A and E (Major Incidents)

Robert Halfon Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

We need to have much better working between the health and social care systems. If the right hon. Gentleman supports that, he should support the better care programme, which from April of this year will see co-operation between the local NHS and local authorities in 150 local authority areas for the first time. Instead, Labour is calling for that plan to be halted.

[Robert Halfon (Harlow) (Con)]

Will my right hon. Friend thank the staff of the NHS at Harlow Princess Alexandra hospital for their passion and commitment? Although the Government have invested £5 million in our accident and emergency services, issues in nearby hospitals mean that the pressure on our A and E has been immense. Princess Alexandra hospital is one of the busiest by far for attends by bed and one in five ambulances arrives from out of the area. The PAH is now admitting four more patients a day than it was this time last year. Will my right hon. Friend meet me and the chief executive of the Princess Alexandra hospital, and will either he or the Minister responsible for hospitals visit the hospital to see what can be done to help the situation?

[Mr Hunt]

I am very happy to do that and I am aware of the significant pressures at the Princess Alexandra. I thank my hon. Friend for the way in which he is supporting staff in his local hospital, getting behind local plans. It is a mistake to say that there is always a new national initiative. Lots of people in the NHS have been saying over the past few days that they do not want new national initiatives. They want exactly what my hon. Friend is doing; they want people to support their local NHS and not to turn it into a political football.

Mental Health (Cambridgeshire)

Robert Halfon Excerpts

Wednesday 10th December 2014 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a pleasure to serve under your chairmanship, Dr McCrea. I congratulate my hon. Friend the Member for Cambridge (Dr Huppert) on securing this debate and commend him on his ongoing interest in local health matters. I know from meeting the chair of his CCG only yesterday that my hon. Friend is a consistent champion of local services.

I am sorry that the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb), cannot be here to respond to the debate, but he has already shown a keen interest in its subject, and I know that he will take action forward. I also echo the tributes that my hon. Friend the Member for Cambridge quite rightly made to NHS staff at the beginning of his remarks.

We all agree that good-quality patient care has to be expected regardless of where in the country we live. As my hon. Friend quite rightly said, for too long, mental health services were the forgotten area of the health service. That is changing under this Government, and I will touch on that later. There is still, however, much to do; I am sure that we would all acknowledge that.

Although I will not dwell on the subject too much in this debate, my hon. Friend was right to comment on prevention and on building resilience. As the public health Minister, those issues are close to my heart. He was also right to talk in broader terms about building resilience in individuals. I know considerable thought is being given to making it possible for people—young people, in particular—to withstand more of what life throws at them.

I move on to questions of national funding. For 2014-15, NHS England allocated £64 billion to CCGs for hospital, community and mental health services—an increase on the previous year of 2.54%, or £1.59 billion. In making allocations, NHS England relies on advice from one of our many health acronyms, ACRA—the Advisory Committee on Resource Allocation. ACRA gives advice on the share of available resources provided to each clinical commissioning group to support equal access for equal need. Much of our debate will revolve around those funding formulas and how they are evolving. The calculation is based on the age of populations, their relative morbidity and unavoidable variations in cost. The objective is to ensure a consistent supply of health services across the country. The greater the health need, the more money is received, because more health services are needed. The CCG model covers only non-specialised hospitals and community care, plus primary care prescribing.

I understand that the baseline varies systematically between locations. To some extent, that reflects different historical commissioning priorities in the predecessor organisations—the primary care trusts—or different mixes between the local and area commissioning responsibilities.

NHS England reviewed the funding formula for 2014-15 and the following years, and it now uses the person-based resource allocation approach, which was developed by the Nuffield Trust. Unlike the previous target models, it allows information about individuals—including their age, gender and recent hospital diagnostic history—to be combined with information about the area in which they live; that information, as my hon. Friend knows, is frequently linked to deprivation. The PBRA formula estimates the relative need of each individual. At a CCG level, the estimates are the most accurate ever used for allocations, so there has obviously been a change in how resources are allocated.

In debates such as this we often discuss the pace of the change from the actual allocation towards the target allocation. The option that NHS England agreed for CCGs reflected the challenge of directing additional funding to the CCGs that are the most under target, while not destabilising areas whose allocations were above target—I have seen that happen in London. If people have had an allocation for a long time, we must ensure that they plan for the change; such things must be done sensibly. That is a continuation of the policy of maximising growth for those furthest below target. We appreciate that CCGs in the east of England are further below their target allocations than those in many other parts of the country—my hon. Friend is right to draw attention to that—and that Cambridgeshire is one of the furthest behind target by some £45 million or 4.85%.

NHS England is already spending £500 million in 2014-15 and 2015-16 to bring under-target CCGs, such as Cambridgeshire, towards their target allocations. That approach was discussed and decided at a public board meeting in December 2013—nearly a year ago. My hon. Friend is pushing us to speak about what will happen in the future. Following my right hon. Friend the Chancellor of the Exchequer’s announcement in the autumn statement of a further £2 billion for front-line services, NHS England is reviewing the 2015-16 allocations. I hope that NHS England shares the hopes of my hon. Friend the Member for Cambridge, and that it will consider how some of that extra £2 billion can be used to help the CCGs that are furthest behind—including Cambridgeshire—to get closer to their fair share. My hon. Friend has already discussed that issue with my ministerial colleague, my right hon. Friend the Member for North Norfolk, who takes it extremely seriously and is committed to raising the matter with NHS England before it makes a decision at its board meeting on 17 December.

Like my hon. Friend the Member for Cambridge, I recognise the commitment and dedication of the staff who provide mental health service, including those who work in specialist trusts and settings, and those who work in primary care and provide services daily. I was pleased that my hon. Friend spoke about the large army of people who are absolutely critical in mental health. They are often not formally part of the NHS composition of services, but their support is invaluable to it. They are the carers and volunteers, who sometimes work in charities or voluntary organisations—my hon. Friend referred to Centre 33 and a number of other organisations in Cambridgeshire. Sometimes they are simply individuals who help or care for a parent, a friend or a neighbour because they think it is the right thing to do. Without those people, the job of the health services would be immeasurably more difficult. Like my hon. Friend, I pay tribute to them.

[Robert Halfon (Harlow) (Con)]

On that point, will my hon. Friend the Minister praise West Essex Mind, whose annual general meeting is this Friday? It does so much to help mental health services in Harlow and across Essex, and it is an example of a charity that is deeply rooted in our community.

[Jane Ellison]

Of course I join my hon. Friend in paying tribute to that organisation. It is obvious from the comments of many hon. Members in this House that local branches of Mind and other groups do terrific work. My hon. Friend clearly has a good relationship with his local branch, and I thank him for placing his regard for it on the record.

The Government have increased funding for mental health by £120 million in 2014-15. Total mental health spending in England will rise from £8.5 billion in 2013-14 to £8.62 billion in 2014-15. The Department of Health and NHS England continue to work together on that important issue. I recognise the challenge faced by the Cambridgeshire and Peterborough health economy. I agree with my hon. Friend the Member for Cambridge about the private finance initiative decisions that the previous Government made about Peterborough, and about the legacy of problems that they left.

As my hon. Friend knows, action is being taken. NHS England, the NHS Trust Development Authority and Monitor are working on a programme to support 11 of the most challenged health economies, of which my hon. Friend’s is one, and to address those with long-term integrated plans. In Cambridgeshire, a programme jointly funded by all local NHS partners and underpinned by a concordat on joint working has been put in place. Its purpose is to find a collectively agreed solution to closing the financial gap facing the economy as a whole, while improving quality of care for my hon. Friend’s constituents and everybody else who is served by the local health economy. That work is due to identify proposals by the end of June 2015.

Mental health is an important part of that work, and emerging ideas focus around closer integration of physical and mental health, and an expanded role for mental health input in a range of hospital settings and community pathways, such as those for long-term conditions. As the Minister with responsibility for public health, I know only too well that people often have extreme co-morbidities, so we must look at them in the round and at all the things that interact with and affect their personal health care.

I know that there are concerns that mental health services could be disproportionately affected, which would not be acceptable. Although payment for mental health services is agreed locally, we expect local commissioners and providers to have regard for the national tariff arrangements. However, they can be flexible when there is good reason to be so.

The tariff arrangements for 2015-16 give a clear signal to the mental health sector to move away from simple block contracts, which currently apply in Cambridgeshire and are not transparent, to local payment models that support recovery and outcomes, as my hon. Friend highlighted, and that reflect the needs of local communities.

My hon. Friend is right that Cambridgeshire and Peterborough CCG invested an additional £1.5 million to address capacity pressures. His CCG is clearly committed to that, and he will continue to champion it. It has also committed to investing a further £2.2 million from next April to deliver the Improving Access to Psychological Therapies programme.

My hon. Friend is right to pay tribute to my ministerial colleague, my right hon. Friend the Member for North Norfolk, who has championed mental health policy in this Parliament very effectively. My hon. Friend the Member for Cambridge drew attention to the Government’s commitment to parity of esteem, which has been made explicit in legislation. Some 2.4 million people have entered treatment under the IAPT programme, and more than 1.4 million have completed that treatment. We invested £54 million in the period from 2011 to 2015-16 in the children and young people’s IAPT programme. My hon. Friend is right that child and adolescent mental health services are a critical part of our local care pathways.

For the first time ever, we have a mental health crisis care concordat to improve the system, signed by more than 20 national organisations. As my hon. Friend said, Cambridgeshire has already put it in place. We invested £25 million to ensure that vulnerable offenders are identified when they first enter the criminal justice system. The aim is to achieve 100% coverage by 2017.

There is a lot going on. We all acknowledge that there is a long way to go on mental health, but we have passed several important milestones on the journey. The NHS—both nationally and in Cambridgeshire—is working hard on the wider funding issues, and I hope I have assured my hon. Friend that progress is being made. He has already had a commitment from my right hon. Friend the Member for North Norfolk, but when I return to the Department I will reiterate that we want to make representations about the points he made to NHS England ahead of the critical funding meeting. I encourage my hon. Friend to keep closely in touch with his local NHS, although I can see that he does that. I thank him for securing this debate. I hope I have given him a measure of comfort and reassured him that considerable progress is under way on this important agenda.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 25th November 2014 Commons Chamber

[Dr Poulter]

I am very confident that the measures already in place to drive efficiencies in the NHS are on course to save £20 billion during this Parliament. Many of those efficiencies are being delivered by improved procurement practice at a trust level. The Government have also invested £15 billion during this Parliament, which is a real-terms increase of £5 billion in NHS funding to support trusts.

[Robert Halfon (Harlow) (Con)]

The Government have invested hugely in the NHS in Harlow, including millions of pounds to our accident and emergency unit. However, for historical reasons the Princess Alexandra hospital has financial difficulties. Will my hon. Friend look at this and see what the Government can do to help?

[Dr Poulter]

Of course. As my hon. Friend is aware, every local health area—every clinical commissioning group—is receiving an increase in the funding available to it year on year. I would be happy to meet him to discuss the matter further, if that would be helpful.

Public Health England Hub Programme and Porton Down

Robert Halfon Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Robert Halfon (Harlow) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate my hon. Friend the Member for Salisbury (John Glen) on securing this important debate. We are in the strange position of being good friends in the House but having completely different perspectives on this issue. I am grateful to him for giving me a couple of minutes to speak. Like him, I have been campaigning on this for the past four years in meetings with Ministers, by speaking in the House and by tabling Commons motions.

The proposed move of Public Health England to Harlow is right for four simple reasons. First, it is right for the organisation itself. The proposed site in Harlow is ideally located on the London to Cambridge science corridor, so Public Health England will be able to benefit from the life sciences and science-based enterprises based around Harlow. The town also has an enterprise zone that specialises in medtech and IT, which will help Public Health England in its vital role of protecting the nation’s security and well-being.

According to the Chrysalis review, the Harlow site

“provides excellent existing buildings as the framework for laboratory, bioinformatics, epidemiology, national microbial culture storage, and office facilities”.

That is because of the closure of the GlaxoSmithKline laboratories and plant.

My hon. Friend talked about transport links, but I stress that we do have good links: we are close to Stansted airport, the M11 and M25 and also have good train links. Transport is not an end in itself, as expertise is needed, but the opportunity to create a scientific corridor with expertise and those transport links in this part of the east of England will provide huge benefits indeed. The board of Public Health England has now formally recommended the relocation of services at Porton Down, Whitechapel and Colindale to Harlow, saying that it would be able to bring together a range of its national functions and improve its efficiency and effectiveness.

Relocation to Harlow would be a great opportunity for Public Health England’s staff. Of course, I empathise with those who do not want to be uprooted, but there are great opportunities in Harlow. We are a sculpture town, with fantastic facilities. We have good quality housing and beautiful countryside. We also have outstanding local schools, such as: Burnt Mill which achieved an 86% GCSE A* to C rate; Harlow college, which according to the Department for Education has for three years in a row been a No. 1 college in England on all statistics; and a brand new Sir Charles Cao university technical college, which has just officially opened—the Prime Minister visited it just before the summer.

The move is right not just for the employees and for Porton Down, but for the taxpayer. We know that Porton Down is coming to the end of its life and something must be done to stop it becoming a health risk. The option of refurbishment was rejected in the business case as representing poor value for money. In fact, Public Health England’s own analysis shows that moving to Harlow would deliver the lowest cost over the 60-year life of the programme. The initial outline business case said that these savings would be in excess of £100 billion.

Finally, yes, as the Harlow MP I argue that the move is right for Harlow as well. Thanks to the enterprise zone and the UTC, the relocation would be a good strategic fit and Harlow council is very supportive of the move. It would also be consistent with the increasingly renowned pathology specialism of the Princess Alexandra hospital. When GSK unfortunately left the town, Harlow lost a lot of jobs. Public Health England’s moving to Harlow would give the town a much needed boost, with an estimated 700 jobs created initially, which would offset the job losses over time.

As I said, the decision is right for Public Health England, for British taxpayers and for Harlow. We have the skills, infrastructure and expertise to make it possible. In essence, it is a no-brainer, which is why, time after time, Public Health England itself has recommended that the move should take place.

Hospital Car Parking Charges

Robert Halfon Excerpts

Monday 1st September 2014 Commons Chamber

[Robert Halfon (Harlow) (Con)]

I congratulate my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has worked with me from the beginning on this debate on hospital car parking, and the many other Members who have been involved, including Opposition Members.

We face three problems on hospital car parking. First, it has become a stealth tax on the most vulnerable. It has hit parents who cannot afford to visit their premature baby in hospital. The charity Bliss states that about 30% of parents of premature babies are unable to visit their baby because they cannot afford the hospital car parking charges. Those who can afford it pay an average of £32 a week to visit their sick child. I do not want to live in a country where parents cannot afford to visit their sick children. It was never envisaged that people with cars would subsidise the national health service.

My hon. Friend the Member for Thurrock set out some hospital car parking charges. The most shocking are those at the Royal Free hospital in London, which I know because, sadly, both my grandparents passed away in that hospital. It costs £500 a week to park a car at that hospital. If there was ever an example of how hospital bosses have used car parking charges as a stealth tax, the Royal Free hospital provides it.

People say that we have to have these charges, but why is there such a wide range of charges across the country? Why do 25% of hospitals not charge at all? I am ashamed to say that my own county of Essex is one of the most expensive areas outside London for hospital parking charges. Why do so many hospitals in the north of England not charge at all?

[Tim Loughton (East Worthing and Shoreham) (Con)]

My hon. Friend has done a fantastic job of leading this campaign. On the subject of neonatal intensive care, there is an added problem. Because of the shortage of facilities, parents often have to travel long distances and pay for accommodation in order to stay near their children overnight. It adds insult to injury that they have to pay hospital parking charges as well. This is a treble whammy, and the charges are particularly unjustified in such cases.

--- Later in debate ---

[Robert Halfon]

My hon. Friend highlights the problem exactly. It applies not only to the parents of premature babies but to people with cancer. Indeed, 10% of hospitals do not give people with cancer any kind of concession at all.

There is also a problem of transparency. No one knows why such huge increases in charges are taking place, and no one knows exactly what the money is being spent on. Southend hospital, in Essex, charges £2.50 for the first hour’s parking. It was highlighted on BBC Essex recently that the hospital had spent more than £7 million on a new multi-storey car park. Even Harrods and Selfridges would not spend £7 million on a car park. The hospital increased its charges in 2011 and raked in nearly £1.4 million in parking fees alone. It was never envisaged that hospital parking should become a cash cow or a tax on the vulnerable and the sick.

We should also remember that it is not only the patients, the vulnerable and those who are visiting them in hospital who face this stealth tax. It is also a tax on nurses, who are paying an average of £200 a month just to park their cars so that they can do their job. If we had to pay that amount to park our cars here at the House of Commons, I am sure that the practice would be stopped immediately. I also want to mention the concessions for people with disabilities. We often need a PhD to understand all the different rules and regulations involved. We need clear guidelines, and I welcome what the Government have said about this over the past week.

[Steve Baker (Wycombe) (Con)]

I want to set in context what my hon. Friend has just said about the scale of these charges. I have just checked the cost of parking at Chiltern Railways’ new multi-storey car park in Wycombe, and it is only £7.50 a day. I say “only” because that seems quite good value given that some people are paying £500 a week for hospital parking. Does he share my amazement that hospitals manage to provide so little parking for so much expense?

[Robert Halfon]

My hon. Friend hits the nail on the head. As I have said, this has become an easy way for hospital bosses to raise money, and there has been no dialogue with the public about it.

People say that the money could be spent elsewhere, but I believe that hospital parking is as much a front-line service as anything else. It is as important as how many nurses and doctors there are. I am glad that the Government have spent an extra £12.5 billion and that there are 3,000 extra nurses since the coalition came to power, but hospital parking is as much a front-line issue as those things and it should be put into the general pot of NHS spending. It should be taken into account in the same way as spending on nurses and doctors and on machinery. That is often forgotten.

The hon. Member for Bolton South East (Yasmin Qureshi) said that no one goes to hospital out of choice; people go because they have to, or because they have to visit relatives or friends. They should not suffer in the way that they do. They should not have to face the stress involved. Many of my constituents have contacted me to tell me of the stress they face when, having paid at the car park machine, they have to wait for a doctor’s appointment that should have been at, say, 11 but does not take place until 1 o’clock. Through no fault of their own, they have to pay extra car parking charges as a result. How can that be right? Again, I welcome what the Government have said about that.

We need to look at this as part of the front-line spending on the NHS. Estimates suggest that it would cost between £200 million and £250 million to scrap hospital parking charges. I believe that the Government should set up a special fund, possibly paid for by using more generic drugs, and I urge the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) to look at that proposal. I welcome the fact that he has listened, and that the Government have published some really tough guidelines for hospitals. I recognise that they are not the ten commandments; they are not written down on tablets of stone, and we cannot force hospitals to comply with them. They are the next best thing, however.

I put it to my hon. Friend the Minister that if hospitals do not comply with the guidelines, and that if they continue to fail to offer proper concessions to people with disabilities, to use hospital parking as a stealth tax on the vulnerable, to charge their staff for parking and to perpetuate the lack of transparency which means that no one can understand what the revenue is being spent on, we should scrap hospital parking charges completely, as Opposition Members have suggested. I hope that we are already moving in that direction.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 15th July 2014 Commons Chamber

[Mr Jeremy Hunt]

I am happy to look into the details of that case and be as much of a bureaucracy buster as I can.

[Robert Halfon (Harlow) (Con)]

T10. Is my hon. Friend aware that nurses are paying an extra £200 a month and patients an extra £40 a week for ever-increasing hospital car parking charges? Will he look into the problem, meet me and do everything he can to end the great hospital car parking rip-off?

[Mr Hunt]

I share my hon. Friend’s concerns that the car park charges in some hospitals are just too high. I understand that hospitals have financial pressures, as do many parts of the system, but I am happy to talk to him on another occasion about what specifically can be done on this issue.

Care Homes

Robert Halfon Excerpts

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

The hon. Lady is absolutely right to recognise that there is great care out there, and we should applaud care workers who deliver fantastic care. I was at an awards dinner recently at which individual care workers were given awards for providing great care. Celebrating great care is incredibly important in changing the culture of the sector.

The Government took steps to fund a helpline that had previously been only for health workers and extended it to social care, so that anyone can seek advice about what to do if they want to whistleblow. The culture must be that anyone feels able to blow the whistle and get things done, and the CQC must respond effectively when that happens.

[Robert Halfon (Harlow) (Con)]

The Minister will be aware that we have previously had problems with a care home in Harlow, but we also have some excellent ones, particularly Tye Green Lodge, Alexandra House and a number of others. Does my hon. Friend agree that we should boost the confidential hotline and set it up as a proper hotline like Crimestoppers, to allow people to feel that they can call? Does he also agree that we should ensure that it is advertised properly to everyone who uses care homes and their relatives?

[Norman Lamb]

My hon. Friend makes an important point and it is right to highlight the great places that are providing excellent care. The Care Quality Commission makes it clear that it encourages members of the public to come forward and alert it to concerns, but we must do much more to make it easy for members of the public, so that they understand exactly what they need to do if they have concerns.

Tobacco Products (Standardised Packaging)

Robert Halfon Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

When my hon. Friend has a chance to look at the report, she will see that there have been a number of new reports in recent years. Sir Cyril commissioned an independent academic review that considered not just the Stirling review, which looked at more than 37 academic reviews on the subject, but the supplement to that, which was published in 2013. He concluded that the reviews were very robust. Much of his report is devoted to a scientific and forensic examination of the methodology used in those reviews. I commend it to her.

[Robert Halfon (Harlow) (Con)]

Is my hon. Friend aware that 15,000 people die from alcohol-related diseases every year in Britain? The logical extension of what she is proposing is that we put brown paper bags over all alcohol. Does she not agree that Conservatives believe in freedom and that the best way to stop smoking is through education, not by banning things? This measure will have a significant impact not just on smuggling, as my hon. Friend the Member for Thurrock (Jackie Doyle-Price) said, but on small shops and small businesses.

[Jane Ellison]

First, I must correct my hon. Friend on one thing. The Government are not proposing to ban anything. I made that quite clear. Secondly, alcohol that is enjoyed in moderation does not do people great harm, but there is no way of enjoying tobacco in moderation that does not harm people’s health. Smoking is a completely different subject from all the others that Members seek to link it to. My hon. Friend wrote to me recently to ask what Health Ministers were doing about cancer in Essex. The more we do to bear down on tobacco use among children, the greater our chances of tackling cancer in Essex and elsewhere.

Adult Autism Strategy

Robert Halfon Excerpts

Wednesday 5th March 2014 Westminster Hall

[Mrs Cheryl Gillan (Chesham and Amersham) (Con)]

It is a pleasure to serve under your chairmanship, Ms Clark. As you know, I always approve of a woman being in the Chair. It is a great privilege to open this debate today. I am pleased to see so many colleagues from both sides of the House joining the debate, which reflects the importance of the subject.

I understand that the Department of Health plans to publish its revised version of the adult autism strategy for England on 2 April, coinciding with world autism awareness day. Today’s debate is therefore timely for us to identify for the Minister what we think and what our constituents have told us are the key priorities for the revision of the strategy. I look forward to hearing from the Minister about the Government’s plans, particularly those to take forward the actions that people require, because we need support for the estimated 460,000 adults with autism in this country.

It is just over four years since my private Member’s Bill on autism became the Autism Act 2009. I still thank colleagues on both sides of the House for making that possible. The passing of the Act was an important landmark in the battle to improve the lives of adults with autism in England. I want to thank everyone, including the people who at first opposed the Bill but who came round to my way of thinking, because they made the Act the first disability-specific legislation ever to be passed in this House.

As we all know, autism is a lifelong developmental disability that affects how a person communicates and makes sense of the world around them. It is a spectrum condition, meaning that it affects people in different ways, making awareness of the diagnosis even more important.

Back in the ’90s, my colleague, Angela Browning, now Baroness Browning—some hon. Members will remember her—made me only too well aware of what happens to adults with autism, particularly if they are being isolated or ignored. Over the years, awareness grew of the needs of adults and children with autism, but even by 2009, there was still no meaningful recognition at Government level of the challenges faced by adults.

[Robert Halfon (Harlow) (Con)]

I congratulate my right hon. Friend on securing this debate on a subject that is incredibly important. Is she aware that 85% of adults with autism in the UK are not in full-time employment? Translating that to my own area, Essex, that is around 7,000 people. The Government have set up Disability Confident, which helps people with disabilities to get into work, but it does not focus on people with autism. My local autism charity—

[Katy Clark (in the Chair)]

Order. Interventions must be brief.

[Robert Halfon]

My local autism charity, Parents and Children Together for Autism, has set up a pilot apprenticeship scheme focusing on people with autism. Does my right hon. Friend agree that that should be rolled out across the country?

[Mrs Gillan]

I congratulate my hon. Friend’s local charity on setting up that apprenticeship scheme. That is important. When I started looking at autism all those years ago, one of the interesting things I realised was how valuable people on the spectrum can be. They can make a fantastic contribution to businesses right across the board. Apprenticeship schemes should be looked at quite carefully by the Government. If there is an example in my hon. Friend’s constituency, I am sure that the Minister will take it on board and perhaps even arrange a visit to see how it operates.

Adults with autism were still being overlooked by local services back in 2009. They were falling through the gap between learning disability and mental health services, because no one had responsibility for taking a lead locally to ensure that appropriate services and support were being developed for adults with autism.

The diagnosis can become more complex as a person gets older and often needs a referral to a specialist centre, for which out-of-area contracts are often needed. Some local authorities are doing that, but some, I am afraid, are not. That is why the Autism Act was so important. As a piece of disability-specific legislation, it set a legislative framework for that gap to be closed and for the responsibility to improve support for adults with autism to cover every local area.

--- Later in debate ---

[Mrs Gillan]

I am grateful for that intervention. This place is about making legislation, both primary and secondary, but for each and every one of us as MPs, it is those individual cases that strike home to our hearts. It is a valuable role for an MP to bring individual cases to the attention of the House, as the hon. Lady has done, because it makes both our laws and their implementation better. I think that we will all have stories of families and individuals in our constituencies who need more help, and there is nothing more moving than a parent coming to plead for help for their child.

[Robert Halfon]

The NAS has highlighted that only 10% of adults with autism receive employment support but 53% would like to receive it. Does my right hon. Friend agree that we need to focus on that issue?

[Mrs Gillan]

Yes. I rely a great deal on statistics from the NAS, which does detailed work in this area. It is still a crying shame that we have wasted capacity and wasted lives in this area, and we should not stand idly by and let that happen.

Having said that, I am gratified by what has been achieved so far in improving the support at the front line. Just for starters, almost all areas now have someone who is responsible for improving services for adults with autism. It might not seem much, but that development alone has been a mighty step forward. I will also highlight some progress in my own constituency of Chesham and Amersham where there are two clinical commissioning groups and they have agreed that one of them will take the lead on autism issues for the whole county, identifying within the two CCGs a GP who will take work on autism forward. That is the sort of activity that I want to see being replicated across the country.

Elsewhere, I know that some excellent and innovative practice has emerged on issues such as training and diagnosis. Sadly, however, as I am sure other colleagues will testify, progress is still patchy and many areas have not made progress as rapidly as we had all hoped for when the Act was passed.

Research by the NAS shows that, four years on from the passage of the Act, many adults with autism are still waiting—unjustly, in my view—for the support they need. Seventy per cent of adults with autism who responded to the recent NAS survey said they are not receiving the help they need from social services, and more than a third of respondents said that they needed help with simply washing and dressing. In addition, two thirds of respondents said they needed help to prepare a meal and 83% said that they needed support to pay a bill or to deal with letters. Those are things that we all do every day of the week, but in the majority of cases adults with autism are unable to get help from their local council to deal with them.

There is also a lack of clarification between low-level and high-level support. Low-level support services are often right for individuals, as they can prevent them from developing more complex problems and therefore can be almost disproportionately cost-effective. My grandmother used to have a saying about such situations: “A stitch in time saves nine.” That is exactly the principle that we should apply in this area.

The impact of such a lack of support is quite clear. The NAS research indicates that a third of adults with autism have developed a severe mental health problem because they lack support. Of course, the statistics vary slightly, but one statistic I will cite is that just 15% of adults with autism are currently in full-time work. We must urge our local authorities to press on, and the necessary support and impetus must come from Government.

The good news is that we are to have a refreshed strategy—it is the Heineken moment for the Minister. I will turn now to the priorities for that refreshed strategy.

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[Mr Buckland]

That is a powerful point. Employing older people and disabled people is good not only for business but for employment. Doing so is not simply about being a kind employer; it is about being savvy. We have already heard about the huge potential that those with autism, Asperger’s and related conditions offer. They have qualities and gifts that we do not have, and they have incredible resources. If we only empower them, they can show us what they are capable of.

[Robert Halfon]

My hon. Friend is making an incredible speech. I have mentioned PACT for Autism, and the pilot apprenticeship schemes for people with autism. Given that the Government are investing so much in apprenticeships, does he agree that they should incentivise companies to hire apprentices with autism?

[Mr Buckland]

That is an excellent idea. As my hon. Friend knows, our hon. Friend the Member for Ilford North (Mr Scott) has pioneered a wonderful scheme in his area whereby employers are matched up to young people with autism in order to offer them apprenticeships and job opportunities. I commend that local initiative to my hon. Friend the Minister as a great example of what can be done to empower young people and adults with autism.

I have talked about local cinemas and hairdressers, but what about training bus drivers to be aware of the needs of passengers with autism? I am sure that bus drivers would be receptive, because such training would make their life much easier. A lot of useful measures, such as the provision of quiet spaces in shops, can be done very easily. As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) said, they will open up business to new opportunities.

I draw a parallel with some of the excellent work that has been done on dementia awareness. The co-ordinated dementia-friendly communities programme has been supported by the Government since 2012, and the Prime Minister has commended it. In dementia-friendly communities, local people come together to decide how to include people with dementia. Transport providers, charities, schools and local authorities all open up their facilities to ensure that people with dementia and their carers—let us not forget them—are not discriminated against. Only two weeks ago, I opened a memory café in the Wyvern theatre in Swindon, where people with dementia and their carers can come on Thursdays to have some space, enjoy mainstream activities and feel part of life.

There is an important parallel to be drawn with autism. How are we going to achieve similar improvements for those with autism? Not only must environments be made easy to navigate, but businesses and services must be respectful and responsible; public and private service providers must receive better training; there should be volunteer-led public education in workplaces and schools; and we must work with venues to help them adapt their buildings. Things such as better signage, more information and befriending schemes are also important. All that has been done with dementia, and we must do the same with autism.

The National Autistic Society gave me an example from a blog of a mother who loves musicals but has not been able to go to see a show for some years because her four-year-old son has autism with hypersensitive hearing. Believe me, I know what that is all about. Last year, she bought tickets for an autism-friendly performance of “The Lion King” in London’s west end. The organisers provided accessible information about the venue to ensure that children with autism would not be overwhelmed on the day. When mother and son went to the theatre, they found that there was a relaxation area where parents could go. At the beginning of the performance, one of the actors came on stage to help children understand the difference between actors and characters in the play. That performance brought families together and beat isolation.

That example relates to children, but there is no reason on earth why we cannot do the same for adults. For a few hours, children and family members were able simply to be themselves. That is the point I made about the Greenbridge cinema experience, which has been invaluable for so many families. Parents are not judged and they do not need to have eyes in the back of their heads. They are accepted and they do not need to apologise for their children or the person for whom they are caring. That is priceless, and I cannot describe how important it is for families of people with autism.

I have to contrast that with my experience some years ago at the Riverside theatre, where we went to see the musical “Salad Days”. As those of us who know and love it will be aware, it is all about a piano that makes people dance. Well, my daughter decided to dance. I thought that that was wonderful, but some in the audience, who did not really understand, did not, so that was the end of that. We really need to move away from such experiences. That has lived with me as a very bad experience for the family, and I hope that I never have to go through that again. I hope that one day we will no longer have to put up with the sort of phrases that I have encountered, or the lack of thought that people often show for those for whom we care.

I hope that the revised and re-published autism strategy will acknowledge what ordinary people and ordinary businesses can do better to make our communities autism friendly. My experience of talking to and e-mailing with many families across the country who are affected by autism indicates that there is a will for change. The right framework and the right resources from central Government could help us make the step change in society’s attitudes towards autism that we have championed, and on which we want to see real action.

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[Norman Lamb]

I absolutely agree with my hon. Friend. I wanted also to touch on the point made by my hon. Friend the Member for South West Bedfordshire (Andrew Selous) about the parents of adults with autism who, far too often, are told by clinicians that they cannot talk to them about their adult child’s circumstances. Clinicians often hide behind the absolute importance of confidentiality about a condition in order to refuse to talk at all to the parents—the people who know the individual better than anyone. That is an attitude of mind among too many clinicians. It has to change.

I also wanted to refer to the points made by my hon. Friend the Member for Strangford (Jim Shannon). I think I can call him my hon. Friend. [Hon. Members: “Hear, hear!”] Thank you for that. He talked about the pressure on families, and he is absolutely right. Whether one is talking about learning disability, autism or dementia—there are parallels with dementia—the need to raise awareness in society is real. I am also happy to look at the Northern Ireland legislation and at what lessons can be learned throughout the jurisdictions.

Another point in response to the debate was to do with transition. Whether with mental health, learning disability or autism, we so often find that disasters happen at the age of 18. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) alluded to that important point. Too often, people are lost to the system. The age of 18 is the worst possible age to withdraw support, whether we are talking about mental health in general or autism in particular.

[Robert Halfon]

I thank my hon. Friend the Minister for giving way. I gave the figure of 85% of people with autism not having full-time employment, and I mentioned the apprenticeship for autism started by my charity, PACT for Autism. Will the Government’s apprenticeship ambassador, my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), who is present, work with the Minister with responsibility for apprenticeships to look at introducing such a scheme and rolling it out across the country?

[Norman Lamb]

My hon. Friend beat me to it, because I was about to refer to his comments on apprenticeships. I am interested in that. I am proud of what the Government have done on apprenticeships in general, but their use for people with autism is an interesting area. I noted the points he made about the scheme in his local area, and I am happy to consider it further.

Tobacco Packaging

Robert Halfon Excerpts

Thursday 28th November 2013 Commons Chamber

[Jane Ellison]

As I have said, I am not going to pre-empt the findings of the independent review, and I am sure that Members understand why it is important not to do so. It will be good to have a review of the evidence, and I am sure that the hon. Gentleman will share my confidence that the review will be extremely worth while and useful.

[Robert Halfon (Harlow) (Con)]

I confess that I enjoyed a Henri Wintermans Café Crème after breakfast this morning on the way to work. Does my hon. Friend agree that there are many lawful smokers who want to be sure what they are buying? Has she made any assessment of the effect that plain packaging could have on the black market by making it easier to smuggle counterfeit cigarettes?