Public Health White Paper

Paul Maynard Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

The health visitor programme is not funded by cutting anything else; it comes from within the NHS budget, because we regard providing support to families when babies first come home and offering a universal health visiting service that signposts other resources to help families as absolutely integral to the improvement of health in the future. That is funded from within what was an historic commitment from this Government to protect the NHS budget and to increase it in real terms over the next four years. We are going to fund this from within the NHS resources.

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

Males in the Blackpool part of my constituency have only a 56% probability of reaching the age of 75. Can the Secretary of State tell me what measures in the White Paper will help to promote the act of ageing and allow more of my constituents to reach a milestone that many of us take for granted?

[Mr Lansley]

I am grateful to my hon. Friend for his question. Many aspects of the White Paper and subsequent strategies relate to these issues. In the long run, his constituents will find that the measures that have an impact early in life or which work through early intervention will make the biggest difference, as was made clear in Sir Michael Marmot’s review, in which he talked of a universal proportionality. Such measures include, for example, our universal health visiting service and family nurse partnerships, which are intervening at that stage. If we have not succeeded through early intervention, however, or many people have chronic ill health, we will continue to ensure through our screening programmes and local health improvement plans that people are identified early and opportunities are created for them to make lifestyle decisions that will improve their chances of disability-free life expectancy thereafter.

Contaminated Blood and Blood Products

Paul Maynard Excerpts

Thursday 14th October 2010 Commons Chamber

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

I thank the Backbench Business Committee for tabling this motion. It is vital to realise that when the noble Lord Owen first took action on this issue as a Minister the year was 1975—the year of my birth, which shows just how long this issue has been current and how long it has not been dealt with by Governments of all political persuasions.

I understand that when medical treatment does not go according to plan—when something goes wrong and disability or a chronic condition results from it—a wound is opened that is very difficult to heal. It cannot be healed by money alone, although compensation is important. Intense frustrations are released. We have heard talk of a lost childhood, for example, or of what might have been or never would be, and of early deaths. Such events affect lives totally in a way that many of us cannot really understand.

That is why I welcome unambiguously the written ministerial statement, not just for what it contains but for the fact that it deals with issues such as travel insurance and access to insurance. I am not going to get hung up on what the meaning of the word “access” might or might not be in the view of the Minister. The fact that we are covering those things is what matters. Many haemophiliacs want to lead as ordinary a life as possible. We need to understand the gap between the lives that ordinary people lead and the effect of haemophilia and other conditions on people’s ability to lead an ordinary life. That, to me, is crucial.

I made an effort to read the Minister’s statement before I came into the Chamber—many hon. Members might have found that a useful exercise. However, having read it carefully, I noted one omission—or, perhaps, one thing that I could not find. It was mentioned by my hon. Friend the Member for Gosport (Caroline Dinenage), but I want to stress it a bit more: it is the Skipton Fund and the arbitrary cut-off date of 28 August 2003 for payments. I was not clear from the statement whether that would be readdressed in the Minister’s review.

I came into politics largely out of frustration at the poor quality of public policy making in this country under all parties—I just happened to pick the Conservative party as the vehicle from which to express my frustration. There is a useful quotation in the briefing documentation with which we were provided, which I want to read as quickly as I can, about the Skipton Fund. It is from the Department of Health and says:

“The announcement of a scheme on 29 August 2003 occurred after the Secretary of State had revisited this issue…The difficult decision not to extend the scheme to people who had died before this date meant that it became an unavoidable cut-off point. We realise that the circumstances are not ideal, but have attempted to provide a pragmatic solution.”

I have seen a fair amount of civil-service speak in my time, but that is as near as I have come to finding one that admits, “This is an awful decision. We know that it is an awful decision, but tough. You will have to live with it.”

I urge the Minister to try to include a review of this arbitrary cut-off date in the work that she is doing in the run-up to Christmas. I unambiguously welcome the progress that we are making, as everybody from all parties should. In particular, I ask for clarity on the figure of £3 billion. If there is a loose zero floating around this debate, it will make it very hard for hon. Members fully to understand the motion and the issues before us, so I ask for clarity.

Finally, the number of people who have wanted to speak has underlined the importance that Members attach to the subject. We will pay very close attention come Christmas to the outcome of the review. I am sure that all of us in the Chamber and in the Public Gallery will hope that we will finally get the closure that so many people want. It will be difficult to achieve, but we need it.

Epilepsy Services

Paul Maynard Excerpts

Tuesday 12th October 2010 Westminster Hall

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

It is a pleasure to serve under your chairmanship today, Mr Streeter. It is also a pleasure to see so many Members in Westminster Hall, which shows how important the topic is to so many people.

I am very pleased to have secured this debate at what is a crucial time for people with epilepsy—crucial because of the uncertainty about how the Government intend to deal with the condition in the future. We are going through a period of structural reform in the NHS, which I strongly believe will lead to substantial benefits for many patients, but there may well be a temptation during this period of reform for the Department of Health to concentrate more on structural reform than on individual conditions such as epilepsy. I want to use this debate to try to explain to the Minister why he should focus on particular chronic conditions and not just on the bigger picture of structural reform. In particular, I want to explain why I think that epilepsy is quite different from many other chronic conditions.

I have epilepsy myself, as well as another chronic condition, cerebral palsy. The cerebral palsy is part of my life, day in and day out; it never goes away, it is always there and I know that it is there. Epilepsy is qualitatively different. I often liken it to a thief in the night, because it creeps up unexpectedly. I have nocturnal epilepsy, so epilepsy affects me when I fall asleep and the chemicals in my brain do whatever they do such that a fit occurs. In my case, fits are triggered by alcohol, so I now have to avoid alcohol continually everywhere I go.

What is important to stress, and what many people without epilepsy may not realise, is the fear that accompanies epilepsy. I do not fear my cerebral palsy, because it is predictable; I know that it is there and I know what is occurring as a result of it. With the epilepsy, however, when I wake up the morning after a fit, I do not know who I am, or even necessarily where I am. My short-term memory has gone and I cannot quite put together what I did the day before, including where I was. Even now, when I have a fit I am not really sure where I am in the country and I fear what has happened to me overnight. Have I soiled myself? Is there a mess on the floor? Will I have to call for help and have to deal with the embarrassment that that might cause? It is therefore very important to stress to those who do not have epilepsy the fear that accompanies a fit, or rather the fear that accompanies the aftermath of a fit. It is not the fit itself that is the unpleasant experience for those of us with epilepsy, because we do not experience it; we are not there during a fit. It is the aftermath—dealing with the consequences of a fit—that is often the problem.

For many people with nocturnal epilepsy, perhaps the biggest fear is something called SUDEP. Those without much familiarity of epilepsy may not be aware of SUDEP, but it stands for sudden unexpected death in epilepsy. Almost 1,000 people die from epilepsy every year, many of them in the younger age groups, and two thirds of those deaths are avoidable. As I say, SUDEP particularly affects young people, yet one survey by Epilepsy Action found that 33% of primary care trusts lack a transition plan for the transition of individuals from childhood to adult care. I think that such a plan is vital, because when an individual moves from childhood to adult care, that is their period of greatest vulnerability. Many of the tragic cases that I have received letters about—I know that many other Members here today have also received such letters—involve young people who one minute were living a happy, normal life, and then suddenly one night they went to sleep and did not wake up. To me, such cases are great tragedies. A focus on the provision of better-quality data on children’s epilepsy and transition care is needed, to see whether we can prevent such cases from occurring. If we could only match the median death rate for the 15 original EU member states, for example, we would prevent a quarter of the current deaths from SUDEP in Britain. If that number of deaths was caused by a single transport accident, we would have a public inquiry tomorrow. These days, calling for a public inquiry has become something of a cliché, but I am talking about a substantial number of deaths, and I believe that we can make progress in reducing it.

The issue is not only the human cost, but the financial cost. In particular, I want to focus on misdiagnosis. Epilepsy Action says that between 20% and 30% of cases of epilepsy are misdiagnosed, at a cost of £140 million to the NHS. I know from personal experience that misdiagnosis happens. When I first started having fits at night, when I moved down to London in my early 20s, I did not really know what was happening to me. I just thought that I was falling out of bed, but there was blood everywhere and I could not quite put two and two together. One evening, I threw myself out of bed sufficiently hard that I banged my head against my bedside table and had quite a deep cut between my eyebrow and one eye, missing taking my eye out by the narrowest of margins. My next door neighbour said, “I really think that you ought to go and get that seen to.” I did not want to get it seen to, because I could not really explain to the nurse what had happened. Nevertheless, I pootled down to the hospital, where the attitude of the nurse was to say, “You’ve been drinking, haven’t you?” To my mind, that is a classic example of misdiagnosis. A chance to diagnose me with epilepsy and to start me on a treatment plan was missed because there was a presumption that I had been drinking and that the cut I had suffered was caused by drunkenness.

Misdiagnosis affects the treatment of epilepsy at every stage of the process. Apparently, some 74,000 people who are diagnosed with epilepsy do not actually have it. Not only does that misdiagnosis have a cost in terms of the cost of the drugs that those people are put on, but it has a human cost in terms of the stigma that those people feel that they have to bear and the worry that they face in their daily lives. If they could only be diagnosed with what they actually have, rather than with what they do not have, that would improve their lives.

There are also 69,000 people who have the wrong type of epilepsy diagnosed. I have gone into quite some detail about the type of epileptic fits that I have. I gather that there are some 40 varieties of epileptic fit that can affect an individual and they all require slightly different treatments, so it is important that people are given the right diagnosis. That is why specialisms matter. Epilepsy is special and I want the Minister to regard it as a special type of chronic condition. That is not to say that other chronic conditions do not matter or are unimportant, but epilepsy is quite different from many other chronic conditions and it needs to be treated in a special way.

That special treatment means having special GPs to deal with epilepsy. I was fortunate that, when I was first diagnosed with epilepsy, I had a GP who was interested in the condition. When I moved house, my next GP was not quite so interested in epilepsy, so the nature and quality of my treatment and care changed. With the formation of local commissioning groups, I hope that we will have the opportunity for GPs to develop those specialisms and to build on those interests, not just in the treatment of epilepsy but in the treatment of the other special conditions that people regularly go to their GP about. I think that local commissioning groups offer an opportunity to advance that agenda and I urge the Minister to explain to us how he thinks the groups can help GPs to develop those specialisms.

It is worth highlighting a report by the all-party group on epilepsy back in 2007—three years ago now—which contained a fantastic quote from Dr Hannah Cock, a senior lecturer at St George’s hospital, who said

“Unless patients with long-term epilepsy at general practice level are in crisis, they do not get referred.”

That is a very important point. People should not have to wait for a crisis to occur before they get the treatment that they most need. I know that President Obama’s recently retired chief of staff is known for saying, “Never let a good crisis go to waste,” but when it comes to epilepsy care, we do not want to get to that crisis point. We want to have consistency of care and that consistency of care is itself very important.

In particular, I want to raise the issue of generic substitution, which again might sound rather arcane to those who are not familiar with it. Like many other people, I take a regular dose of medicines and tablets. I go down to my pharmacy every six or eight weeks to pick up my new set of prescriptions. I have no problem with the idea of substituting generic medicines—it is important that we get value for money and effective medicine. What I am concerned about and what I ask the Minister for reassurance on is consistency of supply. Although the name on the packet might be the same, if the drug comes from a different manufacturer that uses a slightly different compound—if it is altered in ever so tiny a way—it can have a massive impact on how my brain reacts when various things occur in it that might lead to fits. Consistency of supply, not generic substitution itself, is my concern. I know that the Department has engaged in a consultation on the matter, but for the sake of the many people like me who are worried about it, I ask for some reassurance.

The other issue involving consistency on which the Minister can offer some comfort is specialist nurses. They are a wonderful idea. Epilepsy Action has been campaigning to promote their virtues, referring to them as “sapphires”, and they have an important role to play. We have about 250 at the moment, but the best estimate of how many we need is 1,100. There is clearly a gap, and those who are retiring or leaving are not being replaced, so the shortage will continue to worsen. The previous Government recognised the importance of sapphire nurses and was going to study their effectiveness. Will the Minister reassure me that the current Government will proceed with that study and recognise the importance of such nurses? Specialist nurses are a cost-effective means of providing consistent low-cost care that monitors a patient’s condition over time, ensuring that any blips on the radar are picked up early and preventing the need for costlier intervention further down the line.

That is the crucial point: better care and treatment are more cost-effective. We are all, I hope, looking for ways to save money, and that is one way to do so. We do not want inadequate care at the primary care stage to lead to more expensive tertiary care later. We do not want crises to occur. Cheaper care occurs in a primary setting and helps individuals to manage their condition, putting the patient in charge. However, to use the word “special” again, we need more specialism at the tertiary level as well. Neurological consultants are thin on the ground, but neurological consultants with an interest in epilepsy are even scarcer. They offer one way to help to prevent and correct misdiagnoses and to get it right the first time, but I gather from another Epilepsy Action survey that 90% of primary care trusts are not meeting the recommended two-week deadline for seeing a consultant.

I say that with a degree of caution, because I am no fan of two-week deadlines. They can be artificial, lack clinical sophistication and rob clinicians of their own clinical judgment. I have never been a fan of the two-week deadline. However, in my view, it has slightly more than a decorative role, if only because a lot of people present to their GP when the sort of crisis that I mentioned has occurred. Some degree of urgency in referral is needed, particularly because I hear many stories of cases where patients have died after referral but before having seen a consultant. That is an avoidable tragedy. We do not need artificial deadlines or targets, but there needs to be some way to ensure that urgent cases are referred promptly and reasonable confidence that they will see a consultant within a reasonable period.

I also ask for a bit of special treatment on the national level. I would be interested to hear whether the Minister might consider creating the post of national clinical director for epilepsy, which has been a long-term demand of many organisations in the Joint Epilepsy Council. One can commission successfully at regional level—it has been done in many parts of the country for many chronic conditions—but a degree of national oversight is needed to ensure that standards are set and adhered to. I realise that the National Institute for Health and Clinical Excellence has set clinical guidelines, but I have concerns.

In 2005, I was fortunate enough to be the parliamentary candidate for Twickenham, not far from the Minister’s constituency. I wrote a letter to the local paper during national epilepsy week because I wanted to highlight the issues, and someone wrote in the next week to say that clearly I was possessed by evil spirits. I had thought that Twickenham and south-west London were a particularly liberal, enlightened part of the world. That is what I was always told; they were so sophisticated that they had discovered liberal democracy a few years earlier than the rest of us. Blaming evil spirits was perhaps a bit unfair to me, but for many patients, NICE clinical guidelines are a bit like spirits. They have no real substance or tangible meaning, because they are not mandatory.

I know that there is always a big discussion about whether clinical guidelines should be mandatory if we do not want to take clinical power away from consultants, but clinicians are frustrated that they cannot implement the guidelines, and patients are equally disappointed that the guidelines do not mean anything in reality. There is a perhaps more philosophical question to be dealt with. If we are to have clinical guidelines for any condition, how can we deal with the fact that clinicians need to be reasonably confident that they are supposed to implement them and patients need to be confident that they will mean something? There is no point having clinical guidelines as decorative features. They are not Christmas trees; they are meant to help clinicians give better treatment.

The last Government met the Joint Epilepsy Council. I pay immense tribute to the then Opposition spokesman, Earl Howe. I know how much he has done on epilepsy and I have worked with him for many years. He is a good man, and I more than anyone am delighted to see him a Minister at last. He told the conference of NHS commissioners to go away and make a difference. How, specifically, does the present Minister think that NHS commissioners are making a difference? In particular, I make a plea to him to meet with me and representatives of the epilepsy charities—the Joint Epilepsy Council, Epilepsy Bereaved, Epilepsy Action—and senior clinicians to discuss some of the sector’s fundamental concerns. As I said, better treatment and better care will lead to bigger cost savings for the Department, but more importantly, they will improve quality of life of the 400,000 people in this country who have epilepsy.

I was surprised to read that the primary care trust for my Blackpool constituency has the highest incidence of epilepsy in the country. I had not realised that. We are talking not about a small group but of a large group of people who must deal with an immense stigma in their lives, as I know some of my hon. Friends will describe. We must deal with it day in, day out. Epilepsy is unlike any other chronic condition. I thank the Minister for listening and my colleagues for attending. Can we please hear some good, positive news about how the Minister intends to take the agenda forward?

Supporting Carers

Paul Maynard Excerpts

Thursday 1st July 2010 Westminster Hall

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Benton, for my first speech in Westminster Hall.

I was pleased to hear from the Minister that we will have a new carers strategy—it is very much needed. I would like to focus today on three aspects that I believe are important in allowing carers to have a life beyond caring.

The first aspect—working carers—has been touched on by the hon. Members for Stretford and Urmston (Kate Green) and for Liverpool, Wavertree (Luciana Berger). I would like to take a slightly more specific approach than they did when they spoke about the cliff-edge factor in earnings, and look at the needs of carers who want to work and go to Jobcentre Plus hoping to find a job. When they get there, they do not get the help that they need, for several specific reasons revealed in a National Audit Office report, “Supporting Carers to Care”, at this time last year. I shall highlight those reasons for the Minister.

There is an enormous army of carers, as we have recognised today, but they form a small part of the work load at Jobcentre Plus. Many advisers rarely deal with more than one or two carers each month. It is vital that the centres have specialist advisers to deal with carers who are looking for employment. Because of their caring duties, many carers do jobs that, inevitably, are part-time. Therefore, they do not form part of what Jobcentre Plus has to submit to meet its targets for placing people in full-time employment. Because carers do not help Jobcentre Plus to hit the targets that central Government want it to achieve, they are seen by Jobcentre Plus not as a priority but as a marginal part of its business.

I am also concerned by what I read in the NAO report about many Jobcentre Plus advisers not being certain of what they are doing. For example, the report found that two thirds did not realise that carers who claim only carer’s allowance do not need to attend work-focused interviews. It worries me that two thirds of the staff do not understand a crucial part of the needs of carers. Finally, as an example of a Kafkaesque bureaucracy gone mad, Jobcentre Plus advisers are encouraged to hand out carer’s allowance application forms but are not allowed to help fill them in. “Here’s a form, but don’t ask me any questions, please, because I can’t answer them”—I am afraid that we hear that so often. I hope that the new carers strategy will try to address some of those specific issues so that those who go to Jobcentre Plus to look for work get the help that they need.

The second area that I would like to focus on is the need for respite care. I welcome what the previous Government did in recognising that it is good to give carers respite care, but I regret the fact that, for one reason or another, as the Minister said, much of the money never quite made it to the front line. That shows the danger of raising expectations within a group of people that are then not fulfilled.

I pay tribute to organisations such as Vitalise, a charity that provides space for 7,000 people to have respite breaks each year. Its work stretches from Cornwall in the south to Southport in the north; I regret that it cannot manage an extra 20 miles to make it to Blackpool and provide breaks there, but perhaps I can encourage it to do that bit more—who knows? As its part of carers week this year, it set up a care to share forum, which was an opportunity for people who need respite breaks to share experiences of what they had had and, indeed, what they did not get, having expected something as a result of the previous Government’s announcements. That was a useful thing for Vitalise to do, because carers’ nervousness about going abroad, going away, or leaving the person for whom they care, is a significant issue. There are many hurdles to overcome if they are to have that ambition, and the more that we share information and allow carers to feel more confident about leaving the people for whom they care, even for just 24 hours, the easier it will be for respite care to become an established part of the caring agenda.

Will the Minister therefore ensure, in the national health service operating framework and in NHS Vital Signs, that provision of carers support is not just an optional extra for primary care trusts but critical—either tier 1 or tier 2? By having it at tier 3, PCTs are basically given permission not to bother with it. Unfortunately, that is just one of the ways in which micro-management from the centre can become an excuse for not providing a service.

I would also ask that when this or any Government make new moneys available, they make the announcement only when they are confident that they can monitor implementation and ensure that the money is spent on what it is supposed to be spent on. It is not acceptable to raise the hopes of vulnerable groups so that they think that they will get something but then, through no fault of Ministers, the Government or Departments but just because the layers of bureaucracy absorb the money bit by bit, it does not happen further down the line. That simply is not fair.

I echo what my hon. Friend the Member for Totnes (Dr Wollaston) said about young carers. She was right to identify in particular the needs of the 20% who do not do what I would call traditional caring, where the relative has a progressive disease associated, perhaps, with old age. I think that the figure is higher than 20% in a constituency such as mine. Blackpool North and Cleveleys is a deprived area with many public health needs, and I would have thought that many younger carers are dealing with relatives who have a drug addiction, alcohol or mental health problem.

At the back end of carers week this year, I went to the local branch of Frankie and Bennys near the Odeon cinema in Blackpool. The local carers centre, which is funded by the Princess Royal Trust for Carers, as so many carers centres are, has a particular interest in the needs of young carers. Nigel McMurdo, who runs the project, does a fantastic job in trying to give them treats every now and again. One of the treats was dinner at Frankie and Bennys, so I trundled off to meet them, to listen to their stories and to understand a bit more about what they go through.

Nigel told me one tale about how caring can impact on education. A young man caring for his mother, who had a mental health problem, had a geography exam one day, but she would not let him out of the house. There was a real battle just to get him to school to sit the exam. That demonstrates how caring for parents, as an act of love, can be a bar to educational attainment. For many of our young carers, caring has an impact on their health, education and ability to have a social life.

The inadequacy of child and adolescent mental health services is a long-standing problem. If mental health services are the Cinderella service of the NHS, CAMHS is Cinderella’s daughter—it is a Cinderella service within a Cinderella service. I have raised this matter with the Minister in respect of autism but, more widely, I have great concerns about the condition of CAMHS in this country, and how it excludes far too many people who need help. It is a real problem.

In addition, in terms of education, bullying has a major impact on the lives of many young carers. It occurs when someone is seen to be different. If they have a caring responsibility, it means that they cannot hang around outside the school gates after school, or they might be 15 minutes late, or they might not always get their homework done on time. Inevitably, bullying takes place, and young carers need support in relation to that.

Young carers in Blackpool are at present trying to draw up a young carers charter. At the top of their list is a demand that every school should have a nominated teacher who can pay attention to the needs of young carers, as a kind of early warning system. Such a system is needed, and I do not think that we can place the burden entirely on general practitioners, as we always seem to try to do, to act as early warning gatekeepers. There is a difficulty in identifying young carers. We know of about 200 in Blackpool, but we are certain that there are some 600 more whom we simply do not know about—we cannot find them, they are not there. We often speak about the unmet need and how to reach the hard to reach. I fear that that is a perennial question in public health policy.

Platitudes abound in the debate on carers. I desperately try to avoid platitudes in anything that I do, but it is often difficult to avoid them when mentioning this topic. I should like some concrete steps to be taken that benefit carers, including benefit simplification. I have lost count of the number of times that I have tried to explain to people in my constituency that to be able to apply for the carer’s premium they must first apply for pension credit, which they know that they are not entitled to. The people that I explain that to find it illogical, and so do I, but it still seems to go on. Can we please try to change that?

When I first became involved in health policy some 10 years ago, the file in my office marked “Care” focused on the width of doors for wheelchairs as described in the Care Standards Act 2000. I watched the Minister raising care issues many times in the House of Commons. Carers week was regarded as a peripheral matter 10 years ago. The large queue in Portcullis House during carers week, for the photo opportunities and so on, was testament to the progress that is being made, but I still think that we have to go one step further. I may be a new MP, but I am already a little bit tired of photo opportunities—during which I stand beneath a Perspex stand, smile and shake hands—that are somehow meant to provide evidence of my commitment to an issue. I would rather MPs took fewer photo opportunities and visited more local carers centres, as many hon. Members in this Chamber have, to hear what is going on and speak to real carers. That would bring a bit more reality into this place.

It was good that the previous Government recognised that carers have a role to play, and I welcome that. However, we now have to focus on how we enable carers to live a more ordinary life: a life beyond caring. We need to start to fit provision around the needs of carers. As with too much in public life, we expect people to fit into existing tick-boxes on forms and woe betide them if their circumstances do not enable them to fit neatly into those boxes. That is not good enough.

We need to build provision around the individual. I know that that will be difficult, but not every carer wants to play bingo and not every young carer wants to go to the cinema of an evening. We all have individual requirements as carers. We are all individuals, after all, and we should remember that. I hope that the carers strategy that is being drawn up over the summer will mean that we will start to regard carers not just as a group with a label attached and a set of demands, but as individuals who need to be empowered. I look forward to seeing what emerges after the summer.

Oral Answers to Questions

Paul Maynard Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Burstow]

I am very grateful to the hon. Gentleman for that question. He is right; carers are a valuable and valued resource. They make an incredible difference to the quality of life of the people for whom they care. The Government are determined, as we have outlined in the coalition programme for government, to develop respite services further and make them available through direct payments for those people.

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

Given the success of central Government in persuading child and adolescent mental health services to take the needs of those with learning difficulties more seriously, will the Minister commit to doing the same for those with autism, given that only 11% of CAMHS have specialist provision? Will he make a commitment to do the same thing for those with autism, please?

[Mr Burstow]

The hon. Gentleman makes an excellent point. We shall be getting some guidance from the National Institute for Health and Clinical Excellence in a year’s time, and absolutely the answer is yes.