Oral Answers to Questions
Damian Hinds Excerpts(3 years ago)
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Damian Hinds (East Hampshire) (Con)
Suzanne Webb (Stourbridge) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
We are committed to halving childhood obesity in England by 2030, and the 2020 strategy takes decisive action to help everybody to achieve and maintain that healthier weight. We have five trailblazer sites working to create a healthy environment for our children. We have laid regulations for out-of-home calorie labelling. We have put £100 million into funding for adult and child weight management, and announced the introduction of some of the toughest advertising restrictions—both on TV and online—regarding children’s exposure to high fat, salt and sugar products. This is about the cumulative effect of several policies.
Damian Hinds
I am grateful to my hon. Friend for mentioning that wide range of measures. May I also encourage her to work closely with colleagues at the Department for Education and the Department for Digital, Culture, Media and Sport on an expanded children’s sports and activity plan, both in and out of school, to try to make 60 minutes a day as much a norm as five-a-day fruit and vegetables by bringing in the power of sports clubs and the governing bodies, and finally getting more school facilities available for out-of-hours use?
Jo Churchill
My right hon. Friend’s question is music to my ears. He will be pleased to hear that, last week, along with Ministers from DCMS and the DFE, I was in front of the Lords National Plan for Sport and Recreation Committee talking about doing just that—about how we can build on the DFE’s £10.1 million contribution, so that we can unlock the 40% of facilities that lie on school estates and help to get children active for 60 minutes a day. We will be publishing our cross-departmental update to the school sport and activity action plan later this year.
Oral Answers to Questions
Damian Hinds Excerpts(3 years, 1 month ago)
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Ian Levy (Blyth Valley) (Con)
Damian Hinds (East Hampshire) (Con)
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
Ms Dorries
I thank my hon. Friend for his years of service working in mental health. Mental health is one of this Government’s top priorities, and I assure him that we are doing our utmost to ensure that mental health services are there for everyone who needs them. Through the NHS long-term plan, we are expanding and transforming mental health services in England and investing an additional £2.3 billion a year in mental health services by 2023-24.
In addition, we have published our mental health recovery action plan, backed by a one-off targeted investment of £500 million in addition to the £2.3 billion, to ensure that we have the right support in place this year. The plan aims to respond to the impact of the pandemic on the mental health of the public, specifically targeting groups that have been most impacted. We have set up a cross-Government ministerial group to monitor progress against the actions listed in the plan, and the group will also identify areas for further action and collaboration.
Damian Hinds
I welcome the priority put on young people’s mental health, which is perhaps more important now than ever. Will the Minister give an update on progress on implementing the proposals in the children and young people’s mental health Green Paper, particularly on mental health support teams in Hampshire and nationwide?
Ms Dorries
We are making good progress on implementing the Green Paper proposals, and I am pleased to say that we have established 11 mental health support teams in Hampshire. Nationwide, there are currently 180 mental health support teams, covering around 15% of pupils in England. Over 200 more are in training or being commissioned, and we expect to have around 400 in place by 2023-24, covering 35% of pupils. We recently announced £9.5 million to train thousands of senior mental health leads among school and college staff.
Public Health
Damian Hinds Excerpts(3 years, 6 months ago)
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Damian Hinds (East Hampshire) (Con) [V]
It would be an understatement to say that people have restriction fatigue. I, like others, hate having to have the sorts of curtailments on people’s freedoms that a lockdown means. It is right—indeed, it is essential—that these regulations be time-limited, and I welcome the stipulations on regular reviews. I support the regulations because the contrast and choice before us is not between having curtailments or not; it is about the very difficult things that we do now as a country and a society, against even harder things that we would have to do in the future.
The data are startling in Hampshire, as elsewhere, with a dramatic growth in case rates since the start of December. Without truly stringent measures, there is a real risk of overwhelming the NHS. “Overwhelming” and “overtopping” have become commonplace phrases, but we need to stop, pause and reflect on their true meaning and implications far beyond covid.
The difference now, of course, as the Secretary of State has said, is vaccination. We can see, ultimately, a way through. It has been impressive to see the speed with which the Hampshire vaccination programme has got off the ground. Clearly, all hands now have to be put to the programme. I was pleased to hear what the Secretary of State said about the removal of red-tape barriers to volunteering. Clearly, close attention needs to be given to every stage of the vaccine’s production, distribution and administration.
As well as business support during lockdown, we are clearly going to need a sector by sector plan for how to come out of this, including for pubs, hotels and so-called non-essential retail, which are essential to our high streets and to the events business. We are going to need a national effort and mission on the return to school—preparing ahead of it, repairing the impact that this period will have again on children’s lives, and trying to get them back on track. It will need different approaches for different age groups and different individual children. Some will have fallen back in some subjects, not others. Some, of course, will have had truly terrible experiences in this time, and that will also put a strain on children’s services departments, which we need to recognise. More generally, more attention than ever before will need to be given to the mental health of children and young people, and to a return to physical exercise in some cases.
There will need to be specific interventions in schools. The tragedy, of course, is that some of those had already started. The £1 billion fund is in place and, obviously, needs to be kept under review. I very much welcome what the Prime Minister said earlier about one-to-one tuition, but we also need to think about what needs to be done to overcome the constraints on that. In some places it is already hard to find supply teachers, let alone one-to-one tutors. There will be a more important role than ever before for volunteer readers, mentoring programmes and strengthening links with business. I hope that my right hon. Friend the Secretary of State can assure me that that is being considered across Government.
Oral Answers to Questions
Damian Hinds Excerpts(3 years, 8 months ago)
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Scott Benton (Blackpool South) (Con)
Damian Hinds (East Hampshire) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
We are processing coronavirus tests on an unprecedented scale and expanding capacity further, having already met our testing capacity target of 500,000 tests a day by the end of October. We now have five Lighthouse labs operating across the UK, with two more announced yesterday, and significant progress on next-generation testing technologies.
Matt Hancock
We have discussed many times in this House the importance of the use of testing because of the terrible dilemma of wanting to keep people safe in care homes, yet also wanting to allow visiting. Testing can help to resolve that. The pilots are ongoing in some parts of the country, and I very much hope that we can get to a position where we can offer testing to enable visiting across the country before Christmas
Damian Hinds
I welcome the testing pilots that are happening, including in Southampton. How will the Government be able to support local authorities and public health teams with the logistics of mass testing, particularly in large rural areas such as Hampshire?
Matt Hancock
Increasingly, the test itself is only one part of getting a high-quality testing system. The logistics around it are also vital. We are already funding local authorities across the country to support them to roll out mass testing, but we will learn from the pilots, including in Hampshire, to see what extra might be needed.
Covid-19
Damian Hinds Excerpts(4 years, 4 months ago)
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Matt Hancock
Those are both very important points. Children who receive free school meals often receive their best or, in some cases, their only meal at lunch time at school, and it is an issue that I discussed with the Education Secretary over the weekend.
Damian Hinds (East Hampshire) (Con)
My hon. Friend the Member for Folkestone and Hythe (Damian Collins) talked about the importance of information consistency, but some constituents are seeing competing messages which look like they come from credible sources and are then passed on in good faith. In the worst cases, not only do they mislead, they can even be dangerous. May I encourage my right hon. Friend to continue his work with the platforms not only to ensure the primacy of the official information, but to actively work against that which disinforms.
NHS Patient Data
Damian Hinds Excerpts(10 years, 4 months ago)
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George Freeman
My hon. Friend makes a powerful point. I will acknowledge later the veracity of some of the points raised, but he is right that some irresponsible fears have been raised, which do nothing but damage public health. The MMR debacle is a good example of why we need to use those data and why we need very high rates of opt-in so that they can be used in that way.
Unsurprisingly, due to that debacle, many now ask whether there is a future for this quiet revolution in the use of patient data to deliver the benefits outlined above. After all the controversy and public backlash, where can the hope of a data-led NHS go? Is public trust now so low that the Arab spring of health outcomes and transparency is over? I suggest that it is not, and that the Government and NHS England’s decision to delay the care.data initiative in order to give more time for a wider public discourse provides a platform for rebuilding public trust and confidence. I will make some specific suggestions for the Government to consider that I think would go a long way towards achieving that.
I will begin by sketching out the revolution that I believe is currently under way in 21st-century medicine and how data are central to driving it. I will then show how the ten-minute rule Bill that I have introduced on patient rights over patient data, and the Patients4Data campaign that I helped to found, some of whose members are here in the gallery, are articulating the benefits of patient data. I will then summarise and address the understandable concerns of many patient data opponents, which have been aired in the past few weeks. We must carry public trust and confidence; how can we put measures in place to combat those concerns? Finally, I will set out how I believe the scheme can be saved and how we can ensure that patient data can be used to deliver the benefits that we all want in a way that carries public trust.
Fundamentally, I suggest, this debate on data is a small but important test for our politics. Will we let some of the greatest advances in modern medicine and the chance of a truly 21st-century model of health care elude us and get lost in a muddled partisan debate that generates more heat than light, or let failures of health care delivery like those in Mid Staffordshire be compounded by failures of parliamentary and political process? Or will we rise above it to recognise the reasonable objections raised by opponents, address them with the studied calm that an issue of this importance demands and find a workable solution on a truly cross-party basis?
I hope that this debate will play a part in helping us take the latter course and show this House at its best, with politicians coming together to find answers in the interests of the British people, patients and the NHS, as well as the care professionals who rely on us to get it right. As they have a duty of care to the patients of this country, so we as elected representatives have a duty of care to the democratic process and to them as citizens. The transformational impact of data is too important to get lost in a debate dominated by petty factionalism and party rivalry. This serious issue demands serious answers, which this debate will help to provide.
I mentioned a quiet revolution in modern medicine. I suggest that slowly but surely, 21st-century health is changing from something done to us by government when government has thought that we needed it to something that modern citizens do for ourselves. It is a revolution ultimately driven by data in three profound ways—a quiet revolution in transparency of outcomes across the NHS; in research and how medicines are developed; and in empowerment of patients to take more responsibility for their own health care.
On transparency, we saw—most traumatically in the Francis report, although it is working across other areas of health care—that our constituents increasingly want to understand and see that their patient journey through the health system and, crucially, the care system is properly tracked. To share a personal example, I have power of attorney for my elderly mother, who was hospitalised last summer. When she came out of hospital, as thousands of our constituents do every day, she was suffering and in pain, and not getting the care that she needed. I wanted to be able to log on quickly to see what her diagnosis was, what she had been prescribed by way of pain relief and which of the mountain of expensive multicoloured pills she had been prescribed over the previous weeks and months she should have been taking that afternoon. I wanted to be able to ask the right questions of the system and the people in it when she was unable to do so for herself. Why could she not simply have given me her login password so that I, with power of attorney, could log on with her NHS number to her care record and see at a glance live information on her condition?
I have given a small example, but it is one that the younger generation in particular now expect in the delivery of public services. They want and expect data and easy online access to drive accountability. The genie is somewhat out of the bottle in terms of public interest in the power of data and online access to drive both transparency of outcomes and patient empowerment. The frightening truth is that we are currently in a dark age in some areas of our health service. The Government have sought to tackle that through the care.data initiative, and we should welcome that. The issue is how we tackle that in a way that commands public trust and confidence.
Despite all the technological advances of the last century, we are still unable to say how many people receive chemotherapy in the NHS each year, or how many prescriptions are issued. For all we know, there could be another Harold Shipman—God forbid—operating in a GP practice somewhere in Britain; or, more likely, a GP surgery or social care unit that is operating well below acceptable standards. We—the patients, taxpayers and citizens of this country—have a right to know, and to expect that MPs are asking the right questions and using our position in Government and privileged access to that vast data set to ensure that we are asking those questions and demanding the answers.
The horror stories from Mid Staffs were brought to light only by the power of outcomes data. Patients were dying unnecessarily. People were drinking water from flower vases. We now know that whistleblowers were ignored. It was only through the power of data that the scandal was uncovered. After all, data do not lie. If, as the Secretary of State said, sunlight is the best disinfectant, open data provide the light we need to stop the sort of abuses that were going on in places such as Mid Staffs and Winterbourne View.
The second and perhaps most groundbreaking application of data is in research. The truth is that the traditional model of medicines development on which we and the NHS have relied for almost 50 years, in which the pharmaceutical industry goes away for us and spends hundreds of millions—increasingly, billions—and comes back with a perfect drug claiming to suit everyone, is a model that neither we nor the NHS can afford any longer.
Having had a career in biomedical research, my experience is that over the past 10 to 15 years this country has quietly come to lead in the appliance of patient data sets in particular disease areas to drive and accelerate the development of modern medicines. That has had extraordinary benefits for NHS patients. I declare an interest in that I spent the last seven years of my career in biomedical science and research helping to create partnerships in the NHS between NHS clinician scientists, research charities, industry and university scientists, in order to try to accelerate the process by which modern medicines are discovered and developed.
The truth is that the more we learn about genetics, genomics, patients and disease, the more we know that someone else’s disease will probably be different from mine. Our susceptibility to it will be different, as will our response to different drugs. The revolution in research data offers an extraordinary opportunity for the NHS to be the place in the world where we develop and design 21st-century medicines targeted at the patients who need them, and generate extraordinary opportunities for NHS patients and clinicians. Instead of being a country that can no longer afford a spiralling drug bill and that, through inevitable rationing, becomes an ever less attractive place to develop and launch new drugs—accelerating our crisis in access to medicines—we could become the best territory in the world in which to do patient-centred drug design, and thus get the fastest access to the latest medicines. That would be a huge prize for our country.
I shall give an example that brings that opportunity to life. The last project that I worked on before coming to Parliament was at King’s college here in London, with Professor Simon Lovestone, the head of research at the college’s academic health science centre and the professor of psychiatry. The project was funded by the NHS National Institute for Health Research and looked at the catchment population of the South London and Maudsley NHS mental health trust—250,000 patients suffering from a range of mental health ailments. Members will be aware that there is no magic bullet drug in mental health; there is a huge cocktail of some very difficult drugs, with often hugely traumatic experiences and side effects for patients. It is an unsatisfactory area of modern health care in which we are still failing a large number of patients, despite the best efforts of those seeking to care for them.
The system that was put in place, funded by the NIHR, created an anonymised data set of the 250,000 patients, which allows researchers to look across that cohort at relationships between medicines and outcomes and between disease diagnosis and MRI scans. It shines a light on which drugs are working for which patients and starts to allow us to improve treatments, target the right drugs to the right patients, and begin to understand the complex interplay of genetic, lifestyle and pharmaceutical factors shaping disease, as well as giving possible opportunities for breakthroughs in diagnosis and treatment.
Interestingly, in the context of the anonymisation debate, crucial to the success of the NIHR-funded system is the ability to trace and analyse GPs’ notes in a long sequence of diagnoses for an individual patient, and to understand the interaction of a number of different factors in that patient’s life in predicting particular patterns of predisposition and response to drugs. In discussing anonymity, pseudo-anonymisation and total anonymisation, we must therefore be careful to ensure that we support a system that allows the right people to use the right data in the right way in order to drive health benefits.
We must also distinguish the use of data for research from the publication of data. We have discovered from the story this week in The Daily Telegraph about a secondary analysis of data by insurance companies that those data were originally published by a think-tank. We must therefore be careful to put in place an appropriate system so that, for core research within the NHS, the necessary freedoms to look at individual patient and non-anonymised data are protected, but we have a cascade of protections leading out so that published data are absolutely safeguarded against de-anonymisation.
Damian Hinds (East Hampshire) (Con)
I congratulate my hon. Friend very warmly on securing such a timely and important debate. The protections that he is talking about are fundamental to a lot of people with strong views on this issue. By what mechanism does he envisage data sets becoming available? Who would be in charge of the protection? Do we make large data sets available? Would there be some sort of automated system to find breaks in the data? My question, essentially, is: what are the mechanisms to reassure people?
Early Childhood Development
Damian Hinds Excerpts(10 years, 5 months ago)
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Damian Hinds (East Hampshire) (Con)
I rise to support my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) and her cross-party colleagues in the important work that they are doing in highlighting the issues we are discussing. The manifesto is accessible, understandable and persuasive. Speaking as a relatively new dad, so much of it is also very intuitive. It makes one think, “Yeah, of course; that is pretty straightforward and obvious,” although we need to see a lot more of it happening.
I want to take a slightly different angle and talk a little about social mobility and the effect of the first days and years of life on children’s eventual chances. When considering child development, it is always helpful to have in mind a sort of pyramid—in fact, there is such a pyramid in the manifesto. It creates a hierarchy of need. The sharp end of the pyramid is the very sharp end of the scale—the acute cases where, frankly, social mobility is not the top priority. The top priority is child protection, basic safety and health; social mobility is a worry for another day. At the base of the pyramid is the massive part—the world at large; most people. In the middle is the section of children I want to talk about today: those born into poverty and disadvantage who are not quite in the acute bracket.
We know that social mobility in this country is low by international standards—we are usually bracketed with Italy and the United States—and it has not been improving. On average, those of us here in our forties—including, as of a couple of days ago, my hon. Friend the Member for Winchester (Steve Brine)—have been less mobile in our lives than those of us here in their fifties. That is a poor state for any advanced democracy to find itself in. Why is that the case? When I was on the Education Committee, we used to find that everyone blamed the stage before. If we spoke to universities, they said that they were not getting the kids coming through from sixth forms; the sixth forms blamed the teachers doing the GCSEs; the secondary schools blamed the primary schools; the primary schools blamed the nurseries; and the nurseries said, “We are just not getting the kids through the door anymore.”
There is an element of truth in what they all said. The more one studies social mobility and children’s life chances, the more one realises that it increasingly does come down to the very earliest age. The all-party group on social mobility published a report called “Seven key truths about social mobility”. Truth No. 1 was that the point of greatest leverage for children’s life chances is what happens between the ages of zero and three—that is what we said, although it could equally be what happens between the ages of zero and two. The problem is that, of course, this is the public sector—we are trying to influence the Government and so on—and most of what happens between the ages of zero and two or three does not happen in a state-controlled or influenced setting; it happens at home. That makes things much more difficult.
Why is this a social mobility issue? How children are brought up is not particularly, or does not have to be, dependent on parents’ income, but there is quite a strong correlation. Figures from “An Anatomy of Economic Inequality in the UK”, a report made by the previous Government at the end of their term, show that on school readiness, for example, children from the poorest fifth of households reach about a third of the way up the percentile scale at age 3, versus more than 60% of children born into the wealthiest third. There is a bunch of statistics like that.
It is frightening that even toddlers’ cognitive ability test scores vary more dramatically according to their parents’ income than according to innate differences in ability. In the millennium cohort study, which tracks children through time, that gap does not narrow between the ages of three and five; in fact, it seems to widen as children go through school. Why? I am careful not to infer any direct causality. All sorts of factors may be involved, but there are significant differences in some things that people associate with home learning environments, and so on, according to socio-economic groups. In the lowest socio-economic group—the poorest fifth of households—only about 40% of children are read to every day at age 3, as opposed to more than 80% in the top 20%. Again, those figures are from “An Anatomy of Economic Inequality in the UK”. Those things can be tracked with a series of measures, including bed time, and so on.
Fiona O'Donnell
The hon. Gentleman may not be aware of work undertaken by the chief medical officer of Scotland, Harry Burns, on brain development in children from families with generations of economic deprivation. It showed that their brains were developing differently: the fight-or-flight part of the brain was overdeveloped. That shows that there is a real link between children’s life opportunities and deprivation.
Damian Hinds
Clearly, there is a link—a range of studies suggest different ways in which that link manifests itself—and I do not think that any commentator argues about its existence, but there is nothing inevitable about that; it ought to be possible to equalise children’s life chances. Of course, there are examples of both brilliant and awful parenting in every income bracket. Children’s development is no respecter of the home they happen to have been born into. As the right hon. Member for Birkenhead (Mr Field) says,
“it is primarily parents who shape their children’s outcomes—a healthy pregnancy, good mental health, the way that they parent and whether the home environment is educational”.
As he and many others say, what parents do is much more important than who they are.
Home life is difficult territory for the state. I suggest that we need to think harder about how to communicate what is known about successful, positive ways to parent—a quite substantial body of evidence—in a way that does not come across as, and in fact is not, telling people how to bring up their children.
Geography, as well as income group, reveals other interesting differences in early child development. There is a particular difference in London. When people are told this, they assume that child development is worse in London than elsewhere, because of all the issues in a big city like this. However, that is not so. There was another report last week about the different school results of children growing up in London, versus those growing up elsewhere. That is often attributed to the London Challenge, which started in 2003. There are a number of reasons to believe that the London Challenge was not the sole or primary cause of those improvements. One reason to disbelieve that is that the difference in attainment scores for disadvantaged children is apparent way before they get to secondary school; in fact, it is apparent even in pre-school assessments: on average, disadvantaged children in London seem to do about 20% better on the “good level of development” scale than disadvantaged children in the rest of the country. A bunch of things are different about London children and families.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Excuse my missing the beginning of the hon. Gentleman’s speech, Mr Weir. As someone who was involved in the London Challenge, I should like to know what the relationship is. I am not clear about that. If it was not the London Challenge, what made the difference?
Damian Hinds
The hon. Gentleman asks a big question. I do not want to test your patience, Mr Weir, by debating the London Challenge, rather than early child development. I will talk in a minute about societal differences that may or may not be driving factors. The honest answer is that we do not know, but there are reasons to disbelieve that the simple explanation for London’s improvement is the London Challenge. First, the differences are apparent long before children reach secondary school, and the hon. Gentleman will recall that it only started in 2003. Secondly, when translated from London to the black country and Manchester, there were not the same results. Thirdly, so many other things that are different about London are worth looking into.
Andrea Leadsom
My hon. Friend speaks so authoritatively on social mobility. It is always interesting to listen to him. However, I put it to him that one reason for London’s exceptionalism could, of course, be that its large immigrant population comes from a different cultural place. My opinion, as opposed to a research view, is that immigrant populations have not suffered the same degree of family breakdown. We found, through my work with the parent-infant projects, that often in immigrant populations there is much more of a family network. Therefore, the bond is often quite secure, even in areas of great deprivation, because of the support for the earliest period of the baby’s life.
Damian Hinds
My hon. Friend anticipates where I am going. We are into the realm of speculation. We do not know. It is true that many things are different about family structure, and so on, in London, compared with the rest of the country. We do not know what is the causality, if any, of any of those things or of the outcomes.
Let me start by mentioning some of the things that are the same. There is no significant difference in gender mix, age and birth weight of babies born in London; mothers tend to be older—we know that that is a factor in child development—and better educated; families are bigger in London, and children are more likely to have brothers and sisters; and the mix is massively more diverse than in the rest of the country, both in terms of ethnic diversity, recent immigrants and families with English as an additional language.
In London, there is a slightly lower percentage of children with either a single mother or both parents working; in other words, there are more families where at least one parent is at home. This surprises people. There is also lower participation in pre-school provision and use of formal child care, which, again, surprises people, because ordinarily we expect that participation in early years settings and use of formal child care is associated with positive improvements in child development.
Finally, as my hon. Friend the Member for South Northamptonshire mentioned, although it is, bizarrely, difficult to get reliable statistics, it appears that London is above the national average for the proportion of families with children in which parents are married. That flies in the face of what most people would assume about this city. However, that raises an important question. A massive debate has been going on in America in the past couple of weeks about a Harvard report by Chetty et al. called “Where is the Land of Opportunity?” which presented a number of challenging results in the US context, in terms of social mobility. Its No. 1 conclusion is that family structure is the single most important determinant of social mobility in America and that, interestingly, it affects not only the immediate family, but has a broader effect. In other words, in a neighbourhood where most children are born to two-parent families—specifically, families where the two parents are married—even if people are not in one of those families, by being in such a neighbourhood, they have more chance of getting on.
Tim Loughton
My hon. Friend is making a fascinating point. I entirely agree with the personal views of my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) on the different complexion of London, but one only has to look at Mediterranean countries to see the far lesser influence of family breakdown, which is related to inter-generational support. We have spoken about support for parents, the preference for having two parents and how marriage makes for greater stability. Places such as Barcelona have been rebuilt with a view to having different generations living on top of each other, whereas in this country, grandfather and grandma increasingly do not live round the corner, or within easy distance, to help look after the children, which adds extra pressure on the family. There is a bit of a clue, if we look further south, about the influences that may result in different outcomes in London.
Damian Hinds
I have a similar instinct. I want to be careful not to imply a causality that we do not know to exist, but one factor in some ethnic communities is that there is greater multi-generational support and more extended families. Intuitively, it makes sense that such support can be an advantage.
Where does all that leave early child development from the perspective of social mobility? First, the Government have to address, head-on, the thorny question of how to help parents to parent, while keeping in mind the pyramid of need, with acute cases at the top, children born into poverty and disadvantage in the next layer down and everyone else below that. I suggest that that should start pre-natally, which is a big part of the manifesto “The 1,001 Critical Days”. Speaking as a recent dad, it is amazing how little we were told or read about what was going to happen after birth, because we were so fixated on pain and the other things that people worry about at the moment of maternity. Sure Start and Sure Start outreach can play an important part in that. I echo what my hon. Friend the Member for Winchester said on the variety of views on what Sure Start is. On the Select Committee, I always used to ask people to define Sure Start, and even when talking to professionals in the field, I would get different responses.
There is also a question about the role of television and new media in supporting mums and families to bring up children. Bookstart is fantastic, but it could be more targeted. I was surprised when we received free books through our door. If people in the income bracket of all of us in this Chamber are failing to buy books, or to get them out of the library, to read to our children, it is not a problem that will be solved by being given two or three books when the child is born. Like my hon. Friend, I pay massive tribute to the work done by Home-Start UK and others on direct one-to-one support.
Fiona O'Donnell
Will the hon. Gentleman also pay tribute to Mumsnet? Mumsnet is a safe, non-judgmental and anonymous place where mothers can chat and seek advice and information.
Damian Hinds
The hon. Lady makes a good point. Mumsnet is the sort of thing to which I was alluding when I talked about new media. When we talk about Mumsnet, we are obliged to say that Netmums is also available. There is a range of sources of non-judgmental peer-to-peer support, which is vital.
Secondly, the importance of evaluation also comes out of the manifesto “The 1,001 Critical Days”. Intuitively, we all know that there are lots of things that we can do in the earliest years of life that will make a massive difference to a child’s development and later opportunities, but it is difficult to persuade other people of what those things are. Evaluation therefore trades at a huge premium. I pay tribute to the work of the hon. Member for Nottingham North (Mr Allen) on early intervention, which I hope will change our mindset as a polity on how we intervene.
Thirdly, I am not suggesting for a moment that I think I have the answers, but we should not be afraid of talking more about the wider social context and what some of the impacts might be. While respecting people’s life choices and celebrating the diversity of society—families now come in all shapes and sizes—we should not, for the sake of children, be agnostic about what those choices are. We should also see what we can learn from the differences between communities in different parts of the country.
Luciana Berger
My hon. Friend makes knowledgeable points that, given his experience on the Children, Schools and Families Committee, he is well placed to make. The example that I shared with the House—this is separate from the 1,001 days manifesto—shows that there are many activities going on around the country to address some of the issues, but the challenge is that the activity is not happening everywhere. We need to lead from best-case examples, which is why data sharing is so vital to make a difference. Will the Minister comment on what steps the Government are taking to encourage these activities to happen throughout the country?
I am also keen for the Minister to address the point made by my hon. Friend the Member for Rotherham (Sarah Champion), who is no longer in her place. She mentioned the early intervention grant, which has funded many of the programmes that we are discussing. When the fund was first introduced, it totalled nearly £3 billion, but by 2015 it will have almost halved to around £1.5 billion. We have had contributions this afternoon about Sure Start centres, many of which have relied on the funding of the early intervention grant, and it is a blow that 576 such centres have had to close their doors since the last election. The hon. Member for East Hampshire (Damian Hinds) commented that he did not know what Sure Start was for—
Damian Hinds
To be clear, I was talking about what happened when I was on the Education Committee, the successor Committee to the one chaired by the hon. Member for Huddersfield (Mr Sheerman). When we asked people what the purpose of Sure Start was, we got different answers, even from practitioners in the field.
Luciana Berger
I thank the hon. Gentleman for his clarification. I apologise if I misrepresented his words.
Luciana Berger
The point that I wanted to make about Sure Start, as a result of what has been said by both Government and Opposition Members, is that it is widely acknowledged that the centres have made a real difference to families. I have Sure Start centres in my constituency; Liverpool city council has gone out of its way to do everything possible to keep all centres throughout the city open—it has had to remodel and look at a hub-and-spokes model, given that we will have experienced cuts of 54% by 2016-17—all because of the centres’ importance to communities.
In one of the most deprived wards in my constituency, the Sure Start centre is giving vital support to parents in the most deprived households. It is providing meal packets for £1—fresh food with recipes—to encourage parents to cook for their children. That is making a real difference to those children’s nutrition, in particular in their early years. In another, more affluent, part of my constituency, the children’s centre is tailoring its services to the need in that area, because this ward has a high incidence of multiple births. That Sure Start centre is providing a vital support service for mothers who have twins and triplets—for parents contending with the challenges presented by a multiple birth.
Those centres are making a real difference in my constituency. Their staff—including Liz Parsons, a manager in the Picton Sure Start centre, to name just one person—provide vital hands-on support to parents, often first-time parents or parents with lots of children. The centres provide support, including parenting support, to many families in my constituency.
Damian Hinds
Like the hon. Lady, I pay tribute to the staff in the Sure Start centres in my constituency; they do a fantastic job. We all know that there are fantastic Sure Start children’s centres out there, but it is also worth dwelling on the fact that at the macro level we may not quite have cracked the formula. If we compare the millennium cohort study with the previous one, for the children who have been alive throughout the Sure Start period, the gap between the rich and the poor has not been narrowed at age five.
Luciana Berger
Towards the end of my contribution, I shall reflect on the hon. Gentleman’s points about social mobility. He commented that the gap between rich and poor might not have changed. Nevertheless, Sure Start centres have provided vital services to parents and families who might not have contended with that specific issue, but have dealt with a lot of other ones that we have discussed.
In the debate, we have not touched on health visitors, who are integral to this issue. It is welcome that the Government are committed to increasing the number of health visitors. The latest figures from the Health and Social Care Information Centre, however, show that there are 1,234 more health visitors than in April 2010, but that is less than a third of the way towards the Prime Minister’s target of 4,200 new health visitors by April 2015. With the deadline looming, will the Minister please offer some words of assurance about meeting the target?
Oral Answers to Questions
Damian Hinds Excerpts(10 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Poulter
I think the hon. Lady will find that it was getting harder under the previous Government. It was not helped by the fact that, as we know, although it was not the fault of GPs, the contract that GPs were presented with by the previous Government made it difficult for many patients in many parts of the country to access primary and community care out of hours.
Damian Hinds (East Hampshire) (Con)
8. What progress his Department has made on introducing a cap on care costs.
The Minister of State, Department of Health (Norman Lamb)
Everyone will be protected against catastrophic costs by the insurance that, in line with the Dilnot commission recommendations, the cap provides from April 2016. We are currently considering the responses to the recent consultation on how the cap will work, and will publish draft regulations and guidance later this year.
Damian Hinds
Thanks to tough decisions from this Government, we can look forward to a time when people will no longer have to sell their home to afford care, but what can be done to raise awareness of this landmark policy so that older people, and indeed younger people, can be reassured?
Norman Lamb
I thank my hon. Friend for that question, and I am immensely proud that this coalition Government are reforming a grossly unfair system—something that should have happened a long time ago and is massively overdue. This Government completely recognise the absolute importance of an awareness-raising campaign, which will be carried out by local government, national Government and the financial services industry.
Health Transition Risk Register
Damian Hinds Excerpts(12 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
It does not say that. Before Labour Members get up to read out the Whips’ handouts, why do they not read the document that was published on Tuesday about what is in the risk register and how we have mitigated these risks? The hon. Lady’s point is unjustified, not least as regards nurses, because the general secretary of the Royal College of Nursing, in April 2011 and again in December 2011, sat in my office and told me, “We support the Bill.”
Damian Hinds (East Hampshire) (Con)
Will my right hon. Friend detail the changes in Department of Health policy on the publication of risk registers before or since May 2010?
Mr Lansley
The Department of Health’s risk management strategy is the same now as it was in 2009 or 2010.
Social Care Funding
Damian Hinds Excerpts(12 years, 8 months ago)
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Kelvin Hopkins (Luton North) (Lab)
It is a pleasure to serve under your chairmanship this afternoon, Mr Robertson, and it was also a pleasure to hear the speech by the hon. Member for Truro and Falmouth (Sarah Newton). She referred to me, unusually—because I think that I am the only hon. Member here who was born during the second world war, and I survived it, but only just: we were evacuated shortly before a V1 landed on our house and blew it up, but nobody died. Fortunately I was with my grandparents in Leicester at the time. We are concerned about elderly people who fought in that war and now are either in care or being cared for in their own homes.
A headline in The Daily Telegraph of 28 October read, “Misery for millions as elderly care funds cut”. The Telegraph is not a newspaper of the left. It is normally supportive of the Conservative party, and I would hope that that is the basis for some sort of consensus, because we can all agree on this. I do read the Telegraph and find it very useful, and quite a good newspaper at times. I have no particular dislike of it, and it is spot on in that headline.
Importantly, it has been observed on more than one occasion that we do not care enough for our elderly people. Our attitudes to the elderly in Britain are not good, especially compared with those of some minority communities that have come from abroad, which have a kind of reverence for elderly people. Perhaps I would say that, because I am not as young as I was, but I think they value elderly people in a way we do not.
In some circumstances elderly people are regarded as a bit of a nuisance. I have some rather horrifying quotes from Professor David Oliver, who is senior lecturer in elderly care medicine at the university of Reading and secretary of the British Geriatrics Society. He said:
“Not long ago, a senior doctor walked onto my ward, turned to a nurse and laughingly asked: ‘How do you stand working with all these crumblies?’”
That kind of attitude is utterly poisonous. On another occasion a senior doctor said
“he was spending too much of his time ‘market gardening’—ie, looking after cabbages (old people)”.
Those are dreadful things to say, and people who say them should not be around elderly people. We must make sure that the people who look after elderly people have compassion and empathy, and a bit of reverence for people who have spent their lives working in society and contributing. I raise those incidents in a sense to shock us all into realising that in many instances we are not doing right by our elderly people.
That said, I know that there are many people who do wonderful work. I had two local authority care homes in my constituency and I visited them on several occasions. They had devoted staff, whom the residents loved; they thought they were really cared for. The visiting professionals all said that the care homes and what went on in them were first class. They have both been closed down, essentially forced to close by central Government. It is wrong that we should forcibly encourage local authorities to close local authority care homes and send the residents to private care. Some of the people who left may well have gone to Southern Cross homes—some of those that are now being criticised by the Care Quality Commission. We are not doing right by our elderly people, and we must do more.
As to costs, some 12 years ago the royal commission on long term care recommended that all care should be free of charge—free at the point of need, like the national health service. It was not a unanimous recommendation because, I think, the Government of the time, rather mischievously, made sure that one or two members of the commission brought out a minority report opposing free long-term care. Since that time Ministers have time and again said, “Oh, it wasn’t unanimous, therefore, implicitly, we don’t have to do that.” I took a different view, and tabled early-day motions in two successive Parliaments, calling for the Government to implement the recommendation for free long-term care. That did not happen; it was all about cost in the end, but I still believe that is the way forward. The costs involved would be significant, but in the scheme of things not an enormous amount.
I am the chair of the support group in Parliament for the National Pensioners Convention and Andrew Dilnot came along to present his recommendations to us two or three weeks ago. He is quite brilliant, frankly. His analysis and what he has come up with are first class. That should be the minimum default position, which any Government should take. I would like to go further than he went, but I think he is realistic, and, thinking that pushing Government to spend will be hard, wants to find the fulcrum point at which they might accept his idea. What he did was brilliant. The National Pensioners Convention, like me, believes that care should be free at the point of need, like the national health service, but Dilnot has come up with a fine scheme.
The National Insurance Act 1948 recommended that there should be a capital limit, which I think was £8,000 at the time. The minimum amount of capital that people could have was £8,000. If that is indexed forward it comes to a figure of between £250,000 and £300,000, so when Dilnot talks about £100,000 he is way below what would have been the case if we had simply indexed the figure forward. What we have now is disgraceful.
One result of what we have is that working-class people who managed, through saving and struggle, to become owner-occupiers are now having that little bit of equity in the family taken away from them. The wealthy do not have to worry. They have plenty of equity, and to look after granny when she has dementia they can perhaps take a little cash out of their overseas account, so it will not be a problem. However, for working-class people who have bought their home and become the first owner-occupiers in their family—and perhaps all of us would support in principle the idea of owner-occupation, if at all possible—that is being taken away from them. Many people in my constituency bought their council houses. I was not in favour of selling council houses, but it is just those people who now find that their capital has been taken away to use to look after granny. Typically, the grandchildren who would have inherited that equity and gone into owner-occupation will now not be able to do so.
People have come to my surgery and reluctantly admitted that they are keeping granny at home deliberately because they are desperately fearful that if she goes into a care home her house will be sold, the equity will be lost and their children will not be able to get into owner-occupation; there are no council houses to rent and they will be forced into private rented accommodation, and will have a much poorer quality of life as a result. That is the reality—it is actually happening. Those admissions are made reluctantly, because it is not something people want to say. Granny—it is usually granny because women live so much longer than men—may be suffering, and not getting quite the care that she should have, because she is staying at home. In the best of all possible worlds we all want to stay at home for as long as we can, and it is right that we should do so, but even care at home is not up to scratch.
I have examples, as I am sure others do, of care companies that look after elderly people in their own homes. The carers sometimes are not kind and are a bit impatient. The elderly person has to get out of bed when they turn up and go to bed when they turn up, and is sometimes left sitting in a chair all day with stale sandwiches on a plate beside them, not being able to do anything—not even go to the toilet. We are not getting the care even when we have paid-for carers coming in, so a radical change is needed. We must not only pay for care but ensure that it is good care, and that the people who deliver it are caring, compassionate and professionalised.
I spent much of my life before Parliament working as a research officer for the major public services trade union, Unison. In the past, many care home staff would have been Unison members, but the private care homes are not unionised. In my constituency, when one of the care homes I mentioned was privatised—closed down—I had a difficult conversation with the senior officer at the local authority, who eventually, after an hour, said: “We are doing it to cut costs. There will be fewer staff, they will not be in unions, and they will have shorter holidays, lower pay and poorer conditions of work. We can get the costs down.”
Damian Hinds (East Hampshire) (Con)
Does the hon. Gentleman agree that it can be difficult to find people who want to be carers, whether in the public or the private sector, at home or in a care home setting? Perhaps we need to find new ways, beyond just unions, of elevating the status of the job as a profession or occupation, in the same way as social workers are now considering creating a college of social work.
Kelvin Hopkins
I agree absolutely about elevating the status, but we do that first by having the carers professionally trained, ensuring that we get the right people to begin with, having them properly paid and having staffing at the right level. If someone is looking after too many patients and cannot cope, either in a hospital or a care home, the patients do not get proper care. In most areas of life, as quality improves we want higher productivity, which means a lower level of labour intensity, but in this area we want more people working, with each care person or nurse looking after fewer patients, to ensure that everyone gets the care they need, rather than having one junior nurse looking after a large room full of elderly people and not being able to cope late at night.
In the past couple of weeks we have heard some distressing stories about elderly people in hospitals not getting the care they need. We will all be elderly one day, and some of us might finish up in care because we might not have extensive families to care for us. I do not like the idea of being in pain and suffering at night and not being able to get anyone to help. I am physically fit and doing well at the moment, but we shall all be old one day. People are suffering in that way now, and the only way to deal with it is to ensure that we put in sufficient resource. I think there are people around who want to do these kinds of jobs but they will not do them if they are going to be overworked, undertrained, underpaid, and treated badly by private companies or care managers in hospitals.