Early Childhood Development

Barry Sheerman Excerpts

Thursday 30th January 2014 Westminster Hall

[Damian Hinds]

Clearly, there is a link—a range of studies suggest different ways in which that link manifests itself—and I do not think that any commentator argues about its existence, but there is nothing inevitable about that; it ought to be possible to equalise children’s life chances. Of course, there are examples of both brilliant and awful parenting in every income bracket. Children’s development is no respecter of the home they happen to have been born into. As the right hon. Member for Birkenhead (Mr Field) says,

“it is primarily parents who shape their children’s outcomes—a healthy pregnancy, good mental health, the way that they parent and whether the home environment is educational”.

As he and many others say, what parents do is much more important than who they are.

Home life is difficult territory for the state. I suggest that we need to think harder about how to communicate what is known about successful, positive ways to parent—a quite substantial body of evidence—in a way that does not come across as, and in fact is not, telling people how to bring up their children.

Geography, as well as income group, reveals other interesting differences in early child development. There is a particular difference in London. When people are told this, they assume that child development is worse in London than elsewhere, because of all the issues in a big city like this. However, that is not so. There was another report last week about the different school results of children growing up in London, versus those growing up elsewhere. That is often attributed to the London Challenge, which started in 2003. There are a number of reasons to believe that the London Challenge was not the sole or primary cause of those improvements. One reason to disbelieve that is that the difference in attainment scores for disadvantaged children is apparent way before they get to secondary school; in fact, it is apparent even in pre-school assessments: on average, disadvantaged children in London seem to do about 20% better on the “good level of development” scale than disadvantaged children in the rest of the country. A bunch of things are different about London children and families.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Excuse my missing the beginning of the hon. Gentleman’s speech, Mr Weir. As someone who was involved in the London Challenge, I should like to know what the relationship is. I am not clear about that. If it was not the London Challenge, what made the difference?

[Damian Hinds]

The hon. Gentleman asks a big question. I do not want to test your patience, Mr Weir, by debating the London Challenge, rather than early child development. I will talk in a minute about societal differences that may or may not be driving factors. The honest answer is that we do not know, but there are reasons to disbelieve that the simple explanation for London’s improvement is the London Challenge. First, the differences are apparent long before children reach secondary school, and the hon. Gentleman will recall that it only started in 2003. Secondly, when translated from London to the black country and Manchester, there were not the same results. Thirdly, so many other things that are different about London are worth looking into.

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[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I commend and congratulate the hon. Member for South Northamptonshire (Andrea Leadsom) on securing this debate. I also congratulate the hon. Member for Brighton, Pavilion (Caroline Lucas), my right hon. Friend the Member for Birkenhead (Mr Field) and the right hon. Member for Sutton and Cheam (Paul Burstow) on their work in developing this manifesto and promoting the ideas within it. This debate has been constructive and well-informed. Many excellent points have been made that will resonate strongly with those on both sides of this Chamber.

When the first national health service hospital opened its doors in 1948, it was conceived as part of an all-encompassing system of social security, supporting everyone in our society from cradle to grave. Only in recent years, more than 60 years on, have we have come to understand just how much that short time in the cradle—those very first few months—can ultimately decide how long, healthy and happy a life a newborn baby will enjoy.

We must do everything we can to give all babies born in Britain today the best possible start in life. That was underlined earlier this week in an open letter to The Times from 23 of the UK’s leading child health experts. They warned that, for the first time since the Victorian age, it is predicted that living standards for children will be lower than for their parents and that child mortality is still stubbornly higher in Britain than in other western European countries. They called for a greater focus on younger generations. We have heard some powerful and encouraging contributions to that debate today; I want to build on what other hon. Members have said and focus on some of the challenges that we must address. I want to focus on early intervention, maternal support and care, and general help for all mums and dads. That is by no means a comprehensive list of what I would like to cover, but it is most fitting for the debate.

All hon. Members who spoke referred to the importance of early intervention. The maxim that prevention is better than cure is one of the most enduring in public health. As the “The 1001 Critical Days” manifesto details, more than a quarter of all babies in the UK are estimated to be living in complex family situations that present heightened risks to their well-being. The sad reality is that babies are far more likely to suffer from abuse and neglect, and up to seven times more likely to die in distressing circumstances, than older children.

We have a duty to reach out to families in difficult circumstances and to maximise opportunities for them to access support. Not only is it the right thing to do, but it is the best thing for the public purse. According to the Royal College of Paediatrics and Child Health, there is increasing evidence to show that spending on early-years intervention can yield a return on investment as high as 6% to 10%. If it is done in the right way, early intervention can save money, save lives and improve the well-being of parents and children.

An example is the pioneering work by Manchester city council and its partners. They have created a scheme in which midwives, outreach workers and health visitors work together to identify at the earliest opportunity the families most in need. It is an inspiring project, with which my hon. Friend the Member for Manchester Central (Lucy Powell), the shadow Minister with responsibility for children and child care, has been closely associated. We heard from the hon. Member for South Northamptonshire about how the programme is making a difference when it comes to registering a child’s birth.

Under the scheme, every new mother is visited eight times from about 12 weeks before the birth of their child until just before the child’s fifth birthday. Crucially, all the professionals who are supporting those mothers hold joint fortnightly meetings and can let each other know if a parent needs additional help. Their work is integrated and intelligence is shared between organisations —a very strong theme in the “The 1001 Critical Days” manifesto. It is a world away from some of the haphazard experiences of the past. Hon. Members may have heard the anecdote about how health visitors in the past would wait by the nappy aisle in supermarkets to identify expectant mothers; we must do more to encourage close working and data-sharing, so that that is no longer necessary.

[Mr Sheerman]

I totally support the work of the 1,001 group. All the work done—certainly during my chairmanship of the Select Committee on Children, Schools and Families—indicates that early intervention is vital. It is also vital that such intervention is regular, persistent and delivered by highly skilled, well-trained people. The problem is that that is expensive.

[Luciana Berger]

My hon. Friend makes knowledgeable points that, given his experience on the Children, Schools and Families Committee, he is well placed to make. The example that I shared with the House—this is separate from the 1,001 days manifesto—shows that there are many activities going on around the country to address some of the issues, but the challenge is that the activity is not happening everywhere. We need to lead from best-case examples, which is why data sharing is so vital to make a difference. Will the Minister comment on what steps the Government are taking to encourage these activities to happen throughout the country?

I am also keen for the Minister to address the point made by my hon. Friend the Member for Rotherham (Sarah Champion), who is no longer in her place. She mentioned the early intervention grant, which has funded many of the programmes that we are discussing. When the fund was first introduced, it totalled nearly £3 billion, but by 2015 it will have almost halved to around £1.5 billion. We have had contributions this afternoon about Sure Start centres, many of which have relied on the funding of the early intervention grant, and it is a blow that 576 such centres have had to close their doors since the last election. The hon. Member for East Hampshire (Damian Hinds) commented that he did not know what Sure Start was for—

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[Luciana Berger]

I thank the hon. Gentleman for his clarification. I apologise if I misrepresented his words.

[Mr Sheerman]

I, too, found that fascinating. When we first started looking at Sure Start children’s centres, they were concentrated in the 500 wards with the greatest poverty. We soon realised that more families in poverty were outside those 500, so we had to change the policy totally.

[Luciana Berger]

The point that I wanted to make about Sure Start, as a result of what has been said by both Government and Opposition Members, is that it is widely acknowledged that the centres have made a real difference to families. I have Sure Start centres in my constituency; Liverpool city council has gone out of its way to do everything possible to keep all centres throughout the city open—it has had to remodel and look at a hub-and-spokes model, given that we will have experienced cuts of 54% by 2016-17—all because of the centres’ importance to communities.

In one of the most deprived wards in my constituency, the Sure Start centre is giving vital support to parents in the most deprived households. It is providing meal packets for £1—fresh food with recipes—to encourage parents to cook for their children. That is making a real difference to those children’s nutrition, in particular in their early years. In another, more affluent, part of my constituency, the children’s centre is tailoring its services to the need in that area, because this ward has a high incidence of multiple births. That Sure Start centre is providing a vital support service for mothers who have twins and triplets—for parents contending with the challenges presented by a multiple birth.

Those centres are making a real difference in my constituency. Their staff—including Liz Parsons, a manager in the Picton Sure Start centre, to name just one person—provide vital hands-on support to parents, often first-time parents or parents with lots of children. The centres provide support, including parenting support, to many families in my constituency.

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[Luciana Berger]

I thank the hon. Lady for her intervention. I will now seek to conclude.

[Mr Sheerman]

My hon. Friend briefly alluded to smoking and children’s exposure to smoking in cars. There was good news this morning from the Government: there will be a free vote on the issue. Back in the mists of time, my very first private Member’s Bill was on banning children from being carried unrestrained in cars. There was a tremendous backlash against that Bill in certain parts of the House; people said that it breached human and individual rights. We won that battle, and I hope that we can win the next one. It is wrong that a child, who has no choice, has to go in a smoky environment and breathe in dreadful fumes that can affect their health for the rest of their life.

[Luciana Berger]

My hon. Friend’s intervention has given me the opportunity to expand on this serious political issue, with which we are engaging in the House at the moment. He rightly points out the opposition there was to rules on wearing seat belts. The discussions on that issue are relevant to our discussions about banning smoking in cars when children are present. When we had no rules on wearing seat belts, only 25% of the population wore one; since the introduction of the rules, more than 90% of the population wear a seat belt, and that has made a massive contribution to safe car travel.

It is worth noting that there is overwhelming public support for banning smoking in cars when children are present. Around 80% of the public think that we should deal with the issue, and it will be interesting to see what happens in the vote. It is also worth putting on record that when there was a vote on a private Member’s Bill on the issue in 2011, 22 MPs from the coalition supported it, including a current Health Minister. I welcome the free vote, and I hope that we are successful when the proposal comes before the House on, I believe, 10 February.

To conclude, a broad, holistic approach will ultimately make the difference for children, and for future generations.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 14th January 2014 Commons Chamber

[Jane Ellison]

NICE has issued technology appraisal guidance to the NHS on the use of newer anticoagulants—I think there were three in 2012—for the treatment of atrial fibrillation. NHS commissioners are legally required to fund treatments recommended by NICE in its technology appraisal guidance.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Mr Speaker, there is a crisis here. The fact is that half of those who suffer from AF—as a member of my family does—do not know they are suffering from it and are not diagnosed. If they are not diagnosed, that leads to great expense to the health service because they are very prone to having a stroke. Even when doctors know about AF, they say inappropriately, “Have an aspirin as part of your medication.” Some 25% of doctors recommend aspirin, and that is very dangerous. When will the Minister wake up? AF is a dangerous condition and it is very expensive.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

We are in close touch with all the devolved Administrations about the changes that we are making in the NHS in England, and, interestingly, we are experiencing different levels of engagement. We have had very good discussions with the Northern Ireland Health Minister about some of the changes, but those in Wales are still refusing to commission a Keogh report on excess deaths, which I think shows that Labour in Wales has not learnt the lessons of transparency.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

3. What steps he is taking to train and retain more accident and emergency health specialists in the UK.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I have asked Health Education England to consider how we can improve the structure and skill mix of the emergency medicine work force to deal with long-standing shortages in staff at both consultant and trainee levels. Along with the Emergency Medicine Taskforce, we are considering a number of options, such as increasing the non-doctor work force and the number of emergency nurse practitioners.

[Mr Sheerman]

Just what is going on in medical education in this country? We train doctors, but some never work as doctors, and others move abroad. Calderdale and Huddersfield NHS Foundation Trust has advertised and advertised again, but it cannot recruit accident and emergency staff. It certainly cannot recruit any who have been trained in this country, or who have been trained in paediatrics. What is going wrong with medical education here?

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 16th July 2013 Commons Chamber

[Anna Soubry]

What I can say is that it will be centrally funded, but as to the other detail in the hon. Lady’s question, I will have to write to her with those answers. As ever, my door is open and I am more than happy to meet her to discuss it further.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

13. What plans he has to increase the management capability of doctors elected to clinical commissioning groups.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Clinical commissioning groups have the freedom and autonomy to determine the skills and expertise needed to enable them to deliver improved outcomes for their local communities, and NHS England is developing an assurance framework to ensure that they all have the capacity and capability to do that.

[Mr Sheerman]

Is the Secretary of State aware that a number of doctors, certainly the ones I have talked to, are deeply concerned about the inadequacy of their management capabilities to run these complex organisations? Is he worried that many of them are saying that they have to turn to private health care people to back them up and give them advice? Is that healthy in the NHS?

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 11th June 2013 Commons Chamber

[Dr Poulter]

I would be delighted to visit my hon. Friend’s constituency. He has been a tremendous advocate for maternity services, both nationally and in his constituency, in his time in the House. As I am sure that he has realised, if we want a genuinely personalised maternity service, we need to ask women about their experiences of care. That is why the Government are introducing a friends and family test in maternity from October this year.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister knows full well that post-natal depression is the thing that is most likely to kill a healthy young woman, and we know how to deal with it, but in many areas across the country we are cutting the number of visits from midwives after births, and the support given. We know how to tackle post-natal depression. Why should it be that in some parts of the country the support is wonderful, and in others, it is non-existent?

[Dr Poulter]

The hon. Gentleman is absolutely right to highlight that there has, in the past, sometimes been unacceptable variation in the quality of post-natal care. That is why we are increasing the number of midwives and have done so by nearly 1,400, and why we are putting money and effort into increasing the number of health visitors, who play a vital role in supporting mums, babies and families in securing that important bond, and in supporting mums so that they get the right help when they suffer from post-natal depression.

Heart Surgery (Leeds)

Barry Sheerman Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

That is exactly the purpose of a review. Let me reassure my hon. Friend that before I make any decision, I will be getting on my desk independent advice from the Independent Reconfiguration Panel. One thing that that advice does is weigh up the balance of advantage between the greater distances that people have to travel and the advantages of specialisation for complex surgery. My heart goes out, as I know his does, to people who were made extremely worried by what happened over Easter at Leeds. However, he will also understand that if there are concerns, the last thing his constituents would want is an NHS that did nothing because of an argument about data. The right thing to do was to get to the bottom of the data, and I am sure that his constituents are as delighted as he and I are that surgery has now resumed.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

What does the Secretary of State think of the opinion of one of my constituents, who said to me over the weekend, “What a right old mess all this has been”? The fact is that it has been a mess. I have supported the all-party campaign on the basis that we go for the best clinically safe outcomes for all my constituents. My constituents have gone to Leeds general infirmary, as have my children. It is a hospital of great renown, in which the people of Yorkshire have tremendous faith, but in today’s statement the Secretary of State has two or three times put us in the same frame as Mid Staffordshire and Bristol. There is no question but that Leeds general infirmary is a fine institution. Will he put it on the record today that this is not the same sort of case? This is a fine hospital struggling to deliver under a cloud that has been over it for three or four years.

[Mr Hunt]

What I say to the hon. Gentleman is that it is a fine hospital and a safe hospital, but data were presented to the NHS medical director that said that mortality rates there for children’s heart surgery were two and three quarter times higher than should be expected. In that situation, there is of course a great deal of inconvenience and worry caused by a decision to suspend surgery, but I would rather have that inconvenience and worry than continue with surgery when we have not got to the bottom of whether there is any truth in those data. That must be the right thing to do for the people who are due to have operations at that hospital.

Backbench business

Barry Sheerman Excerpts

Thursday 14th February 2013 Westminster Hall

[Caroline Nokes]

My hon. Friend raises an important point. It is thought—I emphasise “thought”—that about 11% of sufferers are male, but interestingly, they are among the fastest-increasing groups.

The figures that I have given do not take into account the families of those who suffer, meaning that the social footprint of eating disorders is breathtaking. Be assured—to refer back to my hon. Friend’s point—that sufferers are by no means all teenage girls. That is one of several myths about eating disorders that need to be exposed.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

A constituent of mine, Cherie Hinchliffe, wrote to me saying how pleased she was that the hon. Lady was holding this debate. She wanted to say that eating disorders destroy families, and that GPs do not know enough about them. Doctors, dentists, local hospitals and schools do not know enough about them; the media know about them but report them in a terrible way. Does the hon. Lady agree?

[Caroline Nokes]

The hon. Gentleman is absolutely bang on. Many parents of sufferers have commented to me that they feel their GPs do not understand enough, and nor do schools and colleges. I will cover all the points that he raised later.

The fastest increase in eating disorders has been among young men. As well as facing the mental health problems typically associated with female sufferers, they are coming under more pressure than ever before to conform to a stereotype of the body beautiful. Imagery in magazines and advertising plays a significant role.

Of particular concern is the prevalence of eating disorders among gay and bisexual men, who are twice as likely to be sufferers as heterosexual men. I understand that eating disorders in gay and bisexual men are even more linked to concerns about body image than in heterosexual male or female sufferers. Although males account for only 11% of the total of those with eating disorders, the percentage is increasing, and we should be conscious of that. In the 10 years up to 2011, the number of hospital admissions for men suffering from an eating disorder rose by 67%. Furthermore, there is evidence that undiagnosed disorders are even more commonplace among men than among women. The scale of the hidden problem could be immense.

It is not only the young who are afflicted, although there is certainly a trend towards eating disorders manifesting at an earlier age than ever before. I was particularly moved by my contact with a woman whose daughter started suffering from anorexia nervosa at 10 years old but was not diagnosed for years, as her GP and other medical practitioners thought that she was too young to have the condition. Eating disorders are also being diagnosed much later; some sufferers present in their 50s and 60s, and there is evidence that increasing numbers of sufferers manage their conditions not just over the average of seven years, but for decades. An increasing number of people in their 30s and 40s have lived with their eating disorder for more than 20 years.

“Eating disorder” is a term used to describe a wide variety of conditions, some well known and others far less so. Obviously, the best known and most recognisable is anorexia nervosa, in which a sufferer intentionally deprives themselves of food and has a body weight at least 15% below the recommended minimum. People with anorexia have an extremely distorted view of their own body and a fear of gaining weight. However, anorexia is but one condition among several. Eating disorders also include bulimia, which in many cases is harder to detect, as sufferers may maintain a normal-looking weight. However, it is achieved through bingeing, purging and fasting, and like anorexia it can cause long-term damage.

From my research for this debate and my conversations with many sufferers of eating disorders, I have learned of many other conditions: binge eating; compulsive overeating; food neophobia, an extreme fear of trying new food; and compulsive over-exercising. A year ago, I met a young man who ran up to 30 miles every day. There is also selective eating: sufferers eat only an extremely limited range of foods.

Bulimia is a disorder linked closely to low self-esteem, emotional problems and stress. The sufferer may think constantly about calories, dieting and ways of getting rid of food that they have eaten. It is actually more common than anorexia, but it is more hidden, because people with bulimia usually maintain an average or just-above-average weight. Bulimia can go unnoticed for a long time while sufferers feel incredibly ill and unhappy.

Those with bulimia become involved in a cycle of eating large amounts of food and making themselves sick, cutting down or starving for a few days, or trying to find other ways to make up for the food that they have eaten. It can cause them to become so hungry that they eat large amounts of food because their bodies crave nourishment. Some people do not vomit, but instead take laxatives, which are especially dangerous. Just because bulimia does not cause the extreme weight loss of anorexia does not mean that it is less serious. Sufferers need help and support, as the side effects and consequences can be serious. I appreciate that I have given a very rapid description of some eating disorders, for which I apologise, but I am sure that other Members will wish to discuss some of them in more detail.

I do not wish to generalise, and I apologise if my next remark causes any offence, but in many instances, due to the extreme control with which sufferers approach their food consumption, eating disorders are a type of addiction. However, unlike addictions to alcohol or narcotics, a fixation with how one controls one’s calorie intake must be faced and addressed every day of a sufferer or recovered sufferer’s life. They cannot simply remove food from their lives in the way that others might develop strategies to avoid alcohol, for instance. They must eat to live. For sufferers, by necessity, that battle will occur three times a day for the rest of their lives.

Eating disorders are not trivial conditions. Anorexia kills about 20% of sufferers, and 40% never recover. It is the single biggest killer of all mental illnesses. It has been dismissed for too long as a problem of teenage girls who just need to get a grip on their eating patterns. That is far from the truth. Eating disorders are serious, potentially fatal, mental illnesses, which, even long after a sufferer has recovered, can have long-term implications for their health. The impact on fertility is well known, but there are many other serious implications. Abnormal heart rhythms are commonplace, even in teenagers with eating disorders. In fact, heart damage is the most common cause of hospitalisation for those suffering from eating disorders, but the kidneys and liver are also badly affected, and reduction in bone density leading to osteoporosis can happen in sufferers, even before there has been any physical manifestation of a problem.

As chair of the all-party group on body image, I have been privileged to work with a number of leading charities supporting those suffering from eating disorders and their families. I pay particular tribute, during eating disorders awareness week, to Beat; many of its members are in the Public Gallery. I also pay tribute to Anorexia and Bulimia Care and the Succeed Foundation. I vividly recall hearing the moving stories of ABC members at a reception hosted by my hon. Friend the Member for Wells a few months ago. These charities all do fantastic work with sufferers and their families, and to ensure that the wider community—Members of Parliament, the medical profession, schools, colleges and universities—have a better understanding of the signs of eating disorders, and how to help those in the grip of such a disorder and those who may be at risk. They also work with the media to ensure that they understand the importance of the portrayal of responsible images on advertising and in editorials.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes a very important point. I am concerned that 114 non-urgent operations were cancelled in the South Tees area between November and January, which is significantly higher than this time last year. He is right that we need to think about the model for an A and E service. Nearly 1 million more people go through A and E every year than they did two years ago. We have to recognise that for A and E services to be sustainable, we need to think about people who would better off seeing their GP or going to an urgent care centre.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Is the Minister aware that health care appointments are still bedevilled by the number of people who do not show up, even for appointments with consultants and senior hospital staff? Is it not about time that we looked at a simple system, in which people could pay up front a small amount of money that they get back when they turn up? I am sure that my constituents, as good Yorkshire people, would take their appointments much more seriously if they got their money back when they turned up?

[Mr Hunt]

I am interested to hear that suggestion from the Labour Benches, which is not necessarily where I would have expected it to come from. The hon. Gentleman might be surprised at my response, which is that I would be very concerned about such a system. I understand the issue and I think we need to modernise the process of GP and hospital appointments. Technology can play a good role in that, for example by giving people text reminders of appointments that they have booked. My concern is that the system suggested by the hon. Gentleman would put people off going to see their doctor if they needed to. I would not want to do anything that deterred people from using the NHS who most need to do so.

Winterbourne View

Barry Sheerman Excerpts

Monday 10th December 2012 Commons Chamber

[Norman Lamb]

I commend my right hon. Friend for the work he did on this subject. When I started this job, it struck me that there was an absence of effective corporate accountability in the law and that that had to be addressed. I was determined to ensure that the Government response addressed that issue head on. In doing that, we need to look both at the regulatory framework—issues such as whether there could be a fit-and-proper persons test for those on the boards of companies—and at the criminal law. It is striking that in the Winterbourne View case the authorities determined that it was not possible, under existing law, to bring prosecutions. I am absolutely clear, however, that responsibility rests at the top of the company for facilitating this sort of outrage. That is why the law needs to change. We need to look both at criminal offences and the regulatory framework.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

May I press the Minister on one aspect? Will he look much more closely at the role of the third sector, particularly charities, in providing services? Hollybank school and community in Mirfield in west Yorkshire, close to my constituency, does a brilliant job. Does he recognise that, in considering the report, it is the quality of management that one worries about and the fact that the most vulnerable people in our society are so often looked after by poorly trained people on the minimum wage working 12-hour shifts? That is often at the heart of the problem.

[Norman Lamb]

I thank the hon. Gentleman for that question and completely agree that we have to address the issue of skills. It is worth pointing out that there are some fantastic providers in the voluntary sector, and in the private sector as well. We should applaud that and recognise that there are many well trained people on low wages providing a fantastic quality of care, but there are also places where that is not the case. That needs to be addressed.

I absolutely agree with the hon. Gentleman that we should look closely at the voluntary or not-for-profit sector. I had a meeting recently with the head of Shared Lives, an organisation that places people with learning disabilities into people’s homes. Surprise, surprise—when people are treated with dignity and treated as human beings, their behaviour improves and sometimes all the complex problems subside. There is an awful lot we can do. In the new year I will bring together the providers of the best care available so that we can learn the lessons from them.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 27th November 2012 Commons Chamber

[Mr Jeremy Hunt]

I can announce that we have already put in place such funds, because dementia is one of the biggest challenges we face across the entire health and social care system. We need more capital funds, but we also need massively to increase the shockingly low diagnosis rates. At the moment, only 42% of the 800,000 people with dementia are being diagnosed properly and therefore getting the treatment they need.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Is the Secretary of State worried about the high level of qualified managers leaving the NHS—fleeing the NHS—to go to other places or retire early when there are few people in clinical commissioning groups with any management experience at all?

[Mr Hunt]

There is always a role for excellent managers in the NHS, but this Government’s priority is front-line clinicians, which is why the number of doctors has increased by 5,000 since we have been in power and why administration costs have been cut, which will save the NHS £1.5 billion every year.