Tobacco Products (Standardised Packaging)

Fiona Bruce Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

The hon. Gentleman mentions illicit trade. As I have said a number of times, it is addressed in the report, but there will be other opportunities to discuss that. I also draw the House’s attention to the fact that stopping illicit tobacco coming into the country is the job of Her Majesty’s Revenue and Customs. It has had great success in that regard over recent years. With regard to the hon. Gentleman’s point about jobs, we will publish a full impact assessment alongside draft regulations at the same time as the final consultation. Jobs will be one of the issues in that impact assessment.

[Fiona Bruce (Congleton) (Con)]

I strongly support the Minister’s statement and proposals. Does she agree that if 4,000 children a year can be discouraged from taking up smoking there will be a double public health win—not only better health outcomes for those 4,000, but the release of funds for the health treatment of others in their generation for illnesses and disease? Those funds would otherwise have to be used, in time, to treat many of those 4,000 for smoking-related diseases.

[Jane Ellison]

I thank my hon. Friend for those comments. She is absolutely right to draw the House’s attention to the fact that the extent to which we can bear down on smoking and stop people taking it up the first place has a major impact on the sustainability of our health services and will, as she says, free up more resources to be spent on other things. It is a very important health priority. She is also right to allude to the impact of, for example, 4,000 children not taking up smoking. Even a modest impact on a major killer is really important.

Mitochondrial Transfer (Three-Parent Children)

Fiona Bruce Excerpts

Wednesday 12th March 2014 Westminster Hall

[Jacob Rees-Mogg]

I certainly think that this matter ought to come to the Floor of the House. I understand from an earlier debate that the Government are committed to full parliamentary scrutiny, but no doubt the Minister will confirm that.

To continue on PNT, at the one-cell stage the donor embryo pronuclei containing the nuclear genes are removed, killing that embryo. The partially gutted donor embryo with its healthy mitochondria is then used to form a new embryo when the pronuclei harvested from the commissioning woman’s embryo are inserted. Harvesting the pronuclei from the commissioning woman’s embryo kills that embryo.

It is important to understand that the techniques are non-therapeutic. They are in no sense a cure for children who are already born, nor do they pretend to be. Rather, the techniques create new people with altered genetic composition—genetically designed individuals who will not inherit mitochondrial disease. Although the mitochondrial DNA is around only 0.1% of a person’s total DNA, a little leaven leavens all the bread, and a different person is thereby created.

The proposed techniques all promote germ-line genetic modification. That is an infinite change that will lead to all the descendants of someone treated in this way being changed, the consequence of which cannot be known.

[Fiona Bruce (Congleton) (Con)]

I thank my hon. Friend for raising this critical subject. Techniques for mitochondrial transfer deliberately create a child who has three genetic ancestors, or, in the case of PNT, four. Is that not extremely concerning, raising as it does serious issues of personal identity for those born through the technique, particularly since Government guidelines propose that such individuals will not be allowed to know the identity of their third or forth parent? Will that not then transfer into future generations, too?

[Jacob Rees-Mogg]

I was going to come on to that. As an aside, the reason we were able to determine that Richard III’s body was his was through the female line, and because we could establish the continuity of the DNA. I do not believe Government promises of secrecy. They promised that to sperm donors historically. Governments cannot be relied upon, because society becomes more open and so demands greater openness. I have no doubt that if the technique is ultimately used the donors will be identified and people with three or potentially four parents will find out.

Oral Answers to Questions

Fiona Bruce Excerpts

Tuesday 25th February 2014 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

15. When he plans to publish his Department’s new guidelines on sex-selective abortion.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The Government will publish more detailed guidance on compliance with the Abortion Act 1967 shortly. That will include guidance on sex-selection abortions and restate our view that abortion on the grounds of gender alone is unlawful.

[Fiona Bruce]

Britain’s biggest abortion provider, the British Pregnancy Advisory Service, has advice on its website claiming that the law is “silent on the matter” of gender-selective abortion. In a leaflet, it actually states that it is not illegal. How does the Minister propose to address that, and to send out the clear message that strong legal action will be taken against anyone who is involved in that wholly unacceptable practice?

[Jane Ellison]

Although the Abortion Act does not mention gender specifically, the Government are clear that abortion on the grounds of gender alone does not meet the criteria set out in the Act. If evidence comes to light that doctors or organisations are sanctioning abortions for that reason alone, we will refer it to the police.

Early Childhood Development

Fiona Bruce Excerpts

Thursday 30th January 2014 Westminster Hall

[Andrea Leadsom]

Yes, Home-Start does a fantastic job, as do other volunteer organisations, peer-support groups and so on; there are many around the country. It is true to say that becoming a parent is the most difficult thing that someone ever does. There is no on-off button for a baby and no rule book, guidebook or handbook, so we all struggle on in our own way, with better or worser results—[Interruption.] Probably not “worser”—worse, thank you. The Secretary of State for Education is not responding to the debate, so we are all right, but the point is about being a good enough parent, and if a baby knows that he or she is loved, a parent does not have to say it at 3 o’clock in the morning when they are at their wits’ end. However, a baby does have to learn that their parent loves them.

When a baby does not receive attention from a loving adult carer, the pre-frontal cortex does not grow and may never grow. Many will remember the tragic story of the Romanian orphanages, where the minimal physical and emotional contact with babies left them profoundly and permanently brain-damaged. Some of them died literally from a lack of love.

It ought to be natural and automatic for families to form a loving and secure bond with their babies, but post-natal depression, problems with conception, trauma during childbirth, domestic violence and issues of poverty and deprivation all get in the way. Insecure attachment is no respecter of social class or wealth. One of the biggest obstacles to forming that crucial secure bond is when mum did not have a secure relationship with her own mother. As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) pointed out, it truly is a cycle of deprivation that is all too often passed down through generations.

[Fiona Bruce (Congleton) (Con)]

I thank my hon. Friend for securing the debate and for the passion that she has for the issue. Does she agree that a strong relationship between the child’s parents is critical? On the tragic costs of family breakdown within the country, she cited some statistics, but another is that £46 billion is the cost of social breakdown. Does she agree that, given that three different Departments have already been mentioned in the debate—the Ministry of Justice, the Department of Health and the Department for Education, and I could add the Department for Communities and Local Government, because we have health and well-being boards—we need to look at having a team responsible in a Government Department, with a lead Minister who will give the issue priority on a daily basis?

[Andrea Leadsom]

My hon. Friend is a passionate advocate for support for relationships, and she is absolutely right that the best results for babies and young children come when they have two parents who love each other. There is no question about that. All the statistics back that up, so she is absolutely right; we ought to prioritise the essential importance of helping families to stay together.

The brain development of babies has deep implications for society. A human being without a properly developed social brain finds it very difficult to properly empathise with other human beings. That can pose risks along a spectrum, from a general lack of emotional resilience, leading to depression or general unhappiness, to antisocial behaviour, drug-taking, criminality and, at the most extreme end, psychotic behaviour.

The charity Railway Children estimates that there are up to 100,000 children at risk on the streets in the UK every year. Research shows that more than 80% of long-term prison inmates have attachment problems that stem from babyhood. Evidence now suggests that two thirds of future chronic criminals can be predicted by the behaviour seen in two-year-olds. A New Zealand study showed that a child with substantial antisocial behaviour aged seven would have a 22-fold increased chance of criminality by the age of 26. Statistics issued by the Office for National Statistics show that almost 80,000 children and young people suffer from severe depression, and that 95% of imprisoned young offenders have a mental health disorder.

There is also a very real financial cost to society: each looked-after child costs the taxpayer about £347 a day, each adult prison inmate costs the taxpayer about £112 a day and each person in acute psychiatric in-patient care costs the taxpayer £225 a day. Analysis of spending in local authorities shows that that cannot go on for much longer. The wonderfully named “Barnet graph of doom” shows that on current trends, spending on children’s services and adult statutory services alone will outstrip the income of the local authority of Barnet by 2025. That means the council will have nothing to spend on other important services such as refuse collections, potholes, or parks and leisure facilities.

A pretty shocking statistic is that research suggests that in Britain, 40% of children are not securely attached by the age of five. Of course, that does not mean that they will all go on to have behavioural or relationship problems, because other life events will play a part, but it does mean that they will be less robust in their emotional make-up to meet the challenges and disappointments of life. It also means that later in life, as parents, they may struggle to form strong attachments to their own babies, thus perpetuating the cycle of misery through the generations.

Having set the scene and described the challenge, I shall move on to the proposals that we have set out in our “The 1001 Critical Days” manifesto. The key overarching call is for an holistic approach to the perinatal period whereby the needs of the family are met in a seamless way.

First, we need specialist mental health midwives and health visitors in every local authority area. We must enable women with a history of mental illness to receive tailored antenatal and post-natal care, and thereby reduce the risk of later post-natal depression. Secondly, those families experiencing difficulties should be able to access evidence-based services that promote parent-infant bonding, such as video interaction guidance and parent-infant psychotherapy. Thirdly, all parents should have access to antenatal classes that deal with both the physical and emotional implications of childbirth, as well as the baby’s own mental health needs.

Fourthly, the registration of the birth of a baby should be made possible in children’s centres in every area. Benchill children’s centre in Manchester Central, where the hon. Member for Manchester Central plays such a key role in promoting early years intervention, is a fantastic example of how registration in children’s centres can help new families. It has been offering birth registration for more than a decade, and its reach to new families has grown from less than 50% in a very deprived ward to 87.5%. In addition, its re-engagement rate with families is astonishing: for young parents, it is 100%. All parents have access to the services that they may desperately need, to help them to get the best start in life with their babies. In—

Mid Staffordshire NHS Foundation Trust

Fiona Bruce Excerpts

Tuesday 19th November 2013 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

An essential part of being a medical professional is to exhibit a compassionate and caring approach whatever one’s circumstances, as indeed most NHS staff do. What new measures will offer patients assurances that this will be a priority in future?

[Mr Hunt]

The biggest assurance that patients will have is that the definition of success as regards how the system views a hospital will be the same as patients’ definition of success. They want to go somewhere that treats them promptly and safely and with decent, compassionate care. That has not been how the system has judged the success of a hospital or its chief executive or board. That is why it is such a profound change to have a new chief inspector and Ofsted-style ratings. I think this will make a big difference, but I do not want to underestimate how big a challenge it is and how long a process it will be fully to make the transformation we need.

Tobacco Products (Plain Packaging)

Fiona Bruce Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

I congratulate my hon. Friend the Member for Harrow East (Bob Blackman) not only on an excellent speech—which I fully support—but on his work on the all-party group on smoking and health, of which I am a member.

My motivation in supporting the debate today comes entirely from wanting to ensure that we protect children and save lives. I echo everyone who has said, “Let’s do as much as we can to prevent young people from starting to smoke,” because the later they start the less likely they will become addicted and the fewer lives we will see debilitated. It is not just about saving lives; it is about the quality of life that many will suffer. How many people who have taken up smoking desperately want to stop? The best way to stop smoking is not to start in the first place.

[John Glen]

Does my hon. Friend share the grave concern that a disproportionate number of people from the poorest communities are taking up smoking in ever increasing numbers?

[Fiona Bruce]

I absolutely do, and I also share the view that young people are attracted to designer brands. They are attracted not just to the product but to the packaging. I have two young sons—one is 17 and one is 20—and I was amazed to discover that not only do young people want to buy designer clothing but there is a trade on eBay for the tags and packaging. People collect the labels.

We have known for a long time that young people are attracted to labels. In 1995 a survey of youth in America told us that young people associated the following words with designer packaging: popular, cool and good-looking. With cigarettes in plain packaging, they associated the words boring, geeky and cheap. In 2012, another survey found that young people felt that if they smoked stylish packs they would be “better and more popular”. The evidence is there. We do not need to delay.

It is a tragedy that each year 200,000 people start to smoke when we could take action. I do not believe that the fact there have already been successful measures is an argument for not taking further action—quite the opposite. According to one statistic I have seen, the display ban on large shops has contributed towards 100,000 fewer young people taking up smoking each year. If that is correct, let us build on the success. Let us do more, and see more and more young people discouraged from taking up smoking.

If I saw a young child drowning in a canal or about to run in front of a car, I would do all that I could to stop them and to save that life. Is that not what we are in a position to do in this House? The public do not want to see young people’s lives and futures damaged by smoking. More than 190 health organisations support standardised packaging. People in this House support it. Let us have a debate and a vote, and take action to protect the health and lives of future generations.

Oral Answers to Questions

Fiona Bruce Excerpts

Tuesday 16th April 2013 Commons Chamber

[Steve Brine (Winchester) (Con)]

8. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.

[Fiona Bruce (Congleton) (Con)]

12. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It would take me a very long time to give all the details of the Department’s work. In short, we have run a number of specific campaigns, both locally and regionally, to deal with a number of cancers. We will now evaluate whether those pilots have been successful. What I can say is that, such is the success of the lung cancer campaign, we will be recommissioning it in July.

--- Later in debate ---

[Anna Soubry]

I pay tribute to the work of my hon. Friend and all those involved with the all-party group—I am indeed looking forward to this afternoon’s session. I particularly commend the group’s work on targeting women over 70. Again, we have run a pilot campaign on that and are evaluating the results, and if there is value in it, it will be rolled out in order to bring huge benefits.

[Fiona Bruce]

Given the link between smoking and cancer and the fact that 70% of smokers start before they are 18 and 94% before they are 25, what consideration have the Government given to introducing plain packaging in order to drive down the number of young people attracted to smoking in the first place?

[Anna Soubry]

We are considering what has been a huge consultation, but I must correct my hon. Friend—I am in no way criticising her—because it is not plain packaging, but what we call standardised packaging. If, like me, hon. Members were to see the cigarette packets now issued in Australia, they would realise that they are far from plain. Some would say that they are a counterfeiter’s nightmare, not a charter for counterfeiters.

Liverpool Care Pathway

Fiona Bruce Excerpts

Tuesday 8th January 2013 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

I congratulate my hon. Friend the Member for Montgomeryshire (Glyn Davies) not only on securing the debate but on the calm and measured way in which he introduced it—his was exactly the constructive tone in which we should discuss this concerning issue.

Last year, an 83-year-old widower was taken into hospital feeling very unwell. His eldest daughter visited him every day. No particular illness was diagnosed, but he was certainly weak and frail. After a few days, the daughter asked a nurse in the corridor, “How is he today?” Almost casually, the nurse said, “Oh, he’s not very well at all. He has not long to live. We are putting him on the Liverpool care pathway.” There was no discussion, no explanation, no consultation—just an announcement, a statement of fact, almost in passing. The daughter was shocked. As his eldest child, she thought, “Surely there should be more formality, more dignity, more of a clear process.” What gave her particular cause for concern was that her mother had become frail just two or so years earlier—admittedly after a brain tumour operation—and had been put on a regime of limited food and fluids. It had taken her weeks to pass away, which was agonising for her and heart-rending for the members of her family, as they waited and waited for their wife and mother to die. Again, there was no discussion or consultation with the daughter, although perhaps there was with the father. He was an elderly man in his 80s, and he was now lying in bed himself, about to be put on a similar regime.

After her mother died, the daughter felt a terrible guilt. Perhaps it had taken too long for her mother to die. Perhaps the daughter should have asked more questions. Perhaps she should not have let her mother suffer so much. With no medical background, however, she was left rather sad and confused. When the nurse announced that the hospital was putting her father on the Liverpool care pathway, the daughter, knowing a little more about it by this time, immediately contacted her sister, and the next day their father was moved to a nursing home. There, his needs were attended to in a positive and caring way. There, he did not die; in fact, he got better.

Now, well over six months later, that elderly man is very much alive. He is still being cared for. He is eating well, getting up when he wants to and resting when he does not want to get up. He enjoys visits from his family, although he does not enjoy it when his favourite football team loses in the last minute or so of a match, as happened last Saturday. He is listening to tapes of Sadler’s Wells opera company singing Gilbert and Sullivan, and he is joining in with “Songs of Praise”. He is having intelligent and considered discussions about his finances and looking forward to his 85th birthday. It is not a fantastic quality of life, but it is a life, and as he told his doctor in the nursing home, “I want to live.”

Minister, Mr Weir, concerned Members, I know all that is true, because the lady who passed away so distressingly was my mother, and the elderly man I have described is my father. I, their daughter, witnessed all those events first hand. In one sense, I am not sure I need to say much else to support the points that have been made, but the application of the LCP needs to be looked into.

[John Glen (Salisbury) (Con)]

My hon. Friend is making a powerful case, and it is obviously painful for her. Does she agree that there is a distinction between accepting the notion that a life must end and accepting that there is an inevitable time frame in which that life must end? We must not make premature assumptions about that period, so it is critical that there is a clear understanding of what the Liverpool pathway means and how it can affect the timings of an event we do not know the actual trajectory of.

[Fiona Bruce]

I thank my hon. Friend for that intelligent comment, and I will talk further about that.

I want to speak now as a vice-chair of the all-party group on dying well and the all-party pro-life group. Despite my personal experiences, I believe the main intent of the Liverpool care pathway is compassionate and good. It is fundamentally aimed at what is increasingly called a good death. When correctly administered, the principles behind it are those of good palliative care, and they are fully in accordance with the view, which I hold, that all life is God-given and should be allowed to run its course, without death being hastened through unnatural intervention.

[Jim Shannon]

I congratulate the hon. Lady on the passionate way in which she has dealt with this issue. Does she agree that it is important that those who work in the Liverpool pathway are highly skilled? If such care is left in the hands of those who are less skilled, there is a possibility that what could be termed voluntary euthanasia will take place. Does she agree that only highly skilled people should be involved in the Liverpool care pathway?

[Fiona Bruce]

I do, and this is where training is so important. Without the proper application of the Liverpool care pathway, death can be hastened, and that is not the intent of the pathway. Occasionally, even with correct application, it can be the unintended consequence—for example, through the use of narcotics to alleviate severe discomfort and facilitate a more peaceful passing.

I wholeheartedly welcome the Minister’s decision to hold an independent public inquiry into the LCP. I have met him, and I thank him for his open-minded, calm and reasoned approach and for the fact that he has had ears to hear concerns about the LCP. Without wishing to prejudge the terms of the inquiry, may I make the following suggestions for it to consider?

First, a number of pressures might subvert the proper implementation of the LCP, and I am grateful to Professor David Albert Jones of Oxford, who is an authority on this topic, for highlighting them. He says they are:

“the subjective character of judgments about how soon someone is going to die…the fact that the LCP may be initiated by people who are not senior clinicians familiar with the individual patient’s case and have not consulted with palliative care physicians… the influence of managerial pressures to reduce bed occupancy …reluctance to face the difficulties of continuing care of certain difficult patients…the euthanasiast outlook of some clinicians…the possibility of doctors or nurses regarding the LCP as a set of ‘tick boxes’…rather than assessing the needs of the patient…Other NHS organizational/staffing procedures or constraints”.

He adds:

“Research shows that care of the dying is poorest in the hospital setting”

in contrast to care in hospices, which I believe we all admire.

I also urge that the inquiry consider the following measures: that no patient should be placed on the LCP unless they are imminently, irreversibly and inevitably dying, which I understand to mean perhaps within 36 hours; no one should be placed on the LCP without its being discussed with a designated relative or carer; every patient placed on the LCP must be continuously monitored and reviewed by a multi-disciplinary team; documentation must be simplified and standardised, so that those implementing the LCP can easily follow the guidelines; training and supervision should be mandatory, as well as standardised and improved; non-clinical priorities in the use of the pathway must be eradicated and every patient must be treated solely according to their needs; payment for such care must be reconsidered; and the communication to relatives should be substantially improved.

I believe that, if it is well used, the LCP can improve standards of end-of-life care, especially in hospitals. It should promote better palliative care and support the kind of good death that we would all wish for ourselves and our loved ones. I sincerely hope that the independent inquiry will be a major step in facilitating that.

Induced Abortion

Fiona Bruce Excerpts

Wednesday 31st October 2012 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

It is a privilege to speak in this debate. I am the vice-chair of the all-party pro-life group. My colleague, the hon. Member for Heywood and Middleton (Jim Dobbin), would have been present but was detained on constituency business.

I hope that my contribution will be received with the respect and compassion with which I give it, for pregnant women and the unborn child. There is growing support for a reduction in the upper limit for abortion for a number of reasons, including improved survival of very premature babies since the Abortion Act 1967, as well as advances in ultrasound imaging, foetal sentience and practice in much of Europe. In 2011 2,729 abortions took place after 20 weeks, with the majority taking place for what are called social reasons.

The fact is that medical advances have been made and survival rates have improved. Indeed, I understand that in America the world’s most premature baby has survived: Amillia Taylor, who was born at 21 weeks. Is not the fact that science has moved on a sufficient argument for looking again at the number of weeks? Such scientific capabilities were never envisaged in 1967, and stories of babies born alive after failed abortions are also not uncommon.

It is interesting to note that many people criticised the Secretary of State for Health, the right hon. Member for South West Surrey (Mr Hunt), for suggesting that a 12-week abortion time limit should be considered. Yet his views are not controversial. In the European Union, 12 weeks is the average time limit.

What about the effect on the medical profession? It is becoming increasingly difficult and discomfiting for doctors in one part of a hospital to fight to save premature babies, but in another part to abort them at the same stage, as highlighted by Max Pemberton recently in The Daily Telegraph. The discomfort felt by doctors and nurses can be further understood when the reality of abortion in private clinics is made clear. I want to pay tribute to the gracious and principled stand against abortion made by Lord Alton in both Houses over many years. Indeed, a quarter of a century ago he described what happened when a child is aborted at a late stage:

“Because this is a long-drawn-out business”—

and there is a chance that the child will be born alive—

“the method of late abortion used in private clinics is primarily dilatation and evacuation. By this method, the cervix is dilated and the baby’s body removed piece by piece. To facilitate its extraction from the womb, the skull is crushed, the spine snapped and the body removed piece by piece. An attendant nurse then has the job of reassembling the body to ensure that nothing has been left behind”.—[Official Report, 22 January 1988; Vol. 125, c. 1232-33.]

[David Simpson (Upper Bann) (DUP)]

The hon. Lady is describing the removal of a baby. Today in the debate we have heard Members referring to babies as foetuses, but they are human beings and the smokescreen needs to come down. Does she agree? The hon. Member for Mid Bedfordshire (Nadine Dorries), who introduced the debate, said that at 24 weeks a needle is put into the heart of the baby and it is killed. If that happened to any individual in the Chamber, it would be murder.

[Fiona Bruce]

I thank the hon. Gentleman for his contribution. I want to ask the Minister to clarify whether the procedure as described 24 years ago by David Alton is the same today. If so, may we have an inquiry into the foetal pain suffered during such a process, which cannot be imagined? Can some research be carried out? The procedure for late-term abortion is traumatic not only for the child but for the woman, physically and psychologically, so could such research also consider the effect on the woman? Moreover, will the Minister consider the impact on women of repeat abortions? Can something not be done in the “caring, compassionate” way mentioned by the hon. Member for East Londonderry (Mr Campbell) to help women who are facing repeat abortions, so that we can help them to avoid that in future?

The 24-week limit is in fact not a limit at all for certain unborn children. As mentioned, abortion is legal in this country up to and even including birth on the ground of disability. I am delighted that here in Britain we are doing more than ever to help those with disabilities, but we have a paradox. A child diagnosed with a disability can be aborted up to and even during birth, but the minute that the child is born a whole panoply of rights and medical and social support comes into play for that child, and quite rightly so. The child is born with rights protected by the Disability Discrimination Act 1995. The law is therefore at odds. The Disability Rights Commission states that a law that permits abortions at any time up to birth for disability alone

“reinforces negative stereotypes of disability; and there is substantial support for the view that to permit terminations”

for such a reason is something that needs to be reviewed. I ask the Minister to look into that law, given equality and diversity legislation. My son has a club foot, which is a disability that under the present law of the land permits abortion up to birth, but it is an entirely correctable defect.

Will the Minister clarify what action has been taken following the revelations earlier this year of abortions being carried out on gender grounds? Finally, what action was taken following the police inquiry and the breach of abortion laws whereby HSA1 forms were pre-signed by one doctor at up to 14 NHS trusts? The life of both mother and child are equally valuable and deserve equal respect accordingly. I hope that I have expressed that today.

Adult Social Care

Fiona Bruce Excerpts

Monday 16th July 2012 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

I welcome the Government’s White Paper “Caring for our future: reforming care and support” and its priority of putting the well-being of the cared for and their carers at the heart of its approach. As the Member who represents the constituency with the highest proportion of elderly people in the north-west of England—there are 72,000 carers in Cheshire—I particularly welcome the proposals.

For the first time there will be a clear legal basis for the cared for and their carers having their own individual care and support plans, a tangible recognition of the utterly invaluable contribution that some 6 million carers make, many of whom often work more than 50 hours a week, at great personal cost. With 2 million people moving in and out of caring roles each year, the Government are right to recognise that giving carers a right to personal assessments and plans is a priority so that their own health and well-being are supported and recognition is given to the fact that they, too, have lives to live.

I am also pleased that the Government have already allocated £400 million for carers’ breaks over the current five-year period, but it is important that that is reviewed to ensure that the effectiveness of such payments is maximised. I welcome the new duties placed on local authorities, which will substantially help the cared for and their carers to access appropriate support, as the fragmented health, housing and care support services that have existed until now have caused at best frustration, and at worst despair.

Clearer dissemination, and the duty on local councils to provide advice and preventive services, should go a long way towards alleviating the problem described by one volunteer in the care sector, when she said that social workers just do not have time to help signpost carers to information, advice and support.

The Government are to be commended for their commitment to working towards the assurance of quality care standards through improved training provision for care workers, the introduction of a new code of conduct and of minimum standards for care workers and the appointment of a chief social worker, and for their aim of doubling the number of care apprenticeships to 100,000 by 2017. In that respect, I commend the excellent work of the apprentices on Cheshire East council’s A-Team, who are already blazing a trail through their apprenticeships as carers for the elderly in our community —soundly rebutting the myth that younger people do not care for our elderly or give them the dignity and respect they deserve.

I also welcome the Government’s proposals to fund adaptations to keep the homes of the elderly safe, because the NHS is estimated to spend £600 million a year treating injuries caused by hazards in inappropriate housing—the majority of cases associated with falls. The Government’s new care and support housing fund of £200 million over five years, to support the development of specialised housing and adaptations of homes, is particularly welcome.

I welcome also the Government’s commitment to abolish per-minute billing for care visits. That will be music to the ears of a distressed care worker who came to my surgery and said that she was seriously considering leaving the profession, because not only was she unable to provide within the time frame allocated the care needed for those she visited, but there was nothing like the necessary allocation of travel time between the homes that she needed to visit. In some cases, they were even in different towns. She showed me her timetable, and I can only say that I entirely agreed with her.

I welcome in particular in the White Paper the Government’s recognition that if we are to address this massive challenge and make a reality of good quality, comprehensive care provision for all, which I am sure is everyone’s aspiration across the House, we will do so only if we harness the energy, resource and skills of the whole community, including community groups, many of which are highly professional and which work very hard to support carers and the cared-for.

I am very pleased that the Government have committed to working closely with Age Action Alliance jointly to find practical approaches to improving the lives of older people; that they have decided to invest funds through Big Society Capital, so that social enterprises, charities and voluntary groups can access greater resources in order to make a difference in communities; and that they have decided to involve those communities in strategic decisions on health and care services through local health and wellbeing boards. That will be particularly welcomed by Crossroads Care Cheshire East, whose director told me, shortly after I was elected in 2010, that

“we could do so much more and add so much value if we were more involved in strategic discussions about care provision.”

The Government’s proposals in the White Paper are to be welcomed.

--- Later in debate ---

[Margot James]

I welcome the hon. Gentleman’s intervention, but I will move on to the present day, relevant though the NHS and social care budgets of 20 or 30 years ago no doubt are.

We are beset by problems, although I was pleased to hear the Minister confirm that according to ADASS, social care spending has gone down by just 1% in the past year. Given the incredibly difficult economic situation that we are in, much of which we inherited from the previous Government, that is an achievement. However, we do have problems.

People value their independence, and most older people want to stay in their own home. With the right support, many can. To a large extent, the White Paper proposals will provide the support that is needed to enable more people to stay at home. Carers are a vital source of people’s ability to maintain their independence at home, and the 5 million carers who do an incredibly important job in our country do not get enough support at the moment. I welcome the extra money that is being put towards enabling them to have respite, because carers tell me that a break is what they need first and foremost. I am sure that no amount of money would ever be enough to give them the breaks and support that they need, but at least the White Paper proposals will provide some support.

Many people do not realise that social care is means-tested until they get to the point in their lives at which they need it. That means that we need more information to be available. We need to be honest with people about what is possible, what is available and what is not. All Governments are guilty of putting the best picture forward, which is sometimes misleading. I applaud the Government’s decision to commit £32.5 million to improving information, but perhaps I can make a plea on behalf of some of my older constituents: that investment should not all be online. Many older people do not communicate in that way, so we must allow for some leaflets in GPs’ surgeries, libraries and day centres, and for other traditional forms of communication. Otherwise, we will make older people who do not engage with new media even more dependent on other people to get information for them.

[Fiona Bruce]

Will my hon. Friend give way?

[Margot James]

No, I promised not to take any more interventions, because I know other Members want to speak.

Then there is the dreaded assessment. Older people often try hard at their assessment to suggest that they can do more than they really can, especially when their carers are present. At the moment, assessments are conducted inconsistently not just around the country but within communities—it depends on who conducts them. I applaud the initiative to make them far more universal and consistent. The Dilnot proposal of making them portable around the country is certainly a huge step in the right direction.

As Members of all parties have indicated, the quality of care needs to improve. I welcome the emphasis on dignity and respect that runs through the White Paper. It is important that we have better training for care workers and an end, if possible, to the terrible business of contracting by the minute, which flies in the face of dignity. I quite agree with other hon. Members that it is impossible to get an elderly person out of bed and dressed in the amount of time that is allocated these days.

Dignity and respect are at the heart of a good-quality care system, and I am pleased that that has been given the prominence that it deserves in the White Paper. Of course we would like to do more, but I applaud the Government for making a very good start and, if I may say so to Opposition Members, they have done so within two and a half years of coming to office, which is a great improvement on the previous Government, who took 12 years before they got round to the same point.