Children and Young People: Mental Health Services
Lord Storey Excerpts(6 years, 9 months ago)
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Lord O’Shaughnessy
I know that the noble Baroness speaks with deep experience and passion on this subject and I completely agree; it is about making sure that those children’s voices are heard. We recognise that the picture of fragmentation described in the CQC report is not good enough and that is one of things we are trying to fix. It is a historic issue and it cannot be done overnight but we are working on it.
Lord Storey (LD)
My Lords, the awareness is very important. Will the Minister ensure that mental health awareness is part of teacher training and part of the qualification of special needs co-ordinators? I have to correct him: psychotherapists are not the same as school psychologists and there has been quite a substantial reduction in the number of school psychologists who are available and able to identify mental health problems.
Lord O’Shaughnessy
I will take the issue about the specifics of teacher training to colleagues in the DfE. I was talking about therapists in the broadest sense of the word: I think there is a recognition that we need more therapists of all kinds in all settings as we expand these services for young people.
Young Women: Self-Harm
Lord Storey Excerpts(7 years, 1 month ago)
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Lord Storey
To ask Her Majesty’s Government what action they propose to take to reduce the number of young women who are self-harming.
Mental Health Services: Young People
Lord Storey Excerpts(9 years, 5 months ago)
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Lord Storey
To ask Her Majesty’s Government what plans they have to develop mental health services for pupils and young people.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
My Lords, we are committed to transforming children and young people’s mental health and well-being across health, social care and education. The Department of Health is working with the Department for Education and other key partners to develop more seamless and integrated mental health services for pupils and young people. Work is under way to pilot single points of contact in schools and mental health services, and joint training to improve access to mental health advice and support in schools.
Lord Storey (LD)
I thank the Minister for his reply. It is a sobering thought that, in every classroom, three pupils have a diagnosable mental health problem. Does the Minister agree that, when pupils are referred, there should be an agreed, minimum time by which they are seen?
Lord Prior of Brampton
I thank the noble Lord for that question. He is right that, out of a class of 30 children, three are probably suffering from diagnosable mental health problems. The Government are commissioning a prevalence survey to establish more precisely what that number is. There is a feeling that it will be increasing with the use of social media and more bullying in schools. I agree with the noble Lord that we must make it easier to access talking therapies in particular and the Government have plans to do that.
Defibrillators
Lord Storey Excerpts(10 years, 5 months ago)
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Lord Storey
To ask Her Majesty’s Government what action they will take to ensure that all schools, sports clubs and public service buildings have defibrillators as part of their first-aid kit provision.
Lord Storey (LD)
My Lords, today we debate a topic that is close to many of our hearts. I note that defibrillation has been raised in your Lordships’ House 57 times in some form or another since 1995, but today I hope that we will see some movement on this issue. Much like the conditions that trigger the need for a defibrillator, this issue will refuse to go away until we fully grasp it. Of course, I am talking about defibrillator provision and what the Government plan to do to ensure that all schools, all sports clubs and all public service buildings include AEDs as part of their first-aid kit provision.
My concern and my involvement in this area stem from the tragic death of a young Liverpudlian boy, Oliver King, in March 2011. He suffered a cardiac arrest during a swimming race at his school, King David High School, in Childwall. Sadly, he passed away as a result of SADS, or sudden arrhythmic death syndrome. His father, who has campaigned tirelessly for the past three years, is here today. I pay tribute to him and the foundation that he and his friends set up in Oliver’s memory, campaigning to get SADS provision in every Merseyside school and for their life-saving work in Merseyside and across the nation. They do tremendous, largely unsung work. I thank them and encourage the Government to pay heed to their suggestions.
In advance of today’s debate, I have received several briefings, notably from the London Ambulance Service, which sent me its Shockingly Easy campaign booklet. That title sums up this issue perfectly. St John Ambulance, the British Red Cross and the British Heart Foundation also sent me notes, as of course did Mr King. I thank them for their assistance and their efforts.
All present will know that a defibrillator is a machine that delivers an electric shock to the heart when someone is having a cardiac arrest. Used in conjunction with cardiopulmonary resuscitation, defibrillation massively increases one’s chances of survival during heart failure. Every second counts, as they say, and I echo calls for defibrillators to be made available within easy reach of anyone who needs such life-saving treatment.
Much like the provision of fire extinguishers and first-aid kits, defibrillators save lives. However, unlike the case with the regulations that mandate fire-extinguisher facilities and first-aid kits, currently no legal safeguards require provision of defibrillators. This is a disgrace, especially when we think that there are 60,000 out-of-hospital cardiac arrests every year in the UK. Survival rates, which have barely improved over the years, range from 2% to 12%. In London, one’s chances of survival shoot from 28% to 80% in cases where a trained person uses an AED.
I shall not labour the facts any further, but they beg the question why, if we think it important to place first-aid kits and fire extinguishers in our schools, old people’s homes and sports clubs, we are holding back defibrillators. More to the point, why is it that we have 16, soon to be 17, defibrillators on the Parliamentary Estate? If it is good enough for your Lordships’ House, surely it is good enough for everybody.
I shall return to the wider question and the topic of this debate. I suggest that the first step towards making our communities more resilient to the devastating effects of cardiac arrest must be to place AEDs in areas that see the highest number of cardiac arrests. To me this sounds like a no-brainer, and it is. I welcome the move by David Laws and the Department for Education to encourage schools to install machines, although I regret that, in this Parliament, we are not yet any further forward in making them mandatory.
As well as the installation of defibrillators in places of high footfall such as schools and public buildings, we should not forget the other side of the coin, which is education. People, young and old, must be educated in how to use a defibrillator, whether in a school, a young offender institution or at work. Fortunately, here in Parliament we are offered training. For the record, the next training session will be at 10 o’clock on 16 November in 7 Millbank, although perhaps that is a long time to wait. In order to make any investment in defibrillators worth while, young people must have access to and be able to engage in first-aid and life-saving education. Only 7% of the population have the skills and confidence to carry out basic first aid in an emergency, which is an appallingly low figure that must increase. What plans do the Government have to ensure a more comprehensive approach to first-aid education?
I know that it is not the done thing to use visual aids, and my noble friend will be pleased to learn that I do not intend to do so, but a defibrillator is very easy to use. You do not actually need any training. Although Mr King has brought one with him, I do not suggest that he should show it to us, but even I could use it without ever having had any training. You just follow the simple instructions. However, it is still important that first-aid training for all should be linked to that.
I think that we agree on the need for and importance of defibrillators, but it is worth stating that they must be installed in areas where there are high numbers of cardiac arrests. According to St John Ambulance, 74% of people think that it should be compulsory to have AEDs in care homes, and I agree. Indeed, I suggest that we should examine the case for having them in all care-home settings, both public and private, because this is a topic that should cut through the distinction between public and private provision. Quite simply, it is too important not to mandate the use of AEDs across the board, whether that be in football clubs, cinemas, schools, train stations or churches. Indeed, I know of some churches that have defibrillators because they save lives.
I am determined that we should do more. My noble friend Lord Nash, who supports efforts in this area, informed me on 3 February that,
“it is a matter for individual schools to decide whether to have defibrillators and to arrange individual training”.—[Official Report, 3/2/14; col. 7.]
Even though the governing bodies of maintained schools must now make arrangements to support pupils with medical conditions—we should remember from the Children and Families Act the importance of the duty of care in terms of medical conditions—perhaps we should extend that duty of care to those pupils who might suffer cardiac arrest.
I want to raise one other issue, on which I have already written to my noble friend the Minister. It concerns a universal logo. If you want to find a fire extinguisher quickly, you know the logo. Similarly, you know the logo for a first-aid kit. However, there is as yet no universal logo for defibrillators, although the Minister did mention that NHS England is considering all avenues to increase the uptake of bystander resuscitation, including the location and use of AEDs. I suggest that a universal logo, combined with their inclusion in first-aid kits and a comprehensive approach to training and education, might be the way forward. Would the Minister consider taking a lead on this issue, particularly with the NHS, by suggesting that we should look at adopting some form of universal logo?
Finally, a word from Mr King, who says that use of defibrillators is often,
“the difference between life and death”.
This fact has been recognised by the national clinical director for heart disease, Professor Huon Gray, who I met with Mr King, as well as the Secretary of State, last year. Let the message go out from this short debate that lives can and will be saved by immediate access to defibrillators.
Children and Families Bill
Lord Storey Excerpts(10 years, 10 months ago)
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Lord Storey (LD)
My Lords, I want to speak to Amendments 57B and 62. First, on Amendment 57B, the Government are to be congratulated. The package that they propose—if I dare to use the term “package”—of proxy purchase, e-cigarettes and looking at the whole question of standardised packaging of cigarettes and tobacco products is to be welcomed. I think it will result in thousands of people being saved from getting respiratory and lung diseases; it will save literally thousands of lives. I congratulate the Minister and the Government. I want also to thank those cross-party noble Lords who put down the original amendment, because they initiated this debate.
On Amendment 62, I said in Committee and say again: some noble Lords have mentioned their grandchildren. Can you imagine carrying your grandson or granddaughter in a carry-cot, putting that child into a metal box—a car—and allowing somebody to pump cigarette fumes into that metal box? You would not do that at all; you would not allow that to happen. Whatever our concerns are about personal space or civil liberties or whatever it is, this is about the rights of a child; the rights of a baby. A baby cannot say, “Well, actually, I don’t mind”; a child cannot say, “Actually, I don’t mind”. In fact, research—certainly from talking to children—shows that they do mind. As we have heard, we can see when we look at the figures that children are particularly vulnerable to second-hand smoke. Why? Because they have small lungs, because they have faster breathing, and because they have a less developed immune system. That makes them more susceptible to respiratory problems: asthma, bronchitis and lung malfunction. Knowing that, and that passive smoking results in more than 165,000 new episodes of all sorts of diseases associated with lungs and respiration—and I am talking about children here—are we serious about allowing children and babies to be strapped in a car where that happens? Surely not; all the other arguments pale into insignificance.
We seem to cite lots of surveys here. Interestingly, in 2010 a survey that directly asked 11 year-olds and 15 year-olds found that one in five reported being exposed to second-hand smoke in cars.
A number of people have said, “How are we going to make this happen? The police are very busy; can we really make it happen?”. I have two answers to that. Do noble Lords remember when seat-belt legislation was suggested? People got up and said, “Oh no, this is an attack on my civil liberties; oh no, we will solve the problem by advertising”. It was the “clunk click” advertisement, was it not? Oh—perhaps we had better move on from that. With the “clunk click” advertisements, in fact, something like 24% of people started to belt up in cars. Legislation was then brought in and we found that 97% of people then put on a seat belt. We do that automatically; we do not think about it, or sit in our cars saying, “This is an infringement of our liberties; we shouldn’t be doing this”; we do it. Why do we do it? Because it saves lives: it saves our lives and the lives of other people who are travelling in the car.
Interestingly, a study conducted in Scotland—we talk about Scotland a lot in this Chamber, thank goodness—suggested that air quality inside a smoker’s car was comparable to industrial smog in cities such as Beijing or Moscow, even when the driver has the window open. Are we seriously suggesting that children and young people should be subjected to air quality which is akin to that in Beijing or Moscow? Of course, we are not. Research by Aberdeen University found that 7% of 11 year-olds experience smoking in cars. That is why I am pleased that one of my colleagues in Scotland, the Liberal Democrat MSP, Jim Hume, is introducing a Private Member’s Bill looking at safeguarding children by banning smoking in cars. That is now going out to public consultation.
I end by making two further brief points. It is easy to find all sorts of reasons why you cannot do something. We could ask, “What about cars that are convertible? What about yachts? What about this? What about that?”. However, if you believe in something and think that it is right, you get on and do it. My only regret regarding the amendment is that it was initially an all-party amendment. When I listen to the news, I hear that it is a Labour initiative. I am sorry that it has been politicised and has become a party-political issue; I hoped that it would not be.
Lord Hunt of Kings Heath
The noble Lord has made an impassioned speech. My understanding was that the original cross-party amendment had been degrouped and would be taken only late at night. I therefore brought forward this amendment to enable the House to make a decision. I agree with him about the cross-party nature of the debate.
Lord Storey
I respect what the noble Lord says and thank him for it.
The Minister is a listening Minister. I hope that he will reflect on what has been said and accept the amendment because it is important to take the whole House with him on issues such as this. I hope that he will look again at continuing the advertising campaign but, perhaps more importantly, that he will consider a review of this issue so that we can go forward on it together.
Lord Scott of Foscote
My Lords, I wish to add a word on the amendment about smoking in cars when children are present. I do not wish to say anything about standardised packaging because I thoroughly support the amendment on that. However, so far as smoking is concerned, the support for the relevant amendment is focused on smoking in motor cars. However, that is not what the amendment says. It refers to “a private vehicle”. Motor cars are a very common—perhaps the most common—species of private vehicle, but there are all sorts of other private vehicles that one must take into account as well. The word “drives”, commonly used in relation to motor vehicles, comes from the driving of carriages and ponies and traps. Suppose that somebody has a pony and trap, and has a child in the trap, why on earth should he or she not smoke? If this amendment were confined simply to motor cars, I would have no objection to it at all; indeed, I think that I would support it. However, in relation to all private vehicles, it simply goes too far. I do not believe that was intended and I think the wording should be modified accordingly.
Lord Storey
My Lords, obviously we should be supporting any family in the situation described by the noble Baronesses, Lady Jones and Lady Meacher. The noble Baroness, Lady Meacher, rightly pointed to the support that can be received from the discretionary housing subsidy. What I do not understand is why, for example, in my local council in Liverpool, last year £337,000 of government discretionary housing payments were left unspent and returned. The sad thing is that, in every year since 2001-02, a large sum of money has been returned.
I do not understand why the Local Government Association is telling the noble Baroness, Lady Jones, that demand is outstripping provision when currently, after six months, Labour councils have spent only 29% of the allowance. In 2012-13, in England as a whole 37% of discretionary housing subsidy was left unspent. Should we not encourage those councils to use that money to do the same things that both noble Baronesses have suggested? If there is money available, it must be used for that. It is a disgrace, when children are in difficult situations—whether they need support because of physical handicap or whether they are in appalling conditions and need that support—to leave 37% of that money unspent across the whole of England.
Baroness Lister of Burtersett (Lab)
My Lords, as of August 2013, there were more than 235,000 children—nearly a quarter of a million children—living in households whose benefits have been cut because of the bedroom tax. We do not know how many children have had to move, disrupting their schooling—a point that has already been made—their friendships and the social networks which enable their parents to get by with childcare and other things. When I asked the Minister earlier today about the implications of this for the Government’s child poverty strategy, I did not get a direct answer. Inevitably, these families are being pushed further into poverty; there are no two ways about it.
There have been a number of reports in newspapers about the struggles that many families face trying to get by. I will not read all of them but simply read from the initial comments from the UN special rapporteur on adequate housing, who put the case very well. She said:
“The right to housing is not about a roof anywhere, at any cost, without any social ties. It is not about reshuffling people according to a snapshot of the number of bedrooms at a given night. It is about enabling environments for people to maintain their family and community bonds, their local schools, work places and health services allowing them to exercise all other rights, like education, work, food or health”.
She continued:
“Of the many testimonies I have heard, let me say that I have been deeply touched by persons with physical and mental disabilities who have felt targeted instead of protected; of the grandmothers who are carers of their children and grandchildren but are now feeling they are forced to move away from their life-long homes due to a spare bedroom or to run the risk of facing arrears; of the single parents who will not have space for their children when they come to visit; of the many people who are increasingly having to choose between food and paying the penalty. Those who are impacted by this policy were not necessarily the most vulnerable a few months ago, but they were on the margins, facing fragility and housing stress, with little extra income to respond to this situation and already barely coping with their expenses”.
The amendment will not solve the problem, but it will go some way to alleviate the problems that those families face. Families are really struggling as a result of this measure, and I hope that we can support the amendment to do something for some of those very vulnerable children.
Children and Families Bill
Lord Storey Excerpts(11 years, 1 month ago)
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Baroness Howarth of Breckland (CB)
My Lords, I want to speak briefly because the health arguments have mainly been made. I want to make two rather different points. I support both of these amendments. I have a long-standing reputation for campaigning in this area. I find it interesting that the industry has suggested, from time to time, that packaging makes no difference. If it makes no difference, why is it so important? Let us get on and take it off the shelves. We have all the evidence to show that children are attracted to packaging and we all know our own instincts. I have never smoked, but both my parents died from smoking related diseases. My mother was addicted and said that I should stop anyone else I could from smoking.
My other point is on the smoking in cars amendment. Having said that the medical arguments are substantially made, which the Minister knows whatever the position he has to take on this, there is also a clear safety issue about smoking with children in cars. Anyone who has driven with two arguing children strapped in the back of their car—because children argue in the backs of cars, and if yours do not, then they are remarkable—will know how distracting it is and how you have to absolutely keep your concentration up. So I have always found it strange that we do not stop people being distracted by fiddling into a bag or a pocket for a packet of cigarettes, finding something to light up with and taking their eye off the road—we have all seen it—while they light a cigarette. They then have a cigarette in one hand while they are driving their children in their cars. This is an added reason for ensuring that people cannot smoke with children in cars. You might say that where there are two people one of them may smoke, but there is the medical reason and this additional safety reason. I have no idea whether there are any statistics on accidents because people have been smoking in cars, but when you think of the legislation we have to stop people using mobiles, which in some ways are much more automatic, I cannot understand why we do not have similar legislation to protect children, not only for the medical issues in relation to their health but also for sheer practical safety reasons.
Lord Storey (LD)
I will speak to Amendments 263 and 264. If you said to some parents that you were going to put their son or daughter or both in a tin box, cut some holes in the box, then fill it with smoke, put it on wheels and drive it around all the time, they would think you were absolutely mad. The tin box is almost like a coffin because you are killing children. You are literally killing children.
My parents were heavy smokers; they smoked 40 Senior Service every day. In fact, they smoked so much that our living room ceiling turned yellow once a year and had to be repainted. I always remember that when my father drove me through the Mersey Tunnel he would say, “We’ll have to put the window up because you can die from carbon monoxide poisoning, you know”, yet—perhaps this is why I get chest infections regularly—he was putting our family in that sort of situation. Of course, he did not know about the effects.
All of us look back at things in our lives that we are really proud of. The thing that I am most proud of in politics was that we introduced Smokefree Liverpool. Thanks to support from noble Lords of all groupings, we were able to influence, in a small part, government thinking. You often get people saying, “Oh, it’s the nanny state. We don’t want a nanny state. We don’t want people telling us what to do. If we ban smoking in cars, the next thing will be that we ban it in the house as well”. Well, nannies are there to protect and look after children, and a nanny state should be there to look after and protect children.
Children are particularly vulnerable to second-hand smoking as they breathe more rapidly and inhale more pollutants than adults. ASH has shown that parental smoking is a causal factor of asthma in children, and that the prevalence of asthma increases when the number of smokers in a car or in the home increases. Children exposed to second-hand smoking also have an increased risk of lower respiratory infections, bronchitis, middle ear disease, bacterial meningitis and sudden infant death syndrome. There is also a very social issue, one that is directly related to making our society fairer. Evidence has shown that children living in the poorest households have the greatest levels of exposure to smoking and that passive smoking has been shown to affect children’s mental development and school absenteeism. That clearly undermines our efforts to increase social mobility. Experts have suggested that banning smoking in cars while driving with children is an important step in limiting the effect of second-hand smoking.
For those more interested in the economic side, the numbers are staggering. The health disorders caused by smoke-generated disorders cost the NHS about £23.3 million a year. In particular, £4 million is spent on asthma drugs for children up to the age of 16. The future treatment costs for smokers who take up smoking as a consequence of smoking by a parent could be as high as £5.7 million each year. Parents need to consider that, in choosing to smoke, they will find it difficult to explain to the children why they in turn should not smoke. The NHS has shown that children who grow up with a parent or family member who smokes are three times as likely to start smoking themselves. As we can see, the issue has implications for public health and our society in general, and ignoring it would mean ignoring the poll in 2009 which found that a majority of adults in England were in favour of banning smoking in cars, with 74% opposed to smoking in cars with children. The message is clear: if we really care about our children and want to improve their health and social mobility, this is a step that we can take.
I can look back, as no doubt all of us can, at moments in our social policies where there has been resistance from some quarters, whether it be from government or a powerful lobby, but the will of people has always come out. Noble Lords may remember the row about seatbelts: “Ooh, you can’t have the nanny state making people wear seatbelts”. In the end we had the courage to fight for that, and we cut the number of deaths in traffic accidents considerably. There was even a fuss about making people riding motorbikes wear crash helmets; there was a feeling that, “We shouldn’t do that. The nanny state is interfering by telling people that they must wear a helmet”. It is quite right that they should wear helmets. More recently, we have had the issue of smoking in public places. As a Government, we have a duty and a responsibility to do this.
Governments of all political persuasions have to think very carefully and be led by evidence, not by emotion or lobbying. I understand that the issue of plain packaging for tobacco products is something that the Government were committed to but they wanted to see quite clearly that the policy that was agreed, particularly in Australia, brought results. It is now clear that that policy is having an impact, and I hope that the Government, having initially said, “Let us wait and see”, might now say, “Come on, this is an opportunity to move forward”. I look forward to the Minister responding to the pressure from your Lordships here.
On children in cars, I would prefer that we agree the amendment in its entirety, but if we cannot do that, we could think about taking the first step by having public information, as we used to do. We could provide adverts and publicity material so that parents could see what needs to be done. But if we really want to be progressive and move forward, we should support these amendments.
Baroness Tyler of Enfield (LD)
My Lords, I rise extremely briefly because I had my go on Monday. I want to add just one point to what my noble friend Lord Storey has said. Some people are saying, “Let’s start with an awareness-raising campaign. Let’s see what we can do there. We don’t need to go straight to legislation”. I do not agree with that. The most effective example that I can cite was the introduction of legislation for the wearing of seatbelts. Awareness-raising had been tried, but it achieved only 25% compliance rates, but soon after the legislation was introduced, alongside the awareness-raising effort—you need both; it is not one or the other—91% of adults started to wear seatbelts. As my noble friend said, it is clear that it has saved lives. I think that very few people in this country, and certainly the polls show it, now think that that is an infringement of civil liberties.
Tobacco Products Directive
Lord Storey Excerpts(11 years, 2 months ago)
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Earl Howe
My noble friend, as ever, makes some very wise comments. The good news is that the most recent figures on smoking prevalence are going in the right direction. It is undoubtedly true that we can never do enough to raise our game on smoking cessation measures, one of them being nicotine-containing products. That is of course a major focus for Public Health England.
Lord Storey (LD)
Does my noble friend agree that if children are being driven in a car where adults, perhaps their parents, are smoking it is extremely dangerous for those children? Does he not think that the Children and Families Bill is an opportunity to put this right?
Health: Cardiology
Lord Storey Excerpts(11 years, 9 months ago)
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Lord Storey
To ask Her Majesty’s Government what measures they are taking to detect and prevent sudden cardiac death.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)
My Lords, as the Cardiovascular Disease Outcomes Strategy published yesterday made clear, the national clinical director for heart disease will continue to work with all relevant stakeholders to develop and spread good practice in this area. Alongside this, the UK National Screening Committee is reviewing the case for screening for sudden cardiac death, and will begin a public consultation on this soon.
Lord Storey
I thank my noble friend the Minister for that Answer. He will no doubt be aware that hundreds of young people die as a result of fatal premature cardiac conditions each year. He may also have heard of the Oliver King Foundation, established in memory of a 12 year-old Liverpool boy who sadly died of sudden death syndrome at his school in 2011. Does the Minister not agree that despite many ambulance trusts having some form of community resuscitation department, it should be policy to install automated external defibrillators in all public buildings? Furthermore, will the Minister agree to meet with the foundation and others to discuss the feasibility of a national screening programme to identify those at risk and prevent further loss of life, particularly among young people?
Earl Howe
My Lords, I pay tribute to the Oliver King Foundation for its work, as indeed I do to Cardiac Risk in the Young, which for many years has been campaigning very tellingly and successfully in this area. I think that my initial Answer should have satisfied my noble friend on the screening question, because that is now being reviewed by the screening committee. Regarding defibrillators, we have to look at the need to improve survival rates in the most effective way. I understand that the majority of these deaths—possibly as many as 80%—occur in the home. While we agree that the wider availability of defibrillators could save additional lives, CPR skills—cardiopulmonary resuscitation—should save more lives. To that end, the outcomes strategy says that my department will work with the Resuscitation Council, the British Heart Foundation and others to increase the number of people who are trained in CPR.