Health

Debate between Rebecca Pow and Derek Thomas

Tuesday 14th May 2019 Commons Chamber

[Rebecca Pow]

The diabetes foot pathway relied on opening eight podiatry clinics across Somerset. Does my hon. Friend agree that it is the podiatrists who are helping to solve the diabetes problem?

[Derek Thomas]

I completely agree with my hon. Friend, and I attended a conference 18 months ago at which the podiatrists and Plymouth University mentioned the risk of this happening. We are now seeing that prophecy being fulfilled. I appreciate what my hon. Friend says about what has been done to improve the pathway and reduce lower limb amputations. We must not see that good work reversed.

When it comes to caring for our feet, we are heading for a perfect storm. Fewer people are going into training because of financial barriers, and in 10 years we will see an enormous amount of podiatrists retiring from the profession. That adds up to a real challenge that we need to address quickly. I ask the Minister to look at what has happened since the nursing bursary was removed for mature students and whether we can address that.

The impact on patients is severe. Type 2 diabetes is the fastest growing health threat facing our nation, and 3 million people are living with it. That figure is set to reach 4 million by 2030. Diabetic foot care costs the NHS in England between £1.1 billion and £1.3 billion a year—£5.7 million per clinical commissioning group. It accounts for £1 in every £100 spent, more than the combined cost of three of the four most common cancers. Some 80% of the 135 lower extremity amputations each week in England are preventable through good foot care, and the Government have made a commitment in legislation and policy to provide safe care. That is just one example of how, if we do not get this right, we will fail to avoid the impact on patients of more lower limb amputations and lower life expectancy. The facts show that after a lower limb amputation, life expectancy is reduced to about five years.

There is also an impact on the NHS. I have mentioned the sheer cost of caring for lower limb problems, and it will have an impact on multidisciplinary teams if we do not keep people with the skills coming through. It will also have an impact on budgets. As well as the impact on social care and on the budgets for those delivering support in people’s homes, making changes around a home because someone has had a lower limb amputation is a costly affair that is easily avoided if we get it right and get enough podiatrists on the ground.

There is an urgent need for action. I ask the Government to look at why mature students are uniquely impacted when going to study these important professions. If a mature student is on any sort of benefit—housing benefit or other financial support—the minute they take out a student loan to study to be a podiatrist, they lose all that support. Perhaps the Department of Health and Social Care and the Department for Work and Pensions need to look at that, because that is a significant barrier to people coming into a skill we so badly need.

I ask the Minister to look at solutions to reverse the reduction of mature students going into important parts of the NHS such as podiatry so that we can save money for the future, to be used where needed, and provide a real opportunity to improve people’s lives.

World Health: 25-Year Environment Plan

Debate between Rebecca Pow and Derek Thomas

Tuesday 9th April 2019 Westminster Hall

[Derek Thomas]

Two things come to mind. First, the environmental plan talks about protecting and enhancing the natural environment. Secondly, in our part of the world, we are seeing the roll-out of the coast path as we speak, which gives far greater access to people to get around the coast and enjoy all that is around us.

To continue with the theme of people supporting this agenda, the Office for National Statistics produced a 2017 report: “The UK environment—fighting pollution, improving our health and saving us money.” It set out the role that the environment plays in tackling air pollution and improving health. The ONS website states:

“Overall, an estimated 1.3 billion kg of air pollutants were removed by woodlands, plants, grasslands and other UK vegetation in 2015”,

saving about

“£1 billion in avoided health damage costs.”

The study by UK Natural Capital states:

“Trees in particular provide a wide range of services and account for most of the volume of air pollutants absorbed by natural vegetation in the UK”.

[Rebecca Pow (Taunton Deane) (Con)]

My hon. Friend is making a powerful case and I thank him for securing the debate. I have tried to get one for ages, so many congratulations to him. On trees helping with pollution, soil is brilliant at combating climate change because it can hold so much carbon. Although we are talking about how soil management should be better, soil health is not listed as a headline indicator in the 25-year environment plan. Does my hon. Friend agree that we should try to get it in there as an indicator because the payback to society would be considerable, given that we pay £1.2 billion a year to combat soil erosion?

[Derek Thomas]

The Minister is best placed to respond to how we get that into the plan, but my hon. Friend is right. I have been to see scientists in my constituency who work to improve the soil not only to produce food but to protect our environment and improve and enhance natural habits. She is absolutely right to raise that point.

Public Health England states:

“There is a very significant and strong body of evidence linking contact and exposure to the natural environment with improved health and wellbeing.”

I will continue with these influential bodies. The National Institute for Health and Care Excellence encourages local authorities to put pedestrians and cyclists first when designing roads, ensuring our local areas have safe and well-maintained open spaces and that everyone can get around the local area easily.

If the benefits to our physical and mental health are not enough to convince the Treasury of the importance of investing in our natural environment, the Natural Capital committee estimated in its 2015 annual report that well-targeted investment could generate large economic returns: for every £1 invested, the return was between £3 and £9. It stated that

“carefully planned investments in natural capital...will deliver significant value for money”

and generate large economic returns. It is vital that we get the Treasury on board in this debate, as well as the many other debates that happen in this place.

Safety of Riders and Horses on Rural Roads

Debate between Rebecca Pow and Derek Thomas

Tuesday 4th July 2017 Westminster Hall

[Derek Thomas]

I thank my right hon. Friend for her intervention; she is absolutely right, and I was pleased to meet the BHS today to discuss its concerns. A lot of the work, including this debate, that we have been doing over the past couple of years with Debbie Smith, the British Horse Society and many others is about raising awareness of how we should use our roads and consider others’ safety, and pressing on the Government that we believe that there is more they can do to take part in this cause.

For many years, Debbie Smith has been working with others to campaign on behalf of horse riders for safer rural roads. Her most recent petition about passing wide and slow, calling for stronger legal protections for riders on our roads, has reached almost 110,000—maybe now it is 110,000—signatures on the change.org site. I first met Debbie in November 2015 and required little persuasion to join her cause to make our roads safer for horses and their riders. Our initial encounter led to a meeting in February 2016 with the former roads Minister, my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), and civil servants from the Department for Transport. We discussed the need for a concerted effort by the Department to make our roads safer. Since then there has been a horse-riding awareness day—earlier this year, in which 15 different locations in the UK took part—and 110,000 signatures on the petition, as I said.

Horse riders make up a significant group of vulnerable road users, but despite there being 2.7 million across the UK, they often find themselves as the forgotten demographic—an afterthought in the minds of drivers and unacceptably low down many politicians’ priority lists. It is for this reason that the British Horse Society launched the horse accidents website in November 2010. Since that launch, 2,510 reports of road incidents involving horses, including near misses and collisions, have been logged by the BHS. That is but the tip of the iceberg. Most significantly, since the launch 222 horses and 38 riders have been killed. This problem is not in decline. In the past year there has been a 29% increase in the number of road incidents involving a horse reported to the British Horse Society.

[Rebecca Pow (Taunton Deane) (Con)]

My hon. Friend is making a very sound case. In fact, it is shocking. I am very nervous of horses, so I go incredibly slowly whenever I am near them because I am afraid of the damage that they might do to me, but does he agree that on the whole many people who drive cars just think of a horse as a horse and forget that they are individuals and that one has to be even more careful if it is a young and nervous horse? The 15 mph and distance from the horse are crucial.

[Derek Thomas]

I thank my hon. Friend for that intervention. I live in west Cornwall, where most of the roads are very narrow and horses and riders enjoy their valuable and important pursuit. It is absolutely right that we raise awareness and help drivers to understand that horses are living beings—they have brains. Something that they see, but we in the car behind perhaps cannot, may well cause them to get spooked. We need to make drivers aware of the risk not only to the horse and the rider, but to them and their vehicle. That might gain their attention. Statistics such as those should cause alarm.

Supported Housing

Debate between Rebecca Pow and Derek Thomas

Tuesday 29th November 2016 Westminster Hall

[Derek Thomas]

Certainly. I will come to the work that the YMCA is doing in my constituency to increase the amount of housing it provides for vulnerable young people, even in these supposedly uncertain times. There is a real opportunity to do something significant. There is work to be done, but the Government are heading in the right direction. What the people who provide the housing solutions need is confidence and a secure footing, and this is an opportunity to achieve that.

[Rebecca Pow]

Is it not then important that we commend the Government for opening up a consultation? I have met many housing associations in my constituency, including Yarlington and Knightstone, which build across the south-west. Although one or two of those associations have projects on hold, they have certainly got some good ideas about how we could succeed in this area and make it better for the vulnerable people who need support and who we absolutely must support.

[Derek Thomas]

I welcome that intervention and completely agree. I delivered supported housing in the past, and there were decisions made, or done “to us”. The current situation is exactly as my hon. Friend says: an opportunity to get the people who understand the situation, the challenge and the solutions to work with the Government to deliver those things. We need confidence in three areas: that we will continue to deliver these essential services, that money awarded for supported living is spent on supported living, and that funding will keep up with demand—that is extremely important.

Long before I came to this place, I worked with people with severe learning disabilities and often with very elderly parents who were looking after adult children. The stress and pressure on the parents were enormous. The worry about where their adult children would end up when they could no longer look after them was significant. They had no confidence that the current arrangements would ever provide housing in the right place that their adult children needed to help them to live full and free lives. It is important that we use this opportunity to focus our attention and to address how we can provide the housing needed to support the whole family as they look to move their adult children into secure, independent housing that looks after them as whole people. We worked hard to do that. Local people put in their money to buy a property where we could house up to five people, close to their families, with the people in place who could support them to live there, but the barriers were so immense that we could not continue that service. The property is not lost because it is supporting homeless people, but we were unable to provide a secure arrangement for those people, where they felt they had a home for life.

Particularly in Cornwall, to which people gravitate because of the quality of living, many people with learning disabilities are living with older parents. We need to meet that housing demand now and in the very near future. We are not discussing the built environment, but it is important that the Government use every resource available to Departments to increase the supply of housing for people who have learning disabilities, to ensure that they are in the right place, with good transport links, close to home, where they can still be in close contact with their families and where they are part of the local community.

Devon and Cornwall Housing run foyers in my constituency, which are places where vulnerable 16 to 18-year-olds with quite horrendous backgrounds are supported. They are invited to live there. Alongside the housing—the roof over their heads—they receive support on growing up and the skills needed to become independent and to live lives that we all take for granted. The YMCA also works in my constituency. Years ago, I was on the board of YMCA Cornwall and sat on a panel that interviewed young people to ensure that the housing we provided was for them and would give them the tools that they needed to move on. They are only ever allowed to live in one of those properties for two years, so it is important that in that time they are supported to learn the skills and have the resources and abilities to go and set up homes of their own.

The challenges facing young people who qualify for such supported services are considerable. For years, both Devon and Cornwall Housing and the YMCA have been influential in helping young people to gain a firm footing in their lives. As I have said, there is good news, despite the uncertainty referred to by the hon. Member for Bermondsey and Old Southwark. Two weeks ago, I attended the annual general meeting of the YMCA. Bearing in mind that this is a rural, west Cornwall constituency where there are enormous housing challenges, the YMCA is being ambitious and is setting out to build 19 extra units in the constituency—it already has several—to support vulnerable young people. While the Government are focusing on what supported housing looks like and how we can respond appropriately and effectively to that important demand, will the Minister also pay attention to the barriers for young people in supported housing environments? A safe place to live is essential, but so is the right support to help them to move on from supported housing.

I would like to read a letter that I received from The Coach House, a foyer run by DCH in my constituency. It is right that we focus on supported housing, but we should also look at the barriers created by Government policy that hinder young people from getting the skills and tools they need. The letter says:

“Further to our conversation last week”—

I went along and sat in on one of the house meetings—

“about the young person I have that would like to do a university course at Cornwall College.”

This gentleman is 19 and has

“completed a level three music course at Penwith college. He completed it with triple distinctions. We went to Cornwall College to talk about him doing the foundation degree and was told that he would have to apply for student finance. I looked into how this would affect his benefits and was told that he couldn’t claim benefits if he had student finance. The rent at the Coach House is £230 per week student finance would not cover this. So he is now in the position that living in supported housing is holding him back. He still needs a lot of support so isn’t ready to move on. I think that if we could support him through the first year of his course he would be more than ready to move on. This would be a fantastic opportunity for this young person. He is more than capable of doing the course.

Since being told that he couldn’t do it because of funding his mental health has spiralled to the point that he hasn’t been getting up, washing, eating properly he is very depressed at the moment. I have just come back from the doctors with him and he has been referred to the mental health team”.

We could do more to help that young person to have a fantastic life—to get the skills and the degree he needs and to find the job satisfaction that we enjoy, but at the moment the system is hindering him from doing that further training. I would be interested to hear what work the Government can do across Departments to remove those unintended barriers.

In summary, can the Minister ensure that money given to local authorities will go in its entirety to supported living? Recently, we have heard about extra money for social care from an extra precept on our council tax. We are a year into that, but in my constituency I have struggled to be absolutely sure that the money has gone to social care. We would not want a repeat of that, so if the Government are to give money to local authorities to deliver locally based, locally driven solutions, we must be absolutely sure that it goes to where it is intended so that the people we are talking about receive the supported living they need and deserve.

What more can the Government do to increase the supply of supported housing for people with learning disabilities? How can we ensure that those homes are in the right places so that tenants can play a full part in local society and, equally importantly, access public transport? Finally, will the Minister address the difficulties faced by young people who want to gain skills but risk losing their support by doing so?

Apprenticeships Funding

Debate between Rebecca Pow and Derek Thomas

Tuesday 1st November 2016 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I thank the right hon. Member for Tottenham (Mr Lammy) for securing this debate. When we consider the skills gap in pretty much every vocation going, a debate on apprenticeships and on ensuring people have the skills they need is timely indeed.

With your permission, Mr Streeter, I would like to briefly talk about my own experience. I left school at 15 and served a traditional apprenticeship as a Cornish mason in the construction industry under a Conservative Government. That skill has enabled me to feed my family and build my home, and it has supported me during a very long journey to become an MP. The apprenticeship also enabled me to stay in west Cornwall, where I grew up. That can be a significant advantage of serving an apprenticeship.

During the previous Parliament, I had a small construction business and took on an apprentice site carpenter. While I enabled him to get a trade, I also saw how the modern apprenticeship programme works in practice. More recently, I have taken on an apprentice in my constituency office and, even in those few years, I have noticed an improvement in the advice and support available to employers.

As Members can tell, I am a big fan of the apprenticeship programme. It is an important part of our young people’s journey to skilled employment. In spring this year, I hosted an event with the Cornwall Apprenticeship Agency. Local employers could come along to my constituency office and quiz a representative of the agency to find out about the pros and cons of offering that form of on-the-job training. I was very pleased to hear the speech from my hon. Friend the Member for North Swindon (Justin Tomlinson). During his time as Minister for Disabled People, he encouraged me a great deal to look at how we can support people with learning disabilities, and I ran one of his reverse job fairs just two weeks ago, so I thank him for that.

In a rural part of the country such as west Cornwall, a modern apprenticeship really is an important part of a local young person’s career path. For so long, Cornwall and the Isles of Scilly have suffered because our young people have found they must leave the county to find the skills and jobs they need. That has left us in a situation where we have a chronic shortage in many sectors, especially construction, farming and engineering. Quite often, these potentially well-paid jobs have disappeared because we have not had the people to fill the vacancies.

[Rebecca Pow]

My hon. Friend is making a passionate case. I come from Somerset, which is not unlike Cornwall in terms of its skills shortages and gaps. We are below national productivity levels. It is important that businesses design these apprenticeships, and that is what the Government’s new scheme is all about. We do not want bland apprenticeships in any skill; we want them tailored to business, which is what my local businesses are all coming to me and saying. I, too, am going to run a course, because people want the knowledge to go forward.

[Derek Thomas]

That is a fantastic point. When I stood in the election and finally won, I met and worked with local businesses, and they kept telling me that they need courses provided by the college to provide the workers they need and the training their young people need. It is important that businesses lead the way in ensuring that they have the skills they need to move forward.

We have massive vacancies in Cornwall, and clearly we cannot continue like this. The modern apprenticeship programme, if communicated properly and successfully delivered, gives young people the opportunity to train locally, work locally, live locally, shop locally—in my part of the world, it is important that we look after our local retailers—and go on to raise a family locally. Rather than just welcome the Government’s ambitious target regarding the number of apprenticeships, it is essential that we meet it, simply because we do not have the people to do the jobs whom we need at the moment.

I heard the points that the right hon. Member for Tottenham made about funding. However, the great challenge we face is to engage more small businesses to take on apprentices. It makes sense that the Government are focusing on and prioritising funding, meaning that 90% of all funding for small businesses will be met by the Government. It makes sense that small businesses do not pay anything towards training people under 18 years of age. The real challenge is not so much the amount of money but how it is spent, as well as improving links between our schools and employers, so that young people and their families are aware of the opportunities available to them in the areas where they live. That would have a significant impact on the skills gap in west Cornwall and across the country. I welcome this debate, but I argue that we should concentrate on how we equip and enable young people to do apprenticeships, rather than fall out about the money available.