Unregulated Accommodation: 16 to 17-year-olds

Debate between Jim Shannon and Andrew Selous

Tuesday 15th October 2019 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

“This cannot be right.” Those were the words of Dr Jackie Sebire, the assistant chief constable of Bedfordshire police, after her officers had spent four to five days trying to find a 16-year-old boy who had gone missing from his unregulated accommodation in Bedfordshire. Her officers had spent an enormous amount of time and effort to return the child to a provision that was inadequate, in which no local Bedfordshire authority would place one of their own children and for which there was no regulatory oversight.

The standards in the accommodation in which the 16-year-old was placed were so poor that this young man regularly went missing, and shortly afterwards he became involved in organised crime and went on to recruit other young people into organised crime. So we have, in effect a multiplier of misfortune as a result. The Local Government Association and the police are concerned that children are being drawn into organised crime, including county lines, from unregulated homes. About 2,000 16 and 17-year-olds are placed outside their home local authorities in this type of unregulated provision. That is a doubling over the last five years. Around 5,000 children in total are in this type of unregulated provision—a 70% increase in the last decade.

Let me provide some further illustrations of why regulatory oversight is needed urgently. We know from the brilliant investigation undertaken by Sally Chesworth and her team at “Newsnight” that a 16-year-old girl was brought to a room in one of these homes late at night. It was freezing cold and had no bed sheets and no curtains, even though it was a ground-floor room looking straight out on to a road. We know that staff regularly enter rooms without knocking. We know that a 17-year-old girl was hit in the face by a 6-feet male staff member who would not let her speak to the police about the incident. We know that staff members are being abusive. One child was told, “It wouldn’t matter if anyone kills you. No one cares about kids in care.” Members of opposing gangs were sent by one London borough to the same home in Bedfordshire, where one duly stabbed the other.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this debate to the House. I sought his permission beforehand to make a comment. The Social Care Inspection blog on the gov.uk website states that unregulated care homes

“should be used as a stepping stone to independence, and only ever when it’s in a child’s best interests”.

Given what we now know from the BBC investigation, which concluded that young people were at risk of organised abuse, is it not time for the Government to at least examine the ways in which the regulatory regime governing such accommodation is structured?

[Andrew Selous]

The hon. Gentleman is absolutely right, and I will go on to call for exactly what he has just highlighted to the House.

Many of these homes also have adults up to the age of 25 in them, and we know that drug taking is prevalent in many of them. We know that a young man on bail for knifepoint robbery was placed in a home with 16-year-old girls. We know that two girls were placed alongside a male sex offender, and that one 17-year-old boy was murdered by another resident. The home had not told either sending local authority about an earlier fight between the two boys.

The impact on police forces of the number of missing person incidents from unregulated homes is significant. Police officer availability is an extremely precious resource to local communities. Quite rightly, a missing child is always a high priority for any police force. If there is a significant increase in the episodes of missing children in a police force area, that means that other vulnerable children and adults in the population area of that police force are left much more unprotected than they should be.

Dental Health: Older People

Debate between Jim Shannon and Andrew Selous

Wednesday 27th February 2019 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

This Adjournment debate provides an opportunity to discuss a very important but often overlooked issue, which can have a major impact on the wellbeing of older people: their oral health. Many of us will have older relatives who have reached the stage where they need some extra support. It might be that they live in a residential care home, have a carer who visits them in their home a couple of times a week, or just require a bit of extra help from us personally to stay independent.

However, one issue that often slips under the radar when we think about an older relative’s needs is their oral health; it can often seem like a small issue, but in fact poor oral health can have much wider implications. Having a painful oral health problem can impact on someone’s ability to eat comfortably, to speak and to socialise with confidence, and on the ease with which they can take medication, something which may be a particular issue if an older person is living with other long-term health conditions. Maintaining good oral health can also become much more challenging for older people with reduced dexterity, who may for example have more difficulty with brushing their teeth. Furthermore, for the most vulnerable older people, such as those with dementia, who may have difficulty communicating where they are experiencing pain, an oral health problem can be especially distressing.

Ensuring that older people are supported to maintain good oral health, and have access to dental services when they need them, is therefore very important. However, while data on this issue is limited, the information that we do have suggests that these are areas in which we often fall short.

The Faculty of Dental Surgery of the Royal College of Surgeons published a report on “Improving older people’s oral health” in 2017, which estimated that 1.8 million people aged 65 and over in England, Wales and Northern Ireland could have an urgent dental condition such as dental pain, oral sepsis or extensive untreated decay. Moreover, the Faculty of Dental Surgery also highlighted that this number could increase to 2.7 million by 2040 as a result of several demographic factors, thereby increasing pressure on dental services in the future. As well as the ageing nature of Britain’s population, increasing numbers of people are also retaining their natural teeth into old age; while this is good news, it also means that dental professionals are facing new challenges as they have to provide increasingly complex treatment to teeth that may already have been heavily restored.

Separately, in 2014 Public Health England published the findings of research looking at oral health services for dependent older people in north-west England, which found that access to domiciliary and emergency dental care can often be very challenging for those living in residential care homes or receiving “care in your home” support services. More recently, Public Health England last year published the results of a national oral health survey of dependent older people living in supported housing. This revealed that nearly 70% of respondents had visible plaque and 61% had visible tartar, indicators of poor oral hygiene, and that in some parts of the country, such as County Durham and Ealing, over a quarter of dependent older people would be unable to visit a dentist and so required domiciliary care in their home.

It is difficult to get a complete up-to-date picture of the oral health needs of older people across the country, partly because there has not been an adult dental health survey for 10 years, an issue I will return to later. However, these figures, as well as anecdotal reports from dental professionals working on the frontline, suggest there is a real issue here which potentially impacts on large numbers of often vulnerable older people.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this important issue to the House. As he said, 1.8 million elderly people across the United Kingdom of Great Britain and Northern Ireland have problems, which is shocking. The hon. Gentleman outlined some of the solutions such as extra attention on domiciliary care and in residential homes, and for those at home and dependent on carers. Does he agree that older people’s confidence can also be diminished by not having their teeth correctly done? My mother went this week to have her teeth done; she is 87 years of age and she depends very much on her dentist. She has attended over the years, but many have not, and we need to have that care at all those different levels.

[Andrew Selous]

I am grateful to the hon. Gentleman for giving us his personal family experience of this issue.

There have been some welcome developments over the last few months, including the recently published NHS long-term plan highlighting oral health as one of the priorities for NHS England as it rolls out a new “Enhanced health in care homes” programme across the country. However, I would like to draw the Minister’s attention to five particular areas in which more could usefully be done: training for health and social care professionals; access to dental services; data; regulation; and the social care Green Paper.

First, on training, health and social care professionals regularly do a brilliant job of caring for older people, but as I have mentioned, oral health is one issue that can easily fall between the cracks, particularly if someone is living with a range of other health conditions that also require care and attention. One example of this is oral care plans. Ideally, whenever someone is admitted as a resident to a care home, their oral health needs should be considered as part of their initial health assessment. Those needs should then be reflected in an oral care plan that all their carers are aware of and that will, for example, set out whether the resident needs extra help brushing their teeth.

There is some good guidance from the National Institute for Health and Clinical Excellence, but this can often be overlooked. In Public Health England’s research in north-west England, 57% of residential care home managers said that they did not have an oral care policy, and one in 10 said that an oral health assessment was not undertaken at the start of care provision. Knowing how to provide good oral care is especially important when it comes to supporting those with more complex needs. For example, for those with dementia, electric toothbrushes can sometimes be quite intimidating, and it makes a big difference if a carer knows that they should use a manual toothbrush when helping with tooth brushing. More broadly, if someone who is living with dementia refuses oral care, this can become an obstacle to maintaining good oral health, so it is important that carers understand how to manage these situations, ideally with input from a dental care professional.

Equally, for those with dentures, it is important that training and procedures are in place to minimise the risk of a denture getting lost, even if this is a simple thing such as ensuring that they are kept in a jar by the bedside when not in use. A lost denture takes weeks to replace, and this can be a devastating experience for an older person who relies on them to eat and speak. This is particularly sensitive if someone is coming to the end of their life, when it may not be possible to manufacture a replacement in time as they spend their remaining days with loved ones. An understanding of good denture care is particularly important in these situations.

Improving awareness of oral health among health and care professionals should therefore be a priority, and was a key recommendation in the Faculty of Dental Surgery’s 2017 report. This highlighted schemes such as the Mouth Care Matters programme, in which mouth care leads are recruited to provide oral care training to staff in hospitals and care homes, and I would be interested to know from the Minister whether there were any plans to replicate such initiatives nationwide.

Secondly, ensuring that older people can access dental services when they need them is essential. It is not uncommon for people to think that if someone has no teeth, they cannot be experiencing pain or other oral problems. Sadly, this is not the case and they should still have an oral check-up once a year, not least because the majority of cases of oral cancer occur in people over 50. There are all too many tragic instances of an older person being diagnosed with oral cancer too late—the saddest two words in the English language—simply because they had not seen a dentist in a number of years. Attending a dental appointment can be a particular challenge for those with reduced mobility—for example, if they are unable to climb stairs to reach a dental practice on the first floor—in which case, domiciliary visits are vital. However, evidence suggests that access to domiciliary dental care can be challenging, particularly for those living in care homes or supported housing, and I would appreciate the Minister’s thoughts on how we can address this.

In 2015, Healthwatch Bolton reported that it was easier for a local care home resident to get access to a hairdresser than to a dentist. In 2016, Healthwatch Kent reported that care homes had told it about accessibility problems for wheelchair users within dental practices. In 2016, Healthwatch Lancashire reported that care home staff said:

“The residents don’t get regular checks; they are only seen when there is a problem.”

Healthwatch Derby was concerned about the lack of information for social care providers about how to access dental services for their residents. While the commitment in the NHS long-term plan to

“ensure that individuals are supported to have good oral health”

in care homes under the “Enhanced health in care homes” section is welcome, there is no mention of a similar commitment for older people who use domiciliary care agencies. Those people should not be forgotten, so what do the Government intend to do about that for domiciliary care agency users under the NHS long-term plan?

Thirdly, the intelligence around older people’s oral health is quite limited, making it difficult to build a full picture of the level of need or assess the barriers that older people face in accessing dental care. The most immediate action that could be taken to address that would be for the Government to commission a new adult dental health survey. It is one of the few resources to provide detailed, national-level data on standards of oral health among older people, and it is a key reference for many commissioners, policy makers and dental professionals. The survey has been conducted every 10 years since 1968, but the last edition was published in 2009, so a new one is due. However, the Government have yet to give any indication of when or if a new survey will be taking place, which is causing increasing concern within the dental profession, so an update on that would be most welcome.

There are other steps that would help to improve our understanding of such issues. For example, NHS Digital publishes a regular set of NHS dental statistics for England, which reports on the proportion of children aged zero to 17 who attended an NHS dentist in the preceding 12 months, as well as the proportion of adults aged 18 and over who attended an NHS dentist in the past two years. That data provides a useful measure of access, and expanding the figures to include attendance rates for older people would help us to develop a clearer picture of whether there are particular groups or areas where access to an NHS dentist is a problem.

[Jim Shannon]

Many elderly people are independent and proud, and one of the things that puts them off attending the dentist—I see this in my constituency—is that they think they have to pay for the treatment, but they do not. Perhaps we need to put out a reminder about that.

[Andrew Selous]

I am grateful to the hon. Gentleman for putting that on the record.

Fourthly, in addition to health services, care home providers and dental professionals, regulators can play an essential role by monitoring standards of oral care and driving improvements. The Care Quality Commission in England does not explicitly look at oral health during its inspections of hospitals and care homes, although I understand that it is doing a lot of work behind the scenes to try and push that on to the agenda for care providers, which is obviously welcome. Health and care regulators in other parts of the UK can also make a valuable contribution to ensuring that the importance of oral health is recognised by those that they inspect.

Lastly, I continue to look forward to the publication of the Government’s long-awaited social care Green Paper. Given the importance of oral health to our wider health and wellbeing, an all-encompassing model of care for older people must include dental services, so it will be important that the Green Paper clearly sets out how social care and dental services can work together in the future and what more can be done to ensure that older people have access to dental services when they need them. As I have mentioned, one of the most valuable things we can do to improve older people’s oral health is to ensure that it is not overlooked amid the many other issues that we are dealing with, and I hope that the Government will show leadership on that in the Green Paper.

Oral health can sometimes seem like a small issue, but it has a significant impact on quality of life. The Minister will be aware that we have spoken a lot in recent years about the need to improve children’s oral health, and quite rightly so, but it is also essential that we do not take our eye off the other groups who need support. For an older person who is in pain because of an oral health problem, finding it difficult to eat or speak, or who may be distressed at the loss of a denture that will take weeks to replace, such issues are very real. We can all contribute to addressing them, including Members who care for older relatives in our everyday lives. Indeed, the Faculty of Dental Surgery published some useful advice over Christmas about using visits to older relatives as an opportunity to check their oral health and for how to spot the signs that they might have an oral health problem. That is something that Members could do over Easter when visiting elderly relatives, and we could encourage our constituents to do the same. However, I hope that the Minister will recognise that Government also have an important role to play and will look carefully at what can be done to help improve oral care for our older people.

International Freedom of Religion or Belief Day

Debate between Jim Shannon and Andrew Selous

Thursday 25th October 2018 Westminster Hall

[Jim Shannon]

I absolutely agree. Wherever there are human rights abuses—abuses of journalists or whatever else—we should certainly speak out. I thank the hon. Lady for reminding us of that case.

Just today I tabled a question to the FCO asking whether it will make a public statement in support of a full, independent investigation into allegations of forced organ harvesting from prisoners of conscience in China. Others will speak about killings along religious lines in Nigeria.

[Andrew Selous (South West Bedfordshire) (Con)]

Before the hon. Gentleman moves on from China, I am sure that, like many of us, he is alarmed by the recent BBC news reports that millions of Muslims in China are being interned, seemingly because of their faith and not much more. Although we rightly want to do lots of trade with China, does he agree that we should take that issue up at the highest levels with the Chinese Government?

[Jim Shannon]

I thank the hon. Gentleman for reminding us of that case. He is absolutely right. The stories in the press in the past few days have been horrendous. We have seen the establishment of what cannot be called anything other than stalags—concentration camps—where people are subjected in every way, emotionally and physically, to efforts to change their views. Those Uyghur Muslims are among the people we speak up for today. I chair the all-party group on international freedom of religion or belief, which speaks out for people of Christian faith, of other faiths and of no faith. I also chair the APPG on Pakistani minorities. I am particularly interested in the issue the hon. Gentleman mentions, and I thank him for doing so.

Closer to home—we should not take away from what is happening here—there has been a 40% increase in hate crime on the basis of religious belief in England and Wales, and it is reported that churches in occupied territories in Ukraine have been denied registration and declared illegal. I am sure hon. Members will discuss those issues in much more detail—I intend to give just a general introduction—but I raise them to highlight the grave importance of International Freedom of Religion or Belief Day. Now more than ever, we must come together to stand up for those who suffer intolerance and persecution.

--- Later in debate ---

[Andrew Selous]

The hon. Gentleman used the phrase “across the world”. While there are excellent organisations such as Christian Solidarity Worldwide that operate in this space, I have always been particularly struck by Open Doors’ “World Watch List 2018”. Going back to that phrase “across the world”, is it not shocking that we can draw a line from the west coast of Africa all the way through the middle east to the Pacific ocean and in every single country along that route there is persecution of Christians? Does he think it might be a good idea if every Christian place of worship in this country had the Open Doors “World Watch List 2018” up in its hall or reception as a visual reminder of what some of our brothers and sisters in the faith have to put up with?

[Jim Shannon]

That is a salient reminder for us all. We have one in the Freedom of Religious Belief office here. I am regularly in contact with Open Doors and many of the other organisations—Christian Solidarity Worldwide, Release International and the Barnabas Fund—and our churches all have them as well. The hon. Gentleman will know this, but every morning in my and other people’s prayer times, when we go around the countries of the world, there are 50 or 60 countries where persecution is rife. That is always a reminder to me at the beginning of the day of the freedom that we have here, and that others do not. He is right and I thank him for his intervention.

We had the ISIS-inspired attack in Madhya Pradesh in India, in which 10 people were killed. For the benefit of both India and its potential for a stable long-term relationship with the UK, we must take a stand against growing human rights violations there. I hope that the Minister can work with the Indian Government at least to make them aware that we are concerned.

I will speak quickly about Nepal. As the Minister knows, the Nepalese penal code 2017 contains problematic provisions that criminalise religious conversion and “hurting religious sentiment”. Those words give the Government power to do a lot of things to persecute religious minorities. We have had reports of 20 Christians being arrested and four churches being burnt down. Where does this stop? The Nepalese Government receives some DFID funding and gets support from our Government. The laws are insensitive to the feelings of religious minorities and their positions, and we believe that the legislation relating to criminal liability for doctors, and the issue of arrest warrants, is completely irrational and illegal. There is an excellent opportunity for the UK to suggest that Nepal reconsiders its problematic provisions in order to stay in line with its obligations as a member of the UN Human Rights Council. Members of the Human Rights Council must adhere to its principles.

Turkey has become a difficult country. The hon. Member for Ealing Central and Acton referred to journalists, and Turkey’s clampdown on journalists and the media has been atrocious. Pakistan has been asked to send 230 Turkish teachers back to Turkey to make them accountable and to have their rights taken away. I have written to the Minister suggesting that we do all we can to ensure that the Turkish Government cannot do that. An early-day motion in the House this week also refers to that.

Gypsies and Travellers

Debate between Jim Shannon and Andrew Selous

Monday 10th September 2018 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

Given the extra time we have tonight, I am happy for other Members not only to intervene, but to make their own contributions after I have spoken, because the Minister will still have plenty of time to respond to all the concerns expressed around the House.

I am extremely proud to represent an area that has successfully integrated different nationalities over the years, resulting in good community cohesion. Italians, Polish and Irish nationals are all well established and make a fantastic contribution to the area that I am proud to represent. My constituency has many Traveller sites, but a planning policy of segregation and separation makes integration and community cohesion hard to achieve. The 2011 census showed that over three quarters of Gypsies and Travellers generally live happily among the settled population, and I have some heart-warming examples of Travellers becoming settled residents, with the children now attending school regularly and the parents in formal work.

My constituents have had to put up with far more than their fair share of “misery”, as one constituent described it to me on Friday, as a result of current Gypsy and Traveller policy. One of my sites has had three major incidents of modern slavery, with 24 slaves saved by the police on the first occasion. Threats, violence, theft and other forms of intimidation have become everyday occurrences to some of my constituents, and Bedfordshire police, with an already overstretched budget, are not able to respond in as timely a manner as they would wish, leaving many of my constituents living in fear. A lady wrote to me in June to say that she will be moving away from the area as she no longer feels safe, having been assaulted by Travellers, Travellers having trespassed in her garden, having been followed by Travellers and her husband’s tools having been stolen from his car three times, causing a loss of income. That lady also has human rights that have not been respected. Of course, there are many decent, law-abiding Travellers, and all groups have good and bad in them, but I hear too many accounts like the one I just recounted.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Gentleman agree that it is essential that local authorities have appropriate training to enable them to deal with the cultural differences of the travelling community? If people are approached in the correct manner, a resolution often can and will be found.

[Andrew Selous]

As always, the hon. Gentleman makes an important point. We should always deal with such issues with humanity, decency and respect, but we also need to see equality under the law. As I am sure he would agree, the two are not mutually exclusive, but he makes a welcome point.

My main concern is with current planning policy, which allows many Traveller pitches in some areas when others have none at all. Multiple Traveller sites lead to many unauthorised encampments. In 2017, there were 116 unauthorised encampments in Central Bedfordshire, and clear-up costs in the area were around £350,000. Over £200,000 of that was spent by Highways England, with one encampment requiring over 100 grab lorries to clear up to 250 tonnes of litter. My constituents are understandably outraged to be told that there is no money for more of the public services that they want when they see huge sums being spent with no ability to recoup the money from those responsible.

Police Funding: Bedfordshire

Debate between Jim Shannon and Andrew Selous

Monday 13th November 2017 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Andrew Selous]

I will, briefly.

[Jim Shannon]

Given the number of police officers who have lost their jobs and the number of forces whose size has decreased, I assume that community policing also faces a downturn. Does the hon. Gentleman share my concern about that? Does he recognise the importance of policing that not only interacts with the community, but serves as the eyes and ears of the police force?

[Andrew Selous]

The hon. Gentleman is exactly right. Community policing plays a vital role in prevention.

In Bedfordshire, 40% of the force’s activity takes place in Luton. While there is insufficient police capacity to deal with the challenges in that town, it means that the rest of Bedfordshire has less than its proportionate share of police cover, for which its residents also pay. A small police budget that has suffered from 13 years of damping would be serious enough even without the fact that Bedfordshire faces unusually high levels of serious threats and criminality which are not normally dealt with by a force of that size.

Let me spell this out. Bedfordshire has the third highest terror risk in the country, and its police force must deal with the fourth highest level of serious acquisitive crime in England and Wales. It has a higher proportion of domestic abuse offences per head of population than the much larger forces of Greater Manchester, West Midlands, Thames Valley and Hertfordshire, and 40% of all firearms discharges in the eastern region take place in Bedfordshire. The number of reports of missing persons between April and June this year was 350% higher than the number during the same period in the previous year. As a Bedfordshire Member of Parliament, I am not happy that the people of my county do not enjoy the same levels of police protection and response in an emergency as are available to the people of Hertfordshire and Thames Valley. We pay no less tax than they do, so what is fair or right about that?

In one incident of gang-related violent disorder this year, no response resources were available and CID detectives went to the scene with no uniform or protective equipment, and a number of officers were injured as a result. In one incident in Luton recently, a single female officer made three arrests on her own and called for assistance, which took eight minutes to come while she was in danger. At present, each Bedfordshire police officer is expected to investigate 12 to 13 crimes at any one time. The level of stress affecting Bedfordshire police officers is leading to burn-out and psychological and physical illness; that is unacceptable, as we owe them a duty of care.

Bedfordshire police are not able to respond to all the daily calls seeking a fast response, nor to all the daily incidents requiring a community response. Recently a Leighton Buzzard businessman being threatened by a man wielding a metal bar dialled 999 and officers failed to attend.

As guardians of taxpayers’ money, the Government are absolutely right to demand efficiency, effectiveness and value for money from our police forces. Bedfordshire police have already achieved £34.7 million of savings between 2011-12 and 2017-18. Bedfordshire also already has one of the most extensive blue-light collaboration programmes in the country, and its tri-force collaboration is improving effectiveness and delivering savings. Some 25% of its resources are already allocated to tri-force and regional collaboration.