many a ward sister, although they welcome having agency staff to fill the gaps, that is not the same as having a fully staffed team. That is what we really want in the health service. It will make the NHS a great place to work and enable it to provide the best possible care for patients. That is why the Government have committed to 50,000 more nurses, so that staff shortages and those high vacancy rates will be a thing of the past.
Before I talk about how we will find thousands of new nurses, I want to discuss the most fundamental thing we have to do to succeed, which is to keep the nurses that we already have in the NHS. Some hospitals and teams do not have a problem with staff retention, and some have very low attrition rates. In others, we know that staff turnover is a real problem. There is no point in the NHS training up lots of new nurses if we cannot hang on to those who have already been trained.
In order to retain nurses, we need to make sure that each day is a good day. We need to look out for each and every nurse, which is the day-to-day job of the trusts that employ nurses. I want those trusts that are struggling with high attrition rates to adopt more of the good practices of successful trusts. The Government are also going to help.
First, as we have discussed today and as we have heard directly from nurses, more investment in ongoing training and continuous professional development would make a big difference. That is why the Government have committed to giving every NHS nurse a £1,000 training budget on top of the training that employers usually provide. That extra funding should help nurses to advance their careers, to move more easily between different roles and, of course, to provide better care to patients.
Secondly, there will be a new offer for all NHS staff. It will be released alongside the NHS people plan, which will set out the support each and every NHS staff member can expect from their employer, including for professional development and for more choice and control over shifts and working patterns. As several hon. Members have said, NHS staff want more control and flexibility. The hon. Member for Strangford mentioned the importance of flexibility. Nurses may have other caring responsibilities. Some trusts are doing well in this area, others not so well. We want all employers to do what they can to give staff more flexibility and control over their working hours.
Jim Shannon
I thank the Minister for her comprehensive response. I know that tax credits, NVQs and time out are not her responsibility, but would she be willing to speak to the Minister with that portfolio to see whether there is any flexibility in the system to enable nurses, especially those with young children, to continue?
Helen Whately
My understanding is that the system in Northern Ireland is different from that in England, so I do not have the answer at my fingertips. I am, however, happy to take up the hon. Gentleman’s question and get back him.
Thirdly, on improving the retention of staff in the NHS, we need to tackle the level of bullying and harassment. The recent NHS staff survey had some really positive results on how NHS staff feel about their work. The Secretary of State and I, however, are greatly concerned about ongoing reports of bullying and harassment that staff experience at the hands of other staff, patients and, sometimes, their families. That is simply not acceptable. We must send out a message, loud and clear, that we will not tolerate the bullying and harassment of staff, whether from other staff or from patients and their families. As a society, we should all be grateful to our NHS staff. Hand in hand with that, we absolutely will not tolerate racism, which is an ongoing problem in some parts of the NHS.
Fourthly, pay has never been the top thing brought up by nurses when I have spoken to them about their concerns, but clearly it is part of the picture. By April this year, we will have increased by 12% the starting salary for new nurses compared with three years ago. More than 200,000 nurses are benefiting from pay rises under the “Agenda for Change” pay deal. Nurses below the top of their pay band have been receiving increases of at least 9%, and those already at the top of their pay band are receiving a pay rise of 6.5% over the course of the “Agenda for Change” pay deal.
I just want to pick up on the point about returning to nursing. The issue of retention also applies to nurses who have, for many reasons, taken time out of nursing. We are very keen that more of those nurses return to work. We are supporting nurses who want to bring back their valuable experience to the NHS. I also want trusts to develop posts that will make the most of those nurses’ experience and to ensure that there is enough flexibility in their shift patterns and ways of working to fit any caring responsibilities they may have.
Jim Shannon
For that to happen and for them to return, there would need to be a database of all former nurses. I am mindful that there will be a statement later about the coronavirus, and a Health Minister has mentioned having a list of people who could come in and help in the event of a pandemic outbreak. If there is such a list, then there must also be a list of former nurses who have left the sector but wish to come back. Is there such a database?
Helen Whately
I have not seen a database. The hon. Member refers to the coronavirus plans, which are very much on my mind as we talk about the immediate and longer-term plans to increase the number of nurses in the NHS. Clearly, we also have the short-term challenge of ensuring that the staff are there, and that work is absolutely in hand. Returners are an important part of it and we need to ensure that we make use of nurses who have already been trained, to boost the NHS workforce. All in all, we want to ensure that the NHS is a great place to work for nurses who return to it and for those working in it right now. The absolute foundation for ensuring that we no longer have nursing shortages is to look after the nurses that we currently have. On that foundation, we can seek to recruit and train new nurses.
Tonia Antoniazzi
I welcome the Minister to her place. As the chair of the all-party parliamentary group on cancer, I would like to take this opportunity to ask her to come to speak to us about the NHS people plan, if possible.
Helen Whately
I thank the hon. Member for her invitation. As I am new to the job, I am trying to ensure that I speak to as many stakeholders as possible. I would be delighted to talk to APPGs such as the one she chairs, as and when I can.
I turn now to the ambition to increase the number of nurses that we train. The latest UCAS stats show that there have been nearly 36,000 applications to study nursing and midwifery courses at English universities this year, which is about 2,000 more than last year. The new students will benefit from the new £5,000-a-year maintenance grant, an extra £1,000 if they study specialist subjects such as learning disability and mental health nursing—where we have shortages—and a further £1,000 if they study in areas struggling to recruit. There is also further funding available to support childcare costs, and that financial support is in addition to the learning support fund, which provides help with travel costs for placements, childcare and exceptional cases of hardship. That is all in addition to being able to apply for a student loan. Unlike other courses, students applying to nursing, midwifery and many allied healthcare professional courses as a second degree will also qualify for the maintenance grant and for student loans.
I set out the financial support we are offering because I recognise that, as the hon. Member for Bedford has said, it can be hard to afford to study nursing, particularly for mature students. We really want more nursing students. Last year, 23,630 people accepted a place to study nursing or midwifery in England. This year, I want to see more. As I have said, there has already been an increase in applicants, but it is not too late for anyone who has yet to apply. UCAS is accepting late applications up to 30 June, and from 6 July people can apply for a course through clearing.
My message goes out to anyone watching this debate who thinks that nursing is for them: please, get applying. If someone wants to become a nurse, we want to help them—no matter who they are or what their background is. However, we know that university is not the route for everyone, so there are other ways to become a nurse. For instance, the Government have developed the apprenticeship pathway, so people can go from being a healthcare support worker to being a nursing associate, and then to being a nurse. If they want, they can then move on to postgraduate advanced clinical practice and nursing. At present there are nearly 2,000 nurse degree apprentices. Although nursing associates are doing a really important job in their own right, they can become registered nurses via a shortened nursing degree.
The things I have just set out are all about increasing our home-grown nurse force, which is absolutely vital step in ensuring that this country has a sustainable nursing workforce. I am fully aware, however, that we will also need to recruit internationally in order to achieve the ambition of 50,000 new nurses. We cannot do that from the home-grown workforce alone. Many of us, including patients and their families, have good reasons to be grateful to nurses who have come from all over the world to work in our NHS. I am grateful to them.
As we look ahead to including international recruitment as a way to boost our nursing workforce, we do so mindful of the ethics of recruiting from elsewhere. We want to ensure that it works not just for us but for the countries that our nurses come from. We are determined to build bridges with health systems across the world, to share NHS expertise and provide staff who come to work in the NHS with a chance to learn from our health system, just as we benefit from their skills.
The hon. Member for Bedford asked how we plan to increase the nursing numbers by 50,000. In essence, the plan is to improve retention, to support returners to the workforce, to boost our home-grown numbers, and to complement that with international recruitment. In response to questions about when we will publish the NHS people plan, that will be done within the next few months. I have also been asked who is responsible for the workforce. I take the responsibility for workforce in my brief very seriously. I feel very strongly that, from day to day, the biggest determinant of the experience of any nurse or member of the NHS workforce is their employer. NHS employers are responsible for their workforce, and I am keen to see every single trust and NHS organisation investing in and supporting and valuing their staff. As I said at the beginning of my speech, the NHS is only as good as its people. They are great, and we must look after them.
I thank all hon. Members for their contributions. This has been an important discussion and some good points have been raised. The mere fact that we are having this conversation demonstrates the importance of nurses to us all and to our health system. Some hon. Members talked about a crisis in our NHS and in nursing, but we have to be careful in getting the right balance in the language we use. Yes, we know that it is tough on the frontline, but we also know that nurses and NHS staff more broadly talk about how very rewarding they find their day-to-day work, and about what a wonderful job it is. I have spoken to nurses who tell me that they would never want to do any other job, so it might be helpful to get the right balance.
The hon. Member for Gower (Tonia Antoniazzi) says that her experience as a teacher means that she knows how to inspire. I call on her and everyone else to follow that guidance, as we need to ensure that everybody knows that working in the NHS is a great career. The NHS is a great place to work. Let us not talk it down. Let us make sure that we spend time talking it up.
Tonia Antoniazzi
I appreciate the Minister’s comments. I would never talk down a profession that we need and depend on so much. The nurses I have come across, whether from throughout the UK or from overseas, have been absolutely wonderful. We are being positive and want to retain people, and this issue is important to us. Does the Minister agree that this is not just about our healthcare, but about our teachers and public services? We also have a commitment to our consultants, who have a lot of issues and are always overworking to ensure that frontline services continue. Their dedication is absolutely brilliant and we appreciate it.
Helen Whately
I thank the hon. Member for her comments. We can absolutely agree how much we value everyone who works in our public services and with the NHS, including consultants, junior doctors, nurses, nursing associates, healthcare assistants and allied healthcare professionals, as well as every single porter, administrator and member of the management team. I am sure that I have left out some individual roles—healthcare scientists, for example—for which I apologise. The whole NHS workforce has my appreciation.
Jim Shannon
The Minister has mentioned the Government’s commitment to increasing national health service funding. It is important to state for the record that we acknowledge the good things they have done.
Helen Whately
I thank the hon. Gentleman. As he says, I have spoken not only about how much we value the NHS workforce, but about our commitment to increasing NHS funding. The two go hand in hand.
A few Members have mentioned that the number of vacancies stands at well over 40,000. Although I absolutely recognise that those numbers are still far too high, the latest data shows a steady downward trend over the past year. I state for the record that as of the third quarter of 2019-20, the number of vacancies was under 39,000.
I will finish with one more piece of good news: the increasing number of nurses in the NHS. As of November 2019, the latest workforce data shows that we had 290,474 nurses in the NHS in England, which is an increase of 8,570, or 3%, since November 2018, and an increase of nearly 17,000, or 6%, since 2010. The numbers are going in the right direction. We have a long way to go but I am determined that we should get all the way to the extra 50,000 nurses in the NHS, so that nursing staff shortages will soon be a thing of the past.
Mohammad Yasin
I thank all hon. Members who have taken part in this important debate, and thank the shadow Minister, my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders), and the Minister, for their responses.
To be honest, I am disappointed with the Minister’s response. We have heard it many times before. It is time to take solid action. I ask her to read the responses to the digital engagement team’s survey, because she will be shocked by people’s comments, which should be an eye-opener for the Government. We are in crisis when it comes to nursing vacancies and getting nurses into jobs. The Government need to take action now, before it is too late. We cannot afford any more delays.
Question put and agreed to.
Resolved,
That this House has considered the nursing workforce shortage in England.
Hammersmith Bridge
(4 years, 9 months ago)
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Andy Slaughter (Hammersmith) (Lab)
I beg to move,
That this House has considered a proposal for Government funding for the repair of Hammersmith Bridge.
It is a great pleasure to see you in the Chair, Ms McDonagh. As a fellow London MP, you are no doubt aware of the intricacies of crossing the River Thames.
It is also a great pleasure to see the Minister in her place with her new brief, given how helpful she was at the Department for Business, Energy and Industrial Strategy on the many issues I pestered her with there. I look forward to a favourable response today—I am definitely in buttering-up mode, because I am asking for money.
In the short time we have for this debate, I will do a tour d’horizon of the history, the life, the engineering and the strategic importance of Hammersmith bridge. At the end, however, to spoil the denouement, we come down to one fact. We know where we are going with the methodology, the necessary works—complex as they are—and what to do about temporary river crossings, and although with most of those issues, we do not have a final timescale or costing, we know the ballpark figures. What we do not have, to put it crudely, is the money.
We have had £25 million, which has taken us thus far with the works that are necessary to the bridge, but we need a substantial amount more—at least £100 million beyond that. This debate is my pitch, and that of others, so I am grateful that my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) and the hon. Member for Richmond Park (Sarah Olney) are present. I think they would agree that if this major strategic river crossing and landmark, an important bridge for London, is to be restored, the co-operation will be required of not only the local authorities, Transport for London and the Greater London Authority, but the Department for Transport.
Baroness Vere is the Minister with direct line of responsibility for the matter, but I am pleased that the Minister present is covering it in the Commons. Since the debate was granted, however, I am grateful that Baroness Vere has agreed to meet me, the hon. Member for Richmond Park and the two borough council leaders most affected on 9 March. I would have loved it if the Minister present had a cheque with her to hand over to me—I would promise to pass it on—but I understand that the discussion is ongoing and may continue at that meeting. Nevertheless, it is useful to set up some of the arguments today, and some of the background, which I will do as briefly as I can.
In four years’ time, we will celebrate the 200th anniversary of the Act of Parliament that granted consent for the first suspension bridge over the River Thames. That bridge was constructed at the cost of £80,000 and opened in 1827. I had a look at the debate on Second Reading, and it was a hotly contented matter. Mr Serjeant Onslow opposed the motion in favour of the bridge. He called the Bill “perfectly uncalled for” and said that:
“There were already two bridges, Kew-bridge and Putney-bridge, within a mile and a half of the site of the intended bridge, which would lead to a part where there were at present hardly any inhabitants.”
That is slightly insulting to the people of Barnes who, no doubt, were busily constructing their community even then.
Sir F. Ommaney spoke in favour of the Bill. He
“complained strongly of the insecure state of Putney-bridge. Not long since, a friend of his happened to be riding over that bridge, when the fore-feet of his horse sank into a hole, and both horse and rider were placed in a most perilous situation.” —[Official Report, 13 April 1824; Vol. 11, c. 397-98.]
Plus ça change, plus c’est la même chose, for anyone who has driven or walked over Hammersmith bridge in the past few years.
The bridge we know now, the famous landmark, is the finest of the Thames bridges, although I am obviously prejudiced. It is the work of Joseph Bazalgette, who is perhaps more famous for constructing the London sewer system on which we all still rely today. This bridge was proposed in the 1870s as a consequence of 12,000 people crowding on to the old bridge to watch the boat race, the belief being that it was in danger of collapse. Again, we may have to restrict numbers later this month for the boat race—little seems to change over time. In 1884, a temporary bridge was put up—we are discussing such issues again—until finally the bridge that we all know and love today was erected, on the piers of the original bridge.
The current bridge opened in 1887, but its piers are still those of the original 1827 bridge. That is relevant today because, had there been a renovation scheme to restore or replace the piers, that might have brought the bridge up to a much heavier standard of weight, allowing many more heavy vehicles to go across it. Again, that would have been a huge additional investment, even beyond the large sums being proposed today—so we will still be using the 1827 piers.
Most of the rest of the superstructure of the bridge needs substantial replacement. One of the reasons is that over the years Hammersmith bridge has three times been the target of IRA bombing, the first time in April 1939. Again looking at Hansard, I see that a Mr Childs—Maurice Childs, a hairdresser from Chiswick —found the bomb while walking across the bridge and had the foresight to throw it off. It exploded, causing some damage to the bridge but saving the main structure, for which he was awarded an MBE following the debate in Parliament.
The two more recent examples of bombing were more serious. The 1996 bomb did not detonate—the Semtex did not go off—fortunately, because at the time it was the largest Semtex bomb ever found in Britain and it would have destroyed the bridge had it done so. Four years later, post the Good Friday agreement, the bridge was damaged by a Real IRA bomb planted underneath the Barnes span. That, in part, led to one of the substantial closures of the bridge. Sadly, the post-war history of the bridge has been a succession of closures over time.
Another debate was held on the 1952 closure, when 13,000 vehicles a day were passing over the bridge—that is slightly more than half the current number—and 2,700 pedal cycles, which I add for the benefit of my hon. Friend the Member for Brentford and Isleworth, who chairs the all-party group for cycling and walking. In response to the proposed closure, Mr Williams suggested
“half closing the bridge or giving the Royal Engineers some practice in building a Bailey bridge across the river”.—[Official Report, 23 June 1952; Vol. 502, c. 1821.]
Again, we are talking in exactly those same terms now—what the degree of closure needs to be and what temporary bridges need to be put in place. So the 1952 closure was significant. Major refurbishments took place in 1973 and again in 1987. In 1997, an 18-month closure of the bridge was for major works. Following that came the substantial restrictions—down to 7.5 tonnes and a limited number of buses—that have gone on until the present day.
The point of rehearsing all that ancient history is that this is not new to those of us familiar with the bridge. Hammersmith bridge is in a different category from many other bridges over the Thames. It is a largely cast-iron and wooden structure. There is no other example—I think it is unique in the world in how it is constructed. That makes it rather like Hammersmith flyover which we had a similar problem with some years ago—a unique structure that required major closures, and £70 million of expenditure—and the bridge, too, will need a radical solution. One good thing coming out of the current closure is that everybody is agreed on a way forward: we have to do sufficient work to give the bridge a long life into the future. A further patch-up job, or even further substantive repair jobs of the type done previously, clearly will not work.
Where are we in the scheme? Thanks to the £25 million that TfL put up when the closure initially happened last April, there has been no impediment to works going forward: the scoping, the planning and feasibility studies defining what is necessary in terms of both the stabilising works and the major works to the bridge. Within a month or two, we will be in a position to let those contracts and to ensure that the work progresses. Although it is taking a substantial amount of time, there is general understanding that it has to be done properly in that way.
Sarah Olney (Richmond Park) (LD)
I congratulate the hon. Gentleman on securing this debate on a matter of utmost importance in my constituency, and I am pleased to have an opportunity to contribute. While we are considering Government funding to repair Hammersmith bridge, I urge the Minister to consider the difficulties that the bridge closure is causing my constituents in Barnes and further afield. Residents are unable to get to their hospital appointments and face much longer journeys to work. Should the Minister come to Barnes, East Sheen and Mortlake, she would see the appalling congestion being caused. Local businesses tell me that they are suffering reduced takings as a result of the bridge closure.
TfL is reporting that something in the region of 9,000 daily journeys have now dispersed as a result of the bridge closure. While we welcome fewer cars on the road, we should consider the economic and social opportunity cost of the journeys that are not being made.
Andy Slaughter
I absolutely agree with the hon. Lady. One of the ironies is that, while many people are affected by the closure, it is those who need to travel into London from the south, including residents of Barnes and Richmond and those from wider afield—the residents of Brentford and Isleworth, Hammersmith, Fulham and Battersea—who are caused additional congestion because of the build-up of traffic going over Putney, Wandsworth and Chiswick bridges.
Ruth Cadbury (Brentford and Isleworth) (Lab)
May I wish you a belated happy birthday, Ms McDonagh? My hon. Friend mentioned the impact on a much wider area than merely Hammersmith borough and Richmond borough. Parts of Hounslow, particularly Chiswick and Brentford, have suffered major congestion since the closure of Hammersmith bridge to vehicle traffic. The economic impact that the hon. Member for Richmond Park (Sarah Olney) described affects a big area. Does my hon. Friend agree that the Government need to consider the bridge as major infrastructure? I hope they will work with all the local authorities affected, and the MPs, to come to a positive solution.
Andy Slaughter
It is no laughing matter for those severely inconvenienced by longer journey times and the changes to their life that have to be made. We take infrastructure such as this for granted; when it breaks down, it causes major problems way beyond the local area or even region.
There are two matters on which there is clear consensus now. The first is whether the bridge should reopen at least to its previous capacity. I totally understand that cycling and other groups suggest that this could be an opportunity to permanently close the bridge to motor traffic. Analysis by TfL shows that cost-benefit ratio of reopening is 5.8:1, which is very high. Essentially, to relieve the congestion on other river crossings and to make that part of London function again —as much as it ever does in terms of traffic movement—it is a bit of a no-brainer. It is regrettable since we want to promote cycling and walking, and I hope we can hang on to the huge increase in those forms of travel over the bridge. We particularly need bus traffic to be restored, because the bridge is a major bus route, with 24,000 people a day crossing it by bus, as well as more than 20,000 private vehicles.
The second point is the issue of how to go about the works. There is consensus on the need for a temporary bridge for cycling and walking—the previous Minister made that clear in a letter to the hon. Member for Richmond Park. There were moves to have a temporary motor bridge, but for many reasons that I will not go into—cost, feasibility, disruption and destruction of private property—that would not be possible. We need a temporary foot and cycling bridge; although it will cost a substantial amount of money, it will come out of the TFL money already allocated and will allow the major works to go on unimpeded and more safely on the main bridge. I think that is decided. I believe a brief was sent by TfL to the Ministry in preparation for this debate and for the meeting with Baroness Vere, which sets out clearly what the methodology will be.
The separate closure of the bridge last year was a matter of safety, when hairline microfractures were discovered in the cast-iron casing around the pedestals that hold the suspension chains. Sadly, that having happened, a major structural survey at the time showed that the corrosion to the suspension mechanisms, the bearings, the decking and so forth means that substantial parts of the bridge will have to be replaced. It will end up like the broom that has had its head replaced three times and its handle four times, but I am sure it will look magnificent when it is finished and reopened.
I will finish speaking soon to allow the Minister to reply. We have allocated, if not spent, the £25 million that has come from TfL. It is not in a position to add to that. I will not go through the argument about the subsidy that has been withdrawn or the restrictions on using its capital on assets it does not own. TfL has stepped up to the plate; its expertise and, frankly, its money, has been very useful to get us this far and to ensure that time is not wasted and works delayed.
Equally, Hammersmith and Fulham council has reacted responsibly, as has the London Borough of Richmond. I pay tribute to Stephen Cowan and Gareth Roberts, the leaders of those two boroughs, who have worked co-operatively together in the interests of their populations and residents. As a borough, Hammersmith, notwithstanding other restrictions on its budget over the last few years, is not in a position to come up with money. Those are not controversial statements to make.
We have to look to Government when major strategic assets fail. That is the case in most of the rest of the country. The large local majors scheme, which is available and which TfL’s bid addresses, is in funds and is available for this type of work in other parts of the country. The proposition is that, if the Department for Transport accepts that the bridge is part of the strategic road network, it has to reopen to at least its previous capacity to cover single-decker electric buses, as well as similar weights of general vehicle traffic as previously. That will cost a substantial amount of money—at least £120 million on current estimates, and the final estimates will come in a few weeks’ time. Crucially, very soon within the next couple of months, work will stop. Even if there is still some money in the kitty, one cannot go on engaging contractors if the money is not there to pay them to do the stabilisation and major works over the next couple of years. That is what we are looking to the Department to fund.
I hope I get some encouraging noises from the Minister, even if she has not brought the cheque with her. Locally, there is a lot of co-operation between politicians of all stripes, because we see the absolute necessity of this work; as I said, it is a bit of a no-brainer. We must get the bridge reopened as quickly as possible and restore it at least to its former weight-bearing ability. I look to the Minister at least to give us some encouragement, and I hope that we can progress discussions quickly over the next few weeks so we can get on with the project.
The Parliamentary Under-Secretary of State for Transport (Kelly Tolhurst)
It is a pleasure to serve under your chairmanship, Ms McDonagh. I, too, wish you a belated happy birthday.
I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing this debate on an important issue for London and its residents. Hammersmith bridge is a key Thames crossing. The Government recognise its vital importance to the residents of London and the concern about the additional congestion caused by its closure. I thank the hon. Gentleman for his constructive tone and the way he tends to engage on all these issues.
I totally understand the strength of feeling about this issue. Picking up on the interventions by the hon. Members for Richmond Park (Sarah Olney) and for Brentford and Isleworth (Ruth Cadbury), I understand completely the challenges when a bridge closure affects a Member’s constituency. I represent a constituency that straddles a river, so I understand the challenges for residents and for people’s ability to get on with their lives when a bridge is taken out of play.
Although I represent Rochester and Strood, I have had the pleasure of passing under Hammersmith bridge, so I am not completely ignorant of its beauty. As the hon. Member for Hammersmith outlined, the bridge was constructed in 1887 and was originally built for horses, carts and penny-farthings. It has done remarkably well considering the volume of traffic it has taken over the years, not to mention the number of terrorist attacks it has suffered. It is not just a beautiful bridge with important heritage considerations, but a marvellous piece of Victorian engineering and the first suspension bridge built over the Thames.
The Government support the efforts to repair Hammersmith bridge and bring it back into operation in a cost-effective and speedy manner. However, we must recognise that it is for the London Borough of Hammersmith and Fulham, as the owner of the bridge, to assess the merits of different funding options for its repair. Local highways authorities such as Hammersmith and Fulham Council have a duty under section 41 of the Highways Act 1980 to maintain the highways network in their area. The 1980 Act does not set out specific standards of maintenance, as it is for each local highways authority to assess which parts of its network are in need of repair, based on its local knowledge and circumstances.
The use of the bridge by people further afield does not change that responsibility. There will of course be instances around the country of highways assets being used by those who are not resident in the area. The Government provide funding for local authorities in England, including London boroughs, to direct towards their local priorities. That is in addition to the funding provided to London boroughs through the local implementation plan process by Transport for London to help implement the Mayor’s transport strategy.
Although the bridge is owned by Hammersmith and Fulham, I am pleased that TfL, which has considerable expertise in this area, is working closely with the borough on options for repair. It is further encouraging that TfL has already committed £25 million towards repair works, as the hon. Gentleman outlined. I also welcome the two proposals that TfL, with Hammersmith and Fulham, recently submitted to the Department for a funding contribution towards the repairs needed to the bridge. The Department is considering those proposals in the context of other funding requests and in view of the devolution settlement for London. The hon. Gentleman mentioned the meeting next week with my colleague Baroness Vere, who is the roads Minister, and the deputy mayor for transport. I know Baroness Vere is looking forward very much to working with colleagues on this issue.
London is, of course, one of the most vibrant and dynamic cities in the world. The Government recognise London’s important contribution to the UK’s economy and culture, and will continue to support its growth and success while delivering on our levelling up agenda. Although London no longer receives a revenue grant from the Government, the Mayor now receives a greater proportion of business rates income, allowing him to direct that funding towards his priorities. That funding is a significant proportion of TfL’s overall income.
The capital’s transport system is critical to its ongoing success. That is why we have continued to invest in transformative projects in London, including Crossrail and the Thameslink upgrade. We have also invested through the housing infrastructure fund; London will benefit from around £500 million to fund a number of transport interventions across the capital, to unlock and facilitate the delivery of some of the housing that it desperately needs.
I understand that closures of this kind can be very disruptive to constituents and their representatives, and I thank the hon. Gentleman for securing this important debate. I am glad to see Hammersmith and Fulham and TfL working so closely on this issue for the benefit of their residents, and I encourage them to continue that close working relationship. I hope that sustainable transport modes will be considered fully and given the importance they deserve as plans for the repair of the bridge are developed and refined, and that the bridge can be made safe and resilient for the future.
Andy Slaughter
I got a press release today from the RAC Foundation, which states that there are 3,000 sub-standard—that is, not fully weight-bearing—bridges in the UK, so this case is not unique. However, it gives a figure of just over £1 billion for bringing all those bridges up to standard, so clearly Hammersmith is a major project. It is a bigger project than a local authority can sustain. I wonder whether the Minister can give us any comfort about the large local majors scheme and indicate whether it will be available at least to consider a bid by TfL and the boroughs.
Kelly Tolhurst
The hon. Gentleman is right. Of course, much of the significant infrastructure across the country, including bridges, is very old and may have a chequered maintenance history. It will always be a challenge to ensure that our infrastructure is invested in and maintained in the right way, in order to deliver for all our residents across the country.
As I said, we have received the proposal from TfL for the repair works, and that is being considered. Baroness Vere welcomes the opportunity to work with hon. Members and the council at the meeting I mentioned to try to find a way of bringing Hammersmith bridge—a significant landmark and a piece of engineering that is loved by many—back into use for the benefit of everybody.
Question put and agreed to.
Housing and Planning
(4 years, 9 months ago)
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Sir Charles Walker (in the Chair)
Colleagues, before I call Mr O’Brien to move the motion, I note that there are a lot of speakers. If you intend to speak, I advise you to be parsimonious with interventions, because it is possible that some speakers will be crowded out.
Neil O'Brien (Harborough) (Con)
I beg to move,
That this House has considered housing and planning.
It is a pleasure to serve under your chairmanship, Sir Charles. It is good to see so many colleagues here and I particularly welcome our brilliant new Housing Minister. I will talk about the wider reforms needed in planning and housing, but I want to start with not the where or what of what we build, but some of the problems caused by the way in which the development industry behaves.
The first problem is what has come to be known as fleeceholding. It has become the norm for bits of new estates, such as car parks and public areas, to be handed over to property management companies for their upkeep, with residents paying for it. Instead of being maintained by the council, the property management company steps in and offers to adopt those responsibilities more cheaply than the council would. Often, however, it makes a cheaper offer only because it is working on the assumption that it will be able to dramatically increase bills.
Several neighbourhoods in my constituency are up in arms about opaque and rapidly rising bills from these property management companies. For example, around Windlass Drive in my constituency, 120 households are charged £60 each to mow around a tiny balancing pond that is much smaller than this Chamber. Absurdly, while the council mows a much bigger area all around it, someone comes down all the way from Derby to mow that last tiny area. That fragmentation increases the costs to householders, and that cost is passed on to people in the form of higher bills. Likewise, residents of Coleridge Way were at one point asked to pay £300 a week for someone to drive over from Solihull to inspect a playground. Four households in Farndon Fields were asked to pay £2,400 for the maintenance of a tiny piece of car park, consisting of no more than 30 minutes’ work over five years. That is £2,400 for 30 minutes’ work—nice work if you can get it, Sir Charles.
These maintenance companies are opaque, and people who move out often have to pay them substantial fees to get the documentation they need. The Homeowners Rights Network and the National Leasehold Campaign have compiled many such horror stories. We could easily have a debate on fleeceholding alone. Having found that some companies have in fact broken the law, the Competition and Markets Authority is now taking action. I hope that the Minister will also take action against bad practice that falls below the threshold of criminal behaviour—the industry is full of cowboys—because my constituents are sick of wasting their time battling unfair bills.
The second problem with development is that of inappropriate access to sites. Residents who moved into new homes on Farndon Fields were told that there would be no development next to them for decades. That was not true. When a different developer got planning permission to build a new estate right next to them, it got an access route agreed that goes through their estate. It goes through tiny, narrow streets, past a playground and down a tiny cul-de-sac. There is mud all over the roads and huge lorries revving their engines outside people’s houses in the early hours of the morning. People on that estate face years of misery. We tried to get the developer to use a different, better access route through a field, but when pressed it said that the farmer was asking for too much money so it was not possible. In the end, the council did not want to be taken to tribunal, so it gave the developer that access route.
I have no idea how much the farmer was asking for, but if the Minister could find a way of creating a better way for councils and developers to secure temporary access routes that avoid disruption to huge numbers of households—it could be a temporary compulsory purchase order or some other solution that provides better access that is not obnoxious to residents—that would be very welcome.
Another big problem in my constituency this winter has, of course, been the flooding caused by inadequate drainage from building sites. Developers typically start work by scraping off the topsoil and only put in the drainage late in the construction process. This year, over winter, many have been caught short, as inadequate, temporary drainage has been overwhelmed by the amount of water. For example, on Kingston Way, developers caused huge flooding on the roads and flooding of people’s gardens. They have built a pathetic little muddy sandcastle to try to direct water down the drain. It is a pathetic reflection on an industry that constantly claims to have compassionate constructors. Again, some of that is for local councils to sort out, but if the Minister has an opportunity to change national guidance about the phasing of drainage works on new sites, that would be very welcome.
Another problem with construction practices is about how planning conditions are often violated, with it being difficult for councils to enforce them. Builders work beyond the hours they are permitted to work, lorries park in residential streets and firms fail to honour commitments on wheel washing, so residents end up tramping huge amounts of mud into their new carpets. At the moment, the onus is totally on the council to take developers to court, which is very cumbersome. I encourage the Minister to look at making it much easier for councils to enforce breaches of the rules through some kind of bond system or fixed penalty notice, because developers need to know that if they consistently breach the rules, they will face sure and swift sanctions, and it will cost them money if they break the rules.
The final set of issues with the industry’s behaviour relates to adoption. On Devana Way in my constituency, developers sold houses on new, tree-lined streets. It was beautiful, lovely, and people really liked the trees. However, the developer, after selling the houses to people, had a dispute with the council over adoption, which it solved simply by turning up one morning and ripping out all the trees. Wonderful! I do not see why any developer should be allowed to go ahead with constructing a new estate if it has not already secured agreement on who will maintain it. Developments should not go ahead without clear agreements on adoption and who will maintain what.
Those are some of the things we need to do to change developer behaviour in the industry. I now turn to the bigger picture. We need four or five big changes to the way in which we approach planning and housing policy. First, we need a clearer vision of where we want to build. I believe we must do more of it in our cities, because there are strong environmental and social arguments for that. It means more walking, better public health, less congestion, less pollution and lower energy use. As the Create Streets think-tank has pointed out, having denser cities does not have to mean ugly tower blocks. The densest neighbourhoods in all of Europe are in Barcelona and the densest in Britain are in Kensington, which are nice places to live. Britain currently has the least dense cities in Europe. We also have many cities that have shrunk, with Dundee, Glasgow, Liverpool, Sunderland, Birkenhead, Hull and Newcastle all having smaller populations in 2017 than in 1981.
James Cartlidge (South Suffolk) (Con)
I congratulate my hon. Friend on his speech on this important subject. I very much admire and agree with what he has previously said on urban regeneration. Does he agree that, at its best, urban regeneration provides not only more new supply, but better supply for existing tenants and leaseholders, and that it also helps us avoid disproportionate development in precious green spaces?
Neil O'Brien
My hon. Friend is absolutely correct. That is why we must change the objectively assessed need process and choose to build more in our cities. We must support such developments and do all the other things required to support their levelling up.
Secondly, we need a clear vision of what kind of development we want, because while there will always be some developments in the shires and suburban areas, at the moment we mainly have piecemeal infill-type development tacked on to the edge of villages. Developers prefer that, because it is much more profitable as they do not have to pay for the new GP surgery, the new school, the new road and so on. Instead, those developments piggyback on existing facilities. Infill is the type of development that attracts the most opposition. That is not surprising, because it takes place next to existing residents who have chosen to live on the edge of a village or town to get a nice view.
There are physical limits to how much can be added to a place without it losing its character, because roads through the centre of a village become congested and cannot be widened, and the village school cannot be expanded even if the money is available, because it is completely surrounded by houses. In larger strategic developments, which lots of councils now want to move towards, developers do not build next to so many existing residents, the infrastructure can be planned properly and people do not have to live on arterial roads. Let us give councils the tools, the fiscal firepower and the legal ability to have genuinely planned development, not a free-for-all.
Kate Green (Stretford and Urmston) (Lab)
I congratulate the hon. Member on the debate. Does he agree that it would be good for the Government to look again at permission in principle, which means that councils have even less grip on strategic planning control and residents have absolutely no means of complaining, raising objections or having their concerns taken into account?
Neil O'Brien
I certainly agree that it would be desirable to get rid of outline planning permission, which many developers use to get a foot in the door and then have councils over a barrel. However, if we are going to give councils the power to have a proper plan-led system, we need to ensure that we have a better system for development to pay its own way.
Part of the opposition to new housing comes from the fact that too often it comes without the necessary infrastructure. Without new schools or roads, the GP’s surgery and everything around the new housing becomes more congested and, of course, people object to that. People see developers making humungous profits while the infrastructure is either not provided at all or the cost is dumped on the taxpayer.
Section 106, the way in which councils currently get developer contributions, is totally dysfunctional. Councils cannot use it to fund recurrent expenditure or anything that meets an existing need in the community. It can only fund a new need that is tied to the new development. Contributions are tied to specific purposes, so if what the community wants changes in five years’ time, that is tough luck.
Given that collection is fragmented among lots of authorities—fire, police, health, county and district councils—developers sometimes get away without paying. They can hold off making payments by staying below certain trigger thresholds, and if they are able to hold off for long enough, the opportunity to build a new village hall, for example, is often lost. If a community has only rolled up enough contributions within a specific time period to pay for half a new school, for example, then it gets nothing and the money goes back to the developers. In 2014, the BBC found that councils had returned to developers £1.5 billion that had been intended for the community. When my constituents read that, they are outraged.
John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)
I congratulate my hon. Friend on making an excellent speech about these important issues. A number of housing developments that have been built in my constituency over the past few years do not have adequate broadband connections. Does he agree that investment in infrastructure should be extended to include connectivity? Developers and councils should work together to ensure that no new developments can be constructed until adequate broadband connections have been demonstrated.
Neil O'Brien
My hon. Friend is right. Broadband is one of the benefits that people seek from new development. Mandates are one potential way to secure such benefits. The broader change that I would like to be made is the removal of all restrictions that depend on section 106 and for the system to be replaced with something that is more fit for purpose.
Beyond the need to create a better system for contributions, we need to give councils other tools to create better quality and more planned development. In my constituency, there is an old rubber factory that is two minutes’ walk from a mainline station, which is only an hour from London. It is the perfect site to build on, but despite the fact that the council gave planning permission in 2004, nothing has happened because there is nothing to disincentivise the owners from simply sitting on their hands. We need to learn from the USA and from other countries in Europe, and give councils the power to buy land, to grant themselves planning permission and to take more of a leading role in development. The current situation is a legal minefield, so I believe we should reform the Land Compensation Act 1961.
Bob Seely (Isle of Wight) (Con)
I thank my hon. Friend for securing this debate and for making a fantastic speech. The planning system is so frustrating. Isle of Wight Council does not have a housing revenue account, so it does not have access to the billions of pounds of funding. On the Island we are desperate to build one and two-bedroom properties, rather than being deluged with endless planning applications for low density, greenfield houses for folks to retire to the Island. Does he agree that we need a more flexible system that caters for the needs of specific communities, especially isolated island communities?
Neil O'Brien
My hon. Friend is completely correct. People want a proper plan-led system. Other countries achieve that by allowing local government to play a stronger role in determining where things go.
We must reform the 1961 Act to make it clear that buyers can pay current market use values for land rather inflated hope values. We should stop land prices being bid up in the first place, by stopping sites going through the plan-making process on the assumption that developers are going to get away without paying for infrastructure. We should turn Homes England into a flying squad to help councils plan and deliver brownfield regeneration. We must make sure that council planning departments are well enough resourced to retain good staff. It is a difficult industry where the poachers, as it were, can pay people a lot of money, and local councils often struggle to hang on to good staff.
My final proposed reform to the planning system is to reboot neighbourhood planning so that it can fulfil its potential. Many places in my constituency have drawn up neighbourhood plans, and people have given a lot of time to them. In some cases they have been a force for good and shaped the way in which, and where, things get built. In other cases, however, they have taken so long to draw up that developers have front-run them. Too many are lengthy and lack the one thing that would give them real bite, which is a map of where development does and does not go.
We should radically simplify and speed up the process of making neighbourhood plans. They should all have a clear map of where development does and does not go. Where councils are planning sensibly, we must give them more legal weight. As I argued in a report for the think-tank Onward, we should reward outstanding councils by making them exempt from any appeal to the planning inspector.
Mr Mark Francois (Rayleigh and Wickford) (Con)
My hon. Friend is making a thoughtful speech. Does he agree that democratic accountability is fundamental to this process? Is he, like me, concerned about the rumours, which I hope are not true—I am looking at the Minister—that the Government are considering changing planning law so that developers will get automatic planning permission, regardless of the quality of their design, if they make an application in an area zoned for housing? Does he agree that democratically that would be completely unacceptable?
Neil O'Brien
My right hon. Friend makes a thoughtful contribution. It depends what we mean by a plan-led system. It is right that councils should be clear about where development is going, but I worry about anything that would ride roughshod over the wishes of local people, so I agree with my right hon. Friend on that point.
There is much to fix in our planning and housing system. The current rules seem almost perfectly set up to cause a huge amount of grief and political friction, and to deliver a relatively small amount of housing, because they push development in the wrong places, without the necessary infrastructure. If we change the system, we can keep green and pleasant those places we value most, but also ensure that the average family can get a house they can afford. We are fortunate that we have exactly the right Minister to deliver that huge reform.
Several hon. Members rose—
Sir Charles Walker (in the Chair)
Order. I will impose a four-minute limit to start with, but it will probably drop to three minutes.
Helen Hayes (Dulwich and West Norwood) (Lab)
I thank the hon. Member for Harborough (Neil O'Brien) for securing the debate and for raising a series of important issues about the planning system. I agree with him that the Land Compensation Act 1961 is in urgent need of reform. In fact, I introduced a Private Member’s Bill in the last Parliament to exactly that end.
We need to remove hope value from the planning system. Lest any Member is in doubt about why that is important, I give the example of a site in the middle part of Southwark—not in my constituency—that became vacant with an existing use value of £5 million, but was put on the market by the developer with an auction starting value of £25 million. That tells us about some of the gross injustices in our housing and planning system. The system recognises the right of a landowner to a windfall value of £20 million, over and above the right of residents in Southwark to genuinely affordable council homes on the same piece of land.
Reform is important, but cannot be limited to looking at hope value. That is important, but unless we also reform the definition of an affordable home, homes that are not affordable to the vast majority will continue to be built in this country. In my constituency, a definition of affordability recognises homes of up to 80% of market rental value as affordable. They are simply not affordable to the vast majority of my constituents.
Matt Rodda (Reading East) (Lab)
As a fellow MP from London and the south-east, does my hon. Friend agree that the current policy has a disproportionate impact on local communities? There are severe shortages of professionals in key parts of the public sector and for some private sector employers. We have a huge shortage of NHS staff in Berkshire, as she probably knows. There is also a shortage of people for key commercial businesses.
Helen Hayes
My hon. Friend raises an important point. That is certainly true of some key public services, such as King’s College Hospital in my constituency, where staff are moving further and further away from the hospital because they cannot afford to live close to it. It is a widespread issue.
Recently the Government have come forward with mooted proposals to increase the cap on the Help to Buy scheme to £600,000 within its affordable housing programme. It beggars belief that the Government think that that will do anything to address genuine housing need in this country.
I want to highlight one further aspect of the planning system that needs urgent attention: permitted development rights. In the last Parliament, the Government expanded permitted development rights. They did so against all advice from the sector, resulting in examples of the most appalling accommodation being delivered across the country, with office accommodation being converted into homes without full planning permission.
There are a number of things wrong with this system. The first is that in bypassing the planning system, a number of the checks on quality of design and space standards are being bypassed altogether. Section 106 opportunities are also being lost, so those homes are not contributing anything to public or open space or to facilities in in the surrounding area.
Those homes being delivered under permitted development rights that are good enough and of a standard would not have had a problem getting through the planning system, so I fail to understand why the Government are continuing to cut the planning system out of this important aspect of housing delivery. We cannot be delivering the slums of tomorrow in order to satisfy spreadsheets today. It simply will not do. It has to stop. I hope the Minister, in responding to the debate, will say some positive things about the need to scrap permitted development rights, rather than expanding them further.
Finally, our planning system has a vital role to play in combating climate change. The relationship between the built environment and climate change is substantial, and unless we fully resource our planning system and enable local authorities to play the fullest possible role in place-making and in driving up standards of insulation and carbon reduction in new development and in new housing, we will not achieve the level of carbon reduction that we need to in order to resolve the climate emergency, and we will still be building homes today that will need to be retrofitted tomorrow. I end with that point, calling on the Government to resource our planning system properly and to recognise the role that it has in facilitating and delivering the high-quality homes we need to build, at scale, in order to resolve both our housing crisis and the climate emergency.
Derek Thomas (St Ives) (Con)
I commend my hon. Friend the Member for Harborough (Neil O'Brien) for securing this debate and for its importance, since no one in this Chamber or elsewhere would deny the need to ensure that we get the right kind of housing for the people who need it most.
While we look at how we get access to affordable housing, I will talk a little bit about how I believe local authorities are as much part of the problem as they are of the solution. I wonder whether the Minister could have a look at the charges that local authorities, including Cornwall Council, are applying to small businesses—small builders and small developers who are trying to solve the problem of ensuring that people have the housing they need.
There are high and, in my view, largely unnecessary charges demanded of small builders as a result of Cornwall Council’s policies. I am sure the same is true elsewhere. For example, just to get and complete the form on the Government website regarding section 106, Cornwall Council charges a legal fee of in excess of £1,200. It also demands that over £300 is spent on getting a market valuation to genuinely confirm that a property is affordable.
The community infrastructure levy, introduced by Labour in 2010 but not taken up by Cornwall Council until last year, can add hundreds of pounds per square metre to every house built, just adding to the cost of the affordable home to the person who is trying to get hold of it. The Minister has powers to scrap the community infrastructure levy, and the irony is that Cornwall Council has not yet fully determined how it will spend that money.
That is all in addition to the normal fees that a developer has to secure. Let us bear in mind that in places such as Cornwall, these are often very small builders, who are trying to train good people in the trade and make housing happen. These are additional fees to the fees demanded for planning approval.
Another thing that Cornwall Council has done recently, which on the face of it looks fantastic, is to increase the amount of money that can be charged for a property’s remaining empty—again, because the Government have allowed it. It is absolutely the right thing to do, but when someone comes along to purchase a property to bring it back into use, there is no exception made whatsoever, and they continue to pay that fee, additional to council tax, right until the house is lived in.
I have met the council and asked for that to be reviewed. The council says there are no exceptions, but the Minister may want to look at how councils are using the additional charge, which slows down the ability to bring homes back into use and improve their efficiency. It is right that the council apply the charge, but there must be some flexibility when people are trying to do something right by it.
Finally, the Minister may be aware that his Department has recently received guidance from No. 10 about how to ensure that affordable homes can be made available so that people can gain access to them. I have been working with an organisation called Rentplus; the rent-to-buy model is simple and provides homes, often on stalled sites, which my hon. Friend described earlier. The properties are built using pension funds, which we all know are not earning huge amounts of money for those investing in them.
The properties thus come at no cost to the taxpayer or to Homes England, but they provide houses for working families. Those working families get an affordable rent for as long as they need the home, and then they have the opportunity to buy it at a later point. It is called rent to buy and it is a really good model, but Cornwall Council refuses to allow it to be delivered in Cornwall. The group I am working with, Rentplus, has probably £200 million that it would like to spend in Cornwall. It identifies 800 homes that would have been built if it had been able to do so. Will the Minister look at the guidance that No. 10 has provided, to give Cornwall Council and others encouragement to use models such as rent to buy?
Tim Farron (Westmorland and Lonsdale) (LD)
It is an honour to serve under your chairmanship, Sir Charles. I pay tribute to the hon. Member for Harborough, who made an excellent speech, and I congratulate him on securing this important debate.
Like everybody else, I feel there is a whole range of issues that we could address when it comes to housing and planning, so I will be specific and talk about planning and regulation relating to those homes that are not typically lived in. In my constituency, roughly a minimum of 7,000 properties are not lived in. They are second homes, boltholes owned by people who can afford more than one home. It is not their principal home. That is not even beginning to count the number of holiday lets, which are an important part of the tourism economy in the lakes and the western dales.
We also have a more recent development with the rise of Airbnb. I want to be very clear that Airbnb, like all technology, is neutral; it is what we do with it that gives it moral value for or against. I can think of many advantages of affordable holidays for people, and I can think of advantages for people who have holiday lets on the platform. It is also a way of making good use of space.
There is a lot that is good about Airbnb, but there are some problems as well. Research conducted for The Guardian just a few weeks ago showed that one in five houses in the Langdales, in Ambleside and in part of Windermere were on Airbnb. Many of those will be in estates that would not typically house second homes or even holiday lets, so it is clear that there is a movement out of the full-time, affordable family market into homes that are being used simply for rental. That is deeply troubling, and I would like the Government to look at it.
I would also like the Government to understand that although in a free society people should be allowed to use their money however they wish, the excess of second homes in communities such as mine can become deeply problematic. When we think that probably 80% to 90% of homes in certain Lake District villages are not lived in all year round, it is no surprise that beautiful places such as Dent and Langdale—wonderful communities at opposite ends of my constituency, one in the lakes, one in the Yorkshire dales—have school rolls of less than 30. Why? Because the majority of the homes that could send children to those schools are owned by people who do not occupy them or add much in the way of economic value to the community.
So what would I like the Government to do? I would like them to tackle this matter, as they have been promising for many months now. I ask the Minister in particular to address this. The Government have had a consultation, which closed in January 2019. They have still to act upon it and say whether or not they are going to close the loophole, as the Welsh Assembly have done, that allows some second home owners to game the system and avoid not only paying business rates, but paying council tax altogether. A conservative estimate in my constituency is that second home owners using that loophole are costing local council tax payers in the south lakes at least £3 million a year.
Will the Minister close that loophole, as the Welsh Assembly have? Will he also look at changing planning law, so that having a second home is actually a separate category of planning use from having a first home, so we can regulate the amount of second home ownership in places such as the lakes and the dales? Will he allow councils to look at raising council tax in certain areas, to create a disincentive and allow a redistribution of income in national parks in particular?
Finally, will the Minister look at the Airbnb market, recognising its value and the contribution it makes, but also recognising that a lack of regulation, health and safety applications, insurance and other things may make it an unfair competitor, added to the fact that Airbnb seems to be taking away houses from the affordable market for local families in the lakes? Those issues are a challenge that a Government ought to be addressing.
Jack Lopresti (Filton and Bradley Stoke) (Con)
It is a pleasure to serve under your chairmanship, Sir Charles. In the time I have, I will address some broader aspects of housing policy.
The manifesto on which my party fought and won the 1951 general election stated:
“Housing is the first of the social services. It is also one of the keys to increased productivity. Work, family life, health and education are all undermined by overcrowded homes. Therefore a Conservative and Unionist Government will give housing a priority second only to national defence.”
Those are sentiments I completely agree with. I wonder why politicians realised that then, whereas many seem to have forgotten it today. I congratulate my right hon. Friend the Minister on his promotion, but the fact that he is the 10th Housing Minister in the past 10 years perhaps offers an interesting perspective on the order of national priorities.
Centre for Policy Studies’ analysis shows that the 2010s saw the fewest new houses built in England since the second world war, but the same could have been said for the 2000s, the 1990s and probably every decade before that for the past half century. The inability of Governments of both political persuasions in the past few decades to address the housing challenge—indeed, crisis—means that the simple laws of supply and demand push house prices even higher. The House of Commons Library suggests that the national average house price hovers around the £250,000 mark.
In a new development in my constituency, the new town of Charlton Hayes, a new three-bedroom end-terrace house now fetches more than £330,000, while a four-bedroom family home costs more than £400,000. This is simply unsustainable. My constituency is by many measures prosperous; unemployment is under 1.5% and weekly earnings substantially outstrip both the regional and national average. However, in terms of affordability, that house in Charlton Hayes costing a third of a million pounds is 10 times the average annual wage for the area.
What I call the housing crisis relates not only to the private sector but to the overall lack of housing generally, including council housing and social housing; there is a chronic shortage of homes for our people. We must consider the crucial value of social housing, which provides homes for families and for key workers, many on low incomes, who are needed if our communities are to flourish.
It is time that many of us in this House started taking responsibility for the situation that has evolved. Too many hon. Members have allowed themselves to be turned into nimbys. Even in the Minister’s Department, the Minister for Local Government and Homelessness, my hon. Friend the Member for Thornbury and Yate (Luke Hall), my constituency neighbour, does not seem to believe in building homes and has made a virtue of opposing all local development in his constituency. How many hon. Members have churned out election leaflet after election leaflet advocating the need for local homes that local people can afford and then opposed just about every single planning application that has come forward in order to court the support of those fortunate enough to already be on the property ladder?
In the post-war era, Britain faced a similar housing crisis, and a Conservative Government solved it. Macmillan oversaw a housebuilding programme that built 2.8 million homes in the 1950s and 3.6 million in the 1960s. That is the scale on which we have to act today. As the working-class son of immigrants, one of the many reasons I became a Conservative was because of the aspiration that our party promoted and believed in. Our party also understood the pride people took in home ownership and the benefits thereof. John Major, in his first speech to our party conference as Prime Minister in 1991, called it
“the power to choose the right to own.”
What are we offering some of our young people today? Some £50,000 of student debt and a room in a shared house if they are lucky.
I have witnessed colleagues rejoice as local housing supply plans for my local council area were consigned to the bin. We were told that the council would now have to come up with a new plan. Do they realise the time that will take and the cost of making those huge applications, and that, within the often several-year timespans involved, political control of the council may have changed, and the whole process may have to start all over again?
Justin Madders (Ellesmere Port and Neston) (Lab)
It is a pleasure to serve under your chairmanship, Sir Charles. I will talk about Mostyn House in Parkgate, which was originally a boarding school and is now a listed building. Once the school closed, the site was certainly attractive to developers.
Revised plans to build apartments into the fabric of the old school were submitted halfway through its redevelopment. Despite the many efforts of under-resourced local authority enforcement officers, the developer, PJ Livesey, continually drags its feet, with the result that there is a list of outstanding works as long as your arm. Planning permission was only finally achieved some five years after residents first moved in. Developers have similarly patchy records elsewhere in the country, but because the system lacks the capacity to challenge these people, they continue to get away with it.
I have long spoken about the industrial scale mis-selling that arose as part of the leasehold scandal, and we finally saw official recognition of that last week from the Competition and Markets Authority. The situation at Mostyn House is slightly different but has many similarities. Little specific legal information was provided at the initial stage, particularly regarding planning and the leasehold position, and little documentation was produced in respect of service charges. What was provided was misleading and inaccurate on ongoing costs. There were also financial incentives to use panel solicitors and pressure to exchange contracts within a tight timescale.
Many people buying these apartments were experienced professionals whose concerns about those issues were assuaged at the time by the developer’s sales staff, who confidently stated that the purchase was covered by a Premier Guarantee warranty, which gave the buyers a 10-year guarantee similar to the National House Building Council’s. That sounds good, does it not—a Premier Guarantee warranty? It sounds pretty solid, and something to give certainty. Being compared to the NHBC’s guarantee gives it an air of respectability.
However, buyers might find that they have more rights if something goes wrong with their kettle. It is at best a dispute resolution service, not a guarantee, and is seriously compromised by virtue of being funded by the developers against whom it is meant to enforce the guarantee. Premier not only provides the warranty on the build of Mostyn House but also acts as the approved inspector in respect of building regulations. Premier is effectively employed as the building control and building regulation compliance body to inspect, approve and guarantee works undertaken by the developer that it is supposed to be insuring against.
After four years of back and forth, Premier’s surveyor recently viewed the development and agreed with the defects raised by residents. However, Premier is not prepared to progress the claims, even though water is pouring into apartments right now from the defective roofs, gutters and walls. Premier said:
“The remit of our service is to attempt to bring the two parties together, investigate the dispute and make recommendations…That being said, the conciliation service will not be suitable for all disputes.”
That is not a guarantee or warranty; it is a cop-out.
It is clear that some works by the developer were non-compliant, as additional fire separation works and modifications have had to be undertaken since occupation took place. How did Premier sign off those works in the first place? It is plainly evident that there has been a general lack of supervision of the development during its construction and a lack of inspections by the approved inspector. If it finds too many faults, it will have to pay out under its own insurance policy, funded by the developer. It is therefore easy to see how the temptation to be less than thorough could arise.
My constituents have been let down. The ombudsman has proven toothless and the Solicitors Regulation Authority ineffective. Indeed, anyone who cares to look at Trustpilot ratings for the ombudsman, the SRA and Premier will see that there is very little customer satisfaction anywhere in the country. There is a wholesale failure of regulation across the board on many issues, including in this case and others we have heard about. It is time that the Minister and the Government listened and sorted out this shambles once and for all.
Sir Charles Walker (in the Chair)
We will have to drop the time limit on speeches to three minutes.
John Howell (Henley) (Con)
I have been involved in planning for most of my working life. I wrote “Open Source Planning”, which helped to guide the reforms of 2010 and 2011; I helped to draft the national planning policy framework; I sat on the local expert planning group, which sought to simplify planning; and most recently I have been the Government champion for neighbourhood planning.
My conclusion from all of that is that the plan-led system we now have is so complex, with so many layers and so many tweaks, that it is no longer fit for purpose, particularly in relation to the delivery of housing. The plan-led system is
“less effective than at any time in the post-war era”.
Those are not my words but the words of Nick Raynsford, whose report on this I found very interesting.
Affordable housing is falling by the wayside. Its quality is highly dubious, and there is a loss of public trust in planning as the most fundamental aspect of this approach. A fundamental reform is required, and I am happy to remove the party political influence of councillors from individual applications, because I am keen to ensure that neighbourhood plans play a much greater role in keeping the involvement of local people in the planning system.
However, there is one more important reform that we should bring in: the use of mediation in the planning system, instead of a costly appeals mechanism. In 2008, the Killian Pretty review said that an alternative dispute resolution—meaning mediation—should be used as a speedy alternative to appeals. The essence of mediation, of course, is that the mediator decides nothing. The process is facilitative and allows the parties to the case to formulate their own solutions under guidance. It can be used for highways, compulsory purchase, sorting out claims however they arrive, and sorting out the thorny issues of section 106 agreements. There is a role for mediation at the beginning of the process in generating the scope of a project and ensuring that local views or needs are included.
Why should mediation even be considered? First, it has been an outstanding success in other areas, including the construction industry, where it is used effectively, but also in other areas of life. The essence of that should be used in the planning system to speed up reform.
Anneliese Dodds (Oxford East) (Lab/Co-op)
I congratulate the hon. Member for Harborough (Neil O’Brien) on securing this debate. I have two specific and brief questions for the Minister. The first concerns the first homes scheme. The Government’s consultation document on the scheme, released last month, includes an extraordinary sentence. It states:
“We are mindful of the trade-off between the level of ambition for First Homes, funded through developer contributions, and the supply of other affordable housing tenures.”
Yet, astonishingly, the consultation mandates that section 106 must be used to deliver first homes, rather than asking whether that is appropriate in the first place. We should not use section 106 contributions for this, especially at the late stage when many local plans have just been concluded or are in contention, and without any ameliorative action to preserve local councils’ abilities to facilitate council and other social housing.
I note that my own local authority has already been prevented by the Government’s planning inspectorate from requiring developer contributions to social homes from smaller sites. There are already problems, which will be massively exacerbated if the first homes scheme is ruled out in such a way. Will the Minister commit to conduct a proper impact assessment on the impact of the first homes proposal on the provision of new social homes? Secondly, on the Oxford-Cambridge arc, some contest the need to have any additional housing along the arc. I am not one of them, and I very much concurred with some of the words spoken by the hon. Member for Filton and Bradley Stoke (Jack Lopresti) when it comes to the need for additional housing and looking at the issue in a manner that is not hypocritical.
As for the arc, I am astonished that the Government have not provided even a signal or an expectation on two critical issues: first, the proportion of new homes, which should be available for social rent and genuinely affordable; and secondly, the energy efficiency and broader environmental performance of those new homes. It is not good enough to suggest that local authorities will deal with all the issues. The Oxford-Cambridge arc is a central Government programme, staffed with dozens of central Government civil servants, and central Government have the power, should they wish to use it, to ensure that the new homes are genuinely affordable, that they include many social homes, and that they are sustainable.
Finally, will the Minister please commit to determining two targets or standards, or even just expectations, for the arc for the percentage of new homes that should be affordable, including social homes, and for the expected environmental performance of the homes?
Craig Whittaker (Calder Valley) (Con)
We all know the drawbacks of the planning system. In areas such as mine, which comes under the jurisdiction of Calderdale Council, we have a local authority that is not only risk-averse when it comes to enforcement, but is driven by the multitude of Government targets around house building to the detriment of everything else. Today I want to highlight the issues around local plans. Calderdale still has not had that signed off and is in the midst of yet another consultation via the planning inspectorate. I want to make it clear that I do not have an issue with the numbers of houses. Whether it is one or 50,000 extra homes, the reality is that we need to build homes. The problem is our infrastructure, and without a robust infrastructure plan to sit alongside a local plan, the local plan is undeliverable.
We all know the issues across our constituencies with failing and stretched infrastructure. On roads, as well as the many pinch points across Calder Valley, we see a single road in and out of the Upper Calder Valley. Whether it is the single lane that we have had to endure for three years while flood defences are built, or whether it is roadworks, not to mention accidents, we have to sit in our cars often for more than an hour just to travel a few miles. On the numerous days throughout the year when the M62 is closed, it does not matter where one lives in the Calder Valley, the roads are like car parks, and that is just the roads.
Our clinical commissioning group has recently announced that five GP surgeries will close because of an inability to recruit GPs to the area. School places are also an issue, particularly in the Lower Calder Valley, where our excellent schools are all over-subscribed. The local authority will say that it has infrastructure improvements within the plan, but its plans do not even touch the sides of the already stretched infrastructure, let alone if a further 15,000 homes are added over the next 15 years.
The final issue that I want to touch on around infrastructure is flooding. The Calder Valley and other parts of Calderdale have just experienced their third 100-year flood in just over seven and a half years. We had 1,187 properties flooded this time. Many of the 650 homes experienced their third flood. Small micro-businesses were flooded, too. There is not one piece of feasibility on flooding on the many dozens of sites in our local plan, and many—in my estimate about 40% of the land parcels—are already flood plains for when it rains. One particular site in Brighouse, earmarked for 200 houses, was six feet under water. Another in Greetland, with 600 homes, was like a waterfall. Finally, I have no confidence in our local authority to amend things at the planning stage.
I have two asks of our fabulous Housing Minister. First, why is there such a bypass of infrastructure requirements within local plans, and why are we allowing that to happen? Secondly, I have much evidence of our local authority ignoring infrastructure requirements for housing plans on flood plains. Now is surely the time to say, “No more building on flood plains or in areas where there is a high flood risk.”
Dr Rupa Huq (Ealing Central and Acton) (Lab)
It used to be said that an Englishman’s home is his castle, but our suburbs are now changing. We have mixed communities. The targets that local authorities are under and the deregulation of planning means that castles in the air are springing up round our way, literally changing the physical form. It might have been called high-rise hell in a different age. London’s highest building is not in the square mile. It has just been approved by the Ealing planning committee and will be 55 storeys in North Acton. Because our capital is girdled by green belt, literally the only way is up. The sky is the limit. Tall buildings raise a range of questions on space standards and air quality. Post-Grenfell we have all heard horror stories of cladding and fire safety. Of the 551 buildings approved last year in London, 450 were residential, with 24 in Ealing, but that is dwarfed by 64 in Greenwich. Groups such as Stop the Towers argue that the new buildings are changing the low-rise, low-density nature of suburban Ealing, and the new developments all seem to come with youth-oriented marketing. One wonders how many more vibrant quarters Ealing can take, particularly as we have an ageing population everywhere. Demographically we know that very soon a majority of the population will be over 60, and people in social housing who come to my surgery want rehousing to the ground floor because of mobility issues. People in their suburban semis, their huge piles, want to sit on those because the new developments are too small to have the grandchildren round.
At the other end of the age scale, in North Acton there is a thing called the Collective, which involves co-living. The Telegraph describes it as the future of renting. There are huge communal spaces, brunches, daily speakers and live music, but tiny accommodation designed for celibacy. [Laughter.] It is not cheap. One has to be in work and able to afford £1,000 a month. So what is my solution? I urge the Minister to take seriously my proposal to have a suburban taskforce. We have crumbling infrastructure and older housing stock alongside hideous towers. He could take a multi-dimensional approach. His predecessor was very warm towards this, but, alas, he has been shuffled off the ministerial coil. May I have a meeting with the Minister? A whole bunch of us, including Conservative Members, want to take this forward to save our suburbs.
Damien Moore (Southport) (Con)
It is an honour to speak under your chairmanship, Sir Charles. I congratulate my hon. Friend the Member for Harborough (Neil O'Brien) on securing this important debate. He gave a powerful speech on one of the most pressing issues that the Government face. I also welcome my right hon. Friend the Minister to his new role.
I want to concentrate on one important issue that has become all too poignant for many of my constituents, as well as for other people around the country, in recent weeks. That issue is flooding, whose impact in my area has been overwhelming. Although it has not been as great as in the constituency of my hon. Friend the Member for Calder Valley (Craig Whittaker), we have still had our problems. When there is flooding in my constituency it is not necessarily because not enough money is being spent on sea or river defences, or dredging, important as they are. It is a question of new homes being built directly on flood plains when the existing homes in that area are already prone to flooding. I am talking about flooding that happens as a direct result of already overburdened local drainage systems and waterways getting worse, and as a consequence of a lack of the infrastructure that should be put in place prior to housing development. Conditions become worse for residents of existing and new properties.
It is not so much, today, that existing communities disagree with local authorities about whether infrastructure should come before, during or after the building of new homes; it is more that they feel dismayed at the rejection of the need to build it at all. Local authorities act as if they are oblivious to the obvious need for infrastructure, and we need to address that. It is as though we have become fixated on house building targets, regardless of the consequences, and that is having a damaging effect on many communities. The quality of life that a house gives is as important as the numbers that are built, for that is what turns a house into a home.
To take my constituency as an example, Bankfield Lane is prone to flooding. It is not close to the sea or a river, or at the bottom of a hill. It is prone to flooding because the drainage system is used by more than 500 homes and is already stretched. It cannot cope any more. After a storm, rainwater simply cannot flow away fast enough, so when it rains it floods. Storm Ciara left, at the end of the weekend, anguish and devastation and thousands of pounds of damage. Improvements have to be carried out. The utility company United Utilities says that the matter needs to be addressed, but it is in disagreement with the council about who should pay. While that stand-off continues, my constituents’ lives are being affected.
We must provide incentives and flexibility for councils, which are rightly concerned about the necessity of meeting housing targets, to reject applications if there is insufficient infrastructure. We must protect individuals whose homes are already subject to flooding. We do not want to make things worse for those who are about to get new homes to live in. I hope that my right hon. Friend the Minister will be able to tackle the challenge head on.
Siobhain McDonagh (Mitcham and Morden) (Lab)
Problems need solutions—and here is one. Within London’s green belt alone there are enough non-green sites surrounding train stations for more than 1 million new homes. Of course, truly green sites should be protected. My frustration is not with parks, hills or areas of environmental protection, but with the scrappy plots of land in towns and cities, surrounding railway stations, that no one in their right mind would see as attractive. I am talking about the car wash in Tottenham Hale, the scrubland in Ealing, the waste plant in Hillingdon and the concrete airfield in Wisley—sites that no one in their right mind would recognise as green belt if it were not for their designation.
Despite the strength of the green-belt brand, 80% of London’s green belt is inaccessible to the public as green space and does not even have an environmental status. Together, those scrappy plots of what I refer to as the grey belt remain wrongly designated, just because of the potential furore that de-designation might cause. It is time to burst the myth that all green belt is green, and use those non-green sites to provide the homes that we so desperately need. I read with interest this weekend the comments of the former Chancellor, the right hon. Member for Bromsgrove (Sajid Javid), about his plan for the upcoming Budget, and his belief that the green belt around major train stations should be reviewed. I wait with cautious optimism to see whether that will happen under the new Chancellor.
Of course, de-designation is one thing, but what the land is used for is another. If any green-belt land is released, it should be fundamental that it be used to help to resolve the housing crisis, providing the social and genuinely affordable homes for which our country is so desperate. To offer it instead as a land bank bonus for the biggest house builders would seem inexcusable to the thousands of my constituents waiting for a place to call home. I ask the Minister please to grasp the nettle of the sensible policy I have outlined—but to use the land for the people who need it most. Otherwise we will be back in this Chamber debating even worse statistics in the months and years ahead.
James Daly (Bury North) (Con)
I am a Greater Manchester MP, so the proposed strategic housing plan for my area for the next 20 years is the Greater Manchester spatial framework. The planning system has created a scenario predicated on the building of three, four and five-bedroom houses on the green belt. That cannot be right. There is no requirement within the Greater Manchester spatial framework to provide affordable housing—certainly not truly affordable housing. The present definition of affordable housing means that most of the people in my constituency cannot afford an affordable house. We need to amend that and prioritise development. We need to incentivise development on brownfield sites within boroughs, and within plans.
We must look at how the population projections in particular are calculated. The GMSF is built on population projections from 2014 figures from the Office for National Statistics. If the housing numbers were based on the most recent figures, which are the 2018 figures, that would mean that in a seat such as mine, and in the Metropolitan Borough of Bury, no green belt would have to be built on. The planning system must be fair. It must produce plans based on the most accurate and recent information. I urge the Minister to consider insisting that local authorities use the most recent figures rather than 2014 figures, and prioritise truly affordable housing. We cannot have a situation where developers get to take the easy way out, building houses at £400,000 and £500,000, which cater to only a small number of people in my constituency.
My last point echoes what some of my hon. Friends have said. Within the Greater Manchester spatial framework, new schools, roads and doctors’ surgeries are required. At the moment they are merely words on a piece of paper. There is no requirement within the document. Planning officers tell me that they will be built. There is no guarantee that they will be built, but I believe there is an absolute guarantee that the green belt will be built over by three, four and five-bedroom houses. We must find a way to get cast-iron guarantees, before planning permission is granted, that infrastructure will be put in place to support the thousands of extra houses that are proposed—certainly in my area.
Lee Rowley (North East Derbyshire) (Con)
It is a pleasure to serve under your chairmanship, Sir Charles. I congratulate my hon. Friend the Member for Harborough (Neil O'Brien) on securing this timely and important debate. The standard of the contributions shows how important it is.
It is a truism to say that planning is a challenge and difficult. We have heard in the past hour or so of different experiences from around the country. My constituency is no different. We have a unique set of circumstances. The previous council administration was kicked out last May, having created problems that built up over a nearly 15-year period—without a plan, with too much speculative development, and with a failure to put infrastructure in place—and a new administration is trying to clear up the mess. The challenge is the relatively blunt instruments inherent to the planning system. In the two minutes I have left, I want to point out to the new Minister—whom I welcome to his position—three such blunt instruments. I hope that he will consider their implications on a larger scale.
The first is the overall framework. The challenge with some of the numbers going through the system, which are having an impact on districts such as mine, is that we are trying to use a national planning policy framework that is supposed to solve problems as disparate as those of Westmorland and Lonsdale, Ealing Central and Acton and North East Derbyshire. That means it does not work well. I should like some form of regional assessment within the NPPF so that we do not need, in the east midlands, to put 6,500 houses in a part of the world where real-terms house prices—the best proxy for demand—have not risen since 2008.
Secondly, I share some of my colleagues’ concerns about neighbourhood plans. When my area’s previous district council administration failed to discharge its responsibilities adequately, parish councils stepped up and tried to fill the gap by passing neighbourhood plans. That gave the unique opportunity of having them signed off by referendums in local communities. Yet, as a result, limited protections are offered. I hope that that can be considered in the future.
Finally, as to the adoption process, which is under way with the new administration in my district, there is a unique issue on which I hope we can somehow get a little more flexibility and pragmatism into the system as a whole. In our part of the world, too much speculative development over the past decade and a half means that we will significantly exceed our own, in my view overinflated, target, which was set by the previous council administration. Yet the inspector is showing only limited pragmatism, at the end of our local plan process, in terms of removing green belt, which still needs to be done to give confidence in the overall local plan process. I hope my remarks have been helpful for the Minister.
Ben Everitt (Milton Keynes North) (Con)
I thank my hon. Friend the Member for Harborough (Neil O'Brien) for initiating this important debate. We have heard from hon. Members of all political colours, representing areas rich in diversity, about the multiple problems with our housing market and planning. We have also heard many proposed solutions. That in itself is a real warning sign.
We should accept that the housing market is like an ecosystem or biosphere of interconnected dependencies and feedback mechanisms. When we put an intervention in one side, it goes into a black box that policy makers must deal with, and something unexpected pops out the other side. This is fiendishly complicated, but we must get it right. The price of failure is obvious: more unaffordable houses and continuing not to meet our supply targets. The prizes for getting it right are multiple and go across many policy areas—from solving homelessness, to local economic productivity and our sense of place. Building houses in the right place can contribute to food sustainability for our country.
My hon. Friend the Member for Bury North (James Daly) made the point well that we are building the wrong kinds of houses in the wrong places. It is as simple as that. If we focused on building more two-bedroom houses and bungalows, we would free up capacity for people who are, frankly, over-occupying larger houses, and that would help the whole system. That, however, relies on liquidity in the market, where stamp duty is a real issue, because it acts as a break on social mobility as well as on liquidity.
I was struck by the comments by the hon. Member for Ealing Central and Acton (Dr Huq). We are blessed with a modern problem: people are living longer, happier, wealthier and more independent lives. That is wonderful. In so doing, however, they are staying in their homes for longer. We must sort out supply and liquidity, and we need homes that are more sustainable, affordable, appropriate to their area and proportionate to the areas they surround.
David Linden (Glasgow East) (SNP)
It is always a pleasure to see you in the Chair, Sir Charles, if not that of the Procedure Committee. I congratulate the hon. Member for Harborough (Neil O'Brien) on securing this debate. I agreed with you beforehand, Sir Charles, that I would keep my remarks short to allow other hon. Members to speak, given that this issue is largely devolved. It has certainly been an interesting debate.
I want to reflect on the planning and housing situation in Scotland. There has been a lot of discussion today about affordable housing, but it is us in Scotland who are trying as hard as possible to deliver 50,000 affordable homes, 35,000 of which will be for social rent, by 2021. We are certainly on track to do that. In my own constituency, Cranhill has an over-55s development, which is important given that people are living longer. Likewise, properties on Cunningham House on Shettletson Road are being built to Passivhaus standard, which is good for energy efficiency measures.
Jim Shannon (Strangford) (DUP)
Does the hon. Member agree that we have a duty to do our best to push for more affordable green homes, and that grants and incentives to cover the costs of renewable and low-carbon innovations must go in hand with greener obligations? In other words, we must meet our obligations for climate change.
David Linden
I absolutely agree with the hon. Gentleman, who chairs the all-party parliamentary group for healthy homes and buildings. Investing in greener homes is costly. Investing in the Passivhaus standard homes in Shettleston has cost Shettleston Housing Association quite a lot of money, but my constituents tell me that their energy bills are a lot lower.
I have concerns about the planning process. I often think of the Broomhouse estate in my constituency, which was supposed to start off as countryside living in the city, but it is now one of my largest polling districts. There is no school, GP practice or shop, and the local train station, in Baillieston, is now overrun by cars.
We often find that planning authorities—this is not confined to England—are more than happy to sign off on building lots of homes, not least because they provide lots of council tax revenue. It seems that little thought has been given to where the children living in those four or five-bedroom homes will go to school. We have seen the pressures put on, for example, Caledonia Primary School in Baillieston.
We have had a fantastic and wide-ranging debate. I have learned more about section 106 of the Town and Country Planning Act 1990 than I knew this morning. I pay tribute to the hon. Member for Harborough, who began by talking about the idea of fleeceholding. Some streets in my constituency have still not been adopted after 60 years. I used to think that was bad, but perhaps, given the situation he highlighted, it is a case of better the devil you know.
Alex Cunningham (Stockton North) (Lab)
It is a pleasure to serve under your chairmanship, Sir Charles. I congratulate the hon. Member for Harborough (Neil O'Brien) on securing this debate. His speech was comprehensive and full of good ideas, some he may have read in our policies. I have no doubt the Minister, however excellent or fabulous he is, will have benefitted greatly from listening. I would go as far as to suggest that the hon. Member seeks membership of the upcoming Bill Committee where there will be lots of scope to legislate on the matters that he has raised today. The same could be said for other hon. Members who have contributed.
My hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) spoke of land reform—that £5 million piece of land eventually being auctioned from £25 million; I don’t know what the final figure was. What an illustration of our failing system and our struggle to get the affordable homes we need. She linked housing and climate change, as well.
The hon. Member for Filton and Bradley Stoke (Jack Lopresti) also recognised the crisis in housing and spoke of MPs being nimbys, opposing housing development in their constituencies—something for us all to think about. My hon. Friend the Member for Reading East (Matt Rodda) spoke of the shortage of professionals to manage planning. I know there is a crisis in that across the country. My hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) spoke of the leasehold scandal, with homebuyers misled and landed with huge ongoing bills. He said people have more rights if their kettle goes wrong.
My hon. Friend the Member for Oxford East (Anneliese Dodds) spoke about her concerns about the first homes scheme. I have heard her speak several times about how new developers are being let off the hook on providing new affordable and social homes. My hon. Friend the Member for Ealing Central and Acton (Dr Huq) talked about high-rises—they are 55 storeys high in her constituency, and there are more tower blocks across the piece. We need houses for our ageing population on the ground floor. My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) spoke about greenfield sites that are not very green, the million homes that could be built around railway stations and the wrong status for so-called green-belt land in her area.
Labour’s plans for housing at the general election were bold and ambitious, but they were necessary. We said on day one that we would start the changes within Government to set up a department for housing, which I hope will happen soon. That would bring together the powers to plan and build new homes and regenerate existing housing across the country.
Despite the election result, Labour was right on housing and we will continue to make our case. We said that within the first year, we would take action to take profiteering out of the land market, which has a severe impact on planning and housing. We said we would revise planning rules and guidance to support the delivery of more genuinely affordable homes through the planning system and we said we would publish plans to make the country’s homes greener and warmer with a new zero-carbon homes standard and retrofit programme.
Our ambition was bold, and we encourage the Government to look at our manifesto closely and recognise the good ideas—some of which we share with Conservative Members, judging from some of the speeches we have heard this afternoon—for what they are. More importantly, we know that we must act. It is easy to talk about house building without recognising the obstacles in the way of doing so. Housing and planning go hand in hand. In order to plan, we must have the resources to do it, such as land. The broken land market is at the heart of our housing crisis. Land ownership, as we have heard, is often opaque, with little transparency on who owns what.
Public land has been sold off for a short-term profit as funding from central Government has dried up. As we have also heard, current planning rules and legislation give windfall gains to landowners and traders at the expense of local communities. We must do better, and work together to look at how we can ensure that our housing and planning system is genuinely fit for purpose.
I was interested to read the article written by the hon. Member for Harborough on what needs to happen to resolve the housing crisis. It was refreshing that he accepted in his article that after 10 years of his Government, we still have a housing crisis. I was pleased to see him outline that there are genuine problems and barriers with regard to housing, and he made a clear case for how these matters can be addressed.
I have spoken before about my 27-year-old researcher, who earns a good salary and has a second income from being a local councillor, but still cannot afford to buy a house in the area where she lives, far out in London’s zone 6. She has been saving for many years and will save for many more to get a deposit, but then she will be ruled out due to her income not being high enough to get a mortgage. Her generation and the generations to come are doomed to fail unless we remove those barriers and make home ownership a reality rather than a dream. But for that to happen, we need to build more homes—not just homes but genuinely affordable homes that people with a range of incomes can afford. However, if local councils and housing associations cannot afford the land on which to build those affordable homes, they will be halted before they can even get going.
Large spaces of land are too expensive for councils and housing associations, so instead—as the hon. Gentleman outlined it in quite some detail—smaller developments are often the only option. That means we are not hitting the capacity that we need to. It is all well and good for private developers to buy land and build housing, yet more often than not such property is tiny flats in prime central London locations that ordinary people cannot afford to live in. The flats around Battersea power station area are an example—they probably call them “apartments” around there, mind. That area is a prime location, but the properties are bought up by people who can afford to buy them yet do not live in them. If anyone goes past those properties in the evening, they will see that most of the lights inside are off. Such developments add to the total number of dwellings that are built, but they are not being occupied by the people who most need a home: those who cannot afford to buy a home in any part of London, let alone a central part where, they may be living already in sub-par accommodation with several other people; and those who grew up in these areas, and are now priced out of staying there.
It is not good enough just to view building homes as the answer. There need to be those genuinely affordable homes, which is what the planning system must account for. Labour’s plan would have meant that at least 150,000 new council and housing association homes a year would have been built within five years—decent homes that people can actually afford to live in. I do not expect this Government or any Conservative Government to match our pledge on the issue or even to come close to it, but the system has to change.
David Linden
I am listening to what the hon. Gentleman is saying about making sure that we invest in council housing and housing association properties. However, one of the things that I am very struck by when looking at the system here is this obsession with the right to buy, which so often means that housing associations and councils are building these properties only to flog them off. Is it Labour’s proposal to abolish the right to buy, which is what we have seen in Scotland?
Alex Cunningham
There is no doubt about it; there is this bias towards owning a home, and time and again we hear MPs, particularly on the Government side, talking about that ambition. These days, however, many people, even well-paid researchers in Parliament with a second income, cannot afford to do that, so we have to address homes for rent as well.
Currently, it feels that we have piecemeal development, with half a dozen flats built here and a few houses built there. That will never address what we need, and so we have longer and longer housing waiting lists, and people are being priced out of the private sector, as the hon. Member for Glasgow East (David Linden) has just mentioned.
One way in which we can show we are taking housing and planning seriously is by empowering local authorities to strengthen their planning departments. They really need more planning officers. I think that most planning officers now work in the private sector, popping up at all these appeals that are held across the country, and of course it is the developers who win out at the end of the day. However, councils do not just need resources; they also need the confidence and the guidance from Government in order to crack on with things.
Alex Cunningham
It is not just happening in the planning sector; it is happening across local authorities. My own local authority in Stockton has lost more than half its budget since 2010, so there is a shortage of expertise across the piece in local government to hold developers and other organisations to account.
I back what the Royal Town Planning Institute has argued for, which is championing civic planning, and building strong and responsive local planning authorities. The RTPI has also recommended that central Government do more by providing grants for social housing, by providing stronger direction on suitable land for housing, and by sharing more of any land value uplift with the public and using that uplift in value to fund affordable housing. The ideas are there and the hon. Member for Harborough has helped the Minister immensely.
That said, I also value the hon. Gentleman’s contribution to the ongoing debate in Parliament about how we can move forward on housing in the best way possible, and I look forward to hearing more of what he has to say in the future. However, the bottom line, which is where I have just got to in my speech, is that it is up to the Government to be prepared to take the steps to make change happen.
Sir Charles Walker (in the Chair)
Minister, will you leave just two minutes at the end for Mr O’Brien to wrap up, please?
The Minister for Housing (Christopher Pincher)
I certainly will do that, Sir Charles, and it is a great pleasure to serve under your chairmanship.
It is also a great pleasure to follow my old friend the hon. Member for Stockton North (Alex Cunningham), and to congratulate my hon. Friend the Member for Harborough (Neil O'Brien) on securing this important debate, and I also thank him for the entirely unsolicited testimonial that he gave me at the start of his remarks. I also thank and congratulate all right hon. and hon. Members for their presence today. The number of colleagues from across the House who have attended the debate is testament to Member’s interest in and concern about this important topic. I thank them all for being here.
I will now address some of the important points raised by hon. Members. I am conscious that I do not have a huge amount of time, so if I am not able to address them all, I certainly contract to meet with or write directly to those I miss, to ensure that we cover all the points that have been raised today effectively.
One of the key issues, raised by a number of colleagues, is unfair practices in the leasehold market. Let me say that those practices have no place in a modern housing market, and neither do excessive ground rents, which exploit consumers, who get nothing in return. That is why we are reforming the system so that it is fairer to leaseholders.
In December 2019, we announced that we would move forward with legislation on leasehold reform, reaffirming our commitment to making the system fairer and more transparent. The Under-Secretary of State for Housing, Communities and Local Government, my hon. Friend the Member for Thornbury and Yate (Luke Hall), will have more to say about that as the Minister responsible for that legislation; I shall certainly relay to him the concerns that Members from all parties have raised in the debate today.
I also agree with my hon. Friend the Member for Harborough that we want to minimise the effect of inappropriate access routes for construction vehicles by encouraging temporary access routes that should ideally be delivered through voluntary arrangements. We have all faced the issue in our constituencies; I have faced it specifically with respect to wagons building the High Speed 2 railway line. I hope that I can give my hon. Friend some reassurance that we have legislated for local authorities and other acquiring bodies to compulsorily purchase land temporarily under the Neighbourhood Planning Act 2017, and we are engaging with the sector on how best to implement those powers.
It is important that breaches of planning conditions are tackled by local planning enforcement teams, given that conditions are often imposed by councils to make a development acceptable to local people. That is why we have provided nearly £2 million of funding this year to help to strengthen enforcement teams in 37 local authorities, and we have also updated the National Association of Planning Enforcement’s practical handbook to help.
We will also outline further measures to help to improve local authority enforcement in the forthcoming planning White Paper, so I hope that Members will forbear and bear with me as that White Paper is released. I hope that that satisfies colleagues about some of the concerns that my hon. Friend raised.
Jack Lopresti
Does the Minister agree that our party needs to end the obsession with the green belt? Does he also accept that if we leave house building to local councils, houses will not get built in anywhere near the numbers that we need?
Christopher Pincher
The green belt is very important. We need to ensure that green spaces are protected, and that we have beautiful spaces in which we can all live. We also need to ensure that local plans are up to date and fit for purpose, in order to ensure that the houses that people want and need can be built.
That brings me rather nicely to my fundamental point. We all know that this country does not have enough homes. That is why we need a more agile and flexible planning system. KPMG and Shelter have both reported that simply to meet rising future demand, a minimum of a quarter of a million new homes will be needed every year. The median house price in England is eight times higher than median gross annual earnings; in London, it is 12.3 times higher.
We have to be bold and ambitious in our vision for the future of planning and house building in England. That is why, in January 2018, we set up Homes England as our housing accelerator, to intervene in the market and drive a step change in housing delivery. We have an unwavering commitment to enable the housing market to deliver at least 300,000 new homes a year by the mid-2020s, and a million homes by the end of this Parliament. I am pleased that the latest figures show that last year housing supply, which has been growing year on year, increased by more than 241,000, to the highest level in the last 31 years.
Christopher Pincher
I will, of course, give way to the hon. Member, as she intervenes at such volume.
Siobhain McDonagh
In the London borough of Merton, 10,000 families are on the waiting list. Since April 2019, they have had access to 18 three-bedroom properties. What does the Minister say to those 10,000 families?
Christopher Pincher
I would say that we need to build more homes in London. That is a conversation that we are having with the Mayor and with local authorities, because if we are to get those people into homes that they desire, we need to ensure that we are building them.
We have also cut the red tape—a perennial bête noire—making it quicker to plan and build homes that people want to live in. However, there is far more that we need to do to address the housing challenge. We are implementing planning reforms to ensure that our planning system creates and supports thriving communities, and to improve the quality, quantity and speed of home building. As I said, we will introduce the planning White Paper shortly, setting out our proposals to make the planning process clearer, more accessible and more certain for all users, including homeowners and small businesses, and I look forward to responses from colleagues across the House. The White Paper will also address resourcing and performance in planning departments, which various colleagues mentioned, and ensure that timely decisions are made.
The Government set national planning policy, but it is important that decisions and policies are made locally. We are clear that councils and their communities are best placed to take decisions on planning issues affecting their local area within the context of national planning policy. Local plans play an important role in outlining the homes that an area needs, and I believe that such plans can deliver local decisions that will remain at the heart of the planning system. Local plans provide clarity to communities and developers about where new homes should be built and how they should look, and such plans identify what developments are needed in an area, supported by the right infrastructure.
Christopher Pincher
I will give way to the hon. Gentleman briefly; I am conscious that time is pressing.
Alex Cunningham
The developer Persimmon applied for planning permission for a large site on Junction Road in my constituency. It was told, “No, you can’t have planning permission.” The Government inspectorate overturned that decision. How are we going to strengthen the powers of local authorities, so that when they make a decision, having consulted the local community, that decision stands? Now Persimmon wants to build even more homes on the same site.
Christopher Pincher
The hon. Gentleman makes an important point. I do not know the specific case, but we need to ensure that the codes that we use, and those that the Planning Inspectorate uses, are fit for purpose, to ensure that when a good plan is introduced, for a site that has appropriate permissions, those developments are built.
Plans that are needed in an area, supported by the right infrastructure, help to ensure that what is planned for is sustainable rather than the result of speculative applications. That also ensures that we build in greater community support. So far, 90% of councils have an adopted local plan compared with just 17% in 2010. Some are a little long in the tooth, but I am pleased that the constituency of my hon. Friend the Member for Harborough adopted local plans for both his authorities in 2019, so those plans are nearly brand new.
I assure the hon. Member for Dulwich and West Norwood (Helen Hayes) that the Government are committed to reviewing permitted development rights for the conversion of buildings to residential use, particularly respecting the quality and standards of those buildings. The review will report, and I will ensure that the report is available to her in due course.
It is also crucial that local authorities plan for the right number of homes. That is why, in July 2018, we introduced a new standard method to assess the minimum number of homes that an area needs. It does not set a target; it is simply a starting point from which authorities consider any constraints, and see whether need is more appropriately met in neighbouring areas. Following the latest household projections, the standard method was changed to ensure that it was consistent with delivering the homes that the country needs. We are reviewing the method and will consult on longer-term options in due course, because we recognise that we need to diversify the products on the market in order to drive up supply.
I will say a few words on small and medium-sized enterprises before I let my hon. Friend the Member for Harborough wind up. We are supporting SME housebuilders with a package of measures to help the sector to grow and develop, including the home building fund, the housing growth and housing delivery fund, the ENABLE Build guarantee scheme, and our ongoing reforms to the planning system, more of which he will hear about in due course. We believe that SMEs have a key part to play by increasing their output, as the biggest home builders in our country will not meet the Government’s housing building target alone. SMEs are well placed to help to deliver new homes, welcomed in their communities rather than resisted, and those homes will be built to last. Not only do we need to supply more homes, we need to make the dream of home ownership, as the hon. Member for Stockton North called it, a reality.
I hope that Members can see that the Government are truly committed to addressing the problems raised in the debate. We know that we need to build more of the right homes, of the right quality and in the right places, so that the housing market works for all parts of our community. We are determined to do that, and I invite all hon. and right hon. Members to step up to the plate and help us to tackle that challenge.
Neil O'Brien
I thank all Members who have taken part in this afternoon’s brilliant debate. I was encouraged by the Minister’s words, particularly on temporary access. I strongly agree with the hon. Member for Ellesmere Port and Neston (Justin Madders) in his coruscating critique of the fleeceholding industry. They are the timeshare salesmen and the dodgy wheel-clampers of our generation, and I hope that the Minister will clamp down on them very strongly. Perhaps the new homes ombudsman can be the vehicle for that.
I agree with the question posed by my hon. Friend the Member for Bury North (James Daly) about what affordable housing is. I think that the type of tenure most missing is cheap rented housing for working people. Although affordable housing is hugely needed, and my local council in Harborough has built a record amount of it, we need something for those people who are earning a bit and do not get social housing.
I was struck by the comments of my hon. Friend the Member for St Ives (Derek Thomas) about developer contributions. We must not go over the top, but on the other hand there is a reason why all economists agree that taxes on land and development are different to other types of taxes. If we lose developer contributions, we typically do not get more houses—just higher land prices and a bigger windfall for the lucky landowner.
Finally, there was a good challenge from my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti). We do need to build more houses. France has built twice as many houses as us since 1970, and French house prices have gone up half as much. Places such as the Netherlands have built more too. We need to learn from them. It is not about shoving more houses through the system; it is about having a proper, plan-led system to do it.
Motion lapsed (Standing Order No. 10(6)).
Innovation in the NHS
(4 years, 9 months ago)
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Chris Green (Bolton West) (Con)
I beg to move,
That this House has considered innovation in the NHS.
It is a delight and a pleasure to have secured this important debate. We are going through an incredible time, with advances in technology across so many different fields, and there is a big question about how the national health service can adopt this important technology that makes such a difference to people’s lives. There is so much potential in the healthtech sector that has led to a transformation in patient outcomes, and that capacity must be expanded within the national health service. Some good work has already taken place to deliver innovation within the NHS, through the structures and approaches established by NHS Digital, Health Data Research UK and NHSX, which is creating the right framework to deliver innovation. However, if the true potential of the NHS is to be harnessed and if innovation is to feed through to trusts right across the country, there needs to be a dramatic acceleration of health technology.
Despite the presence of innovation accelerators such as HS. and bodies such as the Accelerated Access Collaborative, designed to find ways to help innovation products reach patients more quickly, there remain barriers that restrict the ability of healthtech businesses to scale effectively and get their products to market. The first challenge is the speed of the pathway to adoption. NHS Improvement estimates that it takes an average of 17 years for a new product or device to go from successful clinical trial to mainstream adoption, a figure that was highlighted by the Secretary of State earlier this year. Considering the rapid pace of technological change, that is a very concerning statistic for the healthtech business.
Historically, a good deal of that time was taken up by National Institute for Health and Care Excellence appraisals. In 2012, statistics released about the timelines for appraisals showed that the average time for multi-technology appraisals was 5.5 years, and about 2.5 years for single-technology appraisals. The Minister might be interested to know that I will host an event in a couple of weeks, in conjunction with AbbVie, to launch a report entitled “Bridging the Gap between Clinical Trials and Real-World Practice”. That research found that breakthrough medicines that might address high unmet medical needs and have been earmarked for fast-track approval are approved on average one month later than non-prioritised medicines, meaning that patients have slower access to those medicines.
Overall, that report found that approval processes take significantly more time in England than in other European countries, including Germany and France. It also found that NICE is more likely to place restrictions on new medicines than are other countries. On a more positive note, although NICE takes longer to assess medicines, it has one of the highest approval rates among health technology assessment bodies, meaning that a greater number of medicines are available. Although there have been significant positive improvements to the process since 2012, which have greatly accelerated it—for example, the medical technologies guidance, as well as the digital health technologies pilot scheme within that guidance—a lot more needs to be done so that those benefits can reach across the entire health sector.
A bigger concern is the funding opportunities available to healthtech businesses when they have an appraisal. Funding is obviously one of the most important building blocks for growth, but even if a healthtech business has had a NICE appraisal, there is no guarantee that its product will be adopted within the national health service. The medtech funding mandate and schemes such as the AI innovation award within the AAC are welcomed, but there should be greater emphasis on ensuring that centres are allocated the required funding from the NHS, so that they can pay for the devices and services and utilise them to improve patient outcomes.
Furthermore, the current criteria for the inclusion of new medical devices are based on how savings are generated within one year, which can be challenging given the higher up-front costs. For example, complicated surgical implants can be expensive, but can save money for the system through reduced spending on drugs and social care. There are also incoming regulatory barriers that will harm the healthtech sector’s ability to sell its products and the UK’s ability to be a competitive market for innovation. At present, medical devices are operating within the three-year transition period that ends in May 2020, after which devices on the market must fully comply with the medical devices regulation. There is a concern that the lack of notified bodies designated under the MDR may prevent the industry from getting life-changing products to market.
Currently, at a time when the industry will be rushing to ensure its devices are compliant with new regulations, only six notified bodies across the EU are authorised to accept work related to the forthcoming MDR. It is of concern that there is only one notified body in the UK, the Medicines and Healthcare Products Regulatory Agency. There are growing concerns across the industry that a bottleneck will emerge, potentially causing innovative and cost-effective technologies to be taken off the market as they wait to be certified again under the MDR. In a recent Med-Tech Innovation survey, only 4.8% of businesses said they were sufficiently prepared for the new MDR, despite 55% of businesses having begun preparations for those changes over 12 months ago. That shows the extent to which the lack of notified bodies is affecting the sector.
The UK’s departure from the EU presents an opportunity for the UK to establish itself as an international hub for certifications. Furthermore, with both the NHS long-term plan and the Government’s prevention Green Paper highlighting the importance of technologies in easing pressures on health services, it is vital to ensure that new regulation does not instead stifle innovation or discourage global medical device manufacturers from entering the UK market. I am also pleased by the Government’s ambitious strategy to maintain the UK as a global leader in the life sciences, reflected in the life sciences sector deal and their commitment to spend 2.4% of GDP on research and development by 2027. We must make sure that the medical devices sector and the life sciences sector more broadly get their fair share of that investment in R&D.
There are therefore positives that we can point to, but there are still challenges that are holding back innovation. Although the work of the academic health science networks in spreading and driving innovation across the regions of England is welcome, large variations remain, especially in individual centres’ attitudes towards health technology. AHSNs continue to play an important role in spreading best practice and therefore reducing variation across regions; however, the challenges facing healthtech companies in this area should not be underestimated. One challenge faced by technologies as they attempt to become adopted across the NHS relates to the differing nature and characteristics of individual centres. Due to the differing priorities and attitudes of centres across the country, medical device companies must employ different approaches as they roll out across the country. That inevitably delays the adoption of new technologies across the NHS, since individual companies must develop complicated strategies for each local business case. Some areas have more streamlined processes for adopting innovation, but it is by no means uniform, and will further the inequalities in healthcare between different regions. If a more joined-up approach towards innovation adoption were implemented across the NHS, medical technologies could be rolled out more quickly so that centres with the most need could access them.
In health and other sectors, it is always important and necessary to have leadership. I often hear about different trusts and centres that have strong leadership and that can, therefore, drive change. Other centres without such strong leadership are holding themselves back. I will discuss the chief innovation officer position later.
The UK’s great potential for data research is well known. The UK has some excellent datasets, globally leading data scientists and the ambition to make the UK the home of data-driven life sciences research and innovation. In terms of data collection, however, the national health service does not behave as a single organisation. The potential of health data cannot be fully realised until structures and processes enable the interoperability and straightforward accessibility of datasets across the country.
Moreover, health data is globally competitive, with significant investment being made in improving the health data environment in other countries, including the USA, Germany, Israel, France and China. It is not an exact science, but NHS England estimates suggest that harnessing data and delivering on digital plans for the NHS could unlock productivity benefits of about £10 billion a year, allowing for greater investment in other priority areas.
An example of the industry working closely with health service bodies to tackle those challenges is the academic health science networks’ production of an atrial fibrillation toolkit that concisely outlines the relevant data for innovators working to prevent AF-related strokes. The toolkit provides innovators with data on the proportion of patients in a local area diagnosed with AF who have not been anticoagulated and encourages innovators to gather local knowledge on waiting times, pathways and referral criteria.
Unlocking the potential of patient data is key to driving forward research and innovation. The NHS is a rich and unique source of patient data, but public trust and confidence in the use of data is vital. The public need to feel that they can trust and have confidence in the health and social care system to share their information with care and confidence. People want to share their data, but they want to be confident that when their data is being shared, it will be used in the right way by the right organisations.
People are not necessarily hugely concerned by the private sector having access to their data, but they need more reassurance and more confidence in the anonymity that is provided in the data and in the control of the extent to which the data is given to companies, so they cannot just pass it on to other organisations. If the public do not trust the system, they will be unwilling to share their data for research. Ultimately, everyone is a loser from that—charities, the NHS and patients; there will be significant disadvantages across the sector in the UK.
It is essential that we continue to enhance the UK clinical research environment to ensure that global companies look to the NHS first when setting up trials for breakthrough therapies. An essential element for attracting R&D investment into the UK and reaching the Government’s target of 2.4% of GDP is to enhance the UK’s commercial clinical research offer.
Despite the significant size and growth of the global market for clinical research, the UK’s share of clinical trial applications and patient recruits has fallen since 2016, with the UK falling behind the USA, Canada, Germany and Spain for commercial clinical trials. We must build on our strong scientific base and on existing NHS infrastructure and expertise to grow the UK’s share of the global market and improve its commercial clinical trials offer.
The industry already supports the Government’s commitments to clinical research in the life sciences industrial strategy, sector deals and the NHS long-term plan. To be at the forefront of clinical research, however, there needs to be a simplification of the processes for setting up and running clinical trials, harnessing the UK’s data infrastructure for medicines and R&D, embedding patient involvement in clinical research and ensuring continuing high standards for transparency.
In my view, the challenges of adopting innovation in the NHS result, to some extent, from a lack of leadership in the NHS. The Secretary of State leads the way on getting health technology into the system. We need that culture to be better established in the national health service. No one within NHS trusts is specifically addressing the issue as part of their job. If more people were appointed to the chief innovation officer position in NHS trusts, the adoption of innovation might be accelerated. At the moment, about 20 chief innovation officers are in place. More such appointments would do two things: first, accelerate the adoption of innovation in the national health service and secondly, drive innovation and improvement to challenge and bring up to date legacy systems in the NHS.
In conclusion, I reiterate that there are many positives and much good practice to draw on, and there is no lack of ambition to place the NHS at the forefront of innovation. I look forward to the Minister’s remarks.
The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Bolton West (Chris Green) for bringing the issue to Westminster Hall. I have heard him speak on the matter several times. In fact, hon. Members in the main Chamber yesterday will have heard him make those points and others with the passion that he showed today. As well as passion, he has something that makes us nervous—absolute knowledge and understanding of the subject. That is welcome, and his depth of knowledge on tech and innovation in the NHS makes him a welcome addition to the House.
My hon. Friend mentioned the AI award that has just been announced, the adoption of new products, data and clinical trials. I will make a few points about each of those topics at the end of my speech. As he said, not just the Secretary of State for Health and Social Care, but everybody in the Department is passionate about high-tech innovation. Only yesterday, I heard about a new app called Skin Analytics. It has a phone attachment that takes an image of someone’s mole or skin that can be sent through and almost instantly diagnosed as to whether it is skin cancer and requires further treatment. The rate at which AI and technology are accelerating daily is phenomenal.
We can transform the health of millions of patients, improve health outcomes, reduce cost and reinforce the UK’s position as a global hub for life sciences and health tech within the Department, because we are so passionate about it. We can take advantage of those opportunities by seeing what can be achieved by using the technology that is becoming available daily. The UK has a world-leading single player health system, covering 65 million people and—I know that my hon. Friend knows this; I am almost embarrassed saying it—we are the biggest single buyer of medicines in the world. We have some of the world’s best clinical researchers leading universities, charities and life science companies. Indeed, 25 of the world’s 100 most used medicines were developed here, using a public and philanthropic research infrastructure that is, pound for pound, more effective than anywhere else in the world. We should be really proud of that, but we know we must go further.
The NHS long-term plan and the life sciences industrial strategy have set out an ambitious set of actions to create the most collaborative health innovation system in the world—one that gets the best new treatments and technologies from the bench to the bedside faster than ever before. It is beginning to make a difference, first through the Accelerated Access Collaborative, where leaders from across the NHS, patients, charities, industry and the Government are now coming together to tackle the major systemic barriers to the adoption and spread of innovation within the NHS. My hon. Friend is quite right to raise the fact that there have been barriers, but we are tackling the barriers now.
The AAC is supporting greater use of a range of proven innovations, which have the potential to benefit up to 500,000 patients and save the NHS up to £30 million; developing co-ordinated plans to ensure that the NHS is ready for transformative new technologies, such as the advanced therapy medicinal products—ATMPs—and the use of AI technologies in diagnostics and screening; and launching a new medtech funding mandate to drive the best value and most innovative medtech projects across the NHS. With long-term funding for the NHS in place, that collaboration is also now being backed by increased commercial flexibility—flexibility to ensure we can make the best new treatments and technologies available to patients, while ensuring long-term affordability for the NHS.
The impact has already been felt, with Europe’s first access deal for Kymriah and the breakthrough of the CAR-T—chimeric antigen receptor T-cell—therapy, just 10 days after the treatment’s European marketing authorisation, and a pioneering Government collaboration with pharmaceutical company Novartis for the drug Inclisiran to tackle heart disease, which could save up to 30,000 lives over the next decade.
The 15 regional academic health science networks continue to support the local adoption of cutting-edge technologies. More than 3,500 innovations from more than 2,500 companies have benefited from support from the AHSNs in recent years, ranging from new blood tests for pre-eclampsia, which can significantly reduce life-threatening complications in pregnancy, to devices that improve bowel cancer screening.
Finally, we are working to digitally transform the NHS to unlock the technologies for the future. The plans are already being delivered by NHSX. For example, we recently announced a £250 million artificial intelligence lab, which will build and rapidly test cutting-edge prototypes, but the real focus will be on finding and boosting existing technologies and ensuring they can be adopted across the NHS. Over the next three years, the lab will support the £140 million AI Award, led by the AAC, which will be designed to speed up the testing and adoption of the most promising new AI-enabled technologies. It will cover stages of the product cycle from proof of concept, to real-world testing, to initial adoption in the NHS.
By working together across the health system, Government and industry to deliver improvements, we can ensure NHS patients are some of the first in the world to benefit from the best new treatments and technologies. We will ensure that the UK continues to have world-leading life science hubs, where the best innovations get from bench to bedside faster than ever before.
My hon. Friend made a number of specific points. He mentioned AbbVie and its “Bridging the Gap” report. I thank AbbVie for its valuable contribution to the work in this area and I thank my hon. Friend for his support of its report. I know my officials and the Office for Life Sciences have been engaging with the report’s authors, as it has been developed, and they will be closely considering its recommendations. We have made a number of improvements to National Institute for Health and Care Excellence and Medicines and Healthcare Products Regulatory Agency processes since the data on which the report is based and published, including reforming the cancer drugs fund. I hope we are already beginning to see the benefits of those changes through quicker assessment rates.
I am going to speed up, so that I can get everything in. My hon. Friend mentioned the AI award. We believe the funding mandate and the AI award are a fantastic step forward in driving higher adoption of some of the most exciting new medtech in the NHS, but we know we may need to do more. We will learn from the first year of introduction, and we will continue to review how the schemes can be developed to support a wide range of projects in the future.
In terms of the adoption of new products, we recognise that in some cases new products will require a trust to adapt its care pathways or to train staff, and that is why we provided an additional £2 million a year to the AAC through our pathway transformation fund, to support adoption of the products it has selected for support.
I fully agree with my hon. Friend’s comments on the importance of the UK’s clinical trial system to patients and to our economy. The Government are committed to creating the best environment for clinical trials, both in achieving the ambitions set out in the life sciences industrial strategy and as we agree new future trade agreements. The system is coming together to deliver that. We have streamlined the Health Research Authority approval process to make clinical trial set-up faster. NHS England’s long-term plan sets out an ambition to see a million people registering to participate in health research by 2023-24 and to treble commercial research in the health system over the next 10 years.
The National Institute for Health Research clinical research network has also recently completed a competition to establish five purpose-designed centres, dedicated to last phase commercial research within the NHS’s capacity to deliver research. They will enable significant growth and provide more opportunities for patients to benefit from early access to innovation.
Finally, on making the best use of data for the NHS, which is of particular interest to me at the moment, with regard to the women’s agenda and using datasets within the NHS, we fully agree that the better use of NHS data promises significant benefit for patients, including better ways of predicting and diagnosing illnesses and the development of more effective treatments. We have set up NHSX to drive forward the digital transformation of the NHS and to ensure it can make better use of its data and new technologies. The Government have also invested £37.5 million in the digital innovation hubs programme, which will improve the access to and the quality of NHS data through seven health data research hubs, but it is absolutely essential that we build and maintain public trust in this area. That is why the Office for Life Sciences sponsored a robust piece of public engagement, led by Understanding Patient Data, on the commercial uses of healthcare data.
We are also developing a policy framework, which makes it clear that all commercial uses of healthcare data must have an explicit aim to improve the healthcare and welfare of patients in the UK and address the key concerns of the public, such as robust governance processes and transparency requirements.
I shall end where I began, which is to thank my hon. Friend for bringing his depth of knowledge and expertise in this subject to the debate. As I said, from the Secretary of State to the Ministers involved in the Department of Health and Social Care and officials working there, we all see innovation and technology as a way of improving access for patients, improving patient outcomes, reducing costs and enabling access to better and quicker treatments. Because of that, we are totally supportive of both the innovation and the high-tech agenda. It is debates such as this one, and the subject being raised regularly in the House in the way that my hon. Friend does, that keep pushing that agenda forward.
Question put and agreed to.
Children and Domestic Abuse
(4 years, 9 months ago)
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Liz Twist (Blaydon) (Lab)
I beg to move,
That this House has considered children and domestic abuse.
It is a pleasure to have you in the Chair, Mr Hollobone, for a very timely debate. The Leader of the House and relevant Ministers—including the Under-Secretary of State for the Home Department, the hon. Member for Louth and Horncastle (Victoria Atkins), who I am pleased will be responding to this important debate—committed to introducing the Domestic Abuse Bill at the earliest opportunity. I was pleased to see the Bill return to the House earlier today, and I congratulate the Minister on staying true to that commitment. I look forward to hearing her detail the Government’s plans to support children affected by domestic abuse.
I want to continue on that positive note, because the Domestic Abuse Bill is a once-in-a-generation chance to deliver real change in how we respond to domestic abuse. When the Bill was introduced in the last parliamentary session, there was much to be welcomed—not least the introduction of a definition of domestic abuse, which will help guide our response. It is commendable that the definition specifically identified the coercive control elements of abuse, which we know are all too common. There were also improvements to the Bill on the advice of the Joint Select Committee that undertook prelegislative scrutiny, including clarifications on the independence of the new domestic abuse commissioner to ensure that they can carry out their role as effectively as possible. It is also positive that the commissioner will be expected to encourage good practice in identifying children affected by domestic abuse, and I was pleased to see Nicole Jacobs appointed as the commissioner designate; she brings a breadth of experience in this area.
The Domestic Abuse Bill is a prime example of legislation that, if done well, stands a real chance of securing widespread support from hon. Members of all parties, and from outside the House. I am sure that every hon. Member present wants to ensure that we get it right, but the Bill is not perfect. The crux of my concerns is that the Bill fails to grasp the opportunity to truly take account of the needs of children affected by domestic abuse, which is why we are having this debate. It is an issue that was brought close to home by my constituent Christine, who is a survivor of domestic abuse. Christine came to see me about her experiences and about her concern that the needs of children are not properly taken into account when considering the impact of domestic abuse.
Bambos Charalambous (Enfield, Southgate) (Lab)
My hon. Friend is making an excellent speech and I congratulate her on securing this important debate. Does she agree that children who see, overhear or experience domestic abuse are sometimes at risk of copying that abuse and the behaviour of the person who survives it? Does she agree that there is greater need for specialist support for children who experience such abuse, and that the Government should take it seriously and try to fund that support?
Liz Twist
It is absolutely right—it is the crux of my argument—that we need to ensure that specialist and appropriate services are available for all children going through that experience.
My constituent Christine believes strongly that the effect of domestic abuse on children needs much more attention, so that they, too, can be helped to survive and thrive with the right emotional support. She told me that years after her leaving that abusive relationship, her daughter, who is now over 18, is still dealing with the damage caused by experiencing the abuse that her mother suffered. Christine is an amazing, strong woman and I am glad to be able to raise this issue for her.
I sincerely hope the Minister takes on board the points that come from the debate. I also hope she will work with organisations from across the children’s sector and the violence against women and girls sector, which have informed today’s proceedings, to ensure that the Bill addresses the needs of children and young people affected by domestic abuse.
Jessica Morden (Newport East) (Lab)
There is also the issue of abusive relationships between under-16s. Does my hon. Friend agree that we need the Government to look at that as well, and to consider recommendations so that we can help and better support children, particularly girls, who find themselves in those circumstances?
Liz Twist
I certainly do. I know it has been raised by some of the groups working on this issue, and it is important that we take that into account.
Worryingly, the evidence tells us that up to one in five children and young people are exposed to domestic abuse during their childhood. On average, 37 children’s social care assessments that identify domestic violence as a feature of a child’s life are undertaken each day in the north-east alone. However, they will not be seen as victims. Analysis indicates that over 800,000 children in England live in households that report domestic abuse, yet there are still shortcomings in the family courts that deal with domestic abuse cases, with a perpetrator of domestic abuse seen as a violent criminal in the criminal courts but as a “good enough” parent in the family courts.
Although we know that the consequences of such childhood experiences can be devastating and result in emotional, social, psychological and behavioural difficulties, there is significant variability around the country in the level of support available to children. In two thirds of local authorities taking part in a recent study by Action for Children, children face barriers to accessing support. In over 10% of such areas, no support services were available to children at all. Those are just some of the issues that the Bill must deal with if it is to live up to expectations and become the landmark piece of legislation that we all want it to be. I would welcome hearing how the Minister envisages the Bill supporting children affected by domestic abuse.
I want to highlight two key areas in the time I have left. I know that hon. Members will pick up a multitude of other concerns directly, from migrant children and their families through to the operation of the family courts, but time will not allow me to address them all. My first concern is about the definition of domestic abuse. Although it is welcome, the statutory definition will not, as it stands, include children, relegating them instead to the statutory guidance. That is problematic on a number of fronts, not least because the guidance is yet to be published.
First and foremost, it worries me greatly that overlooking children in the definition of domestic abuse fails to recognise the serious impact that seeing, hearing or being otherwise exposed to domestic abuse perpetrated by one adult against another can have on children. In short, they will be considered witnesses to domestic abuse, rather than being recognised as victims themselves. Given that we know about the seriousness of the impact that this can have on children, such an approach is untenable.
Secondly, the Government have made it clear that frontline practitioners and public authorities, including the police and social services, are to adopt the Bill’s definition in their day-to-day duties. However, I share the concerns of organisations across the children’s sector that, if children are not included, it could affect how they are treated by the professionals coming into contact with their families. I therefore urge the Minister to consider broadening the Bill’s definition of domestic abuse to include children.
My second key concern is about the provision of support services for children. I have already mentioned that domestic abuse can result in long-lasting impacts on a child’s health, development, ability to learn and wellbeing. That is on top of increased risks of criminal behaviour and interpersonal difficulties in future intimate relationships and friendships. Analysis of the millennium cohort study shows that children whose parents reported experiencing domestic violence when children were aged three reported 30% higher than average antisocial behaviours at age 14, a finding that should be seen in the context of the trauma suffered by children who are affected by domestic abuse. With the right support, however, children can thrive in even the most difficult circumstances.
It is very concerning that the percentage of domestic abuse services providing dedicated support to children and young people fell from 62% in 2010 to just 52% in 2017. More alarming still, research from Action for Children suggests that that support is patchy at best, with significant variability in what is available for young people depending on where they are in the country. A fundamental part of the problem is the lack of clear requirements for delivering support services specifically for children who are impacted by domestic abuse. As a result, insufficient funding is allocated to providing a sustainable future for those vital projects.
Although the Ministry of Housing, Communities and Local Government’s recent consultation on a statutory duty for accommodation-based services is welcome, clarity is needed on the all-important community-based services that support so many children and families, especially as they deal with many of the issues that accommodation-based services face. I recognise that that matter is not part of the Minister’s brief, but I hope that she will both offer reassurances that the Government are looking at it and outline how non-accommodation-based support services will be provided and funded under the new statutory duty.
I am glad to lead this debate on the day that the Domestic Abuse Bill is introduced and very much hope that the Government will work to strengthen the Bill for children. I thank my constituent Christine, who so powerfully brought the issue to my attention.
Several hon. Members rose—
Mr Philip Hollobone (in the Chair)
The debate can last until 5.30 pm. I am obliged to call the Front-Bench spokespeople at no later than 5.12 pm. The guideline limits are five minutes for Her Majesty’s Opposition, 10 minutes for the Minister, and two or three minutes for Liz Twist to sum up, but until 5.12 pm, we are in Back-Bench time. Three Members wish to speak, and I am determined that they should all get their fair share. We will start with Jim Shannon.
Jim Shannon (Strangford) (DUP)
Thank you, Mr Hollobone. That is quite easy to work out, with seven minutes each or thereabouts. I will do my best to keep to that and hopefully I will finish a wee bit sooner.
I thank the hon. Member for Blaydon (Liz Twist) for setting the scene. In the short time that she has been in the House, she and I—and many others who are present—have spoken about things of interest to us. I look forward to the contributions from other hon. Members, who will refer to the same issues as the hon. Lady, and, I hope, that I will as well.
I know from the work that my constituency office does that domestic abuse is, very unfortunately, a common occurrence. That is sad in a society in which we hope that people will have understanding and respect for each other. Every one of those occasions in my constituency has involved a lady and, more often than not, her children, who have borne the brunt of the domestic abuse.
Women’s Aid NI states:
“Children and young people have often been referred to as the hidden or forgotten victims of domestic violence. In recent years however, recognition that children and young people are impacted upon by domestic violence has spread, and policy and practice has begun to develop accordingly. It is important to remember that whole families suffer from domestic violence. For every woman experiencing violence in the home there will usually be children who are also suffering. The experiences of these children and young people are often overlooked.”
That is key to this issue. The hon. Lady referred to that very honestly in her contribution.
It is not just the lady who suffers abuse, but the children, and I will offer some examples from my constituency casework. I have witnessed at first hand the effect of domestic abuse on children when, through my constituency office, I have attempted to help women find their way out of abusive situations and into safe places. I put on the record my sincere thanks to those at North Down and Ards Women’s Aid, who have often been the difference between life and death for women and a source of new starts for children in my constituency. Despite cuts in funding and an increase in paperwork, all that they do, as well as the compassion and dedication with which they do it, makes a difference.
I know that the Minister does not have responsibility for Northern Ireland, but when she has spoken in any debate that I have been involved in, she has always spoken with compassion and understanding, and has really grasped the issue. I think that every one of us is impressed by her ability to do that. I look forward to her response.
Between July 2018 and June 2019, there were 16,575 domestic abuse crimes recorded in Northern Ireland, which represents an increase of 10% on the previous 12 months, and is the highest since records began in 2004-05. We are seeing more domestic abuse, and I am not sure why that is. Is the cause social media, the society we live in, or do people have more addiction issues? I am not sure, but there is definitely more of it.
A study of 108 mothers who had been victims of domestic violence in Northern Ireland uncovered some horrendous statistics: 90% of children in these homes were aware that violence was occurring; 75% had witnessed violence at home; and 27% of the children had themselves been physically abused by the violent partner. Those numbers may be increasing because more people are reporting domestic abuse. Although the rise in reports is a success, whatever way we look at it, homes are being torn apart and children are being scarred for life by it.
I overheard my parliamentary aide speaking with a friend of hers whose partner was threatening violence and, even though the friend tried to qualify that by saying that it was the first time he had done it, my aide said something that stuck in my mind, because it might be the first time, but that might lead to a number of times. My aide said to her friend, “Okay. So will it be okay the first time your daughter hears that from a man? Because if it is okay for her to watch and hear you going through it, then she will believe it is okay for her to go through and accept it.” If it is okay for the mother, is it okay for the child? I do not think so. We were able to help that young girl and her three children to find a safe place and get help. We need to be able to help children who watch and live through the abuse, even if they are not touched—that is so important.
I hope that the Minister will acknowledge in her response, which I know will be positive, that the issue is not just about how we help mothers, but their children. That is the thrust of the debate. I also look forward to the response from the shadow Minister, the hon. Member for Swansea East (Carolyn Harris), with whom I have worked on many issues. We need support systems in place for children to prevent them from repeating the cycle by becoming the abuser they have witnessed or accepting abuse as the norm. We need better systems in place to provide help, counselling and support for children who have witnessed domestic abuse—that must be a priority. Well-balanced children are not taught to bury pain but to express it in a helpful way. They need help to do so, and that is what we are asking for. I look to the Minister for an understanding of the strategy to improve support provided to children who witness domestic abuse and who, too often, are a part of its cycle. That has to stop, and it has to stop now.
Jess Phillips (Birmingham, Yardley) (Lab)
The most common thing that women in refuges or community services have said to me is that they wish that there was something for their children—somewhere that their children could go to speak to somebody about what was happening at home. Although many of those women appreciated the support that was available to them, there was a hole for at-risk children, whether in classrooms or even in social services, with zero therapeutic support or play care support, or even just somebody at school who they could speak to and who would understand.
If the women of this country who have suffered domestic violence had written the Domestic Abuse Bill and had picked a single thing to ask for, they would have asked for their children to be supported. Across the country, support for children who are victims of domestic violence is patchy at best. Sometimes it is done well. The organisation where I used to work has a huge team of children’s support workers, funded as a pilot project through the Home Office. Unfortunately, however, such things are often pilot projects that do not extend to everywhere in the country and often go to those places that are best at writing bids. As the bid writer, I am delighted that we had that project, but the reality in most parts of the country is that if a teenager who was suffering abuse stepped forward at school, or if a child in a primary school stepped forward to say something about what was happening at home with his mum and dad, there would be nowhere to send that child.
I am fairly well versed in the local domestic abuse projects where I live, and I have most of their mobile phone numbers, but I would not know where to send a child who needed therapeutic support in Birmingham, the second biggest city in the country. If provision is patchy where I live, I cannot imagine what it is like in Blaydon.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
My hon. Friend, whose background is in this area, is making a really good speech. As a former children’s services manager in Birmingham, she is absolutely spot on when she says that there is nowhere to refer children, especially when even children on child protection plans are not given support. Does she agree that it is wholly inadequate not to recognise children in the definition?
Jess Phillips
I absolutely agree. The Domestic Abuse Bill gives us a real opportunity. We will not get the moon on a stick—the Bill will not give us everything—but the annual case load at Women’s Aid, where I used to work, involved on average 8,000 women and 16,000 children. Children’s names are written down on a form and their social work paperwork is in the file, but no one from my organisation would necessarily have laid eyes on them. A tiny fraction of them would have lived in refuge accommodation—less than 10% of the total number would have gone through that in a year—so we are talking about thousands of children in the west midlands who, every day, are without someone to confide in, to talk to, or to deal with the trauma they are feeling in their lives.
Anyone who sits for five minutes with people who have been a child victim of domestic abuse, who have grown up in a home, will tell us that that trauma stays with them in adulthood. They are likely to suffer from PTSD and from problems within their own intimate relationships. All the findings from studies of crime data on knife crime or even terrorism show links to people who grow up in traumatised households. It is imperative for the future of those children and our country that we get this right. Children must be included in the Bill, and at the same time we must take a huge, wholesale look at funding for children’s services in the country. I ask the Minister directly: how many young people’s violence advisers and specialist children’s workers are there across England and Wales? The SafeLives data shows that it would cost only £2.5 million to provide those services across England and Wales. In the greater scheme of things, what it would save would be huge.
We are moving into an era when this will be talked about in schools. All of us in the Chamber have fought—some of us literally had to fight directly on the streets—to ensure that compulsory sex and relationship education will be available in our schools. As we roll that out and talk about such subjects in schools, we must ensure that we do not open a door into an empty room. We must ensure that specialist training and specialist single points of contact are available to handle this in every school, and to handle it well.
The murder rate of women and girls were released the week before last. I have forgotten the name of the organisation, but the data was released: 144 women and girls were murdered last year. That is an increase of about 27 on the previous year. Those figures include the murder of girls younger than three. The reality is that we need to provide support for victims of domestic violence who are children, and it is also imperative that they are safeguarded. We need to start looking at where we are failing in the system of children’s social care. To look at my own city again, I am sure that my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill) could tell horror stories about how the under-resourcing of children’s services is leading to dangerous situations for the city’s children.
I cannot stress one thing enough when it comes to the review being undertaken of the family court. All of us have been in meetings with the likes of Claire Throssell, whose children were burned in their home by a violent perpetrator who the family courts had allowed to have access to them, even though she had begged and pleaded against that. The presumption of access for domestic violence perpetrators has to end.
Laura Farris (Newbury) (Con)
To build on the hon. Lady’s point, the presumption in favour of access for a parent who in a criminal court would be considered a violent offender has a hidden dimension. Sometimes the perpetrator of domestic abuse will use the child as a pawn. Enhanced right of access will, typically, be used as a tool to torture the mother. The hon. Lady gave powerful figures not only for women who have been killed by domestic abuse but for children as young as three. She also gave an example of arson. That grim conclusion might not be reached, but children are still treated as pawns. They are placed with the perpetrator parent, in a highly dangerous situation, and they are denied access to their mother. That is a tool to torture the mother, and goodness knows what is happening. Another problem is the reporting restrictions in the family court, which make it difficult to know how the decisions are reached and the slipstream in which those children are moving.
Jess Phillips
The hon. Lady is absolutely right. I have seen hundreds of cases in which access to a child is used simply to extend the abuse. Children become pawns, and that has a psychological effect on them. They are pulled about and told that they have to go somewhere, such that they do not feel safe. Their mothers have to watch on and say goodbye to their children, putting them into the custody of someone they do not believe to be safe. That is psychological torture in our family court system—although, thanks to its secrecy, we will never truly know. However, I am sent emails with reams of accounts about that exact thing happening, day in, day out. We have to stop wringing our hands.
The Children and Family Court Advisory and Support Service is also an issue with regard to the family court. CAFCASS provides support and services for perpetrators to try to stop the perpetration of domestic abuse. I am not here to criticise that, but I note that CAFCASS does not provide the same support for women and children. I often found a disparity when people decided to fund local commissioned services for perpetrators. Again, I have no problem with that, but there was always a discrepancy between the amount of money that would go to the perpetrator project and the amount that would go to the project that ran alongside it for women and children. Double the number of people was always a fraction of the price, I noted.
Jess Phillips
I will but for the last time, because I want to leave time for my hon. Friend the Member for Edmonton (Kate Osamor) to speak.
Jim Shannon
I am conscious of the psychological, financial and emotional ways in which a partner can put pressure on a wife and mother of the children. My office has dealt on many occasions with the issue of finance, where the male controls the money and the female and the children depend on him for finances. It is another nasty form of control. I have spoken about it many times, as has the hon. Lady.
Jess Phillips
The hon. Gentleman is right. We will welcome the Domestic Abuse Bill giving recognition to the issue of financial abuse. Things will only ever change if there are proper support services in every part of the country, to ensure that people can recognise financial abuse and that there is a route out.
People often say, “Why doesn’t she leave?” When a woman leaves a domestic violence perpetrator, with her children, the risk that she will be murdered elevates. There is a pattern in all domestic homicide reviews and children’s safeguarding serious case reviews: when people try to escape, the likelihood of their being murdered increases. That is one reason, but the other reason a woman might have nothing is that she will have no money. It is easy for us to say that we would leave, but it is very different in practice.
It would not be a day with me and the Minister if I did not mention the plight of migrant women, but my hon. Friend for Edmonton will talk much more about that, so I shall give her the time to do so. Until the Domestic Abuse Bill accounts for all victims, whether they be children or adult victims, and can guarantee at least an opportunity of safety—we cannot guarantee safety; no Government Department can, no matter how great—for every woman in this country who comes forward, homicide rates will not decline. The people whose names I will have to read out every year will increasingly be those of migrant women and children. I shall leave the Minister with that.
Kate Osamor (Edmonton) (Lab/Co-op)
I am grateful to serve under your chairship, Mr Hollobone, and I look forward to doing so again in future. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing today’s important debate, and I thank my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) for her usual passion in speaking about this important subject that needs a lot more forensic inspection, especially in the light of the Bill.
I speak not only as a Member of Parliament but as the chair of the all-party parliamentary group on no recourse to public funds. I am particularly keen to contribute to this debate to speak up for those mothers who, as result of their immigration status, have had the condition of no recourse to public funds imposed on them, and who are also more likely to be subject to domestic abuse and less able to escape it. Children in those families are in an especially vulnerable position. The reality for thousands of families and children in this country is that if they find themselves in an abusive situation, they have no safety net to fall back on. Many of those families are presented with a choice: continued abuse or possible destitution. Nobody should have to make that choice.
The Children’s Society’s research found that between 2013 and 2015, more than 50,000 individuals with children had no access to mainstream welfare support. According to the University of Wolverhampton and the Greater London Authority, there are 250,000 undocumented migrant children living in the UK. I want to speak up for those families and children. They must not be forgotten in this debate and in the Bill.
No child should be more vulnerable to domestic abuse as a result of barriers placed in their way by the Government’s hostile environment policy. The bottom line is that protection from domestic abuse must be provided regardless of immigration status. Yet, as it stands, those with no recourse to public funds are incredibly vulnerable to suffering from abuse and being trapped in an abusive cycle from which they cannot escape.
One common pathway for children to escape abuse is assistance from social services but, for many, that pathway is blocked because of their immigration status. Under section 17 of the Children Act 1989, local authorities have a duty to safeguard and promote the wellbeing of children in need. However, many families with no recourse to public funds find that route to safety totally blocked. Charities such as the Children’s Society and Project 17 have even found that social workers have assessed that it is safer for children to be placed with an abusive parent than it is for them to face living with a parent who has no recourse to public funds. That is shocking.
Project 17’s report “Not Seen, Not Heard: Children’s Experiences of the Hostile Environment” contains multiple accounts of local authorities who refuse support to destitute families because their parents—generally, mothers —have a pending immigration application. Decisions such as those prevent survivors of abuse from seeking help from local councils, in effect removing their access to that vital support. As a result of Government cuts over the last 10 years, our councils’ social services are under huge strain, but social services must never use a family’s immigration status as a way of gatekeeping and preventing them from getting the help they need to escape. What will the Government do to prevent this appalling situation, and ensure that local authorities properly recognise their duty towards all children, regardless of immigration status?
We are debating the abuse of children. All children must be protected from abuse, under all circumstances. No ifs, no buts. The uncomfortable truth is that they cannot be protected properly while that support is dependent on the immigration status of a child’s parents. I hope the Minister will agree that we cannot have a two-tier system when it comes to child abuse; there can be no hierarchy of protection. For children and parents living in an abusive relationship, all barriers to receiving support and escaping their abusers must be removed. It is therefore vital that the Domestic Abuse Bill ensures that every migrant survivor of domestic abuse has access to public funds.
I hope the Government will look again at families with no recourse to public funds, and ensure that every child has full access to the support needed to escape abuse. It is time to recognise all survivors of domestic abuse, regardless of age, immigration status or entitlement to support. I hope that today’s debate can be a step towards that.
Carolyn Harris (Swansea East) (Lab)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing this important debate and on her wonderful advocacy of her constituent Christine.
It is welcome news that the Domestic Abuse Bill has returned to the House. As the Bill has only been published in the last couple of hours, I have not had a chance to familiarise myself with all of the changes, but it is up to us all to ensure that the Bill is robust, makes rapid progress through Parliament and that the new legislation is in place to protect victims as soon as possible. That includes the sometimes hidden victims of domestic abuse —the children. Some children may be living in homes where they are victims of physical, emotional or even sexual violence. For others, the psychological effects of seeing a parent suffering abuse can be just as damaging. All children who experience domestic abuse, be it as a victim or as a witness, must have protected places on all NHS waiting lists, including for mental health services. Likewise, they should be given priority access to school places if required, to give them parity with looked-after children. We must ensure that child victims of domestic abuse, who already face huge upheaval in their lives, do not experience unnecessary additional disruption or trauma.
We must also look at the role of the family courts in domestic abuse cases. I am pleased that the new enhanced Bill includes a wider ban on cross-examination of victims, but I have heard too many first-hand accounts of incidents in which the courts have let down the children they should be there to protect—incidents in which the safety and wellbeing of young people is overshadowed by the rights of perpetrators. No one who is awaiting trial, on bail or facing ongoing criminal proceedings for domestic abuse-related offences should be permitted unsupervised contact with their children. Family courts need to be accountable for prioritising the physical safety and emotional wellbeing of all the vulnerable young people they are there to protect.
We must also consider children in families with no recourse to public funds. There has been much discussion about migrant women with insecure immigration status, who struggle to find protection from domestic abuse. I understand that the Government have begun a review of what support can be provided, but those women and their children need urgent action. In addition, teenagers in abusive relationships all too often are not considered to be victims of domestic abuse, but they are.
We must never lose sight of how big an impact domestic abuse can have on children, both at the time of the experience and in the future. Although physical injuries may heal, the emotional and psychological effects of being a victim or a witness last a lifetime. I welcome the introduction of the Bill and eagerly await details of its Second Reading and Committee stage. The Bill is long overdue; we must not delay any longer. Protection for those affected by domestic abuse desperately needs to be brought into legislation. Survivors want to see it happen, victims need to see it happen, and the innocent, vulnerable children who are caught up in it all deserve to see it happen.
Mr Philip Hollobone (in the Chair)
The Minister has oodles of time to respond, but if she brings her remarks to a conclusion by 5.27 pm, that will give Liz Twist time to sum up the debate.
The Parliamentary Under-Secretary of State for the Home Department (Victoria Atkins)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Blaydon (Liz Twist) on securing this important debate about a subject that we all clearly care so much about. May I congratulate her on her timing as well? As she said, the Bill is back today.
I am delighted that my very first act as the Minister leading the Bill through the House is to respond to this incredibly important debate about the impact of domestic abuse on the lives of children, not just in the immediate term but in the much longer term. The hon. Lady articulated that extremely well with the example of her constituent Christine, who set out not just the impact on her own life but the long-term impact on the life of her daughter, who is now over the age of 18. I hope that everyone watching the debate realises that we all genuinely understand the impact that domestic abuse can have.
I am extremely grateful to the hon. Member for Strangford (Jim Shannon), who, as always, brought the perspective of a vital part of our United Kingdom to the Chamber. He made the point that domestic abuse affects many families in Northern Ireland. I hope he is pleased that we were able to remove from the latest iteration of the Bill the sections we were going to include to ensure that legislation is passed in Northern Ireland. Of course, we were able to do that because the Northern Ireland Executive is back. We have confirmation that the Executive intend to legislate on this important subject locally, which is as it should be. I am delighted by that development.
As was set out, we know that as many as one in five children in the UK are witness to or exposed to this awful crime type in their households. We know too that domestic abuse has a devastating impact on young people. Growing up in a household of fear and intimidation can have serious, long-lasting effects on the health, wellbeing and development of a young person. We know that children exposed to domestic abuse are more likely to experience mental health difficulties, to be excluded from school and to become victims of domestic abuse later in life. I do not for a moment say that is the life outcome of every child—of course it is not—but we must pay attention to the statistics and to the trends that we see in them.
The hon. Member for Blaydon rightly challenged the Government on why the definition has been set at the age of 16 and above. As I hope I have been clear when speaking about previous iterations of the Bill, that is something we have grappled with. In 2012, following a consultation, the cross-Government definition of domestic abuse was amended to include 16 and 17-year-olds, with the aim of increasing awareness of young people’s experience of domestic abuse. Indeed, there was strong support for maintaining that age limit in responses to the domestic abuse consultation we held in 2018, which was part of the foundations of the Bill.
The concern is that lowering the age limit below 16 risks blurring the line between child abuse and domestic abuse between adults. Abuse perpetrated by an adult towards someone under 16 is classified as child abuse. We argue that the distinction needs to be maintained because, as colleagues will know, many interactions with social services and so on may flow from that definition.
We note that the Joint Committee on the Draft Domestic Abuse Bill, which scrutinised the draft Bill in huge detail and heard evidence from many witnesses, concluded that an age limit of 16 is the right one, but we are absolutely clear that the impact of domestic abuse on young people needs to be recognised properly, and that we must ensure that the agencies are aware of it and know how to identify and respond to it.
Jess Phillips
Are we therefore to assume that any child under 16 who suffered as a victim of domestic abuse, either directly or indirectly, would meet the threshold for child abuse and therefore should be reported to children’s social care immediately by all the authorities that we would expect to report that? For example, should every schoolteacher who hears about something like that report it as child abuse? If so, what will the Government put in place to ensure that children’s social care can deal with that?
Victoria Atkins
The hon. Lady will appreciate that I cannot give a broad-brush answer for each and every case; clearly, every case must be treated on its facts. However, the definition of harm in the Children Act 1989—again, the Joint Committee looked at that very carefully—includes
“forms of ill-treatment which are not physical”
as well as
“impairment suffered from seeing or hearing the ill-treatment of another”.
We are therefore clear that the definition of harm in the 1989 Act includes witnessing and experiencing coercive control. From that, we concluded that the most effective way of trying to act on the Committee’s recommendation with regard to that definition is to amend the Department for Education’s statutory guidance, “Working together to safeguard children”. I hope that helps to clarify the point.
We are also clear that the impact of domestic abuse includes the impact on children living in households where abuse is conducted, teenage relationship abuse—the hon. Member for Newport East (Jessica Morden) mentioned that—and abuse directed towards siblings and parents, which is perhaps one of the most hidden forms of abuse in a crime already typified by concealment and hiding.
We are seeking to address the very real points and concerns raised by Members and, indeed, others outside this House in a number of ways. First and foremost, the statutory guidance, which will sit alongside the definition in the Act—when it is passed, I hope—will specifically address the adverse impact of abuse on children. We are working closely with key charities such as Barnardo’s, Action for Children and the Children’s Society as well as the domestic abuse commissioner—the commissioner designate, I should say—the Children’s Commissioner and many others to ensure that the guidance makes the impact on children clear.
To answer the question from the hon. Member for Blaydon, we will publish a draft version of the statutory guidance ahead of the Commons Committee stage to assist in scrutiny of the Bill. I genuinely encourage hon. Members and their networks of experts and survivors to consider that draft guidance and feed back to us on it, because we want to get it right.
Importantly, the Bill as introduced today includes a new statutory duty that will require tier 1 local authorities in England to provide support to domestic abuse victims and their children in refuges and other safe accommodation. That will result in the right level of tailored support for victims and their children across the country at the time of need, with improved recovery rates and the release of bed spaces as people rebuild their lives more quickly. We will ensure that local authorities receive appropriate financial support to meet the proposed duty.
Kate Osamor
Will the Minister expand slightly on the authority that the Government will be giving to local authorities? Will that include mothers who have no recourse to public funds but are experiencing domestic violence?
Victoria Atkins
The hon. Lady knows that there is already provision under the domestic violence concession in some circumstances. I am pleased that she raised migrant women, because, as I hope she knows, alongside our introduction of the Bill the Government published today our further response to the Joint Committee’s recommendations, and in that we set out our response to this particularly difficult situation. She will understand the complexity involved. At the moment, I am afraid, we are still reviewing the consultation responses, but we have said that we will set out our conclusions before Report stage in this House.
One of the key functions of the domestic abuse commissioner will be to encourage good practice in the identification of children affected by domestic abuse as well as the provision of protection and support to people, including children, affected by domestic abuse. Under the terms of the commissioner’s appointment, they are required to have a thematic lead in the heart of their office to represent the interests of children. We are working with the commissioner to address some of the important points raised on community-based services and how those can be provided better across the country.
In terms of helping children above and beyond the law, the statutory guidance and so on, legislation can achieve so much, but much more needs to be done to address the impact on children. That is why in 2018 we launched the £8 million fund for children affected by domestic abuse, which funds projects that support children experiencing domestic abuse at home, focused on early intervention and reducing the impact of domestic abuse on children’s physical and mental wellbeing. Those projects are making a difference. We see those services really helping children and young people across England and Wales, supporting them through innovative practices and therapy.
The hon. Member for Birmingham, Yardley (Jess Phillips) rightly raised the issue of schools. She will know of Operation Encompass, and we are funding the national roll-out of this fantastic project, which gives the police a set of simple procedures to enable them to communicate quickly and effectively with schools in relation to any pupils who may have been exposed to domestic abuse the night preceding the start of the school day. We all know examples of where the project has had a real impact. It will help schools provide timely and effective help to the pupils involved. Whereas children’s social care intervenes only in the most serious cases, Operation Encompass enables every child to receive support, regardless of whether an incident is recorded as a crime. We have also provided £220,000 to develop and pilot a training programme for children and family social workers to improve awareness of coercive control, indicators of domestic abuse, and how best to support families.
Many Members have raised the impact and role of the family courts, not just in today’s debate but in more general discussions. That is a critical part of our addressing this hidden crime. The welfare of the child is the family court’s paramount concern when making any decision about their upbringing, including with whom the child is to live or spend time. The law is clear that the presumption in favour of contact with each parent will apply unless there is evidence to the contrary, such as in cases that may involve domestic abuse. We have revised a practice direction to set out procedure for the courts to follow when dealing with applications for child arrangement orders where domestic abuse is alleged, which makes it clear that the presumption of contact can be explicitly displaced—
Victoria Atkins
I am so sorry; I have about 30 seconds left.
We have an expert panel to gather evidence to better understand how the family courts are responding, because we understand the concerns that hon. Members and survivors have expressed. The panel is working through a body of evidence and we expect its findings and recommendations for next steps to be published this spring.
I thank the hon. Member for Blaydon again for raising the issues in this debate as well as all people not just in this place but outside who are working so hard to support the victims and survivors of domestic abuse, including children. We are committed to getting this Bill right. With their help, we can.
Liz Twist
I thank all hon. Members who took part by speaking or intervening in the debate. There is much shared concern from everyone who raised an issue. The hon. Member for Strangford (Jim Shannon) referred to children as the forgotten victims of domestic abuse. The purpose of the debate is to ensure that they are not forgotten but properly cared for.
My hon. Friend the Member for Birmingham, Yardley (Jess Phillips) talked about the support that is available. If there is patchy support in Birmingham, she said, how is it in Blaydon? We see very mixed provision across the country and it is important that we get that right. She also talked about access by perpetrators of domestic abuse to children and about the Home Office pilots. We all think these services need secure funding, not funding based on a bidding process and who writes the best paper. My hon. Friend the Member for Edmonton (Kate Osamor) explained clearly the issues faced by migrant women and those with no recourse to public funds.
In the minute and a half left to me, I want to recapitulate some of the asks. We talked about revising the definition to include children, and I heard the Minister’s statement and explanation about how she had grappled with the definition. I say to her: please grapple some more, because this is a really important issue. Many organisations representing the interests of children are supportive of that move. The other big ask was to ensure that support services, whether accommodation-based or community-based, are available to all children so that they get what they need. This is not just a failure of financing; it is a failure to look after the most vulnerable children who face difficult situations. I ask her to look at that.
The Minister asked us to look at the guidelines and to provide feedback, and I have no doubt that many people and organisations will do that. I thank her for her comments and ask her to look again at those key asks to look after children.
Question put and agreed to.
Resolved,
That this House has considered children and domestic abuse.