Childhood Obesity and Diabetes

Philip Davies Excerpts

Wednesday 24th April 2013 Westminster Hall

[Philip Davies (in the Chair)]

Before I call Mr Keith Vaz, Members should be aware that although things are quiet at the moment, we have been advised that there is a possibility of lots of noise outside, due to the work being carried out to try and get the visitors’ entrance up and running. If the noise reaches an unacceptable level and people are struggling to hear, we can ask them to stop. Things are all quiet at the moment, but if that happens, please let me know and we can do something about it.

[Keith Vaz (Leicester East) (Lab)]

It is a huge pleasure for me both to serve under your chairmanship during this important debate, Mr Davies, and to raise the issue of childhood obesity and type 2 diabetes. In 2007, after a chance testing by my local GP, Professor Azhar Farooqi, who is now the clinical commissioning group lead in Leicester, I was diagnosed with type 2 diabetes. Before I discovered that I had diabetes, it was not really a subject that I was aware of. Since then, it has become my passion inside and outside Parliament.

I begin by paying tribute to the Minister, who has truly revitalised the debate on obesity and diabetes since becoming a Minister. I agree with what she said, in her interview with Total Politics this week, about the public health Minister’s job. I have deleted one or two words, but she said that

“this is not a soft…girly option, it is a…serious job”,

and she is absolutely right. That is why I am delighted to see, on the Opposition Front Bench, the shadow Minister for public health, my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who entered the House with me in 1987.

I am also delighted to see so many other Members of Parliament who have either raised the issue of diabetes or have been involved in campaigns. There is the hon. Member for Strangford (Jim Shannon), who, like me, is a type 2 diabetes sufferer; the hon. Member for Mid Derbyshire (Pauline Latham), who has raised the matter many times in the House; and my hon. Friend the Member for Inverclyde (Mr McKenzie), who was in the Chamber, but has popped out. There is also the hon. Member for Southport (John Pugh), the hon. Member for Morecambe and Lunesdale (David Morris), who is my next-door neighbour in Norman Shaw North, and last but not least, the hon. Member for Torbay (Mr Sanders), who is the chairman of the all-party parliamentary group on diabetes and who, for many years, has raised the issue with such passion.

Childhood obesity has become an important political issue. The NHS report, “Statistics on Obesity, Physical Activity and Diet”, of February 2012, stated that in 2010, about 30% of boys and girls were classified as either overweight or obese. The study found that 17% of boys and 15% of girls were obese, which is an increase from 11% and 12% respectively in only 15 years. The factors that cause childhood obesity are a major part of the debate. A recent study by University college London found that 30% of the difference between the bodyweight of one child and another can be explained by their genes. However, genes alone cannot explain the rapidly increasing incidence of childhood obesity.

The ever-increasing numbers of overweight children must be addressed, or we will have a generation of obese children growing into obese adults. It will be a generation at risk from the associated dangers of being overweight, including having type 2 diabetes. Unless we do something about that trend now, the twin epidemics of obesity and diabetes will overwhelm the NHS.

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[Anna Soubry]

Yes, I agree, and I also think that there is no doubt that there is a link between being overweight or obesity and mental health. Which comes first, I do not know, but it is certainly all connected.

The call for action on obesity set out the steps that we are taking to help people to make healthy choices. That is what we aim to do: provide people with the education and knowledge they need, then ensure that they have the opportunities and options to make healthy choices. We have the national child measurement programme; we have change for life. The hon. Member for Strangford may like to know that 1 million families have joined change for life, and 684,000 people have downloaded the “Be food smart” application.

There is much more that we can do, and obesity in children is one of my absolute top priorities. I want to know why we have stopped weighing pregnant women. It seems absolutely bonkers. I am looking at the advice that we give to new mothers on how to feed their babies, and I am also looking at the role of health visitors, midwives and our great NHS workers. As I have said, in Rotherham there is a wonderful project, which anyone who has an interest in this subject really needs to go and see, because one of the things that is happening there is that everything is integrated. The project has been up and running for three to four years, and the NHS, dieticians, GPs, nurses and health visitors all work with schools, teachers and the local authority—in many ways, it is driven by the local authority. It is a wonderful experience, where the project workers do not demonise food, but look with kindness and care at the causes of problems. They help people, not only with their diet through the information that they provide, but by helping them to exercise.

I have completely run out of time. In no way have I completed my speech, and I apologise profusely for that. However, I pay credit and tribute to everybody who has signed up for the responsibility deal. There is much more that we can do; I completely accept that. Nevertheless, I would say that the labelling on packaging is something that we are particularly proud of. We are getting a standardised system that will enable people to make healthy choices and take responsibility. I could talk about schools and the great work that they are doing, but that will have to be the subject of a letter.

[Philip Davies (in the Chair)]

Order. We now come to the next debate.

Leeds Children’s Heart Surgery Unit

Philip Davies Excerpts

Tuesday 30th October 2012 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to have a further opportunity—you might wonder why we are taking another chance to raise the issue—to discuss the Leeds children’s heart unit. Given that there is a new ministerial team at the Department of Health—I am delighted to welcome the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry) to her new post—and that the decision on the unit has been referred to the Independent Reconfiguration Panel, it is critical that the independent review gets this right. The issues that we have been raising need to be assessed in great detail by the independent panel.

It is important for us to remind ourselves of the key issues. I want to make it crystal clear at the outset that we have always supported the objective of the review. Of course, we all want the best services for our children, and having fewer specialist centres is a principle that we have never doubted. My grave concern is that the review will fail to meet the objectives, particularly in the north of England, subjecting my constituents and those in Yorkshire and Lincolnshire to a worse service than the one that they currently enjoy. That is why I want to outline our concerns.

First, the review has always made it clear that units need to perform 400 operations or more a year. If that is the agreed standard, we must accept that. However, a survey by PricewaterhouseCoopers showed that the majority of patients who live in east, west and south Yorkshire would not travel to Newcastle. Instead they would go to Liverpool, Birmingham, or, in some cases, even to London. Anyone who knows our area knows that that is instinctively the case. Since the decision was made, adverse weather over the past couple of months has caused huge problems on the A1. Would a parent go there or would they choose less problematic routes? The issue is made clear in the analysis. The independent review document states:

“There was more reluctance amongst members of the public to consider travelling to Newcastle as a centre. If the preference of the parents and the public were factored into assumptions of patient flows, they may have implications for projected levels of activity at – in particular – the Newcastle centre.”

What is the review’s answer to the problem? At the decision-making process meeting—a seven-hour meeting to rubber-stamp a decision that clearly had already been made—it was said that patients preferring centres other than Newcastle would be influenced by referring doctors, with the assumption made that they would be pointed to Newcastle. Frankly, the evidence points to the contrary: all 20 referring clinicians in the Leeds network, whose views were never sought by the Safe and Sustainable review, said that they would not refer patients there for treatment.

In addition, the review argued that if 25% of patients from Leeds, Sheffield, Doncaster and Wakefield chose to go to Newcastle, that unit would perform 403 operations a year, conveniently just over the target of 400. That also assumes that 100% of patients in the other remaining postcodes, including Hull and Harrogate, would go to Newcastle. Newcastle can only reach the 400 figure if all the assumptions—that 25% will go from south and west Yorkshire, that clinicians will refer, and that 100% in Harrogate, Hull and elsewhere would use the centre—are correct, but there is no evidence to support such assumptions.

Given the importance of the 400 figure, it is staggering that it has been reached on the basis of assumptions. I know my hon. Friend the Minister was a barrister before entering the House. I wonder how the court would have reacted if she had based her defence or her prosecution on assumptions. That is why I believe the review is flawed. If we are going to change, it must be for a much better service.

That brings me to the issue of co-location. The foundation of the review was the inquiry at Bristol, and ensuring that such events never happen again is crucial. A key recommendation of the inquiry was to have all paediatric services under one roof. The British Congenital Cardiac Association has stated:

“It is important that the centres designated to provide paediatric cardiac surgery must be equipped to deal with all of the needs of increasingly complex patients. For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

I completely agree with that statement. Indeed, Professor Sir Ian Kennedy, in his report following the Bristol inquiry, stated in recommendation 178:

“Children’s acute hospital services should ideally be located in a children’s hospital, which should be physically as close as possible to an acute general hospital. This should be the preferred model for the future.”

Yet despite Sir Ian’s assessment panel describing the location of key services on a single site as optimal, Sir Ian accepted a watered-down definition of co-location, which allowed Newcastle to be described as a co-located service, and that led to the decision to close Leeds, despite the Paediatric Intensive Care Society’s assertion that it

“would dismiss any suggestion that a service located on another hospital within the same city can be regarded as being equivalent to a service located on the same hospital site.”

What has caused Sir Ian Kennedy to change his mind? Anyone visiting the Leeds unit will know that it is a wonderful, integrated unit. It has all the services that are needed for children with complex and multiple needs. They need paediatricians there with other specialities. On my several visits to that unit, on each occasion I have seen paediatricians coming to help patients with complex needs.

[Philip Davies (Shipley) (Con)]

My hon. Friend has led this campaign in Parliament with his customary charm and tenacity. As ever, he is making an excellent case. The national health service is paid for by the public for the benefit of the public. Ultimately, the services that we provide should be the ones that the public want. MPs from our region, from across the parties, are here today, and it is clear that the people in Yorkshire have confidence in the unit, want it to continue and believe it will offer the best possible treatment. Should that not be one of the most important factors that the Government bear in mind?

Social Care (Local Sufficiency) and Identification of Carers Bill

Philip Davies Excerpts

Friday 7th September 2012 Commons Chamber

[Barbara Keeley]

I do, and I will come on to the issue of student carers. The Bill explores student carers for the first time. I do not know why the issue has not been discussed more in the House, but it is vital that we, as constituency Members, take note of it.

Joint strategic needs assessments done at local level do not link care provision with work, and that is why the clause is important. The Department of Health has an upcoming event on developing care markets, the invitation to which we received yesterday. It says:

“the ability to choose from a variety of high-quality services should be available to all people in a local area, regardless of who pays for their care.”

Age UK, in its support for my Bill, commented on that Government aim to give people who need care and support a greater choice. It said:

“this cannot become a reality unless local care markets work effectively to provide people, including those with specialised needs, with appropriate services. Whilst we welcome proposed duties in the draft Care and Support Bill that would require local authorities to take steps to ensure that appropriate services are available this falls a long way short of a requirement to ensure sufficiency. We will certainly be advocating for a Bill or subsequent regulations that will include more specific duties on local authorities.”

[Philip Davies (Shipley) (Con)]

I congratulate the hon. Lady on introducing the Bill and bringing the plight of carers to the House. We all owe carers a big debt of gratitude. The Bill is littered with phrases such as “practical steps”, “reasonable steps” and “sufficiency”. What does she consider sufficient and reasonable, because the Bill does not make that clear, and how much would those steps cost?

[Barbara Keeley]

I will come on to the sufficiency measures, which are similar to a provision in the Childcare Act 2006, which placed a duty on local authorities to report on the sufficiency of child care in their area. The key thing is to ensure, first, that local authorities have a good enough picture. At the moment, the only picture they have is of what they are commissioning and providing, and, as I said, 80% of people who need care are self-funding, and their needs and whether they are being met are not looked at all. We therefore have a huge gap in information on the needs of those people and whether they are being met. There might be a need for nursing home beds for people with certain categories of dementia, and unless they were paying for them, local authorities would have no idea whether those existed. That information does not exist for all the people living in an area who needed that provision. As I said, health bodies and local authorities do joint strategic needs assessments, but they are not taking account of the fact that that can help people to work. We are trying to ensure that, as with child care, there is such provision, so it is similar to that measure.

The Bill does not go into detail because that is usually done in regulations which would be decided after the Bill had been passed. These are matters that can be debated and decided in Committee. However, in placing new duties on local authorities we are aware that we want regulation to be as light touch and low cost as possible. That is why some of the language is hedged around with phrases such as “reasonable steps”. We do not want to put expectations on local authorities that they cannot meet in the present environment.

[Philip Davies]

That was a helpful response. To get to the nub of the issue, does the hon. Lady believe that the House should pass legislation to provide certain duties, at whatever cost, which should be met, or does she accept that only a certain amount of money can be afforded and that the question then is how best that can be allocated?

[Barbara Keeley]

We are talking about a reporting duty. If local authorities, working with their health partners, do not report on social care provision, no one else will. Those of us interested in these matters ask questions, but we do not get very good information. Sending freedom of information requests to every social care authority in the country is not the best way for national organisations or Members of the House to get such information. We are asking for a picture of the market to be held in each local area. I am not suggesting a move in a direction in which the Government are not already going. The Government now expect local authorities to be what they call “market shaping”, taking action to drive the market. We are saying that they do not even have a picture of what exists now. Until we have such a picture, which is not just gathered by freedom of information requests, the expectation of the Department and the Government of local authorities is perhaps not reasonable. It is not a budgeting duty but a reporting duty.

I was dealing with sufficiency and the reporting duty and saying that organisations such as Age UK believe it is important that local authorities have a view of the sufficiency of their local care services. To expand on a point my hon. Friend the Member for Leicester West has made, the way local authorities are currently cutting back on what they pay in fees for social care beds and nursing home beds is actually creating market distortions, because some providers are simply moving to areas where there are more self-funders. In Greater Manchester, for example, all the nursing home providers might move to Trafford, which is a wealthier borough, and we would not have proper provision in Salford, part of which I represent. What is happening in the market could result in that kind of distortion, and that should be spotted.

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[Barbara Keeley]

I agree; that is a very good point.

[Philip Davies]

I wonder whether the hon. Lady is being unfair to universities by saying that there is a gap in the provision of information for student carers. I do not doubt that she knows more about the subject than I do, but my local university, Bradford, has a very extensive policy on student carers, with lots of information about what help could be provided. In saying that there is a gap, does she think that he might be doing a disservice to universities such as Bradford, which are clearly doing an awful lot to help student carers?

[Barbara Keeley]

I am very glad to hear that Bradford does that. Professor Luke Clements of Cardiff university, who helped to draft the Bill, says that it depends on having the right sort of vice-chancellor with go-ahead policies. It is not only I who believe that there are gaps; so does the National Union of Students, which understands these things. Particularly in Scotland, the websites of people who are standing for representative positions in the NUS show that they are all campaigning on Fair to Care and asking universities to have a carers strategy. It must therefore be the case that lots of universities, including those in Scotland, do not have a carers strategy. We are asking that a policy be put in place to recognise carers’ needs and tell them where to go for support. I am glad that the Bill would remedy the situation whereby perhaps hundreds of thousands of student carers are left to struggle alone with the difficult demands of juggling their caring responsibilities alongside studying.

The Bill deals with vital issues for carers and for disabled people. I thank Professor Luke Clements and Carers UK for their help in drafting the Bill. Emily Holzhausen and Chloe Wright of Carers UK have provided much extra support in preparing for today’s debate, and I thank them for that. I also thank Kate Emms of the Public Bill Office for her sound advice and help. I thank all the co-sponsors of the Bill for their support for the measures it contains. It has been good to know, as we have worked on this, that the issues involved in social care and the need to identify carers, young carers and student carers generate such great cross-party support.

The provisions in the Bill should be taken forward, and I hope that we will get the chance to discuss and, if necessary, modify them in Committee. Five million carers, including young carers and student carers, depend on our progress on measures that will help them, and I hope that we do not let them down.

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[Sir Tony Baldry]

It is very rare that an area of public policy, particularly on something as important as carers, can be dealt with by just one Department. I have absolutely no doubt that the Government’s White Paper on social care is the subject of an enormous amount of interdepartmental discussion. One task of the various all-party groups is to highlight to the Department of Health the issues that relate to other Departments, so that it can negotiate with those Departments before bringing forward its Bill. There will be cost implications in different areas, and I am sure there will be a robust debate about money on Second Reading of the Care and Support Bill. We have not yet come to that.

I say to the hon. Lady that the White Paper was published only shortly before the summer Adjournment. There has been little opportunity for any of us to interrogate Ministers in other Departments about policy areas such as those that she rightly identifies. Of course, a number of Ministers, like the one who is here today, have only just taken on new ministerial briefs. I believe that at Minister of State and Parliamentary Under-Secretary of State level, only 11 Ministers will be opening the same red boxes this weekend as they did last weekend. Those of us who have been Ministers know that it takes two or three weeks just to absorb the briefing for incoming Ministers, so we should not be impatient. What is important is to ensure that those of us who are in all-party groups relating to carers, or who are concerned about carers policy, can support the Government’s social care Bill on Second Reading.

[Philip Davies]

Will my hon. Friend give way?

[Sir Tony Baldry]

I give way to the other sexton.

[Philip Davies]

I am grateful. I have been trying to decode what my hon. Friend said about me and my hon. Friend the Member for Bury North (Mr Nuttall). I do not know whether he was trying to be insulting, but in his characteristically charming way, or whether he was merely saying that we take a close interest in each private Member’s Bill, which I would say was a compliment, even though perhaps a rather ham-fisted one.

Is my hon. Friend trying to say that if we get the undertakings that I am sure we would all like from the Minister today—he has already made some—it would be helpful if the hon. Member for Worsley and Eccles South (Barbara Keeley) were to withdraw her Bill?

[Sir Tony Baldry]

We all have to be grown-up about this. The hon. Member for Worsley and Eccles South has come up in the ballot, and it is a matter for her how she deals with the Bill. She is perfectly entitled to take it forward. I am just concerned to ensure that there is no scintilla of a suggestion that we will get ourselves into a hole. I was in the House when Nick Scott was the Minister responsible for the disabled. We got ourselves into a terrible hole over a private Member’s Bill by giving the impression that we were not interested in policy relating to the disabled, which of course was totally untrue. I do not want there to be any suggestion of that happening in relation to carers. I hope that we have now found a constructive way forward.

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[Mr Nuttall]

That would appear to be the case. If the survey used the wider definition, which I believe it might have, it would indeed indicate that the number of people affected by the Bill would be fewer as a result of its using the statutory definition.

After the Carers Trust’s definition of a carer as

“someone of any age who provides unpaid support to family or friends who could not manage without this help”,

it goes on to state:

“This could be caring for a relative, partner or friend”—

we should note that this definition includes friends as well—

“who is ill, frail, disabled or has mental health or substance misuse problems.”

At this point, we come to what I submit are some of the problems with the interpretation of the Bill. What exactly constitutes a “substantial” amount of care? Who is to be the judge of whether care is substantial or not? One man’s definition of what is “substantial” may not be the same as another’s. Therein lies the first of a number of uncertainties in the Bill.

[Philip Davies]

I am looking at the 1995 Act, too. As my hon. Friend makes clear, it defines a carer as someone who

“provides or intends to provide a substantial amount of care”,

but it also includes the phrase, “on a regular basis”. Does my hon. Friend agree that while there might be a lot of debate about what constitutes “substantial”, there might be quite some debate, too, about what constitutes a “regular” basis of support?

[Mr Nuttall]

My hon. Friend is quite right that there are two legs to the definition. It is not just a question of whether it is “substantial” but of whether it is “regular”. It could be once a year. If someone visits their elderly granny once a year, that is regular, but it is not the same as going around morning, noon and night to look after an elderly mother who needs care almost constantly. I therefore think there are difficulties with the definition, and I submit that it needs clarification. The Bill is silent on that and I fear that the explanatory notes, which are excellent in many ways, as I shall explain later, are silent on it, too.

[Philip Davies]

On that point, does my hon. Friend agree that the wider definition is more helpful than the one set in statute? There might well be cases—I am sure we have all come across them; I have certainly come across them in my constituency—where people need some kind of care and help, yet the local authority, probably for financial reasons above all else, has decided that it is not going to give them the support they need. Many people are looking after relatives or friends who need care, but who have not passed the test of being assessed as such by a local authority.

[Mr Nuttall]

My hon. Friend touches on an important point. I fear—I am sure others will, too—that this Bill may unreasonably raise the expectations of that group of carers covered by the wider definition. They may think, “This is me; I’m a carer”, but would they be a carer under the much narrower definition in the Bill? As I say, there is a danger that many carers will feel that this debate is about them, when under the statutory definition in clause 8—it is clear, referring back to section 1 of the Carers (Recognition and Services) Act 1995—they may not be covered.

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[Philip Davies]

Before my hon. Friend continues his speech, may I urge him not to be distracted by the tactics of the hon. Member for Kingston upon Hull North (Diana Johnson), who is trying to do something that might be described as rather despicable? She is trying to argue that the fact that someone does not support a particular Bill means that that person is against the whole concept of the aim of the Bill or the subject area. Anyone who knows my hon. Friend will be aware that he is passionate about helping carers and people who need this kind of support. He should not be distracted by those who try to characterise his opposition to certain elements of a piece of legislation as opposition to the welfare of carers as a whole. I urge him to continue in his current vein.

[Mr Nuttall]

I am grateful to my hon. Friend. I feel that there is a danger that some of the content of the Bill may cause scarce resources to be diverted from front-line services to carers for the purpose of the production of assessments, surveys and strategies, rather than providing real, genuine help for those who need it most.

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[Mr Nuttall]

I have already made my support for carers absolutely clear. My hon. Friend the Member for Banbury (Sir Tony Baldry) has also secured a helpful undertaking from the Minister on ensuring that the Government engage with the Bill’s supporters about the subjects that it deals with in the context of the draft Care and Support Bill.

[Philip Davies]

Has my hon. Friend noted the irony that Labour Members who regularly troop through the Lobby to vote against Government programme motions, because they say that those motions allow insufficient time for debate and effective scrutiny, now take the view that this Bill should go through the House without any scrutiny whatsoever just because it happens to have their support? Our duty in this place is to scrutinise legislation, whether Labour Members like it or not.

[Mr Nuttall]

There is indeed such an irony. Legislation of all kinds should receive proper scrutiny.

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[Mr Nuttall]

I am certainly not trying to destroy the Bill. I will stick to my point, because I think that we need to look at this—[Interruption.] [Hon. Members: “In Committee.”] It is an important part of the Bill. Existing legislation covers all members of the public, so I do not think that we need to single out a specific group.

[Philip Davies]

Opposition Members talk about these matters being considered in Committee. Given that the Government have published a draft Bill on this very subject, does my hon. Friend not agree that Opposition Members, if their overwhelming priority is to discuss these matters in Committee, will have an amazingly good opportunity to do so at length in relation to the draft Bill? That can be done without this Bill progressing any further.

[Mr Nuttall]

That is indeed the case. I am sure that it will be possible to consider all these matters in detail when we look at the draft Bill in Committee.

The NHS operating framework for 2012-13 already provides that carers must receive help and support from local NHS organisations. Primary care trusts are required to agree policies, plans and budgets to support carers with local authorities and carers’ organisations and make them available to local people. It states:

“Following a joint assessment of local needs, which should be published with plans, PCT clusters need to agree policies, plans and budgets with local authorities and voluntary groups to support carers, where possible using direct payments or personal budgets. For 2012/13 this means plans should be in line with the Carers Strategy and: be explicitly agreed and signed off by both local authorities and PCT clusters; identify the financial contribution made to support carers by both local authorities and PCT clusters and that any transfer of funds from the NHS to local authorities is through a section 256 agreement; identify how much of the total is being spent on carers’ breaks; identify an indicative number of breaks that should be available within that funding; and be published on the PCT or PCT cluster’s website by 30 September 2012 at the latest.”

So there is already a lot going on within the NHS. Let us not forget that the Department of Health is providing the NHS with £400 million over the four-year period from 2011-15 to support carers in taking breaks from their caring responsibilities. The Department has also funded the national carers strategy demonstrator sites programme, which is focused on three areas of support to improve carers’ health and well-being, carers’ breaks and health checks, with better NHS support. The new idea of national carers strategy demonstrator sites has been independently evaluated by the Centre for International Research on Care, Labour and Equalities at Leeds university, which has prepared an excellent report on how successful it has already been.

Clause 5 seeks to place a duty on a local authority to ensure that within 12 months of Royal Assent

“it takes all reasonable steps”—

again, we have no idea of what “reasonable” may amount to—

“to ensure that in relation to…any school within its area and under its control, and…any functions it discharges…there is in place a policy”

to identify and support young carers. However, the clause makes no mention of academy schools. Perhaps when the hon. Member for Worsley and Eccles South winds up she will be able to explain why academy schools would not be covered, because they are state schools that are independent of local authorities but still funded—

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[Philip Davies (Shipley) (Con)]

Thank you, Mr Deputy Speaker. I have not been left with much time, but I am conscious of the fact that other people wish to speak. I will therefore try to be as quick as possible, as is customary for me on such occasions. It is a pleasure to have you back in the Chair.

I commend the hon. Member for Washington and Sunderland West (Mrs Hodgson) for her closing remarks, because they got to the nub of the debate. What is important is that today’s debate has raised the issues that are important to all of us. We all want to support carers. Like my hon. Friend the Member for Bury North (Mr Nuttall), I remember my mum acting as a carer for my granddad and her father, Charlie, who had cancer. She dedicated many hours to looking after him and other family members came and helped. I understand from first-hand experience how important it is that we give as much support to carers as possible.

The most important thing about today’s debate, which the hon. Member for Washington and Sunderland West made clear as she summed up, is that we have gone through the issues that we hope will be addressed by the Government. They have produced a draft Bill and presumably legislation will come before the House in the not-too-distant future. All the issues that have been debated today, including the contents of the private Member’s Bill, can be debated during the passage of the Government Bill. Amendments can be made at the Committee and Report stages of that Bill, and far more time than we have been allowed today will be available to scrutinise those measures. We all hope that, at the end of all of that, we will have a measure that we can all agree upon, if that is possible, and that gives the best possible support to the carers who need it. The important thing is not whether this specific Bill gets through to the next stage, but what the overall outcome is. That will be determined by the Government’s draft Bill, and that is where it is best left.

I will move on to discuss the specific issues. It is important to look back at the history. The hon. Member for Worsley and Eccles South (Barbara Keeley), who presented the Bill, said when I intervened on her— I apologise if I get this wrong—that the Bill is about putting reporting responsibilities on local authorities. It goes far beyond that, however. Clause 1 introduces a

“duty to ensure sufficient social care support”.

That goes far beyond the reporting of that support.

As my hon. Friend the Member for Bury North said in dealing with an intervention, the Bill comes after more than a decade of the hon. Lady’s party being in government, and she is now calling for more to be done. It was only in 2008—I seem to remember that the hon. Lady was a Minister at that time, although I could be wrong about that as well—that her Government published an update to the carers strategy that was introduced in 1999. The update stated:

“By March 2011, we will have invested over £1.7 billion for councils to use to support carers in a range of ways through the annual Carers Grant. This includes £25 million a year announced as part of the New Deal for Carers for emergency break provision.

We have also committed a further £22 million to cover the costs of the establishment of information services via a helpline and a training programme for carers and information service, and £3.4 million to directly support young carers through extended Family Pathfinders and support for whole-family working.

We are now investing over £255 million on new commitments as part of this strategy.”

It seems to me that the hon. Lady is asking in the Bill for things that her Government claimed were already happening. Perhaps she will explain why her Government did not do what she seeks.

[Barbara Keeley]

It is quite clear from all the excellent contributions to the debate that Members understand that this is not just about allocating budgets. It is about having the right processes and about people taking their duties seriously. We can throw any amount of money at carers’ breaks or anything else, but if carers are not identified, if GPs ignore the fact that people are carers or if young carers are not taken seriously at school and are bullied and intimidated, it does not make any difference how much money is sloshing about. That is why the specific reporting and other duties in the Bill are so important. The Bill is mostly about having processes and procedures in place and ensuring that health and other professionals take them seriously.

[Philip Davies]

I could not agree more. I totally and utterly endorse what the hon. Lady says. Joking aside, it is refreshing to hear an Opposition Member say that it is not just spending money but getting results that is important. All too often, spending money was all it was about under the previous Government. It was about input rather than output. I am delighted that she wants to concentrate on output, as I do.

I contend that much of what the hon. Lady seeks to do in the Bill is already happening in one form or another. She might argue that it is not happening as well as it should, and I am sure that it could always be better. She may well argue that it is happening better in some parts of the country than others, and I suspect that will always be true whether or not there is legislation. When she referred to the lack of support for carers at universities, I pointed out the excellent work that Bradford university does to support carers. I believe that the same work is done at Leeds university. I have certainly seen a document from that university about the support that it wants to give to students who are carers. I argue that much of what she wants is happening anyway in various places, and there is certainly nothing to prevent them from happening even without the Bill. I am sure that if all of us, including the Minister and the hon. Lady, contacted universities, showed them best practice from other universities and urged them to follow suit, their vice-chancellors would be happy to do so without the need for further legislation. There are other, more imaginative and perhaps quicker ways of achieving her aims than going through the rigmarole of passing the Bill.

Much of what the hon. Lady seeks is covered in the Government’s draft Bill and White Paper. I take the point made by my hon. Friend the Member for Banbury (Sir Tony Baldry) that the hon. Lady introduced her Bill before any of that was known, so she was absolutely right to do that, but we are where we are. Given that the Government have adopted in the White Paper much of what she wants, we can safely leave the Minister to carry on. We all accept that he is a capable and decent person, and he has given the House assurances today that will have reassured us all about how he intends to proceed. He has said that he wants to involve the hon. Lady in the discussions about the Government’s draft Bill before it proceeds, and I am sure she knows that he means that. We can rely on the Government to introduce the best aspects of her Bill, so we do not need to proceed with it.

My hon. Friend the Member for Bury North made the point, which the Minister reiterated, that some of the duties that the hon. Lady’s Bill would place on local authorities, although well meant and with a positive element to them, could take money away from the front-line resources that we want to go to people who need them. It could instead have to be spent on further reporting, strategies, documents and other things that could eat up a considerable amount of local authorities’ money before we know it. I am not sure whether that approach is desirable. As I said, there might be some desirable ends, but overall it is more likely to take money from carers than to give them support.

[Barbara Keeley]

Do the hon. Gentleman and his colleague, the hon. Member for Bury North (Mr Nuttall), have a view on the billions of pounds that could remain in the economy if people do not give up work to become carers? If local authorities draw up the local sufficiency picture, it will help carers to stay in work. If carers stay in work, they are earning money, they are not on benefits and they pay tax and national insurance. Does the hon. Gentleman not see that there is a balance to be struck? I am sure that the sufficiency reporting duty will in no way match the billions of pounds that would be lost if 1 million carers give up work to care.

[Philip Davies]

The hon. Lady makes a fair point although I cannot speak for my hon. Friend the Member for Bury North. If he had not been cut short we might have learned his view of the sufficiency measures, but perhaps we will hear it at a later date. I do not want to get bogged down or I will be criticised for trying to talk out a Bill that I have no intention of talking out. On this occasion—one for the record books—I endorse what the Government are doing. I wish the Minister well in developing the strategy, and I hope that we get the outcome we seek. In all honesty, however, we can do that without the Bill, and if the hon. Member for Worsley and Eccles South had known the Government’s plans at the time of the ballot for the private Members’ Bills she might have chosen a different issue. As she must acknowledge, the Government are doing much to go down the route she has advocated today.

Business of the House

Philip Davies Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I am surprised that the hon. Gentleman did not put that in the context of the overall reduction in the number of households with nobody in work, which I believe is very much to be applauded.

[Philip Davies (Shipley) (Con)]

May we have a debate on the appointment of judges, and on how to make them more reflective of public opinion? A great deal of concern has been expressed about lily-livered judges by many people, not least me, and yesterday we heard a judge saying that it took a huge amount of courage to burgle a house, and refusing to send a persistent burglar to prison. How can we ensure that idiots like that do not remain in the judiciary, and that the people who are appointed to the judiciary do not reflect the views of that individual?

[Mr Lansley]

I am conscious that, in my new privileged position, I stand at a constitutional juxtaposition between the legislature and the Executive. One of the last things I would want to do, on my first occasion at the Dispatch Box, would be to trespass on the relationship between the legislature, the Executive and the judiciary, and in particular on the independence of the judiciary, so I will avoid commenting on that. However, my hon. Friend’s observations are on the record.

Health and Social Care Bill

Philip Davies Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

The hon. Gentleman should go and talk to the clinical commissioning groups across the country that are delivering on the clinical leadership that will modernise and improve the NHS rather than simply sitting reading the newspapers and imagining that he knows what is going on in the NHS.

[Philip Davies (Shipley) (Con)]

Does my right hon. Friend agree that when she was in government, Baroness Williams was one of the chief architects of ruining the state education system in this country? Given that, why would a Conservative-dominated Government wish to dance to her tune?

[Mr Lansley]

My right hon. and noble Friend Baroness Williams is now a member of the Liberal Democrat party, and in that respect I am not aware that she has ever transgressed in government.

Alcohol Strategy

Philip Davies Excerpts

Tuesday 7th February 2012 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

How far should the state step in to regulate the free market and alcohol? If a jumbo jet fully laden with passengers crashed over Britain every fortnight, drastic action would be taken, and that is what we are talking about—22,000 people die every year in Britain as a result of alcohol. The Office for National Statistics cites the figure of 8,790, but that excludes all the accidental deaths, the homicides, the impulsive suicides and the many victims of road traffic accidents. Alcohol is linked to more than 60 medical conditions, including many cancers.

Some will argue that this is all about personal responsibility and that we should resist the interference of the nanny state, but how can the 705,000 children who live with an alcohol-dependent parent exercise personal responsibility? We have a blind spot when it comes to the destructive effect of alcohol. Yesterday, I spoke to Stephen Otter, the chief constable of Devon and Cornwall police, who told me that the statistics for 2004-05 showed that about a third of violent crime in Devon and Cornwall was related to alcohol. Since then, the statistics have followed a steadily upward path and alcohol is now related to about half of such crime. The trend is increasing, so how do the victims of violent crime feel when we say that we should leave this to the market?

What about taxpayers? The cost of the epidemic is out of control. It is at least £20 billion, but if we look at the finer details of the impact on productivity, we will see that the evidence given to the Health Committee when it looked at this issue showed that the cost could be as high as £55 billion. At a time when the NHS has to make efficiency savings of £20 billion over the next four years, is it right that we are flushing down the drain at least £20 billion a year on alcohol?

The Secretary of State talks frequently about outcomes, so I would like to give some that I think he should look at. Forty per cent. to 70% of all accident and emergency admissions are related to alcohol. The impact on health inequalities is undeniable. The difference between the poorest and the wealthiest neighbourhoods in terms of average life expectancy is about seven years, and early deaths from alcohol-related liver disease are a significant contributor to that. Almost one in four deaths in young people is directly caused by alcohol. That means that every week 12 young people are losing their lives, which is a far higher figure than the number who die as a result of knife crime.

Positive outcomes could be achieved from a reduction in teenage pregnancies, as well as in educational failure and its impact and sexually transmitted diseases. The state has a duty to protect young people and take action. On personal responsibility, harmful drinking does not just affect the individual; it has a knock-on effect on all those around them when they leave a destructive trail in their wake.

If it were possible to solve this problem just through education and gentleman’s agreements with the drinks industry and supermarkets, I would say that we should go that way, but that approach has clearly failed. The fact is that when alcohol is too cheap, people die. That was as true in the 18th century with its gin craze as it is today. This, however, is a general debate on what should be in the alcohol strategy, so I do not want to dwell too long on pricing. Suffice it to say that without action on pricing, I am afraid that nothing else will be as effective as it could be. Alcohol is no ordinary commodity and we should not treat it just through market forces.

[Philip Davies (Shipley) (Con)]

My hon. Friend appears to be making a coherent argument for banning alcohol altogether. I am concerned that she is like the anti-smoking lobby, which tries to come up with different things to restrict smoking in order to hide its real agenda, which is to abolish smoking altogether. If she thinks that alcohol is such a bad thing and that it does so much damage, why not have the courage of her convictions, follow her argument through and say that alcohol should be banned altogether?

[Dr Wollaston]

There is a simple reply to that question—it would not work. We have seen that clearly from the efforts at prohibition in the States. I myself enjoy a drink, as I am sure do most Members present. Everyone might like a drink, but nobody likes a drunk, and that is what this is about. It is not about stopping people drinking, but about asking at what point the state should step in to address the real harm. There is a balance to be achieved. I am not suggesting for one moment that my proposals will stop people drinking, and I would not want them to do so. I just want to do something about 22,000 people dying every year in this country.

I propose that we act on price and address availability, marketing, education and labelling, and that we take action on offending behaviour. We should also change the drink-drive limit. Crucially, if we are to put all those measures in place, we also need to help people who already have a problem, which means better screening and treatment in the health service for hazardous, harmful and dependent drinkers. It is also time to send a clear message that we have had enough of drunken antisocial behaviour and violent crime.

On availability—I will try to be brief, because I know that lots of Members want to speak—I welcome the consultation on dealing with the problem of late-night drinking. It is absolutely right that communities should have a greater say in the licensing hours, and I welcome the return from 3 am back to midnight and the idea that those who supply late-night alcohol should contribute to the clean-up cost. Will the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), go further and address whether supermarkets should face greater penalties? The problem for late-night premises and clubs is that their customers are already drunk when they arrive, having pre-loaded on very cheap alcohol. It is crucial that supermarkets should contribute to the clean-up cost.

On marketing, we currently spend £800 million a year on alcohol marketing, which dwarfs the budget given to the Drinkaware Trust, which is industry controlled. There is clear evidence that marketing encourages not only drinking earlier, but children to drink more when they do. Although it is encouraging that fewer children overall are drinking, we should still remember that, after the Isle of Man and Denmark, we are the country with the highest levels of binge drinking and drunkenness in our schoolchildren. The problem is that the current controls are complex and easily circumvented. There is an off-the-peg solution that is compatible with European Union law, namely to introduce similar measures to those in France under the Loi Évin. Rather than having a set of complicated measures saying what we cannot do, we would set out clearly where alcohol can be marketed and everything else would not be allowed. If we want to protect children, why do we allow alcohol advertising before screenings of 15-cetificate films? It is also confusing that, while we say that alcohol cannot be associated with youth culture or sporting success, we allow alcohol-related sponsorship of the FA cup and events such as T in the park. We need to protect children.

--- Later in debate ---

[Philip Davies (Shipley) (Con)]

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

As a libertarian and a believer in individual freedoms, I had hoped that the country had escaped from the nanny-state health police with the end of the previous Labour Government but, sadly, I was clearly naive in that thought. A great many people in the House seem to want to do nothing else but ban everyone else from doing all the things that they do not happen to like themselves, and I was certainly not brought into politics to do that. I urge the Minister not to be seduced by the reasonableness of my hon. Friend the Member for Totnes (Dr Wollaston), because I assure her that, were she to implement everything that my hon. Friend asked for today, my hon. Friend and the health zealots would still return with another list of things that they want the Minister to do. Such people will never be appeased or satisfied until alcohol has been banned altogether.

I want to focus on two points—the futile proposal on minimum pricing, and advertising and marketing. The very principle of minimum pricing goes against all my Conservative instincts and beliefs—the free market and freedom of choice. The process of setting a minimum price is predicated on the assumption that raising the price of alcohol will make those who misuse alcohol behave differently. However, that is an incredibly simplistic belief. It is worrying that people in the Chamber think that, by increasing the price of a bottle of wine by 30p or 40p, or of a can of beer by 40p, all the problems associated with drinking would at a stroke disappear. People who think that minimum pricing will stop young people going into town centres on Friday and Saturday nights with the intention of getting bladdered, or whatever the current term is, are living in cloud cuckoo land.

[John Pugh]

Will the hon. Gentleman give way?

[Philip Davies]

I will not give way, because plenty of other people want to speak and time is pressing. I will happily debate with the hon. Gentleman in the Tea Room or at some other point, although I am the only one arguing from this perspective, I suspect.

The Centre for Economics and Business Research conducted research on minimum pricing and concluded that the heaviest drinkers are the least responsive to higher prices. For example, at a minimum unit price of 40p, the CEBR found that harmful drinkers, which the policy is supposed to be targeting, would reduce their weekly consumption by only 1.7 units per week, which at the end of the day is less than one pint of weak beer. A report by Sheffield university found that a minimum price of 45p per unit would trigger a 6% fall in overall alcohol consumption and 60 fewer deaths in the first year alone. Yet the Government figures for 2009-10 show that overall alcohol consumption fell by 7%, while alcohol-related deaths rose by 36. Clearly, there is no link between the two.

Minimum pricing treats all drinkers the same, and penalises—financially and practically—the overwhelming majority of adults, all those people who drink alcohol responsibly and in a socially acceptable way, causing harm neither to themselves nor to others. The people who would be most penalised by minimum pricing are those who are already on tight budgets, such as pensioners, people on fixed incomes or those in low-paid jobs. I simply cannot understand how hon. Members, in a time of economic austerity, are prepared to force some of their poorest constituents to pay more for alcohol, when they know full well that the overwhelming majority of those constituents drink alcohol responsibly and in moderation. If hon. Members want to tackle binge drinking and alcoholism, they should focus their efforts on binge drinkers and alcoholics, not on everyone in the country, which would be unjustifiable.

The Institute for Fiscal Studies produced a report on minimum pricing that found that poorer households, compared with richer households, on average pay less for a unit of off-sale alcohol. For example, households with an income of less than £10,000 a year pay 39.8p per unit, while those on a household income of more than £70,000 pay 49.3p per unit on average. As a result, a minimum price of 40p or 45p per unit would have a larger impact on poorer households and virtually no impact on richer ones.

[Dr Wollaston]

Does my hon. Friend accept that our poorest constituents are paying the price for harmful drinking and that we should consider the effect of alcohol on health inequalities? Furthermore, the Sheffield study showed that minimum pricing at 50p per unit would only add an extra £12 a year to the cost for moderate drinkers.

[Philip Davies]

I do not accept that for two reasons. First, people should be free to spend their own money as they so wish, without having to obtain the permission of my hon. Friend before they decide how to live their life, in particular if no one else is affected; it is their responsibility. Secondly, the one thing that I have learned about alcoholism is that alcoholics will go to any lengths to get the alcohol they need; if we increase the price of alcohol, all that will happen is that they will give over a bigger proportion of their money to buying alcohol, leaving them less money to spend on other things—it will not change their behaviour at all.

I want to touch on advertising, but not for long. I opposed the ten-minute rule Bill of my hon. Friend the Member for Totnes on advertising. I used to work in marketing, for my sins, and I want to stress its purpose: it is about brand awareness and increased market share. When Cadbury sponsored “Coronation Street”, does anyone really believe that at the moment the Cadbury advert appeared at the start of the programme everyone leapt off their seat, switched off the TV set and dashed to the nearest newsagent to buy a bar of Dairy Milk? Of course not. All that Cadbury hoped was that, next time people went into the newsagent, they would buy a bar of Cadbury’s Dairy Milk rather than a Kit Kat. That is the whole point of marketing.

If we curb alcohol advertising, more than £80 million of revenue for the broadcasting industry would be jeopardised, leading to a direct loss in programme making in this country. It would also wreak havoc on sporting events, and I expect that the Department of Health would prefer to encourage as much sporting activity as possible. We already have a robust system of advertising regulation in this country, administered by the Advertising Standards Authority and in this case the Portman Group, endorsed by Ofcom. We hear that so many young people are made aware of alcohol by advertising, but lots of young children know about car advertising and yet it does not mean that they go straight out and start driving a car, merely because they are aware of the advertising.

I worry where this will stop. Will my hon. Friend the Member for Totnes return to the House in a few months’ time and urge us to ban the advertising of cream cakes, pizzas, chocolate, fish and chips or curry, because they are all bad for us if eaten to excess? This is a slippery slope, and certainly not one that I am prepared to support.

Organ Donation

Philip Davies Excerpts

Wednesday 9th November 2011 Westminster Hall

[Dr Poulter]

As the Minister will be aware, in 1994, there were 2,500 people on the organ donor waiting list, and last year there were over 7,500. Only 29% of the UK population are signed up to organ donation, which is woefully inadequate given that 552 people died last year while waiting for an organ transplant, excluding those who were taken off the list because they had become too unwell. It is a big problem; people are living longer, sometimes with multiple medical co-morbidities, which means that more people will need transplants. The problem will become an increasing challenge for health care providers and the Government.

Philosophically, I agree with the Minister and I am not in favour of compulsion. Does he agree, however, that we need a more targeted community-focused approach and, as with the cot death campaign that reduced cot deaths from 2,000 to about 300—

[Philip Davies (in the Chair)]

Order. Interventions must be brief.

[Paul Burstow]

The hon. Gentleman advances an important point. We cannot tackle the issue from the top down; it requires leadership from the bottom up in local communities. That is why NHS Blood and Transplant’s website provides constituency-level information about the number of people on the register, the number of transplants that have taken place, and the number of people waiting for a transplant. That information is invaluable to us as MPs and leaders in our local communities, and we should work with others in our community to break down some of the barriers of misunderstanding and misconception that were referred to by the hon. Member for Wolverhampton South West.

We have seen an increase in the number of organ donors by around 28% since 2008, and we are on track to meet the 50% improvement by 2013 set by the taskforce. As the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said, 29% of the UK population are on the organ donor register, and it is interesting to note how levels of registration change from one constituency to another—I urge hon. Members to look at that. The number of deceased organ donations rose to 1,010 in 2010-11, compared with 745 in 2001-02. The year 2010-11 also saw a record number of transplants from deceased and living donors, with 3,740 transplants carried out in the UK, compared with 2,633 in 2001-02.

Despite the considerable progress made over the past few years, however, there is still a shortage of organs donated for transplant. The situation is particularly serious for people from African-Caribbean and Asian backgrounds, because they are three to five times more likely to need a kidney transplant than white people. That is why we cannot be complacent, and we will continue to work with partner organisations to promote donations. That can be done through the Give and Let Live initiative in schools, where new information about the issue is circulated by NHS Blood and Transplant; by requiring people to answer a question about organ donation when applying for a driving licence; or by asking people to sign the organ donor register when applying for a European health insurance card and so on. The African-Caribbean Leukaemia Trust seeks to raise the importance of organ donation in black and minority ethnic communities, and local leadership is a key ingredient in delivering improvement.

Through various public awareness campaigns, NHS Blood and Transplant also publicises the need for more people to register as donors. Work continues at national, regional and local levels further to strengthen the donation programme, to support the excellent work of the NHS in identifying, referring and procuring donor organs, and to make organ donation a usual part of end-of-life care.

I am grateful for the opportunity to reassure all hon. Members in the debate that, as we modernise the NHS, we will continue to focus on driving forward an improvement in donation rates. To maintain that momentum, with the support of all UK health administrations, we have established a transitional steering group that includes health departments, NHS Blood and Transplant, the British Transplantation Society, and the royal colleges. It aims to focus on actions that will continue to embed donation within end-of-life care, and provide a link between oversight of the programme delivery board and the establishment of the NHS commissioning board in 2013. It will also provide a clear link to Health Ministers for any reports on progress.

The transitional steering group will focus on six key areas: increasing consent rates; brain stem death testing in all appropriate cases; donation after circulatory death to be considered in all circumstances; increased donation from emergency medicine; increased and more timely referral of potential donors; and improved donor management. The work of the transitional steering group will continue to drive improvements in the UK’s organ donation programme, and increase donation rates.

The hon. Member for Wolverhampton South West asked about leadership, which is an essential issue. The national clinical director for transplantation, Chris Rudge, has recently retired from that role, although I confirm that he will be appointed as leader of the transitional group, which will provide continuity of leadership. I hope that that reassures the hon. Gentleman, and others, about the Government’s serious intent to deliver on the important target. I can also inform the hon. Gentleman that we will not wait until 2013 to look at what should happen next, and we have already begun to develop a post-2013 strategy. NHS Blood and Transplant is starting to prepare the relevant documents, and is working closely with the transitional steering group.

This has been an incredibly important debate and significant points have been raised. I hope I have demonstrated that, in terms of leadership, intent and drive, we are committed to building on the improvements we have already seen and, where appropriate, to learn lessons from other parts of the world. That will require us all to play our part in raising awareness of organ donation, and of what the consequences for people’s lives will be if donations are not made.

As the hon. Member for Wolverhampton South West said, donation is a precious gift. We need more people to realise that and give such a gift by putting their name on the register and being willing to donate.

Oral Answers to Questions

Philip Davies Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Lansley]

Under those circumstances, if a referral is made to me, I will wish to apply the kind of criteria that I set out last year for reconfigurations across the country for the first time: that they must meet the tests of being consistent with the result of any public consultation and with the public’s view, with the views of prospective future commissioners—such as the commissioning consortia that are coming together as a pathfinder in the hon. Gentleman’s constituency—and with the future choices made by patients about where and how they want services to be provided to them, and that they must meet clinical criteria for safety and quality.

[Philip Davies (Shipley) (Con)]

May I join my hon. Friend the Member for Leeds North West (Greg Mulholland) in urging the Secretary of State to protect the children’s heart unit at Leeds hospital as it is a very worthwhile facility for people in Yorkshire, and does my right hon. Friend the Secretary of State agree with me that doctors should go to where the patients are, rather than the other way around by expecting patients to travel for many hours to get to such an important service?

[Mr Lansley]

I am grateful to my hon. Friend for his question, but in response I will simply reiterate what I said to our hon. Friend the Member for Leeds North West: that these matters are currently the subject of consultation by an independent group representing the primary care trusts collectively, and not by the Department of Health at this stage.

Oral Answers to Questions

Philip Davies Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Speaker]

Order. I am very grateful, but from now on we do need briefer answers—[Interruption.] No, we need briefer answers, because I want to accommodate Back-Bench Members. It is about them that I am concerned.

[Philip Davies (Shipley) (Con)]

T2. I believe that the introduction of plain packaging for cigarettes would be gesture politics of the worst kind, that it would have no basis in evidence and that it would simply be a triumph for the nanny state—and an absurd one at that. Given that, does the Secretary of State believe that I am still a Conservative, and if so, is he?

[Mr Lansley]

I am happy to believe that we are both Conservatives. The coalition Government made a commitment in our public health White Paper to publishing a tobacco control plan. We will do so shortly, and the purpose will be very clear: to secure a further reduction in the number of people smoking, and as a consequence, a reduction in avoidable deaths and disease.

Neuromuscular Care (North-West)

Philip Davies Excerpts

Wednesday 9th February 2011 Westminster Hall

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Weaver Vale (Graham Evans) on securing this debate, which is important to many people. Although the title of the debate refers to neuromuscular services in the north-west, my constituency neighbour the hon. Member for East Londonderry (Mr Campbell) and I come from the north-west of a different island. This is not revenge for the map-reading errors that many of us would have heard excuses for over the years in border areas in Northern Ireland, nor is it an attempt to hijack this debate. I want to give positive support to the articulate efforts of the hon. Member for Weaver Vale, who spoke compellingly about what muscular dystrophy can mean for the individuals affected and their families.

Unlike the hon. Gentleman, I do not have a relative who suffers from muscular dystrophy, but I remember being particularly impressed by a young constituent of mine and his family. My constituent, who unfortunately died a couple of years ago, was named Donovan McKeever. When his parents, Brendan and Teresa, heard Donovan’s diagnosis, they were confounded by the degree to which nobody knew what to say to them or what they were talking about, asking about or looking for. Donovan’s father Brendan wrote a small book about his experience, titled “It Shouldn’t Have to Be Like This”.

Unfortunately, when a child is diagnosed with muscular dystrophy—this also happens with many other conditions, such as autism—parents often have to navigate systems and negotiate between services as though they were the first to find themselves in that situation. The hon. Gentleman’s speech reflected such frustrations. Because people know the good work of the Muscular Dystrophy Campaign and know that it is a recognised disease, they assume that care services are in place and that the system kicks in and knows what to do, how to pass people on and how to connect services. They assume that key workers exist to ensure that needs are met, whether that involves a disabled facilities grant for adapting housing, or assistance deciding which school environment will be most conducive or accessible. Families need support, and they expect the system to provide it. For people with muscular dystrophy—Donovan had Duchenne muscular dystrophy—that does not always happen.

The hon. Gentleman mentioned the importance of care advisers, as did the hon. Member for East Londonderry in his intervention. Northern Ireland has a muscular dystrophy care adviser, but unfortunately the funding for that care adviser is committed only until the end of March, and no long-term funding is in place. Not only are things not as they should be, but the existing service and the commitments that have been made may well disappear in the context of budget squeezes and other changes.

We should use this occasion to call for better services, planning and support, not just in the interest of individuals with such conditions and their families but in the interest of providing well-managed public services and savings. The hon. Member for Weaver Vale mentioned unplanned emergency admissions. Some 2,000 people in Northern Ireland suffer from muscular disease, and their unplanned emergency admissions cost at least £2.25 million a year. Better and more appropriate and available services would lead to savings. Making people present themselves in a less appropriate context puts pressure on other services and adds to costs, which is not efficient. Cutting corners in such areas in the name of efficiency savings is wrong, and some of the cuts and squeezes taking place are counter-efficient.

I know that the Minister is particularly concerned about the health services that the hon. Gentleman and I have mentioned. The issues on which patients need to engage the public policy system are not confined to clinical presentations. In the context of some other changes that the Government are introducing, such as changes to disability living allowance and medical assessments, I would hope that the Minister acts as an advocate for patients with muscular dystrophy to ensure that they are not overburdened by medical assessments. They find it difficult enough to navigate the system and get the services that they expect; it should not be made harder for them to get support such as disability living allowance and the mobility component.

On the intended removal of the mobility component of DLA from people in residential care, many young adults with muscular dystrophy choose to live in a residential care setting because of their situation. Their parents may have passed on, and other family members may have moved on. It is nonsense for people who have made that choice to lose the mobility component, with all the social support, access, personal outlets and socialising that it allows. I hope that this debate is not purely about the important issue of clinical and medical services for those with muscular dystrophy; I hope that we will take a holistic approach to people’s particular needs.

The hon. Member for Weaver Vale mentioned specialist multidisciplinary care. If we break the issue down to our different locations, whether we are talking about the new single commissioner for Northern Ireland, the Health and Social Care Board—

[Philip Davies (in the Chair)]

Order. I do not wish to interrupt the hon. Gentleman’s flow, but I hope that he appreciates that the terms of the debate relate specifically to the north-west. Although his comments on Northern Ireland are interesting, I hope that he will tie them in to the situation in the north-west, as that is the title of the debate.

[Mark Durkan]

I fully accept your admonition, Mr Davies. I made that point at the start.

If we consider specialist multidisciplinary care in relation only to different localities—whether primary care trusts and GP-led commissioning in the north-west of England or purely within the devolved regions of Scotland or Northern Ireland—we might miss a point. In the case of rarer diseases and conditions, a bigger commitment and wider consideration at a UK level provides a better context of scale. As we have heard, individual GPs sometimes are not good at responding to particular needs or realising the importance of a condition because they do not see enough instances of it. That problem applies not only to GPs but, more broadly, to other services and public management bodies.

I hope that, during the Minister’s tenure, the Joint Ministerial Committee, which brings together Ministers from the devolved entities as well as those from Whitehall, and the British-Irish Council will undertake initiatives to examine whether we can learn lessons from one another. When I was a Minister in the Northern Ireland Assembly, I was privileged to attend the council’s very first meeting. I remember the late Donald Dewar saying that one of the most undervalued art forms was plagiarism and that we needed a vehicle to bring together public policy planners and overseers, such as Ministers, from different parts of these islands. We need that not just in order to see who is doing well at what and to copy them, but in order to be honest and admit what we are all doing badly; to discuss the serious issues that we are not doing enough about; and to constantly agree, as public representatives, that more should be done and that there should be better laws, better services and better funding. If we cannot do enough of that in relation to our own individual pressures, perhaps the British-Irish Council and the Joint Ministerial Committee can together ask some of the fundamental questions, at the heart of government, that were raised by the hon. Member for Weaver Vale.