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House of Commons

Tuesday 26 June 2007

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]


Whitehaven Harbour Bill [Lords]

Considered; to be read the Third time.

Oral Answers to Questions


The Secretary of State was asked—

Smoking Ban

1. Mr. Jim Devine (Livingston) (Lab): What progress has been made on preparations for the implementation of the ban on smoking in enclosed public places. [145310]

13. Lyn Brown (West Ham) (Lab): What preparations her Department is making for the implementation of the ban on smoking in enclosed public places in England. [145322]

The Secretary of State for Health (Ms Patricia Hewitt): Since the Health Act received Royal Assent last year, my hon. Friend the Minister with responsibility for public health and officials have worked tirelessly, with local authorities, businesses and others, to prepare for implementation. As a result, I believe that going smoke-free in England next Sunday will be just as successful as it has already been in the rest of the United Kingdom.

Mr. Devine: I thank my right hon. Friend for that answer. I am sure that history will be kind not only to her but to her Front-Bench colleagues, and, dare I say it, to her Parliamentary Private Secretaries and formers PPSs, for this bold and imaginative move. Lives will be saved, lung function among staff will be improved, and it will be possible to enjoy lovely meals in a restaurant or pub. Does she agree that the initiative will be as successful in England as it has been in Scotland, Ireland and Wales?

Ms Hewitt: I strongly agree with my hon. Friend. I pay particular tribute to my hon. Friend the Minister with responsibility for public health and to my hon. Friend for their contribution. Researchers in Scotland have already found that going smoke-free has had an immediate and positive impact on the health of bar
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workers. We will see similar effects in England, and over time thousands of people’s lives will be saved, reinforcing the fact that smoke-free legislation will be the biggest step forward for public health in our generation.

Lyn Brown: Does the Secretary of State agree that Newham council and primary care trust should be congratulated on their work in preparation for this legislation? They have engaged with over 250 businesses and have so far encouraged 2,000 people to quit, in the “Big Quit” campaign.

Ms Hewitt: I readily congratulate Newham borough council on the excellent work that it and local authorities up and down the country have done to prepare for the smoking ban. As a result, not only does almost every business know that it needs to make preparations for going smoke-free on Sunday, but almost every member of the public is aware of the change to come. I am delighted that thousands of people have already taken advantage of the excellent stop smoking services provided by the NHS. Thanks to the efforts of the NHS, local councils and many others, we will go on reducing the single biggest cause of illness and premature death in our country.

Dr. Richard Taylor (Wyre Forest) (Ind): I am sure that the Secretary of State is aware of recent reports from Italy that the occurrence of heart attacks has dropped significantly since its ban on smoking in public places. Does she agree that that would be an excellent way of publicising the benefits of the ban in this country?

Ms Hewitt: The hon. Gentleman makes an extremely important point. One of the compelling pieces of evidence from the chief medical officer was that even second-hand smoke, over quite a short space of time, can have a disastrous effect on people’s heart health. Conversely, going smoke-free will save thousands of people’s lives and save thousands of families from the grief of the premature death of a beloved family member.

Sir Patrick Cormack (South Staffordshire) (Con): Has the absurd and misguided proposition that no smoking signs be erected outside churches and cathedrals been withdrawn?

Ms Hewitt: I have to say that the whole issue of signage was fully debated in Committee, both in the House and another place, before the Health Bill received Royal Assent last year. None of the hon. Gentleman’s Conservative party colleagues raised any complaint or proposed any amendment at the time. The signage regulations introduced in England are less onerous than those in Scotland, which have not given rise to any problems. In Southwark cathedral, for instance, there are already public signs saying, “No mobile phones”, “No drinking”, and even, I am told, “We accept Visa”.

Mr. Kevin Barron (Rother Valley) (Lab): The World Health Organisation framework convention on tobacco control meets in Bangkok next week to agree best practice guidelines for protection from second-hand
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smoke. Given that all parts of the UK will have legal protection from second-hand smoke from Sunday, will the Government be supporting the guidelines next week?

Ms Hewitt: I thank my right hon. Friend for that question. I also thank him for, and congratulate him on, the superb work that he and his Select Committee did in securing such a large cross-party majority for going smoke-free. I am happy to assure him that we not only endorse the draft guidelines for the WHO framework convention, but have played an active role in developing them. We will support the adoption of the guidelines as they stand at the conference of the convention parties which is being held next month.

Dr. Andrew Murrison (Westbury) (Con): On 1 July, prison cells will be one of the very few enclosed public places where people can smoke, yet the health of the prison population is appalling and half of those who enter prison as non-smokers leave as smokers. When the Secretary of State has gone, she will best be remembered for her spectacular U-turn on smoke-free pubs. In the very short time remaining to her, will she assess the health consequences for convicts and prison officers of the exceptional smoking rights that she has granted to prisoners?

Ms Hewitt: I am sorry that at a time when, thanks to a stunningly large majority in the House, to which the hon. Gentleman contributed, England is about to go smoke-free, he takes the tone that he does. We have taken the view, and Parliament took the view, that given that prison is akin to an individual’s own home, it was right to take the approach that we did, but it is also right, and absolutely essential, that we go on working with the prison authorities to reduce smoking in prison and to help more prisoners to give up smoking. I very much hope that the hon. Gentleman and his colleagues in the Conservative party will take the view, which I am sure all my hon. Friends do, that those who are Members of this House or who seek to be Members of this House should support and respect the laws that are made in this place. Otherwise, they might find themselves in prison.

Julie Morgan (Cardiff, North) (Lab): Is my right hon. Friend aware that since the introduction of the smoking ban in Wales on 2 April, there has been a huge increase in the number of smokers who want to give up and, I think, a 30 per cent. rise in the number of calls to the helpline? Does she agree that it is very important that extra resources are made available to respond to the needs of people who want to give up smoking?

Ms Hewitt: My hon. Friend is absolutely right. I am glad to say that the NHS in England is already seeing an increase in the number of people who are coming forward and asking for support from stop smoking services. With more than £8 billion of additional funding going into the NHS this year, I have no doubt at all that primary care trusts all over the country will be ensuring that stop smoking services, nicotine replacement therapy on prescription and so on will all be available to support the growing number of people who want to give up smoking.

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Respite Care

2. Kitty Ussher (Burnley) (Lab): What guidance her Department has issued on the introduction of emergency respite care for carers. [145311]

3. Martin Salter (Reading, West) (Lab): What guidance her Department has issued on the introduction of emergency respite care for carers. [145312]

The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): Next month we plan to issue guidance on the introduction of emergency short breaks to councils, and £25 million will be made available to support implementation of the guidance from October of this year.

Kitty Ussher: I am grateful to the Minister for that response. Some of the most impressive people that I have met in my constituency are the young people, sometimes still at school or in other full-time education, who for whatever reason are also the sole carers for parents, grandparents or other family members. Obviously, times are tough for them on a number of occasions, particularly when they try to balance their aspirations with their caring responsibilities. What are the Government doing to ensure that, when times are tough, emergency respite care is available for those young carers?

Mr. Lewis: I entirely agree with my hon. Friend. There is no doubt that young carers do a tremendous job and in many ways are the hidden heroes. On the other hand, their caring responsibilities often undermine their education and have a negative impact on their life chances. Therefore, we have a duty—a responsibility—to give the needs of young carers a much greater priority than we have in the past. They will be able to access the new emergency respite care funding that we are announcing, which will be available from October. They will be central to the consultation that we are undertaking on a new national strategy for carers. We want to hear the voice and the real-life experiences of young carers as we develop a new deal for carers in every part of this country.

Martin Salter: The Minister will be aware that the recent national carers week had as its objective widening access to support services for carers. Will the recently announced review of the national carers strategy include an expansion of emergency respite care for carers who need it, and if not, why not?

Mr. Lewis: My hon. Friend raises an important point. It is essential that the review of the future new deal for carers takes account of every element that affects carers’ responsibilities and life. Carers want a system that is on their side, in terms of the NHS and social care, but they also want a life of their own and access to employment, lifelong learning and leisure opportunities. Therefore it is essential that our new deal for carers expands emergency respite care, but also touches on every single aspect that affects a carer’s caring responsibilities and their right to a life of their own.

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Tim Farron (Westmorland and Lonsdale) (LD): Help the Aged estimates that 500,000 people in this country are victims of elder abuse, many of whom live in care homes. Given that, does the Minister feel that the current inspection and regulation arrangements are adequate to ensure that we identify and eradicate elder abuse in our care homes?

Mr. Lewis: The hon. Gentleman raises an important issue. The demographics of our society are changing. People are living longer and longer, but in doing so they have more and more challenging conditions, such as Alzheimer’s and dementia. As a consequence, we face new questions as a Government, as politicians and as a society. One of those questions is the abuse of older people. A shocking report last week talked of the abuse that takes place in people’s homes, mainly—it has to be said—by relatives. However, there is also the issue of the abuse of older people in care establishments of one kind or another. Of course the existing regulatory system for the protection of vulnerable adults seeks to address that, but as people live longer we need new solutions to tackle one of the great challenges that our society now faces.

Mark Pritchard (The Wrekin) (Con): Would the Minister like to join me in paying tribute to Leonard Cheshire, which provides excellent respite care facilities in Wellington in my constituency? Does he agree that that charity does an excellent job across the country?

Mr. Lewis: I thank the hon. Gentleman for a simple question. Leonard Cheshire does an entirely appropriate job. The bigger point is the relationship between statutory organisations and the voluntary sector, and their capacity to work together to improve dignity, respect and support for older people and their families. We need a new understanding that those responsibilities are shared, that some are the responsibility properly of Government and the state, and others of families and carers, but that the voluntary sector has a unique and important role to play in offering people innovative and responsive services.

Charlotte Atkins (Staffordshire, Moorlands) (Lab): Does my hon. Friend recognise the vital role of day care for the elderly in providing respite for carers? If so, will he ask Staffordshire county council to reconsider its over-hasty plans to close day care facilities for elderly people, because that would put an impossible burden on their carers?

Mr. Lewis: I am sure that my hon. Friend will accept that it is not for me to intervene directly in the decisions that are taken by local authorities where people are democratically elected to serve their local community —[ Interruption. ] I thought that the Conservatives believed in localism and local decision making. Let us be consistent about that position. Having said that, in a society in which the demographics are changing and people are living longer, we need the full range of provision—domiciliary care, respite care, day care and support for carers—to be available so that older people who, rightly, want to remain in their own homes with maximum dignity, respect and quality of life, can do so.
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Therefore, in every locality, that full range of services must be provided by the NHS, local government and the voluntary sector, working in a far more integrated way than they have done historically.

Mr. Stephen O'Brien (Eddisbury) (Con): In response to our call, the £25 million for emergency respite care may go some way to mitigate the cuts in planned respite care. Given the enormous disparity in care provision across the country, how many people stand to lose £38 a week towards their long-term care by next year from the reductions, which have just been announced in today’s national framework for continuing care, in the high-band registered nursing care contribution? How will the Minister justify that to the new Secretary of State?

Mr. Lewis: I have to say that that is complete nonsense. Today, we announced an ending of the postcode lottery for the funding of continuing care. That has been demanded by the Opposition, charities, relatives and residents’ groups through the years. As a result of decisions by the ombudsman and rulings by the courts, we have today issued national guidance that will end the postcode lottery. That means that people in different parts of the country with the same needs will have access to the same level of NHS funding for their continuing care.

With respect to nursing care, the existing three bands have been swept into one. More than 80 per cent. of people who were on the lower or middle band will benefit significantly as a consequence of the £101 a week. A significant proportion of the remaining 20 per cent. will fall into the continuing care category and be entitled to full funding for that care. The burden will not fall on the remaining individuals in that 20 per cent, but will be borne by the care homes, 80 per cent. of whose residents overall will benefit.

Barbara Keeley (Worsley) (Lab): My hon. Friend the Member for Burnley (Kitty Ussher) mentioned young carers. As a group, they are very difficult to reach, but we know that thousands of them care for 50 hours a week, which puts a great strain on them. Will my hon. Friend the Minister talk to colleagues in the Department for Education and Skills to see whether we can get schools to do more to identify young carers, so that more of them can have access to the help that he has talked about?

Mr. Lewis: I agree entirely with my hon. Friend. Raising educational standards and performance is, of course, related to teaching and learning, but also to good leadership. The content of the curriculum is also relevant, but so are the factors that impact on the lives of children and young people before they arrive at the school door every morning. The fact that young people have to fulfil the responsibilities of the young carer, or suffer bullying or antisocial behaviour inside or outside school, has a direct impact on our ability to raise standards and ensure that every child fulfils their potential. A core part of a school’s responsibility should be to identify the problems of students and pupils. For me, young caring is a fundamental part of a school’s responsibility in the modern world.

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Mental Health

4. Mr. Graham Brady (Altrincham and Sale, West) (Con): What guidance she has issued on maximum waiting times for primary care psychological services. [145313]

The Secretary of State for Health (Ms Patricia Hewitt): Currently, there are no national waiting times targets for access to psychological therapies in primary care. Waiting times standards are being developed and will be tested in the 10 new pathfinder sites in 2007-08. They will include appropriate access times for the different stages of treatment set out in the National Institute for Health and Clinical Excellence guidelines.

Mr. Brady: When I tabled a question asking the Secretary of State how long my constituents had to wait for these services, she did not know. However, the Bolton, Salford and Trafford mental health trust tells me that, whereas patients in Salford have to wait only eight weeks for a first appointment, my constituents in Timperley have to wait a staggering 22 months. Does she agree that that is entirely unacceptable, and will she advise her successor to deal with the problem as a matter of urgency?

Ms Hewitt: The hon. Gentleman is quite right: waiting times for psychological therapies are too long in many places, including his constituency. However, I hope he welcomes the work being done by his local mental health trust to cut those waiting times, for example by reducing the levels of non-attendance. The trust is introducing new ways of working that are based on best practice elsewhere, and it expects to see improvements by September of this year. In addition, it would appear that the hon. Gentleman is asking for a new national target, even though the Opposition recently said that they intend to scrap all targets. I am grateful that he at least recognises—

Mr. Speaker: Order.

Lynne Jones (Birmingham, Selly Oak) (Lab): Does my right hon. Friend keep records of cases in which people are treated with medication compulsorily because access to psychological therapies is not available? Does she agree that, in the 21st century, such a practice is unacceptable?

Ms Hewitt: My hon. Friend raises an important point. The NHS keeps detailed records on every patient who is subjected to compulsory treatment of whatever kind, but she is absolutely right to say that, as we give patients access to psychological therapies often at a much earlier stage in the development of mental health problems, it is likely—this would be of great benefit to those patients and their families—that we can avoid the need for more acute treatment, and particularly compulsory treatment, further down the line.

John Bercow (Buckingham) (Con): What estimate has the right hon. Lady made of the level of the shortfall in the number of trained and qualified psychologists?

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