Autism and Learning Disability Training: Healthcare Professionals

Mike Wood Excerpts

Monday 22nd October 2018 Westminster Hall

[Mike Wood (Dudley South) (Con)]

It is a particular pleasure to serve under your chairmanship this evening, Dame Cheryl; we are debating an issue on which you have done much, not only to raise awareness, but to transform the legislative framework in which we operate. I thank the Petitions Committee for ensuring that time was made available for the debate, and congratulate the hon. Member for Cambridge (Daniel Zeichner) on his opening speech. I pay tribute to Oliver’s family in particular, and to the many other families who have done so much and worked so hard, exhausting reserves of energy and emotion that I am not sure many of us could have found, to ensure that some public benefit can come from their individual personal tragedies.

I have rather less direct personal experience of autism than many of the Members who will contribute today, but as a former governor at a special needs school that had a particular focus on autism I am familiar with many of the issues that Members have raised. As of last week I am a proud officer of the all-party parliamentary group on autism. I am fortunate to benefit from the fact that many constituents contact me to give me advice and tell me of their and their families’ experience in the healthcare system. I also benefit from the advice and experience of my former colleagues, the staff and governors at the school, and the National Autistic Society, which does much important work to push forward the agenda.

As has already been said, there are clear healthcare inequalities between people who have autism and the general population. That is clearly recognised by the Government. It was recognised in their mandate to NHS England and, of course, as one of four clinical priorities in the 10-year plan published last month. Those inequalities clearly have many causes. There are many co-factors more likely to affect people who have autism, such as issues to do with unemployment, mental health and poverty; but one of the most obvious ones, which is referred to in the petition, is the interaction between the national health service and healthcare professionals, and people with autism.

For many of us it can be hard to decipher what medical professionals tell us, particularly when we are very ill and perhaps not thinking as straight as we might. For people with learning disabilities and communication difficulties, the difficulty is on an entirely different scale. For many people with autism it is a question of heightened difficulty not only in understanding what they are being told, but also, of course, in communicating how they feel physically, emotionally and mentally. It is therefore essential that understanding of autism becomes part of the mandatory training for healthcare professionals, just as it is finally becoming a core part of initial teacher training.

Like other hon. Members, I am pleased to see that the new core skills education and training framework finally sets out proposals for a tiered approach and levels of training depending on levels of contact that can be expected for people with autism. There are half a million people in England—more than 1% of the population—who we already know have autism, so there can be barely any part of the healthcare system in which any worker is unlikely to have regular contact with patients with autism and their families. So it is a core part of their job and responsibilities to be able to respond, and to make necessary adaptations in the way they behave. That is a core part of being a healthcare professional.

[Dr Whitford]

There are throughout society people with varying skills, disabilities or learning difficulties, so do not we need to bring that right into medical and nursing school, and try to have a philosophy that counters what we see in society? That, frankly, is attacking the “other”. We have had so much of the politics of “other”, and attacking the “other” socially, and we need to try to get rid of that when people are at school and in medical and nursing school—not just when they have qualified.

[Mike Wood]

There are two important and slightly distinct points there. For mainstream education it is vital that an understanding of autism and other learning disabilities is part of personal, social, health and economic education—I do not know whether we still call it that—for precisely the reasons that the hon. Lady describes. Of course, in medical or nursing school it is vital that there is a core level of understanding of the issues for autism and other learning disabilities and of the impact they have on how people need to do their job once they have qualified and are practising and in work. That needs to be embedded from day one, but just as importantly, it must be reinforced and built on with continuing professional development.

Although there is clear evidence of inequality in many health outcomes, there is little concrete evidence yet known about how the wellness of people with autism compares with that of the general population. I hope the new framework will explicitly cover primary and community health as well as acute healthcare. Primary and community health is where much of the early interaction with patients and the wider population takes place. It could not be more important that our GPs and community healthcare staff understand the particular issues faced by patients with autism and their families, and how they should respond to them.

However, I hope the framework will go slightly further than that. I am sure that you, Dame Cheryl, might have wished to raise this issue were you not chairing the debate: the need for a GP autism register, as recommended by the National Institute for Health and Care Excellence, with a relatively easy and simple code so that people’s progression through primary healthcare pathways and on to an acute healthcare or a mental health setting can be tracked and we can have a better understanding of the impact of autism and learning disability on wellness and the particular challenges and experiences of people with autism.

[Dr Whitford]

The hon. Gentleman touched on poverty earlier. The learning disability employment gap is over 90%; if we actually want to look at the wellness of people with learning or communication difficulties, we as a society must include them, rather than parking them on the side and wasting their talents.

[Mike Wood]

The hon. Lady is right, and if I may give a quick plug, the all-party parliamentary group has done some important work with the National Autistic Society on precisely the issue of autism, employment and education. I understand it will be published shortly and I hope it provides a focus for a future debate.

[Hannah Bardell]

Following on from that point, does the hon. Gentleman agree that people with autism and additional support needs have a huge contribution to make to our economy and society? As someone who has had a number of people on work experience, they have helped me to see the world in a different way. I am sure the hon. Gentleman will have seen “The Curious Incident of the Dog in the Night-Time”; when I went to see that in the west end, it was a turning point for me in understanding the world and a little window into how people with autism see it.

[Mike Wood]

The hon. Lady is absolutely right. That enormous employment gap is a tragedy in terms of not only the lost opportunities for those people directly affected, but the wasted opportunities for the many employers who could be benefiting from the skills of people with autism and other learning disabilities, and for wider society, which is losing the contributions that they can make.

Finally, I will touch quickly on the issue of mental health. Autism is not a mental illness, but we know that people with autism are much more likely to be affected by many mental illnesses, particularly anxiety-related illnesses, than the general population. We need to ensure that the new framework is properly embedded across mental healthcare as well as physical healthcare, so that our mental health services can ensure that people with autism get the proper services they need. Far too often, people with autism find not only that their condition means their mental health problems are not properly diagnosed at an early stage, but that, if diagnosed, their condition can interfere with their receiving the appropriate treatment in a way that might be expected elsewhere.

We must ensure that autism is one of the four clinical priorities right across the healthcare system and that the training our healthcare professionals receive reflects that. Only then can we start to address the healthcare inequalities that we see in this country and, hopefully, try to ensure that there are fewer repeats of the terrible stories we have heard this afternoon.

[Dame Cheryl Gillan (in the Chair)]

Before I call the next speaker, I think that, without compromising the objectivity of the Chair, I should probably have put on record at the beginning of this sitting that I currently chair the all-party parliamentary group on autism, in case people have not gathered that by this stage. Secondly, I apologise for the temperature in this room, which is below what I would consider comfortable standards. We have made inquiries and unfortunately we cannot adjust the temperature unless the room is vacated and the engineers come in to look at the equipment. I apologise for that, but, unusually, if anybody wants to put on their coats, they are welcome to. I understand that some people are feeling very cold in this environment and I can only apologise.

Autism

Mike Wood Excerpts

Thursday 29th March 2018 Commons Chamber

[Mrs Trevelyan]

The hon. Lady is absolutely right. Not every council needs a child psychologist who is an expert in the identification of autism, but it would be great if there were one or two across the north-east, in my region, whom we knew we could always tap into. There have not been for years. The situation is getting better, but it is not good enough. We need to think more intelligently about how we provide that resource for families.

I want to talk in more detail about interventions. It is so exciting that the teacher training module will come into the system from September. Before I talk about that, I want to read from a letter sent to me by one of my constituents, a lady called Skye. I have not met her; I have knocked on her door, but there has never been anyone in. She wrote to me about her son, who is four years old and has complex needs. He attends our special school in Berwick. She says:

“Every day so many simple things in life that we all take for granted become a moment of stress, worry and concern”.

She says that could give a vast list of examples of the stresses her child undergoes every day. My heart goes out to her; I was there some 15 years ago, too. She highlights one particular issue:

“Shopping trolleys with child seats are designed for toddlers. My little/big man squeezes into this trolley with pain and distress. I have to lift him above my head because I am only a 5ft mummy.”

Those are the sort of practical things that day-to-day life can throw at mums who are having to deal with this. She goes on to say that

“many younger autism sufferers…have no boundaries, no understanding of the consequence of their actions, and if they have a crisis moment could injure themselves”

by falling out of the trolley or running away. I lost James once in a supermarket, and it was possibly the worst half-hour of my life. She says:

“Being confined to a safe space (trolley seat) is safer for them. It provides an object reference”,

as well as security, as a pram does for a much smaller child. That is a really interesting challenge to us, to think about how we might encourage the tools that can help a family in those public spaces where we go every week.

I almost never took James shopping until recently, as part of our plastics challenge, which I am sure the Minister will join us in. We went shopping and I said, “I’m not buying plastics.” He wanted a particular cheese that only came wrapped in plastic, so he had to buy it himself. There is a lesson for an 18-year-old boy who has never been shopping before: he gets taken shopping, and his mother then makes him do his own shopping.

The reality is that the tools to help people get over the crisis points are vital. I really hope that as the autism module rolls out, teachers are given those tools. James had an amazing teacher when he was six years old. He was not diagnosed, but she could see his meltdowns coming. She told me to bring a beanbag into school, which she put behind her desk. She said to James that whenever it all got too much for him—which was quite often, when somebody was prodding him, he was sitting in the wrong place or he could not see or hear—he was allowed to get up and leave his desk or wherever he was and go and sit in the beanbag behind the desk. The teacher knew where he was, because that is where he always went. The other children did not know or care; they carried on with their school activities. It gave him a safe place that was invisible to everybody else, but they knew he was safe, and then the moment passed.

This is a child who got three A-levels last year and is going to Newcastle to read zoology in September, but when he was seven or eight years old and undiagnosed, nobody thought he would be mainstreamed. He was mainstreamed because teachers thought about how they might give him the tools to get around those moments. We need the teacher training framework to think about the practicalities. These children are simply different, and we have to understand what not being neurotypical means. It is hard for those of us who are neurotypical to understand it.

We must give teachers the opportunity to ask questions. For many teachers in busy classrooms, if one or two children are struggling, the exclusion line is the one that is followed. The behavioural problem kicks in because the child is under a great deal of stress, entirely unnecessarily, and we find those children suffering huge long-term educational failure as a result of the teacher’s inability to intervene early on with something quite simple that can give the child time to recover.

[Mike Wood (Dudley South) (Con)]

My hon. Friend is absolutely right. It is fantastic news that special educational needs and autism are finally part of initial teacher training. Does she agree that, to make a really big difference, we need to ensure that autism training is a core part of continuing professional development for teachers, so that we can get it into all classrooms?

[Mrs Trevelyan]

I completely agree with my hon. Friend. That is exactly the challenge. If we can embed understanding that these children simply see the world and react to it in a different way and that those different ways of looking at a classroom space can be all that is required, we can ensure that we get the very best out of every child.

As I often say, if we look at some of our great inventors, we see that the autistic mind is wired differently and therefore sees the world differently. They are an incredibly valuable part of our society’s intellectual value. Without them, we all think the same way. Group-think and moving in a single direction are not where the great stages of improvements come from. We need minds that look at the world in a completely different way. It does not make any sense to me half the time, but that is fantastic, because it throws in something completely different. They can direct change in a way that very few of us who are neurotypical will ever do, and to lose that by allowing these children to fall out of the education system early on is a great loss to society and to our intellectual value as a nation. I hope very much that the Minister will feed that back.

I reiterate that not being able to access support and a diagnosis is a continuing pressure for families that we should not be allowing to go on. When a doctor says, “I can tell you what it is with your child that you haven’t understood: it’s that they’re on the autistic spectrum,” it is like having a weight lifted off your shoulders. At that point, the world makes sense. As the hon. Member for Huddersfield said, you start to understand and be able to educate yourself as a family and bring others in. You still have to shout at people, because not everybody understands yet, but that is okay. You are empowered as a family member, and as grannies and grandpas, because you can understand why this child is not quite like others in the family. You can then move forwards and value them, and really give them the tools, so that they can be the great success that we know they can be.

Organ Donation (Deemed Consent) Bill

Mike Wood Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Mike Wood (Dudley South) (Con)]

I support the Bill today. Like my hon. Friend the Member for Shipley (Philip Davies), I am not entirely comfortable with the principle of the state taking control of bodies without express permission, but I think that that option is far less bad than the situation whereby hundreds of lives are unnecessarily lost every year effectively through inertia. We know that action could be taken that most people would agree with. The hon. Member for Coventry North West (Mr Robinson) referred to the massive gap between the number of people who agree with donation and would be willing to be donors and the far smaller number of people who actually register as donors.

None the less, a number of points have been raised with me by constituents that I hope the hon. Gentleman and the Minister will consider during the passage of the Bill to strengthen it further. First, we should strengthen the safeguards—I was reassured by the hon. Gentleman’s comments on this—to make sure that hospitals are absolutely sure whether people are on the register. It must not be a question of, if systems are down, hospitals taking a chance and operating anyway. If people have actively opted out, we need to have belt and braces to make sure that their choices are respected. Secondly, we need to strengthen the existing law in other areas to make sure that in no circumstances can organs be harvested to be sold, which would clearly be outside the scope and the intention of this Bill.

This is a very worthwhile and important Bill. My constituent Sam emailed me this morning to say:

“This important change in legislation will prevent the needless waste of usable healthy organs being sent for cremation when they could instead change many thousands of lives.”

Hospital Car Parking Charges

Mike Wood Excerpts

Thursday 1st February 2018 Commons Chamber

[Lucy Allan (Telford) (Con)]

It is a great pleasure to follow the hon. Member for Great Grimsby (Melanie Onn), who made a very thoughtful and engaging speech on this important issue. I am very glad that so many Members are in the Chamber to take part in the debate.

I particularly congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on steadfastly championing this issue in Parliament for many years. He is much admired across the House for taking up issues that not everybody chooses to champion, but his work on such issues so often makes the lives of the people he and I represent much better, so I thank him for it. Indeed, I was inspired by his efforts in this area when, before I became an MP, I campaigned in my constituency of Telford on the whole issue of parking charges after they went up by 75% at our Princess Royal Hospital, creating a great deal of local upset.

My constituents, like my right hon. Friend’s, raise their concerns about this issue frequently. During the time I have campaigned on it, I have received over 5,000 letters —letters, not emails—on this specific issue. In Telford, we really care about this, and that is why I am here today. I was supposed to giving a speech at Thomas Telford School’s ethical debating society but, unfortunately, I have had to cancel at short notice so that I can be here, because this matters so much. I apologise to the students at Thomas Telford School.

I was told by my hospital trust in 2014 that it was not possible to change the existing arrangement because of the long-term nature of the trust’s legally binding contract with CP Plus, a parking contractor. Even poorly negotiated long-term contracts eventually expire, so we must look forward to what we will put in place when they do. It is not acceptable for those who can effect change simply to stand back and wait for onerous contracts with parking contractors to be renewed.

[Mike Wood (Dudley South) (Con)]

As my hon. Friend says, part of the problem is that so many hospital trusts are locked into long-term PFI contracts. Many of them were negotiated in the late 1990s or early 2000s and will shortly be coming up for renewal or expiry. Does she agree that now is the time to look at what provisions we can put in place to ensure that, as the contracts are renewed, they do not contain exploitative provisions that allow hospital trusts to take patients, as well as their families and visitors, for mugs by overcharging them for parking?

[Lucy Allan]

My hon. Friend eloquently makes a very important point, and I am very glad that he has raised it. The debate is timely, and it is important for us to be here to make this case.

Sadly, my local hospital trust has continued to increase hospital parking charges in a way that some feel thoughtless and has been described to me as cavalier. Following the rises in 2017, it is cheaper to park in Southwater shopping centre in Telford than to go to hospital to visit a sick relative. There is clearly something wrong with a model that operates in that way, because, as many hon. Members have said, no one chooses to go to hospital.

Telford is a new town, much like the constituency of my right hon. Friend the Member for Harlow. There are problems to do with the way in which many new towns were designed because, rightly or wrongly, they are all about road users. Major roads and roundabout systems are much loved in Telford. Everything is focused on the car, and it was never intended that the pedestrian should be able to walk from A to B. That is one of the problems that makes this such an important issue locally.

We do not have good public transport. We cannot just hop on a bus, jump on a tube or walk to the local hospital, as people might in other areas; instead, we have to take buses, changing a few times. Many people are therefore driven, or drive, to hospital, and they have to pay. My trust gave several reasons why its charges increased, one of which was that they were lower than those elsewhere in the country. That argument does not have a lot of teeth to it, because London is very different from Telford, in terms of income and accessibility of transport. Trusts need to consider local factors when setting charges.

It is good if concessions are offered, and there are concessions at the Princess Royal in Telford, but they are complicated to administer and operate. People have to prove that they are on benefits, that they have had an appointment and that they have paid their charges. Healthcare staff have to administer that system. They have to cancel charges and give out refunds and concessions, but that is not what they are there for. It is no good saying that if there was more money for hospitals, they would not need to charge for parking, because we all know what happens in many cases. In my local hospital, 50% of the revenue goes to CP Plus, the parking contractor, which has to be wrong.

Another argument that we have heard today is that if there were no parking charges, there would be nowhere for people to park, because anyone who wished to could use the hospital car park. It is argued that charges are a disincentive to parking. My local hospital trust says that without charges, people might stay all day in the hospital cafés, having refreshments, rather than leaving the site. Clearly that is complete nonsense, because even with incredibly high charges, there is nowhere to park. All the spaces—and the grass and concrete—are filled. The argument that everyone is sitting in a café is simply beyond my comprehension. This issue needs to be addressed with careful thought, rather than charges being seen as an instant panacea to a problem, when they clearly are not.

Bizarrely, my hospital trust tried to justify the increase by talking to residents about the number of nurses whom the parking revenue has paid for. I do not like that argument, because nurses are paid for by taxpayers through Government funding, not by parking charges. The increase that it implemented was in the contractual agreement, and nothing whatever to do with the number of nurses whom it employed.

I worry when hospital managers think that the charge is not that big a deal because parking is cheaper than somewhere else; that transport is not really their problem; and that if people are spending too long in cafés, managers need to move them on by putting up the charges. That shows that they probably do not understand the people whom they serve as well as they should.

If we dig a little deeper, we see the reason why it is not possible to park at the Princess Royal is that there has been a huge increase in the number of staff working on the site and therefore parking in the car park. We need to look at ways of helping staff to reduce car park use, as that would free up many spaces for patients to use throughout the day. We need to think imaginatively about how that might be done. Perhaps park and ride schemes specifically tailored to shift times might help. It is a surprise to find that hospitals are not looking at that.

We have heard today that this is a tax on the sick. Most taxes take account of people’s ability to pay, as is absolutely right, yet hospital managers and porters pay the same to park at work. It is always the least well-off who are hit the hardest. If the aim is to tax people and then give half the tax revenue to a car parking company—that is a bit senseless in any event—do it through pay-as-you-earn, and do not get nurses and other healthcare staff involved in the enforcement. It is completely inefficient to operate the system in this way.

Others have touched on the rigmarole that goes with paying for parking. Whether that means people paying with coins, typing in their number plate, or being videoed as they go in or come out, there is a punitive element. When a person is rushing to see someone who is extremely ill, or if they are waiting for an appointment and the consultant is running over time, it all adds to the anxiety, and in this context, it is completely inappropriate.

No one really wants to own this issue, so we all end up accepting it rather than solving it. Too many people say, “It is not our problem, it is too difficult to fix and actually, it is not really that important, because it is only £8 a day.” Too often, people in power look at the world through their own eyes and not through the eyes of those whom they serve.

There is little appetite among hospital management to deal with this. It is not a big-ticket issue. It is not exciting. It is not a shiny new hospital. It does not cost £300 million—in Telford, we spend a lot of time talking about our new emergency unit—so that is why I am here today. I want the Government and hospital managers to sit up and take notice. Do not brush this off as a non-issue—it is not. Try to see it through the eyes of others and tackle the issue that is facing everyday users of our hospitals. It can be fixed and it will make a difference to the lives of those who most need hospital services. For that reason, we should all care about it.

My right hon. Friend the Member for Harlow does a great service to his constituents. I thank him for securing this debate and I support him entirely.

Mental Health Units (Use of Force) Bill

Mike Wood Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Mike Wood (Dudley South) (Con)]

Like other hon. Members, I wish to start by congratulating the hon. Member for Croydon North (Mr Reed) on introducing such an important Bill. I know from my own experience two years ago of being drawn high up in the private Members’ Bill ballot that it can feel a bit of a mixed blessing. There are a few days in the lead-up to publishing the Bill when they are probably among the most popular Members of Parliament; telephone lines and email inboxes are rarely idle. Of course once the simple step of presenting the Bill is done, the really hard work begins, not only in producing the Bill and the explanatory notes, but in starting to build the consensus that allows the Bill to have a reasonable chance of progressing into legislation. The hon. Gentleman has done that exceptionally well to this point, and I know he will be proceeding as he has begun.

I also wish to thank my constituents who have contacted me, some with their own experiences and others with their own views of the current use of force in mental health units. I also thank West Midlands police and the range of organisations with an interest in mental health policy which have briefed us all, shedding new light on both the scale and nature of the problems in the system.

In recent years, mental health has come to the fore in public policy, and much of that is due to the outstanding work done by a number of right hon. and hon. Members who have a real passion for improving the way mental health is treated and ensuring that parity of esteem is not just a catchphrase but rather that it reflects the way mental health is treated, not only in the NHS, but across public policy and society more widely. In particular, I am thinking of the excellent work done by my hon. Friend the Member for Halesowen and Rowley Regis (James Morris), when he chaired the all-party group on mental health; by the Secretary of State for Health; and by my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) and, of course, the right hon. Member for North Norfolk (Norman Lamb), when they were Ministers responsible for mental health.

We have seen the changes in the guidelines and the way sections 135 and 136 of the Mental Health Act 1983 are handled, and the new provisions that will be brought in through the Policing and Crime Act 2017, which gained Royal Assent earlier this year. The political consensus that there is a need to do more is being matched with real progress in both policy and legislation. All of us have welcomed the prominent place mental health reform has had, not just in the Conservative manifesto ahead of the general election, but in its being reflected in the Queen’s Speech and in the Prime Minister’s announcement that the Government would begin a comprehensive review of the Mental Health Act. Public servants who work in the police, the NHS and the justice system are often on the frontline of dealing with people with mental ill health, particularly those affected by acute episodes of mental ill health. My hon. Friend the Member for Berwick-upon-Tweed (Mrs Trevelyan) was, though, right to question why we always talk about mental health in terms of mental illness, because it is also important to talk about mental wellness and consider how we support, develop and improve people’s positive mental health.

A lot of the changes in the public policy framework in recent years have been driven by innovation in public services. I think in particular of the excellent work done by Inspector Michael Brown, who blogs as Mental Health Cop. He previously worked for West Midlands police, and I think he now works for the chief constable of Dyfed-Powys police. It is largely because of his work that the need to address sections 135 and 136 came to the fore of the public policy agenda. In recent decades, section 136 has set the framework within which people suffering from mental ill health are treated in the police and criminal justice system. Although it is part of legislation that is nearly 35 years old, it is barely different from equivalent measures in the Mental Health Act 1959. That was 60 years ago, when there were still asylums in Britain and the whole approach to mental health was completely different. Thankfully, we no longer have asylums and we make huge efforts to treat people in the appropriate settings and in the community. We need to ensure that we adapt not only public policy but a legislative framework that was designed for a completely different society with a completely different outlook on and approach to mental healthcare. The Bill has an important part to play in changing the legislative framework.

In my area, West Midlands police have made substantial progress in how they deal with people suffering from mental illness. In July, the office of the West Midlands police and crime commissioner and the West Midlands combined authority provided an update on and summary of some of their innovations, particularly the model of mental health triage that has been operating for the past few years. A successful model for mental health triage is being rolled out across the force, throughout the Black country, Birmingham and Solihull. The model relies on an ambulance vehicle, a mental health nurse and a paramedic being available between 10 o’clock in the morning and 2 o’clock the following morning, so that when there is a call-out and it is thought there might be mental health issues to consider, there can be an appropriate health response and health assessment, alongside and as part of the police response. Shortly before I was elected to Parliament, I had the privilege of joining a triage team on a call-out in Birmingham. I saw how it worked and the difference it made compared with the old model of police officers being deployed and, more often than not, somebody suffering from a serious episode of mental ill health ending up in a police cell or another custodial setting.

Let me give an example of how the system has worked. When the police and ambulance services received a report of a 19-year-old female self-harming in the street and threatening to kill herself, a check on the mental health systems was able to establish quickly that she had an extensive history with mental health services. The paramedic had wanted to take the female to an acute hospital immediately, but the deployment of the street triage team meant not only that her wounds could be dressed by the paramedic in the car at the scene, but that the mental health nurse could carry out a face-to-face assessment and make an urgent referral to the home treatment team. As a result, she got crisis access to services overnight and then home treatment the next day, which was a much more appropriate response for somebody going through a crisis. Ultimately, she was safeguarded with a friend for the evening, who took her home and stayed with her through the night, and the whole incident lasted 45 minutes, compared with the many hours it would have taken had she gone to A&E and then other more conventional settings.

The triage teams in the west midlands have treated about 9,000 people in the last year, and as a result—despite the worrying figures we have heard from around the country—the use of section 136 powers in the west midlands has been reduced by about a third over the last five years, from typically 1,200 to 1,300 a year to 852 last year. Remarkably, in the first half of the year, nobody at all in the west midlands was detained in police custody under section 136 of the Mental Health Act—the first time this has ever happened in the west midlands. Instead, more than 8,000 people have received alternative outcomes, including referrals to a GP or other partners, to ensure they get mental health care rather than have their case treated as a purely criminal justice matter.

Although significant progress has been made, and continues to be made, the Bill will help to make further progress, especially through the way it addresses the use of force and restraint against people suffering from mental ill health. Currently, the code of practice clearly states that restrictive practices should only be used where there is a real possibility of harm, either to the patient or to someone else, and should not be used either to punish or inflict pain or suffering, and should be used with minimum interference to autonomy, privacy and dignity. In the case of children and young people, it should not be used at all. Staff should always ensure that restraint is used only after taking into account an individual’s age, size, physical vulnerability and emotional and psychological maturity.

Although the guidelines exist, further openness around the use of force and restraint is not only welcome and progressive but absolutely necessary for the individuals involved and if our public service workers are to have confidence that their actions are reasonable and defensible. That is why clause 5, which requires that registered managers have a training programme for frontline staff, is particularly important. “Frontline staff” would include all registered managers who might reasonably expect to use force or authorise its use on patients. The proposal to guarantee that staff use the latest and safest procedures should be an opportunity to build on previous learning, not only on mental health care and proportionate use, but on wider issues of equality and necessity.

Clause 6 deals with the requirement on all mental health providers systematically to record information on their use of force. As has been said, if we can measure it, we can track progress and drive changes in behaviour. Including records on the gender, age and ethnicity of patients will help to improve our understanding and, more importantly, the understanding of public services about the use of restraint, particularly on the basis of gender and race.

Let me turn now to body-worn video. Clause 13 provides that on-duty police officers who are called to a mental health unit for any reason must wear body cameras that start recording from as soon as is reasonably practicable. The west midlands, which is within my own force area, is now rolling out body cameras to all its response officers. The kind of body cameras it is using can be automatically triggered by a siren or a blue light, or if airbags are deployed and firearms are drawn. We should consider how these body cameras can be automatically deployed and, without having to think about human error, can automatically stay on until they are manually turned off.

[Kevin Foster]

Does it make sense that, if a police officer is on duty in a response role, the presumption should be that the camera is on? We see that in other walks of life—for example, it is the case with ticket inspectors, so it should not be that difficult to apply this practice to on-duty, on-call police officers.

[Mike Wood]

My hon. Friend makes an excellent point, and he is absolutely right. We have seen body cameras used in other scenarios. They help to protect the police as well as those to whom they are responding.

[Philip Davies]

I agree with everything that my hon. Friend has said, but my understanding is that, in some areas—certainly with some police forces—the issue is that the battery life on some of these cameras is not all that it could be, which means that the cameras might not last long enough in all these circumstances. Does he agree that we need better technology for the battery life before we start insisting on these things being used in all circumstances?

[Mike Wood]

It is extremely important that we have adequate and appropriate technology. Of course the battery life of these cameras on the frontline is a key part of that. Police using the system being rolled out in the west midlands, which is partly funded through the Home Office, are confident that they can use the cameras from when they are automatically triggered through to when the footage can be uploaded back at the station. As has already been pointed out, research strongly suggests that the use of force is reduced by about half if body cameras are worn. Attacks on police officers are also reduced. In the west midlands, harm to police officers has been reduced by about three quarters since body cameras started being routinely used, and complaints against police officers have fallen by more than 90% when evidence from a body camera is used.

There has been great progress in the area of mental health, but there is still much more that needs to be done. We need a greater focus on mental wellness, prevention, early intervention and ensuring that primary care is in a position to support and treat our patients at an early stage. There will always be occasions when restraint is appropriate and even a small number of circumstances in which the use of force is necessary. That use of force must be properly regulated, registered, controlled and used as a last resort—when no other adequate course of action is available.

[Kelly Tolhurst]

There has been increased police use of body-worn cameras in Kent and it has been going quite well. Will my hon. Friend give me slightly more information about what has been happening in Dudley South?

[Mike Wood]

In the first year of general use, there has been a sharp fall in the number of assaults against police officers. There are also fewer complaints against police officers, and the time it takes to handle responses has fallen. It used to take many of hours of investigating and phone calls; now, in some cases, it takes barely minutes of reviewing clear body camera evidence.

The measures in the Bill are necessary and welcome, so I wholeheartedly support it today and look forward to supporting it in its passage through this place.

Young People’s Mental Health

Mike Wood Excerpts

Thursday 27th October 2016 Commons Chamber

[Lyn Brown]

Absolutely. I totally agree with my hon. Friend, and as I go through my speech I am hoping to provide an example to show how intervention is particularly important for a very young child because of the impact on the rest of the family. Early intervention can do a lot to mitigate other events and difficulties occurring in the family that might include other family members, too.

Unfortunately, tragically and outrageously, young people’s mental health services often receive less attention than adult mental health services, so that young people’s mental health services have been called the “Cinderella of Cinderella services”. In November 2014, the Health Committee found that there were

“serious and deeply ingrained problems with the commissioning and provision of services for young people’s mental health.”

Many providers reported increased waiting times and increased referral thresholds for specialist services, where patients would have to show severer symptoms to receive treatment than they would have done in the past. GPs reported feeling ill-equipped and lacking in confidence when dealing with young people’s mental health issues. The Select Committee found that early intervention programmes were

“suffering from insecure or short term funding, or being cut altogether.”

There really is no excuse for this failing. Around half of people with lifetime mental health problems experience symptoms by the age of 14, and about 75% of them before the age of 18. Catching these problems early could well lessen the severity of adult problems, possibly saving the NHS money in the long term. More importantly, I would suggest, it would reduce unnecessary suffering and enable people to live better lives.

I want to be fair to the Government, who have recognised that there is a problem. In 2014 they set up a children and young people’s mental health and wellbeing taskforce, which made a number of recommendations in its 2015 “Future in mind” report. The taskforce identified a number of problems with young people’s mental health services. The right hon. Member for North Norfolk (Norman Lamb), who was then the responsible Minister, said that there needed to be a fundamental shift in culture, with a much greater focus on prevention and early intervention.

The taskforce rightly recognised that one of the challenges facing young people’s mental health services was—unsurprisingly—funding. I was pleased when the Government responded by announcing the provision of an additional £1.4 billion of transitional funding for youth mental health services, but that additional money needs to be considered in the context of the less encouraging overall picture of mental health services funding. NHS England’s planning guidance states that all clinical commissioning groups must increase their spending on mental health services by at least as much as their overall budget increases. However, there have been warnings from organisations including mental health trusts that mental health funding is not properly ring-fenced, and that NHS England’s target is being missed.

Let me again follow in the footsteps of my hon. Friend the Member for Dulwich and West Norwood. We know from the responses to a series of freedom of information requests from my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) that more than 50% of CCGs intend to spend a smaller proportion of their budgets on mental health in 2016-17. That clearly demonstrates that what the Government tried to do has failed, and that that target is being missed as well.

[Mike Wood (Dudley South) (Con)]

The hon. Lady is making some important points. She referred to the taskforce’s “Future in mind” report. According to one of its startling statistics, only between 25% and 35% of young people with diagnosable mental health conditions access support. Does that not underline the need for much better training and much more awareness among both teachers and GPs, in respect of early identification as well as early intervention?

[Lyn Brown]

We need early identification and we need early intervention, but we also need the funds to ensure that there are services to which people can be referred. That is the rub of this whole debate. There does not seem to be the necessary funding at any point in the journey of young people who need help, whether in the form of awareness, intervention or services.

I have been looking into the good work done in my borough, the London borough of Newham. Even in these difficult times, it is increasing its mental health spending in both absolute and relative terms, and its children’s mental health services received an “outstanding” rating from the Care Quality Commission. I wanted to find out how we could improve young people’s mental health provision, and to learn about the challenges that an “outstanding” local provider continued to face in its fight for better services. Professionals in Newham recognise that a good young people’s mental health service does not just help those who have already developed severe and serious conditions, but provides early intervention and preventive programmes so that problems can be dealt with at source.

Health Service Medical Supplies (Costs) Bill

Mike Wood Excerpts

2nd reading: House of Commons & Programme motion: House of Commons
Monday 24th October 2016 Commons Chamber

[Mike Wood (Dudley South) (Con)]

Has my right hon. Friend made any assessment of how the prices of the drugs quoted in the article in The Times compare with those paid in other health services and by healthcare providers in other western European countries?

[Mr Hunt]

We have made some assessments of those things, but, in essence, our concern is that, even without comparisons with what is happening in other countries, we are talking about totally unreasonable behaviour. I mentioned one example earlier, but I can give another of a medicine whose price increased by 3,600% between 2011 and 2016. I just do not think we can justify that. Given that we want to have strong, harmonious, positive relationships between the NHS and the pharmaceutical industry, we need to eliminate the possibility of that kind of behaviour happening in the future.

This Bill therefore amends the 2006 Act to allow the Government to control prices of these medicines, even when the manufacturer is a member of the voluntary PPRS scheme. We intend to use the power only where there is no competition in the market and companies are charging the NHS an unreasonably high price. We will engage with the industry representative body, which is also keen to address this practice, on how we will exercise this power.

The final element of the Bill will strengthen the Government’s powers to collect information on the costs of medicines, medical supplies and other related products from across the supply chain, from factory gate to those who supply medicines to patients. We currently collect information on the sale and purchases of medicines from various parts of the supply chain under a range of different arrangements and for a range of specific purposes. Some of these arrangements are voluntary, whereas others are statutory. The Bill will streamline the existing information requirements in the 2006 Act relating to controlling the cost of healthcare products. It will enable the Government to make regulations to require all those involved in the manufacture, distribution or supply of health service medicines, medical supplies or other related products to record, keep and provide on request information on sales and purchases. The use of this information would be for defined purposes: the reimbursement of community pharmacies and GPs, determining the value for money that the supply chain or products provide; and controlling the cost of medicines. This will enable the Government to put the current voluntary arrangements for data provision with manufacturers and wholesalers of unbranded generic medicines and manufactured specials on a statutory footing. As the arrangements are currently voluntary, they do not cover all products and companies, which limits the robustness of the reimbursement price setting mechanism.

A statutory footing for these data collections is important so that the Government can run a robust reimbursement system for community pharmacies. I know that some colleagues have raised concerns about the implications of our funding decisions for community pharmacies, and today I want to reassure the House that this Bill does not impact on those decisions, nor does it remove the requirement for consultation with the representative body of pharmacy contractors on their funding arrangements in the future. However, the information power will give us more data on which to base those discussions and decisions, rather than relying on data only available to us under voluntary schemes and arrangements. The information power would also enable the Government to obtain information from across the supply chain to assure themselves that the supply chain is, or parts of it are, delivering value for money for NHS patients and the taxpayer—we cannot do that with our existing fragmented data.

Junior Doctors: Industrial Action

Mike Wood Excerpts

Monday 5th September 2016 Commons Chamber

[Mr Hunt]

Yes, I can absolutely confirm that. We have put in place pay protection to make that happen. My hon. Friend is right that this is very damaging for his constituents in Cheltenham. Given that there is so much pressure in the NHS, the junior doctors who are thinking of striking must ask themselves whether it is really going to help their organisation respond to those pressures if it has this enormous distraction—this incredible demoralisation that we get with these kinds of strikes.

[Mike Wood (Dudley South) (Con)]

Does my right hon. Friend share my disappointment that the BMA leader who co-authored the new contract and said that it was beneficial for our patients and for our junior doctors is now trying to whip up support for a series of strikes that every credible medical leader has said would be disproportionate and harmful to patients?

[Mr Hunt]

I am extremely disappointed and I hope that she reconsiders.

Alcohol Consumption Guidelines

Mike Wood Excerpts

Tuesday 28th June 2016 Westminster Hall

[Mike Wood (Dudley South) (Con)]

We as Members should question the credibility of alcohol advice, but our primary role is surely to consider the wisdom and effectiveness of such guidance from a public policy viewpoint. The guidelines fail to acknowledge the decades of research demonstrating that moderate alcohol consumption is compatible with a healthy lifestyle. Multiple studies since the 1970s show that light to moderate alcohol drinkers have a lower mortality rate than non-drinkers or heavy drinkers. When plotted on a graph, the relationship between moderate consumption and total mortality appears as a J-shaped curve, demonstrating the benefits of light to moderate alcohol consumption compared with both abstinence and heavy drinking.

I would not presume to argue with the chief medical officer’s opinion that any alcohol is damaging, but I do not believe that as a matter of public policy, an abstinence approach is either wise or effective. We recognise that recommending abstinence is a counterproductive policy in tackling teenage pregnancies, yet we are asked to imagine that saying that there is no safe amount of alcohol is an effective way of tackling alcohol abuse. The previous unit limit might have been an arbitrary figure, but it was a realistic target for most people and helped reinforce the message that alcohol needs to be kept to light and moderate levels. The guidelines threaten that.

As well as significant evidence about physical health, there is growing evidence about the benefits of moderate alcohol consumption in a safe and social environment for mental health. In particular, a recent study commissioned by the Campaign for Real Ale from Oxford University found that people who regularly visit a community-type pub tend to have more close friends on whom they can call for support, and that they are happier, healthier and more trusting of others. A moderate amount of alcohol improves wellbeing and some social skills, just as it has been shown to improve other cognitive abilities and health.

Any future guidance must, of course, be cautious, but it should also recognise the protective effects of moderate alcohol consumption. I also advocate withdrawing the advice that there is no safe level of alcohol consumption so that we can concentrate on the social and medical benefits of limiting alcohol consumption to moderate levels.

Carers

Mike Wood Excerpts

Thursday 9th June 2016 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to contribute to this debate, and to thank the hon. Member for Eastleigh (Mims Davies) for bringing it forward for us all to participate in. This is the second such debate that she has led on this subject, and we look forward to many more on similar subjects in times to come. I also thank all those who have spoken—I understand that I will be the last to speak from the Back Benches before the shadow Minister and the Minister. The hon. Member for Worsley and Eccles South (Barbara Keeley) has just nipped out, but I look forward to her speech, and I very much look forward to the Minister’s. I have honestly found the shadow Minister and the Minister to be compassionate—we have a compassionate shadow Minister and a compassionate Minister—and I am convinced that their responses will both focus on the issues we have raised and those that it is important for us to be involved with.

Carers UK estimates that there are some 6.5 million carers in the UK. Over 1 million people in the UK say that they are supporting or caring for family members who have an illness that is terminal, which is also an issue. To put those figures into perspective, there are two carers for every person who died last year in the United Kingdom. Statistically, that is a massive figure. It is estimated that the NHS saves some £11.6 billion each year because of these unsung heroes. We have used that expression often today, but just because we use it often does not mean that it is any less appropriate. Their contribution as volunteer carers is immeasurably valuable.

Carers may end up providing more than 100 hours of care per week. From my knowledge of those who come to see me and those with whom I have worked in my constituency, I know that 100 hours per week is a low estimate. For some of them, caring is a 24/7 exercise, such are the medical and health difficulties of those for whom they care. All too often the outside world is completely oblivious of their efforts. Even those who know carers may be oblivious, because they do not always know what is happening once the door is closed and the carer is left alone to look after the cared for. We do not know what happens behind those closed doors.

I believe that employers are forcing some workers to forgo promotions. That is clearly stated in the background information that has been provided, on which I congratulate those in the Library. Its staff are not often thanked for what they do, but the background information they have provided—the stats and the paperwork—is very detailed and informative, and they deserve to be congratulated on how well they have prepared us for this debate.

Carers have said that they have had to forgo promotions, reduce working hours or leave work altogether. More than a third of them do not feel comfortable at work talking about caring, just over a third say their employer does not understand their caring role and exactly a third say their employer does not have policies in place to support carers. Some 60% of carers have given up work or reduced their hours to provide care, 25% have been unable to pursue or have had to turn down a promotion, 37% say their work has suffered and 42% say they have struggled financially. These are not just figures; these are people’s lives.

The figures illustrate very clearly what the issues are. Some 55% of carers have struggled financially, as it says in the background information. My colleague, the hon. Member for South Antrim (Danny Kinahan), mentioned that. I suppose all MPs have personal knowledge of this, but we are certainly aware of how carers are struggling in Northern Ireland. Some 72% of carers have given up work or reduced their hours. Again, these figures tell us where the problems are.

As the hon. Member for Eastleigh said, Carers Week is being supported by all the health organisations, including Age UK, the Carers Trust, Independent Age, Macmillan Cancer Support, the Motor Neurone Disease Association, and the Multiple Sclerosis Society. I work with these organisations almost every day of the week. They are household names, unfortunately, because of the level of problems that we have across the whole of Northern Ireland and the United Kingdom.

A subject close to my heart, as is the case for many of those here, is dementia and Alzheimer’s disease. A few months ago, we had a debate on that in Westminster Hall. I have not experienced it personally in my family, but I have certainly experienced it through meeting some of my constituents and their families. It is hard to explain to anyone who has not experienced it. These are very delicate issues to address; they are not just physical but emotional and mental. I have seen people with dementia who can often, unknowingly, become agitated or even violent. Night-time wandering can have a serious impact on carers’ sleep patterns, let alone the sufferer’s. Many people out there require someone close to them to give up much of their lives to provide the care that they need. Sleep patterns are just the tip of the iceberg.

I commend the groups in my area, particularly some of the church groups. For example, a Church of Ireland church, St Mark’s in Newtownards, has a group for the whole of Ards and North Down where people with dementia and Alzheimer’s come together to do painting and crafts. Music is a wonderful thing for helping those with dementia and Alzheimer’s. It helps to relax them, and for some people it takes them back to where they were many years ago—to their youth and their childhood.

[Mike Wood (Dudley South) (Con)]

The hon. Gentleman is speaking movingly about the challenges that dementia sufferers and their carers face. This week the Carers Trust raised with me concerns about patchy levels of support in dementia care around the country. Does he agree that local authorities need to go out and learn from best practice around the country, such as the church groups in his constituency and the successful dementia gateways in Dudley, to make sure that more carers and more dementia sufferers can receive the support they so desperately need?

[Jim Shannon]

I thank the hon. Gentleman for his intervention. I wholeheartedly agree; I think we all do. Those of us who are aware of this issue will understand the importance of all these groups. The issue that he touches on was frequently mentioned in the debate in Westminster Hall. Some 38 Members were involved in that debate, and it got a massive response. I thank him for his very important words.

The hon. Member for Eastleigh referred to young carers, as have other hon. Members. Crossroads Young Carers in Newtownards has been around for many years. We have a massive number of young carers in my constituency alone. I was rather shocked to find that they were so numerically strong. That illustrated to me the importance of the role of these schoolchildren, sometimes even primary schoolchildren, who almost become old before their time in looking after parents and family. The Carers Trust says that 80% of young carers miss out childhood experiences. They grow up before their time. They miss out on the leisure, the fun and the nights out with friends because they are looking after their mum, dad, brother, sister, or whoever it may be. They are almost hidden carers in the job that they do. I recognise the good work that Crossroads Young Carers does in my constituency.

We need an awareness campaign about carers so that they are no longer the unsung heroes but become the recognised heroes that they should be, not just in this House but in all our constituencies across the whole of the United Kingdom of Great Britain and Northern Ireland. Too often, carers are left to suffer in silence. The services on offer are not publicised enough and, sadly, too often are not up to standard either. When we read the background material that explains some of the everyday events that carers have to deal with, we get a feeling for and an idea of what they endure each day. I am not sure whether this has been mentioned yet, but, if not, it needs to be put on the record: many carers suffer from bad health themselves as a result of looking after others. In an intense situation, looking after someone 24/7, they need some time to switch off—their brain and their body have to get a bit of rest. It is very important every now and again to get a weekend, or even an hour or two, away from it all.

The main social security benefit available to carers is carer’s allowance. This is for someone who provides more than 35 hours of care a week, and it entitles them to only £62.10. Furthermore, carers may incur sanctions on how much they can earn on top of the allowance. Dementia carers save the NHS more than £11 billion per year, to put a financial cost on it, yet they get only £62.10 per week for giving up their lives for someone less fortunate. I know that the Minister’s Department is not responsible for that, but, with respect, it is not a good reflection on Government, given the hours that carers spend on caring. I recognise that times are tough financially. You cannot produce a high-quality suit if you have low-quality cloth, and the same thing applies to finances. We therefore have to be realistic about what we can do, but it must be highly insulting to carers to see some of the things happening in the news when they are getting only £62.10 per week. Although the Minister is not responsible for benefits, could he give some pointer for carers with regard to benefits advice? I give them benefits advice when they come to my office. To be fair, the benefits system is very responsive. We just have to point people in the right direction and show them the right opportunity. Perhaps there is a role for Government in that. I understand that our colleagues in Scotland have considered upping the carer’s allowance. That was discussed in our debate on dementia and Alzheimer’s.

Carers UK calculates that the value of unpaid care is some £132 billion each year—the equivalent of NHS spending. Although it is hard to calculate how much of this relates to people who care for someone who has a terminal illness, research has found that carers who look after someone with one of the four most prevalent cancers—lung, breast, colorectal or prostate—provide care worth £219 million per year: a third of the total of end-of-life care costs. Providing end-of-life care—that difficult time for people emotionally and physically—saves the NHS a massive amount of money as well. Other people have referred to personal things in families. My mother looked after my dad before he passed away, and that was not always easy. My mum is a fresh 85-year-old, or she will be on 14 July. If it were not for the closeness and the commitment of family, we would face a lot of other serious issues.

According to research by Carers UK’s Northern Ireland subsidiary, Carers NI, 16% of carers cannot afford to pay their utility bills, while nearly 40% cannot afford their bills without struggling financially. I can vouch for that in my constituency, given the numbers of people who come to me who are finding it very difficult to make ends meet financially. The hon. Member for South Antrim (Danny Kinahan) raised the question of heating or eating during the cold spell. That is a reality today as well, perhaps even more so than in the past. A third of carers are using savings to pay everyday living costs, and a third have used up any savings they had and now have nothing to fall back on. Thirty-two per cent. of carers have ended up in debt as a result of caring, and over four in 10 carers—almost half—are cutting back on food or heating. Furthermore, carers experience higher levels of fuel poverty in Northern Ireland than anywhere else in the UK. We have the highest levels of fuel poverty in the whole of the United Kingdom of Great Britain and Northern Ireland.

Information given to us by the Library indicates that 51% of carers

“have let a health problem go untreated…Half of carers (50%) have seen their mental health get worse…Two thirds of carers (66%) have given up work or reduced their hours to care…Almost half of carers (47%) have struggled financially…Almost one third of carers (31%) only get help when it is an emergency.”

That is the reality for carers. Full-time carers are twice as likely as non-carers to be in bad health. Eighty per cent. of carers say that caring has had a negative impact on their health, and half of carers state that they experienced depression after taking on a caring role. Sixty-three per cent. of carers say that they are at breaking point, and one in six carers receive no practical support at all. Despite an ongoing rise in the number of carers in the UK and sharp rises in the number of people caring full time, the number of people who receive carers’ assessments and carers’ services is falling. When we hear all those stats, we need to remember that there are people behind them who have to deal with reality.

It is often said, and we need to say it again, that food banks have been extremely helpful. That is the case in my constituency and, I am sure, in others. Food banks operate out of compassion and heart. They bring together Government bodies, churches and individuals who want to do their bit for the community. The food bank in my area, run by the Trussell Trust, has done exceptional work with carers, those who are under financial pressure and those who are experiencing delays in benefit or not getting all the benefits that they should be getting. The food bank is very much a part of life in my constituency. By the way, I think it is good to have food banks in our constituencies. They bring a lot of good things to my area. I do not see them as a negative; I see them as a positive, because people reach out and want to help each other. That is good, because if we help each other, we do what we are supposed to be doing in this world, which is to make lives better as best we can.

Carers UK estimates that the number of carers will grow to 9 million by 2037. Will any of us in this Chamber be here in 2037? I am not sure. I probably will not be—if I am, I will be the oldest man in the world, but that is by the way. We have to look at the stats, because they take us to where we will be in a few years’ time. I hope that the Government take cognisance of the stats, because it is important to form a strategy.

It is clear already that the support provided to carers does not suffice. Independent analysis demonstrates that the gap in funding for social care is expected to reach between £2.8 billion and £3.5 billion by the end of this Parliament, and that does not even begin to cover what will happen if the Government do not take into account the fact that the number of carers is growing. This should serve as a wake-up call to everyone—the Government, the regional Assemblies in the devolved Administrations and all stakeholders—about the reality ahead. There will be significantly more carers than there are already, and appropriate planning is needed to ensure that support is there.

I conclude with these comments. I welcome the fact that the Government are developing a new carers strategy, and I look forward to the Minister’s response on that. It is important that we, as elected representatives, put forward this debate in a positive fashion to get a strategy and responses to our questions, which we can feed back to our constituents. On the issues that I and others have raised, I impress on the policy makers the need to remember that there are real people behind all the statistics. It is people such as carers whom we are elected to serve. I can only hope that the debate will raise awareness of the need for urgent and large-scale reform of the way in which the Government treat carers.

A number of carer support groups come together in the churches and the community centres of Strangford. They are wonderful people who do great work, and they deserve to be supported and helped by us, as MPs through our Government and through the regional Assemblies, in whatever way we can. Those groups bring together all the people of the Ards and North Down Council area who want to participate. They give carers much needed opportunities for rest and socialisation. The opportunity to socialise and interact with others, or to get a moment or two to themselves, can make a world of difference to carers.