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The same is true of the proposals on educational guidance. Most further education colleges, the careers service and jobcentres already provide a full range of guidance to youngsters, yet there is still a hard core of people who are not attracted to education. The final building block are the new apprenticeships, but we already offer a range of opportunities, whether through involvement in community-based schemes, industry-based schemes or training, so young people are doing hard work. The Government have tried to play down the compulsory element, but I am not sure that the proposals will increase the attractiveness of training for that hard-to-reach group of young people, which is why I support the amendment. If we are to raise expectation, there is no point trying to do so once people are totally turned off education, because they do not even have the skills to read or write. They are turned off by the indiscipline in schools, so if resources are to be directed at them, that should be done before the lights are switched off, rather than trying to raise their expectations once they have left school without qualifications. That is the emphasis of the amendment—its sentiments were shared by a number of Government Members, who warned that we must reach those young
people at an early stage—and that is why I have taken part in the debate, and am happy to take part in the vote.
8.33 pm
Mrs. Sharon Hodgson (Gateshead, East and Washington, West) (Lab): I am pleased to talk about education and health in our debate on the Gracious Speech. It seems to me—and, I am sure, to many other hon. Members—that it is a major step forward to ensure that we do all that we can to educate children about health. The Government have responded well to the challenges that we face in those areas. At the brand new Cardinal Hume Catholic school in Gateshead in my constituency, it is a joy to see teachers and pupils excited about their new learning environment and the facilities that are on offer to them. Oxclose school in Washington has been fully refurbished using money made available through the building schools for the future programme, and it is a lesson to all of us that we do not always have to knock something down and start again to make it better.
I want to talk about two issues that can be clearly linked across health and education. The Government rightly note the need to tackle obesity, promote skills and change lifestyles. My constituency suffers from health inequalities, which must be reversed. Obesity rates, smoking rates, cancer rates and deaths from heart disease are all higher than average. Despite that, I remind hon. Members that it remains one of the most scenic and friendly places in which one could hope to live.
To help reverse these health inequalities, I know how important it is that we go further still in delivering good quality school food. We hear tales of mums passing pizzas through the school gates, chip shops making record lunchtime profits, and some children causing a mess and a nuisance out on the streets. The solution that I propose is straightforward and simple: free, universal, locally sourced, hot school lunches, given to all pupils under the age of 16, coupled with a policy whereby pupils are not allowed off the school site at lunchtime—a lunchtime lock-in, so to speak.
If the scheme is to work properly, packed lunches should be discouraged. A large number of parents send their children to school with a packed lunch, but unfortunately most lunch boxes are far from healthy. What parent would go to the hassle and cost of providing a packed lunch, healthy or otherwise, if they could have a free, healthy, hot school meal for their child? Sourcing food locally would not only cut food miles, but play a role in supporting the local economy. In addition, universal free school meals would remove any stigma that is often attached to claiming free school meals, usually because children would rather be with their friends having a packed lunch or out at the chippie.
Some 250,000 children who are entitled to free school meals do not get them because they do not claim them. In my constituency hundreds of children lose out every day, despite the best efforts of my local councils to increase take-up. A universal free school meals policy has been working in Sweden, Finland and Honduras, delivering significant results. Closer to home, there are pilots in Scotland and north Tyneside.
These pilots are possible in England because of the Education and Inspections Act 2006, which removed any statutory obligation on schools to charge for meals, so let us make the most of that change. Surely that is why it was made.
That would, of course, have a cost implication, but the long-term benefits of boosting educational attainment, fighting child poverty and tackling health inequalities must begin to outweigh the cost. Estimates of the cost vary, and I have heard a figure of £2 billion. However, the House of Commons Library, which is highly respected and a credible source, has put the cost between £900 million and £1.1 billion. That includes the cost of providing more meals and restructuring current catering contracts, but savings would be made through economies of scale. That sum is not peanuts, but it is still only about 0.2 per cent. of Government spending. It is worth noting that the cost of obesity is conservatively estimated to be about £3.5 billion a year, and we know the old adage about a stitch in time. I am sure that that provides us with some food for thought, and I hope the Minister digests it well.
The second issue that I wish to raise in the time allowed is closely related to education. I urge Ministers to train a dyslexia specialist in every school, who in turn will train all teachers to recognise the signs of dyslexia. I also propose that during their training all teachers are taught a compulsory special educational needs module, rather than SEN as an optional extra, as at present. As a parent with a severely dyslexic son, I know only too well the pressure and frustration faced by many other parents in the same situation. My son was eventually statemented, and with that comes not only the recognition that he needs extra help, but the extra funding to pay for it. We can give all dyslexic children across the country—even those without statements—the help that they need and save money at the same time.
Dyslexia affects one in 10 people. That means there are around 1 million dyslexic children in our schools. They need extra help and support. All our brains work in different ways and we need to ensure that pupils with special educational needs are given special teaching, with teachers who are qualified and able to meet their needs. It has taken 10 years of government and we have come an awful long way. We could not have done it without listening to people and stakeholders. We must listen to the parents of dyslexic children.
A recent survey of such parents carried out by the charity Xtraordinary People and the British Dyslexia Association says that nine out of 10 parents think the support that their children are receiving is ineffective, and seven out of 10 believe their children are being given support by staff who have no specialist training in dyslexia. I welcome the one-on-one tuition that is being given to children who are falling behind in school, but for dyslexic pupils what makes the biggest difference is the opportunity to spend time with a specially trained teacher.
I shall give one quick example. Ben, a 12-year-old dyslexic pupil, had spent six years being helped by a learning support assistant, at a cost of £27,000, and he had shown little, if any, improvement. I know this example to be true because it is exactly the same as my son Joseph’s. After only 20 hours working with a
dyslexia specialist, Ben’s reading and spelling age rose by two years—all that at a cost of only £600.
I am proud to say that the Government are delivering nearly £1 billion in funding for personalised learning, but we must ensure that it is spent wisely and not wasted. I hope that the Minister will give sincere consideration to the points that I have made.
8.40 pm
Dr. Richard Taylor (Wyre Forest) (Ind): Quality of care and safety are at the heart of the Health and Social Care Bill, and I shall spend my precious few minutes talking about quality of care. I am not whingeing or scoring political points; I shall just give the House some examples of the truly awful quality of care that is brought to my notice. I shall then consider some of the measures in the Bill to address the problem.
My first example involves a patient known to have terminal cancer. After treatment at a local cancer centre, with which he was very satisfied, he had to be admitted to another hospital for the investigation of an unexplained fever. The admission process took a long time. Staff were busy and there was no sympathy for his family. Eventually, he was admitted, but no information was given to him or his family. When they went to visit him the next day, he said, “Get me out of here; they do not know what they are doing.” The family were told that no doctor was available to talk to them, although at times doctors and nurses were laughing and joking at the nurses’ station.
On one occasion, the patient’s family were told that he was not in the ward where he in fact was, and they feared that he might have died. When they found him, he was obviously dehydrated and had not been washed. He said, pitifully, “I don’t feel safe in this hospital. They are leaving me to die.” Eventually, the family saw a junior doctor who knew nothing about the patient, so they took the patient home.
I have to declare an interest in respect of my second example. My wife’s elderly aunt—a fit 90-year-old, except for her bad case of cancer—has completed her radiotherapy. She had a check-up on 9 October; she was supposed to have had a scan. Her journey was wasted, as the scan had not been done. It was done on 6 November. Today, she went for the result, only to be told that it was not available as it had to be reviewed at a weekly meeting, which had not been held. How is that patient-centred care—care organised around the patient? It is not; it is care for the convenience of the staff.
I have received letters from people appalled by their treatment in hospital. They mention delays in responding to calls, alarms being ignored, wet beds not being changed, staff sitting around talking and joking, and days without fluids—“If you can’t eat, you don’t get anything.”
I am speaking out about that sort of thing on the basis of local complaints, but it is a national issue. Compulsory reading for everybody—Department of Health Ministers, Members, administrators, NHS staff—is an article in the British Medical Journal this week. It is a personal view, written by a psychiatrist and headed, “So, you want to know what’s wrong with the NHS?” It is about the care of the psychiatrist’s mother
during the course of her schizophrenia, which merged into Alzheimer’s disease. He paints a vivid picture of uncaring, incompetent senior health care staff, the difficulty of complaining, the lack of continuity of care and the migration of an elderly woman across five wards in 14 days. I shall give two quotes:
“Those who cannot do their jobs, who cannot elicit histories or examine the sick, are curiously diligent when it comes to applying the rules under which complaints can be made against them.”
“It doesn’t matter what you do because the “carers” do not care. It does not matter what you say, because they do not listen.”
Dr. Gibson: Are those anecdotes or do they involve real figures?
Dr. Taylor: I thank the hon. Gentleman for that point; it allows me to say that these are not anecdotes but actual occasions of which I am personally aware.
How does the Bill propose to tackle what are, I hope, pockets of appalling care? We are to have a single inspectorate—the care quality commission—instead of the three existing bodies. Is that an economising move? Will it have enough resources? The timing seems pretty poor. The Healthcare Commission is just getting to grips with having annual health checks instead of star ratings and surely needs time to refine that process. Is self-certification of compliance with standards a reliable system? The bodies are to be merged in March 2009—what will be the effect in the meantime? The Healthcare Commission has picked up 19 weak hospitals on quality of care, and it needs time to follow that up.
I am worried by the reform of the complaints process, particularly the loss of the second stage. The Healthcare Commission seems to be escaping from that process because it is insufficiently resourced to cope with the huge number of complaints that it receives. I do not understand why the Department of Health paper, “The future regulation of health and adult social care in England”, states:
“We do not believe the investigation of complaints from individual patients or users of services sits easily with the functions of a regulatory body.”
Why ever not? One of the best ways of assessing what is happening with an organisation’s performance is to examine complaints and the responses to them. When we lose referral to the Healthcare Commission, we lose the automatic inclusion of an independent opinion, which is absolutely necessary in clinical cases.
There is a stress on the use of PALS—patient advice and liaison services. Those are not independent and have been widespread casualties of the financial deficits and actions taken to balance the books. I would like to know whether most trusts are like mine, which, when I last inquired, had precisely one PALS officer for three hospitals. The Independent Complaints Advocacy Service is extremely helpful, but we still depend on the trust that is being complained about calling in independent advisers of its own choosing. The paper, “Making experiences count: a new approach to responding to complaints”, mentions the use of independent mediators and specialist advocates, including:
“People independent of the service provider, the commissioning organisation and even the locality, who could be called on to conduct an investigation where complaints cannot be resolved satisfactorily and/or there are complex issues involved.”
An independent review is absolutely crucial before the case has to go to the ombudsman.
My main concern is whether a merged inspectorate can really cope with the vital issues of improving quality of care in failing hospitals. Is the complaints process being watered down to the disadvantage of the complainant?
8.48 pm
Dr. Roberta Blackman-Woods (City of Durham) (Lab): I thank and pay tribute to my hon. Friend the Member for Gateshead, East and Washington, West (Mrs. Hodgson) for raising the issue of free school meals. We saw an excellent system operating in Sweden, and I too urge the Government to take note of what is being delivered there and to think about setting up pilots here.
I congratulate the Government on setting up the Department for Innovation, Universities and Skills—evidence, if it were needed, of their looking to the future needs of the economy and putting our universities at the centre of the agenda, not only to foster innovation but to deliver skills that are needed for the future. I strongly support the measures in the Gracious Speech to support skills development, and I suppose that I am therefore speaking against the amendment.
It is vital that we continue to upskill our population so that we can compete in the global economy, not at the bottom end of the market but at the top. The importance of concentrating on higher-level skills is demonstrated by even a quick glance at future skills requirements. As our Prime Minister has pointed out, we have 6 million unskilled workers today, but by 2020 we shall need only half a million such workers. The rising demand for skilled employees is the reason why we have to ensure that our young people leave school with skills and qualifications, and why we have to upskill our work force.
In passing, I applaud the Government for their bold step of wishing to guarantee training or education for every young person up to the age of 18. It is important that we do not allow the Opposition, or sloppy journalism, to package the change as simply raising to 18 the age below which staying on school is compulsory. The policy is one of providing training, which will be made available in a range of settings to meet the needs and aspirations of the young person concerned. Of course, we have to pay attention to the quality of that training and ensure that it is implemented properly in a way that does not further alienate the young person. Lord Leitch set the agenda and outlined the rationale for improving skills to meet the needs of the individual as well as those of the economy. He showed that better skills lead to better-paid jobs and improved social mobility. It is therefore important that we consider the development of individuals and communities as well.
I say to the hon. Member for East Antrim (Sammy Wilson) that the Government are not ducking the huge cultural change that needs to take place to ensure that education and qualifications are valued in all sections
of our society. We know that that is a difficult task, and the Government are leading the discussions that say that there is no quick fix to the problem. It requires long-term investment and gradual change, including working with parents, young people, the wider community and employers to instil respect for education in all sectors of our society. Some of the measures being introduced, such as diplomas, apprenticeships and work-based training, will help to do that.
Despite the huge challenges that undoubtedly exist, the Government have set their sights high. There is a commitment to become a world leader in skills by 2020, benchmarked against the upper quartile of the Organisation for Economic Co-operation and Development, which will mean 95 per cent. of adults achieving functional literacy and numeracy, and a shift in the balance of intermediate skills from level 2 to level 3. It will also mean, as many other hon. Members have said, boosting the number of apprenticeships to 500,000.
In many constituencies such as mine, where there has been a tradition of heavy industry, the increased emphasis on apprenticeships and vocational-based subjects is very much welcome, as is the opportunity to move from an apprenticeship to an advanced apprenticeship, and then on to degree level. Such progression routes are extremely important if we are to deliver world-class training. “Train to gain” and learner accounts will, we hope, encourage employers and adult learners to improve their skills as well. The commission for employment and skills is also to be welcomed, not least because it will advise on necessary skills and give employers an important voice.
Clearly, further education has an important role to play, but we must also look at what our higher education institutions are doing. There are some who think that universities should not be dragged into the murky world of skills for employment and should concentrate on education for its own sake. In reality they can, and do, do both. That will be increasingly important as we move towards the 50 per cent. target. It is important that we use our universities to develop in as many young people as possible the ideas, creativity and innovation needed if we are to compete successfully in a global market. Science is essential, but high-level skills in a range of sectors, including creative industries, art and design, are also important.
The Government are raising their expectations of universities but they are also continuing to improve investment in them. The DIUS budget following the comprehensive spending review will rise 2.2 per cent. above inflation. I am stressing that point because the increased investment in universities is not always recognised by people who work within the sector, and sometimes not by those outside it. Additional money has certainly been given to universities so that they can reach out to the wider community and support knowledge transfer, so that constituencies such as mine can be ahead of the game in developing a knowledge-based economy for the future.
8.55 pm
Mr. David Burrowes (Enfield, Southgate) (Con): I commend the amendment, and in particular the reference to
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