Meningitis B Vaccine

Mark Durkan Excerpts

Monday 25th April 2016 Westminster Hall

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to serve under your chairmanship, Mr Pritchard, and to follow the hon. Member for Faversham and Mid Kent (Helen Whately). She spoke so strongly on behalf of the Burdett family, whom she represents, and about the tragedy they have faced, and she also spoke to the wider issues raised by the petition following Faye’s death.

I thank the hon. Member for Bath (Ben Howlett) for introducing the debate in the way he did, and I also thank the members of the Petitions Committee for the great service they provided to not only the House but the public by holding hearings in conjunction with the Health Committee. These petitions are a new way for Parliament to engage with the public on important issues, and I hope we will learn from this debate that there is also a new way for Members to engage with Ministers to deal with questions that are not always as easy to address as we might want them to be.

Over the past few years, ever since Bexsero was first licensed as a vaccine in Europe, I have tabled a number of early-day motions encouraging the Government and the Joint Committee on Vaccination and Immunisation to move more quickly. Like Meningitis Now and the original Meningitis UK “Beat it now” campaign, I wanted to ensure that we did not have to wait another five years, as we had to for the meningitis C vaccine, with all the accompanying loss of life and life-changing damage done to children in the meantime.

[Peter Dowd (Bootle) (Lab)]

I met Harmonie-Rose the other day, and what a beautiful little girl she is. I do not want to make inappropriate or spurious comparisons, but the swine flu vaccine cost £1 billion, which, despite the criticism, was money well spent. Does the hon. Gentleman agree that a vaccine catch-up programme would also be money well spent?

[Mark Durkan]

I believe that it would. I will come to that point shortly.

Many Government and Opposition MPs in the previous Parliament and this one have been aware of the issues and concerns involved. First, there was the issue of whether we would get the men B vaccine on to the immunisation schedule as soon as we should. Thankfully, steps were taken last spring, and it came on stream in the autumn. The decision that was made by the Department of Health here effectively became the predictive text for what happened in my devolved area, and I welcome the fact that the Health Minister in Northern Ireland followed suit. A similar issue has arisen here. If the Department responds to the evidence that the Petitions Committee and the Health Committee took, which was based on the issues that the petition raised, that will make a difference not only to NHS England, but to my devolved area.

Being based in Northern Ireland, I am conscious that the south of Ireland has taken the decision to follow the UK on the men B vaccine. It will take it up later this year, which may have an impact on the supply of the vaccine. That is why we need to ensure that, when we talk to Government Ministers here and the devolved Ministers, we also talk to the authorities in the south of Ireland. Between us, we have a very good instrument—the British-Irish Council—which brings together all the Administrations on these islands. They should collectively discuss these policy issues and challenges, and they should combine their muscle to improve their negotiating power with Glaxo on any price implications or sensitivities in relation to the drug.

We have been asked to address three main questions, and I hope that the Minister will do so. I know that some will sound like technocratic issues, and perhaps talking in those terms will make the Minister feel uncomfortable or insensitive. There are the issues that delayed the men B vaccine being put on the schedule in the first place and the issues that we face now, particularly the cost-effectiveness framework. As many hon. Members have said, the framework needs to be adjusted to take into account peace of mind factors and the lifelong impact on those who survive meningitis but suffer lasting damage and have difficulties with the economic and social costs that arise from that. The hon. Member for Bath addressed the issue of ensuring that there is a commitment to funding the adolescent intervention study. Rightly, he did not over-speculate about that, but we need to fully understand it and see what can come of it.

As the hon. Member for Bootle (Peter Dowd) said, there is the question of the under-fives catch-up. Most parents understand that that is a basic thing that should be done. People find it hard to believe that there is a significant case against it; they think it is just a question of how we manage and organise it. It is not enough to say, “If we reach the newborns, that will be enough.” The risk is significant.

Like the hon. Gentleman, I met Harmonie-Rose last week in Westminster Hall. I could not help but be conscious that I was talking to a beautiful, lovely child, and that perhaps, if the men B vaccine had been on stream earlier and in the immunisation schedule when it was licensed, she would not have had to use her great charm to lobby on this issue.

If we delay the under-fives catch-up, how many other people will be affected? How many other young, precious lives will be lost? How many families will be plunged into grief? How many young lives will be harmed? How many young people will lose limbs or suffer brain damage or facial disfiguration? We need a response and an intervention, which is why people have petitioned so strongly. The people who petitioned us want action, and I hope the Minister will address them in honest but hopeful terms.

Brain Tumours

Mark Durkan Excerpts

Monday 18th April 2016 Westminster Hall

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to speak in this debate under your chairmanship, Sir Edward. I apologise to other Members: I was not here for the start of the debate because I was upstairs in a Delegated Legislation Committee dealing with the code of practice under the Modern Slavery Act 2015, so unfortunately I did not hear what by all accounts was a powerful speech by the hon. Member for Warrington North (Helen Jones). I want to thank her not only for her role in securing today’s debate, but for the quality of the Petitions Committee report, “Funding for research into brain tumours”.

I was delighted to be here for the contribution by the hon. Member for Castle Point (Rebecca Harris), whose work as chair of the all-party group on brain tumours I admire and, as a member of the group, try to support. I thank Maria Lester for the petition, which is welcome and gives us the chance to follow up on the work done by so many other people to point out exactly how little funding goes into research into brain tumours compared with other cancers. The statistics have been quoted again and again today. I can do my little bit as well, but no matter how many times the statistics are quoted they do not become cliché-worn. It is still a shock when we consider the impact that brain tumours have.

[Ms Karen Buck in the Chair]

Brain tumours represent 1% of cancer diagnoses and 3% of cancer deaths. They also represent 2% of all deaths under 60, so that shows us what we are dealing with. It is shocking that the Government persist in committing relatively little to specifically support research into brain tumours. That is why I want to thank Brain Tumour Research for its work in Parliament and so many other places to raise awareness and funds, and then to have those funds applied to excellent work that hopefully can transform prospects for many people.

Like others, I have been contacted by constituents about this debate, including by Anne-Marie, who wrote to me about her husband, who is 45 and was diagnosed with a glioblastoma last August. She has pointed out the major effort going on in the United States via the “moonshot” campaign, which received a lot of attention after the tragic death of Joe Biden’s son. She referred me to some of the letters that were written to Joe Biden in the context of the “moonshot” campaign. She said she identified strongly with some of those letters, which spelled out the frustrations and feelings that she and her husband experienced. Our efforts should not just be about ensuring that more funding goes into research per se. We must ensure that it incentivises new treatments and fosters and facilitates innovation. Doing one will help us do the others; it will make such a huge difference.

One of the reasons why my constituents are so aware of brain tumours at the moment is that the top-class footballer Mark Farren, a young man of 33, died in February. He was a record-setting and record-breaking goal scorer who played for Derry City and Glenavon. He tragically lost his battle, even though the football family—not just those in Ireland, but people here such as Wayne Rooney, Roy Keane and others—raised money to help to get innovative treatment for him. He lost his battle, but the fight goes on.

Dementia and Alzheimer’s Disease

Mark Durkan Excerpts

Tuesday 12th April 2016 Westminster Hall

[Mark Durkan (Foyle) (SDLP)]

I commend the hon. Gentleman for securing the debate. On Northern Ireland, he may be aware that the Joseph Rowntree Foundation supports the Dementia without Walls programme, and one place in which it has done something is in a city with walls—the Derry Engaging and Empowering Dementia project has included: work at the level of schools and everywhere to ensure that everyone is more aware of dementia; and Derry having the first dementia-friendly pantomime in Ireland last December, in the Millennium Forum.

[Jim Shannon]

I thank the hon. Gentleman for his intervention and for giving an example of some of the good things happening throughout the whole country.

I tabled an early-day motion some time ago to highlight what can happen in people’s homes, and I suggested issues such as smoking, drinking, diet, excessive weight, healthy weight and social interaction, which is so important. Many may enjoy a tipple or an alcoholic beverage, but for too long alcohol has been overlooked as a cause of dementia. The hon. Member for Beckenham asked what some of the causes are, and that is one of them. No one is saying to people to go cold turkey or to hang up their dancing shoes, but the facts are there and they need to be heard.

We have alcohol-related dementia, which is formally attributed to alcoholism, and conclusive evidence now shows that heavy drinking over a long period increases the chance not only of dementia in the long term but of early onset dementia. To illustrate that, Alcohol Concern has provided comparative data showing that the brains of men who drank more than four units of alcohol a day—approximately two or three drinks a day—over 10 years age at a higher rate than those of light or non-alcohol drinkers. The brains of men who regularly drank alcohol appeared between 1.5 and 5.7 years older than their healthier counterparts. Those are just some of the things we have got to address.

One other thing we have done in Northern Ireland is provide funding for dementia-specific nurses, new studies into treating dementia—seven studies are taking place in Northern Ireland—and we have clinical leads for research. That is what we need to do. I thank the Minister, the shadow Minister and right hon. and hon. Members for coming to participate in the debate. I hope that my comments and the interventions have helped to focus attention and that we can do a lot more in advancing the race against dementia and Alzheimer’s, supporting the carers better and furthering awareness of the potential causes.

Oral Answers to Questions

Mark Durkan Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Jeremy Hunt]

I absolutely recognise the excellent work that is happening in Hednesford, and in South Staffordshire, as a dementia-friendly community. I know that there are more than 2,000 dementia friends in Cannock Chase. Fantastic work is going on, and I thank my hon. Friend for her support.

[Mark Durkan (Foyle) (SDLP)]

When will we have a decision on the future of the human papilloma virus vaccination programme? Will it be clear, and is there due engagement with the devolved counterparts?

[Jane Ellison]

As the hon. Gentleman knows, two programmes are going on. There is a very large-scale piece of modelling work going on with regard to the HPV vaccination for boys, and that work, as I have previously told the House, will look to report in 2017. We already have guidance on HPV for men who have sex with men from the Joint Committee on Vaccination and Immunisation, and we are working through it in some detail to see how we can take it forward in practical terms.

Mental Health Taskforce

Mark Durkan Excerpts

Tuesday 23rd February 2016 Commons Chamber

[Alistair Burt]

My hon. Friend is absolutely right. I praise the storyline editors of “Coronation Street” just as much as I do those of “EastEnders”, which has done a remarkable job in relation to perinatal mental health with Stacey’s story over the past few weeks.

The Government’s anti-stigma campaign will certainly continue. We are much informed particularly by young people, with whom we have worked on Time to Change, to which we have made a further commitment of financial support. Stigma is a terrible thing, and is partly responsible for breaking the link between physical and mental health. The taskforce recommended that the Government deliver on the objective to make sure that more people with mental health problems receive help for their physical issues, so that we can deal with the terrible difference in mortality rates between those with mental health difficulties and other people. Dealing with the stigma, so that people feel able to raise their problems, is an important part of that.

[Mark Durkan (Foyle) (SDLP)]

I thank the Minister for his statement, and I acknowledge the work of the taskforce and its report.

I encourage the Minister, along with his colleagues in the Department for Education, to take a particular interest in the mental health in schools training programme, which has been developed by practitioners to ensure that schools are better equipped to support the mental health and wellbeing of pupils. Will they help to safeguard those interests in a system that is designed to be run in a similar way to the child protection system, with which schools are familiar?

[Alistair Burt]

The hon. Gentleman has a long-standing interest in these issues. He is absolutely right: in England, a pilot project with 27 schools is being run by the Department for Education to locate and identify a single point of contact in those schools on mental health issues for young people. Depending on the results, more projects can be rolled out. Early identification and support in school are absolutely essential, and that work is under way.

There are a number of different initiatives, sometimes inspired by people who have experienced personal tragedy in their own family. They realise that the tragedy that has befallen their young person might not have happened if their friends had been more aware of their circumstances, or if the school or college had been more aware. We look at all those different initiatives to see how best practice can be spread, but the hon. Gentleman is right to raise the issue.

NHS and Social Care Commission

Mark Durkan Excerpts

Thursday 28th January 2016 Commons Chamber

[Helen Whately]

The hon. Gentleman might want to hear what else I have to say before he agrees entirely with what I am saying, but we share the view that scaremongering is unhelpful.

In a health system that spends £135 billion of taxpayers’ money every year, that employs 1.3 million staff and that has over 60 million users in the British population, there is no way in which this issue cannot be political, as the hon. Member for Leicester West said. It just is political. It is no bad thing that it is political, because it means that there is a debate about it and, out of debate, we get better answers. It also means that the public are given a choice.

One concern I have about the proposed commission is that there appears not to be a consensus on what it should be about among those who support it. I have heard this afternoon that it should be about the future funding settlement for health and social care, but also that it should be about public health, the structure and configuration of the NHS—the estate solutions—the future role of mental health in the health service, prevention, and the integration of health and social care. To me, that is a problem. If the commission is to be effective and short—a period of one year is proposed—and if it is to lead to something concrete, it cannot possibly be that wide-ranging. I worry that those involved in the commission will spend a huge amount of time working out, and disagreeing among themselves about, what the commission is looking into. That process would be an enormous waste of time, money and attention—there is a limited amount of attention, brain power and resources to put into such a discussion about the future of health and social care, which is an opportunity cost.

To the extent that the commission might focus on future funding for the long term of health and social care, that is important and should be given a huge amount of attention. We need to look further out, but if anything is political, it is that question. Questions such as how much as a society we should spend on health and social care, what proportion of GDP or what amount per person we should spend, and how it should be funded—should it be taxes, charges or co-payments—are important, but they are very political. They are questions of value. It would be incredibly difficult to take the politics out of them.

In fact, it would be wrong to come to a consensus. We need a debate and we need to disagree. We need to give the public a choice. Just as the current funding settlement through to 2020—the £8 billion or £10 billion in this Parliament—was put to the public last year at the general election as part of an overall package of Government spending, taxation, debt and deficit proposals, future funding for the health and social care system should be put to the public at a future election. It is not something that should be agreed by insiders in a commission between now and the next election—the suggestion is that it should move quickly. That is a worrying proposal if I have understood it right. The public should decide that and it should be debated in the run-up to an election.

[Mark Durkan (Foyle) (SDLP)]

Does the hon. Lady really believe that the public would be happier with a confused and disagreed choice that has been argued over between parties rather than an agreed and long-term choice that puts real priorities and undertakings in front of them?

[Helen Whately]

The public would rather be given a choice. We will have a debate about Europe in the run-up to the forthcoming referendum, which voters voted for in the election. We should respect voters and put choices to them on which they can take a view.

--- Later in debate ---

[Debbie Abrahams]

I would not disagree with my right hon. Friend, but to pretend—and that is what it would be—that we could reach that conclusion on a cross-party basis would be an illusion. That does need to happen, but we come from completely different perspectives, and that needs to be considered.

In the first year of the legislation, contracts worth £16.8 billion of public money went out to tender under the Health and Social Care Act, with 40% going to private healthcare companies. We could track that because it was on Supply2Health, a public website that was taken down, which meant we could no longer monitor it. Care UK won 41 contracts worth £110 million; and again, the association of donations to different political parties is on the record. Some £5 million has been wrapped up in funding for competition lawyers. In my constituency in Oldham, my community trust, which also provides our mental health services, has said that the amount of time and money wrapped up in competing for tenders has increased inexorably. That is a distraction, and having a commission, getting away from these central points, would also be a distraction. As I say, we come from different ideological perspectives.

[Mark Durkan]

Given what my hon. Friend has said about the impact of the legislation in the last Parliament, does she believe that a commission would have a more adverse impact on the long-term future of the health service than that legislation is having, which is based on the old way of doing business?

[Debbie Abrahams]

We come from completely different perspectives, as I have just mentioned to my right hon. Friend the Member for Don Valley (Caroline Flint). My hon. Friend the Member for Walsall South said this had been mooted back in the ’60s, but if we think that now, just a few months after our debate on the Health and Social Care Act, something has suddenly changed, I would respectfully ask, what has changed?

Again, a commission would be a distraction from what we really need to have our eye on: what is happening in health and social care at the moment. We know that the decisions made about staffing and training, for example, have put our workforce plans in jeopardy. One reason why we have financial problems is that three out of four trusts are now in deficit—currently a deficit total of about £840 million, which will run up to £1 billion by the end of the year.

Infected Blood

Mark Durkan Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

That is clearly the hon. Gentleman’s view and I invite him to submit it to the consultation. This is exactly why we are consulting. We have made some proposals, but some of the questions are very open, and we will look at what comes back from the consultation. I urge him and other Members to take part in the consultation.

[Mark Durkan (Foyle) (SDLP)]

I welcome the statement and commend the shadow Minister’s tone. Victims in Northern Ireland share the compound frustration that we have heard from other Members on behalf of their constituents, but maybe feel more pointedly the contrast with their friends in the south of Ireland, who have had a path of justice available to them over many years. I know the Minister is absolutely sincere in her commitment to the issue of treatment, but will she give assurances that the effort she is putting into making sure people can be made well will not detract or distract from the obligation we still have to make good this travesty that people have suffered?

[Jane Ellison]

I thank the hon. Gentleman for that question and his sustained interest over such a long time, speaking on behalf of people from his area. Based on our previous conversations, I recognise there might be aspects of the proposals that the hon. Gentleman does not feel meet his own aspirations, so again I invite him to respond to the consultation. I will take note of his—and all other Members’—views. These are our proposals. Some of the questions are very open and people can give us their views. I recognise that something different happened in the Republic of Ireland, and it is down to another Government to make those decisions. The circumstances were different for reasons I have gone into previously from this Dispatch Box.

NHS Bursary

Mark Durkan Excerpts

Monday 11th January 2016 Westminster Hall

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to take part in this important debate. I commend the hon. Member for Sutton and Cheam (Paul Scully) for introducing it as a Petitions Committee member. He had the difficult task of framing the wider debate by drawing attention to a number of the background and contextual issues in the way that he felt was fairest and on the broadest issues. Many of us are in-filling the debate with a different emphasis, taking account of some other considerations.

As a Northern Ireland MP, I am conscious that this debate is about the bursary scheme for the NHS in England. Of course, the scheme recruits students from Northern Ireland who are undertaking courses in England, and as a devolved Administration we also have our own variant of the scheme. In previous contributions on this subject, the hon. Member for Ilford North (Wes Streeting) has raised the question of whether there will be an immediate Barnett consequential to this change to the NHS in England. Even when we get the answer from the Treasury, it changes over time. I have served as a devolved Finance Minister, so I know that in one instance the Treasury will tell you that there is no Barnett consequential, but then a year or two later some new thinking will mean that there is and that the vice has been tightened. Its usual rule of thumb is, “We’re the Treasury; we don’t need a reason,” so it can change at will.

Although, as the hon. Member for Belfast East (Gavin Robinson) said earlier in an intervention, the current Health Minister in Northern Ireland has properly set his face against going down the same road as the UK Government on the bursary scheme, the fact is that a significant change such as this has the potential to become the predictable text of future devolved policy. It has a conditioning effect by creating a context, and even when devolved Administrations resist such policy changes it usually adds to their costs, which makes the choice not to make the change harder. There is usually policy opportunity cost elsewhere as well.

We need to ask where the rush to this policy change has come from. Two lines in the autumn statement have heralded a significant change. We are told that a consultation will start this month, so will the Minister tell us how serious, thorough and far-reaching that consultation is going to be? Will it include a comprehensive consideration of all the implications of the change and a proper consultation on all the shortcomings and benefits of the current scheme?

Those of us with concerns are not coming here with a “Little House on the Prairie” picture of how the existing scheme operates. We are not pretending that nursing students and students in the allied health professions currently have a sweet life. They clearly face many serious pressures, but we heard from the hon. Member for Sutton and Cheam that the pressures, difficulties and life costs justify the change. In my view, they justify taking great care with any change. We need to address the problems that exist without creating new problems or compounding the existing ones, for exactly the reasons mentioned by other Members, including the hon. Member for Isle of Wight (Mr Turner), who described the implications of changing to a loan-based system.

We must recognise that the roots of nursing education have historically been very different from those of other education. It is only recently that we have seen the well motivated move to ensure that nursing and the allied health professions are truly recognised as professions of degree standard. The problem is that some people take that to mean that we should treat the bursaries in the same way as any other student loan and that that should be the norm. We know, for the reasons that Members have set out, that it should not. The students in question are not just in training but in service in a real, pertinent and highly pressurised way, which means that they do not have the options for covering their maintenance costs that other people have, and that their time is much more precious. Given their life circumstances, they have responsibilities that students on many other courses do not, so we are not comparing like with like.

Where has the support for the change come from? Has it come from the professional bodies that represent nurses, midwives, physiotherapists, speech and language therapists, occupational therapists, dieticians, radiographers, chiropodists and podiatrists? No, it has not. They have real concerns about the implications of the change for their members and the services they work in. Has it come directly from the employers? Health service employers in Northern Ireland, including in my constituency, constantly talk about workforce problems and the huge pressure to fill places and keep services running. A new radiotherapy unit has opened in a hospital in my constituency, and there will be huge pressure on it to employ and sustain radiologists for the future. Health service employers in Northern Ireland are acutely conscious of the pressures, but none of them has said to me that they believe this change will solve the problem.

The change seems to be sponsored mostly by the Council of Deans of Health, which is responsible for education, because it will perhaps solve a problem for universities. Universities look at their numbers and their funding and ask what the change will do for their economics, given that they have a key role in educating health service professionals. It will solve a problem for them, but not for the services that are meant to be supported or the professions. We must include in the consultation those whose voices have not been listened to and who have not canvassed and pushed for this change. Their voices must be heard, which is why this debate and others like it are so important.

The hon. Member for Sutton and Cheam said that something has to give and that the bursaries need to be changed. At one point, he actually said that one reason why bursaries are not good is that they can be taken away, as though that was an argument against bursaries. It is pretty cheeky to justify a proposal to take bursaries away by saying that we should do it because they can be taken away.

[Paul Scully]

Forgive me, I was talking about the title and the semantics. “Bursary” is a bit of a misnomer when, as had been said, it is more like a salary, albeit an inappropriately low one.

[Mark Durkan]

I take the hon. Gentleman’s point, which resets the context of his comments. I gladly acknowledge that clarification.

Just as we should not presume that bursaries are a given and cannot be taken away, people cannot afford to presume that the assurances about the loans-based policy are a given. The current rate of 9% of earnings over £21,000 can change—we must remember that the registration fees for people in the nursing and midwifery service have been hiked up. The Government’s justification for that significant hike in percentage terms is that they have been raised from a fairly low base. When people hear the argument that some students will not pay much of the loan or the whole loan, many fear that more money will be sought in the future in comparative and relative loan repayments. People cannot rely on the assurances that have been given and some of the other arguments that have been made. I hope the Minister is able to convince us that the consultation will look at all those issues and that they will be answered properly.

--- Later in debate ---

[Ben Gummer]

The hon. Lady probes like an expert, but she should know that there has been a detailed assessment of the impact of the changes as part of the policy development, which is still taking place. When we launch the consultation, the full details of the assessment will be made public as part of the process, so she will be able to see very soon what the changes will mean.

My hon. Friend the Member for Lewes spoke with great eloquence about her own nursing experience. Other hon. Members may not know that she has a master’s degree connected with her nursing work. She certainly knows about the full gamut of the academic discipline of nursing, and I take her views with considerable seriousness. She was right to point out that the change is part of a wider package of reform.

Several hon. Members spoke clearly and, in one case, movingly, about people who want to become nurses but cannot, either because they did not achieve the necessary grades earlier in life to go to university—that was a failing of their education rather than because of an innate inability to be a nurse or to pass the exams—or because they have caring responsibilities. We want both sorts of people to be in nursing, because they care and because of their vocational call to be nurses. At the moment, a significant number of them are working as healthcare assistants and cannot progress to being nurses. They are prevented from doing so unless they leave the workforce, go to university and then come back into the system. Even under the existing arrangements, that makes it impossible for many of them, which is profoundly wrong.

That is why it is a priority for me, as I announced a few weeks ago, to open up an apprenticeship route to enable healthcare assistants to move from a band 3 position in the NHS to an intermediate new position—nursing associate—that is part of a vocational route to full nursing registration. The exciting thing about that is that it will provide a dual training route into nursing. There is the traditional nursing undergraduate route, which will still take three years, and there will be the new route—an apprenticeship—which will open up nursing to a whole new group of applicants who are currently precluded from achieving their dream of going into nursing and who do not even count in the statistics of those refused a place.

In the round, we are doing what I hope many Opposition Members want. I share their wish to see the diversity of the workforce, which is already one of the most diverse in the country, improve still further, and to see opportunity expanded, the quality of training improved and support given to people at university. Conservative Members also want all those things.

I appreciate the sensitive way in which hon. Members on both sides of the Chamber have spoken. I also appreciate that they may disagree with how the Government want to proceed to try to improve nurse training. In the absence of alternative ideas, I believe that our proposals really are the way to expand places, improve diversity, increase opportunity, especially for those from disadvantaged backgrounds, improve quality and provide support for those at university.

[Mark Durkan]

The Minister has criticised colleagues several times during the debate and said that the Government are not hearing alternatives. Will he reframe the consultation so that they can hear alternatives? It is clear that people want to work on a different premise and to a different agenda, with much better outcomes, including achieving the important goal of better equipment that he referred to. Widening the consultation would allow those alternatives to be heard, but the way the consultation is framed at the moment means they will not be heard.

[Ben Gummer]

I would be delighted to hear alternatives, and not just via the medium of the consultation. I would very much like them to be offered within the current spending envelope, but if people wish to offer alternatives outside that envelope, they must explain how much they will cost and how they will be funded. Within that spending envelope, the reforms will allow us to expand the number of places and improve quality, support and opportunity.

Conception to Age 2: The First 1001 Days

Mark Durkan Excerpts

Thursday 17th December 2015 Commons Chamber

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to follow the right hon. Member for North Norfolk (Norman Lamb), who touched strongly on perinatal mental health. That is one of the issues addressed in the work of the all-party parliamentary group on conception to age two—the first 1001 days. In common with others, I pay tribute to the hon. Member for East Worthing and Shoreham (Tim Loughton) not just for his introduction to the debate, but for the way in which he has chaired that all-party group and the thorough way in which evidence has been drawn and accumulated from so many practitioners, academics and others. He has followed up the pioneering work done by the hon. Member for South Northamptonshire (Andrea Leadsom) in establishing the group, along with the right hon. Member for Birkenhead (Frank Field) and the hon. Member for Brighton, Pavilion (Caroline Lucas).

I have been a member of the all-party parliamentary group since its own conception, and I have been particularly impressed by the way in which so many different organisations, all of which have pledged their support to this manifesto, have engaged with its work with the aim of making us better informed about the policy questions that we raise, the policy priorities that we identify, and the ideas that we present.

It is great that the hon. Member for Nottingham North (Mr Allen) has been here to contribute to the debate, because in a number of respects he has been a policy prophet. For many years, people who talked about early years policy tended to mean the year or two before a child went to school, when the child was three or four years old. All too often, early intervention or early years policy has concentrated less on the role of parents as parents than on their role as workers who have parental responsibilities and are therefore in need of childcare, and who, along with their employers, benefit from good childcare support. We need to support parents in their capacity as parents with key responsibilities for their children, and that means supporting them when the children are experiencing those first, formative stages of their lives.

We have already heard today about all the scientific evidence relating to the plasticity of the brain and the key development of neurological pathways during the early stages of life. One of the academics who gave evidence to the all-party parliamentary group made the telling point that many of the experiences that affect people over their lifetimes can be traced back to childhood experiences that could have been averted, or prevented, by good early years support, and that means adequate support for parents during the formative years of their children’s lives. For instance, there may be a high correlation between child and adolescent mental health issues in the later stages of people’s lives and some of their experiences during their early years, when they may have faced challenges such as an upbringing in distressed circumstances or the absence of opportunities that could have been afforded if their parents had been given proper support.

That academic used a striking phrase. He was a north American, so perhaps it came from him all the better. He said, “Unlike what happens in Las Vegas, what happens in the early years does not stay in the early years.” For good or bad, what happens in the early years is with us throughout our lives, and many of those experiences may inform our expectations in life and of life. That is all the more reason for us to invest strongly in the early years, not just in terms of family love but in terms of policy and programme planning, and of actual support in the form of local services.

While I have been hugely impressed by much of the evidence that I have received as a member of the all-party parliamentary group—and, like the right hon. Member for North Norfolk (Norman Lamb), by the compelling case that has been put forward by George Hosking and others—I am happy to say that I have benefited from the presence in my constituency of the Lifestart Foundation, which was established in Ireland back in the 1980s and which operates active programmes in different parts of that country. Its essential mission is to provide high-quality parental support in order to produce better child development outcomes. It gives parents evidence-based information about the way in which young children learn and develop, and helps them to use the knowledge that they have gained.

The foundation also promotes the delivery of its Growing Child programme. Unfortunately time does not permit me to spell out the details of the programme, but they chime with all the points that Members have made today, and accord very strongly with the main points and principles in the manifesto that we are discussing. The foundation delivers a systematic evidence-based child development programme by means of home visiting, from which, as a parent myself, I benefited in my own area. That goes to parents of children from birth right up to pre-school, and indeed school entry. The outcomes are informed by sound empirical research, and they are designed and reviewed by child development and parenting experts.

There has been a randomised control trial conducted by Queen’s University from 2008 to this year and beyond. It involves 848 parents and children, and it has already proved the findings that argue for this manifesto. I encourage the Minister to look up those findings from the centre for effective education at Queen’s University in Belfast, because they prove that the Lifestart programme and the home visiting service work as predicted, with significant positive outcomes for parents and improved outcomes for children. Parents are less stressed, have greater knowledge of child development, demonstrate higher levels of parenting efficacy, are more confident around child discipline and boundary setting, report better parenting mood, have increased feelings of attachment with their children—the hon. Member for East Worthing and Shoreham stressed that earlier—and feel less restricted in their parenting role. Of course, for children there are better cognitive skills, better social and emotional development, improved behaviour, and fewer speech and language referrals, and these positive effects on children will be expected to continue through life. This research team will be following the children’s development through school.

This all goes to show what international research points to: the quality of parenting, the amount of time adults spend interacting with children, and the nature of the whole learning environment are critical to child development and ensuring we avoid many of the social stresses and problems and behavioural issues that affect us all, and inform some of our debates on other subjects in this House.

As well as giving that example of Lifestart and its work in my constituency and elsewhere in the north and south of Ireland, I encourage the Minister not just to look at this manifesto in terms of what he can do in his own departmental responsibilities and in talking to ministerial colleagues here, but to see whether he should have a wider conversation not just with devolved Ministers, but using the British Irish Council model which takes in all eight Administrations on these islands, to talk about how we might roll out truly effective early years and proactive early intervention policies more widely, building on the arguments in this manifesto and drawing on the evidential experiences from elsewhere. What this shows is that all the rendered science chimes with our most tender instincts about what is the best thing to do for children in these early years.

Victims of Contaminated Blood: Support

Mark Durkan Excerpts

Wednesday 16th December 2015 Commons Chamber

[Jane Ellison]

I cannot right the wrongs of 30 years; I can only try to do what I can in the circumstances, and with the money that we will allocate. We will present plans for a reformed scheme, and I invite the hon. Gentleman and his constituents to respond to them. In developing those plans, I must look to the future, and ask what we can do to support people with a reformed scheme. In particular, I must ask how we can respond to some of the ways in which the circumstances in which we address this terrible, difficult tragedy have changed, and ensure that our response reflects those new circumstances.

[Mark Durkan (Foyle) (SDLP)]

The Minister may recall that when the all-party group met her in early November we warned her that any slippage would be greeted as slipperiness by people who had suffered delays for too long. Does she appreciate that people will worry about the possibility that the extra time has been taken to ensure that the consultation is more controlled and options are sealed off? Will she also address the underlying question that people want to ask? Why, if liability could be admitted by the Irish health service on the basis that the risk was known, can liability not be admitted by the NHS, and why cannot compensation be forthcoming?

[Jane Ellison]

Payments made by the Republic of Ireland are a matter for the Republic, and they were made in response to circumstances in Ireland relating to the use of blood products. We have covered that before, in debates.

Of course I understand the hon. Gentleman’s frustration—I spoke to him informally last night to alert him to the fact that there was some delay—but I reiterate that it is better for us to produce a scheme into which we have had a chance to put more effort and a little more detail than, for the sake of a few weeks, to rush out something that would not give people any real sense of what was being consulted on. Although the delay is frustrating, as I have acknowledged a number of times, I think that it will give rise to a better and more meaningful consultation.