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House of Commons

Tuesday 6 May 2008

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]

Private Business

Transport for London Bill [Lords]

Read the Third time, and passed.

Oral Answers to Questions


The Secretary of State was asked—


1. Mr. Philip Hollobone (Kettering) (Con): How many repeat abortions there were in (a) Kettering, (b) Northamptonshire and (c) England in the last three years; and if he will make a statement. [203357]

The Parliamentary Under-Secretary of State for Health (Ann Keen): The number of repeat abortions in Kettering and Northamptonshire combined in the past three years was as follows: 508 in 2004; 546 in 2005; and 599 in 2006. The number of repeat abortions in England in the past three years was as follows: 56,645 in 2004; 58,068 in 2005; and 59,687 in 2006.

Mr. Hollobone: Are not those figures truly appalling? Given that a third of all abortions are repeat abortions, what steps will the Government take to bring down those horrendous figures?

Ann Keen: We are working very hard to ensure that women have access to abortion services as soon as possible, because evidence shows that the risk of complications increases the later in the gestation. We have made investment to improve early access, and primary care trust performance in this area has been measured as part of the Healthcare Commission’s annual health check. The latest data for 2006 show that progress is being made to increase early access; some 65 per cent. of national health service-funded abortions took place at under 10 weeks.

David Taylor (North-West Leicestershire) (Lab/Co-op): Unfortunately, a good proportion of the numbers that the Minister has just given to the Chamber relate to teenage pregnancies—I believe that 19 year olds are the age group that has the highest number of abortions in the country. Could she tell us what she has done in
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the wake of last summer’s Government-funded advisory report entitled “Sex, Drugs, Alcohol and Young People”, which concluded that British teenagers were in the grip of a sexual health crisis fuelled by a “celebrity culture” that condoned alcohol abuse, drug addiction and promiscuity? Can she say what her Department is doing to tackle those three issues referred to in the report’s recommendations?

Ann Keen: My hon. Friend raises a very serious issue in relation to teenage pregnancy, and, all across government, Departments must take responsibility for dealing with it. Of course, sex education and contraception are paramount, so that we do not have teenage pregnancies and their consequences, which affect not only the girl, but the family and all concerned for the rest of their lives.

Miss Julie Kirkbride (Bromsgrove) (Con): I am sure the Minister would agree that the number of repeat abortions is extremely disappointing, bearing in mind the likely impact on the health of the ladies involved. She will also be aware—perhaps she will agree with me—that for some people the number of repeat abortions is a good reason to tighten up on abortion laws and deny women the right to choose. Does she agree with me that, while it is regrettable that there are so many repeat abortions, that should still be permissible?

Ann Keen: Again, the hon. Lady raises very serious issues, which this House will be considering shortly and in respect of which it is always this House’s decision to make. We need to re-examine the role of contraception and, in particular, that of long-acting reversible contraception, which I know many primary care trusts are pushing—it is for all PCTs to examine that option. National Institute for Health and Clinical Excellence guidelines on long-acting reversible contraception show that if 7 per cent. of women switched from the contraceptive pill to long-acting methods, thus doubling the proportion of usage to 15 per cent., the NHS could save £100 million by reducing the number of unplanned pregnancies.

Sir Patrick Cormack (South Staffordshire) (Con): That might be all right for mature women, but does not the Minister share my concern that the giving out and the encouraging of the giving out of the morning-after pill to teenagers is an incentive, almost, to promiscuity?

Ann Keen: I would have to disagree with the hon. Gentleman. This is such a complex and serious issue, and it is for parents, those in education and all Departments to address it. It is in all our hands to try to prevent teenage pregnancies and to provide help. As I mentioned, the consequences, not only for the young woman, but for her family and for the young father, must be taken into account. Fathers and young men should be taking much more responsibility than they do at present, but that can come about only with good, positive education.

Premature Babies

2. Ms Katy Clark (North Ayrshire and Arran) (Lab): What the survival rate of premature babies born before 24 weeks was in each of the last three years. [203358]

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The Parliamentary Under-Secretary of State for Health (Ann Keen): In 2005, there were 435 premature births in England and Wales with a gestational age below 24 weeks; some 383—or about 88 per cent.—of those babies died before they reached their first birthday. No further information is currently available.

Ms Clark: I thank my hon. Friend for that reply. She will be aware of the debate taking place on viability. Does she agree that, when considering this issue, population-based data, such as EPICure 2, are the most reliable available?

Ann Keen: The House will be fully aware that we will shortly discuss those serious issues. The British Association of Perinatal Medicine, the British Medical Association, the Royal College of Nursing and the Royal College of Obstetricians and Gynaecologists issued a joint statement in April stating that there is no evidence of a significant improvement in the survival of pre-term infants below 24 weeks gestation in the UK in the past 18 years.

Dr. Evan Harris (Oxford, West and Abingdon) (LD): Although there are studies that claim to show improvements in individual hospitals, does the Minister agree that the reason the organisations that she has just cited are of the view that there has been no reduction in the threshold of viability below 24 weeks is that the best research, which looks at every birth rather than a selected sample—more findings have recently emerged—has failed to show any reduction since 1995? That is a good argument for keeping the time limit as it is.

Ann Keen: The hon. Gentleman has always shown a great interest in this issue, and he is correct.

Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): I am sure that the Minister is aware that the EPICure 2 study averaged out every birth in the UK, wherever they took place and whether they were in a hospital with a neonatal unit or not. Does she agree that if a woman goes into premature labour in a hospital with a good neonatal unit, to which the baby is immediately transferred, the outcome for that baby is likely to be much improved?

Ann Keen: The hon. Lady is consistent in her arguments: I am equally as consistent in saying that the evidence shows the contrary.

New Deal for Carers

3. Stephen Pound (Ealing, North) (Lab): What progress has been made in developing the new deal for carers; and if he will make a statement. [203359]

6. Tom Levitt (High Peak) (Lab): What progress has been made in developing the new deal for carers; and if he will make a statement. [203362]

7. Jessica Morden (Newport, East) (Lab): What progress has been made in developing the new deal for carers; and if he will make a statement. [203363]

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The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): We have already given councils in England an extra £25 million to allow them to provide emergency cover for carers. We have committed to a further £25 million a year for the next three years. We are progressing work on the information helpline, which will give carers access to reliable information and enable them to access services and support for themselves and the person they care for. Finally, work on the revised national carers strategy is progressing well and we will publish the new 10-year strategy shortly.

Stephen Pound: I thank my hon. Friend for that reply. The fact that so many Labour Members have asked similar questions shows the high level of concern about this subject. What are my hon. Friend and his Department doing to help carers who are trying to balance work with their caring responsibilities?

Mr. Lewis: My hon. Friend is right to raise this issue. We are seeing many changes in our society, with an increasing number of people struggling to bring up children while also caring for an elderly or disabled relative. An increased number of people have to balance their work responsibilities with child care and caring for an adult. That is why we have introduced, for the first time, the right to request flexible working for those who have caring responsibilities and we want to raise awareness of that right. Many employers acknowledge the importance of providing the necessary flexibility for, and supporting, employees who have difficulties with, for example, an ageing relative. One of the issues that the new carers strategy will address is the balance between working responsibilities and caring for an older relative.

Tom Levitt: My hon. Friend will be aware that many people do not recognise themselves as carers, even though they are looking after an adult child or an elderly parent, because that is just “what you do” when the need arises. Therefore, many people will not be aware of the facilities now available to support carers or of the new rights and support that will be available in the future. How will he ensure that the message about the good news—including that yet to come—will be put across to the people who need it most?

Mr. Lewis: My hon. Friend is right. In an ageing society, in which people are living longer, and in a health and social care system in which an increasing number of people want to stay in their own homes rather than go into institutionalised care, more responsibilities will be placed on family members. An increasing number of people, who previously have had no experience of the health and social care system, suddenly find themselves having contact with that system because of an ageing parent. One of the challenges is to raise the status, value and recognition of carers in our society. We should support families who want to take responsibility for looking after an elderly relative or a disabled son or daughter, but we must ensure that people are fully aware of the range of available support.

Jessica Morden: May I welcome the consultation’s emphasis on young carers and the role that they play? The young carers whom I met recently say that they often feel isolated and weighed down with responsibility. They miss school and can miss out on a social life. What specific help will be targeted on that group?

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Mr. Lewis: My hon. Friend is absolutely right. We do not want any children to have their childhood stolen as a result of fulfilling inappropriate caring responsibilities. It is not for politicians to stop children wanting to love a parent who may be dependent because of illness. None of us should want to stop that, nor will we ever be able to do it, but we must ensure that no child is expected to fulfil inappropriate caring responsibilities. That is why for the first time we have made it clear to adult services that, when they assess the needs of an adult with an illness or a social care need, they must make sure that they are not leaving a child in that position. It is also why the forthcoming strategy must look into expanding the number of support groups for young carers. One thing that children and young people say is that it is much easier for them to talk to other young people in the same situation as themselves than it can be to talk to other teenagers, who find it alien.

Sir George Young (North-West Hampshire) (Con): Does the Minister agree that many adult services departments would like to extend the support that they offer to carers but are constrained by resources? Does he recognise that the recent local government settlement has made it very difficult for some local authorities to maintain even the level of support that they currently give?

Mr. Lewis: If one looks at the local government settlement, one sees that there are specific grants to meet social needs and that £500 million has been set aside for the social care reform grant. In 1999, this Government introduced to local authorities the first ever annual carers grant: no such grant existed before, and it is clear that an unprecedented amount of money is going into supporting carers. However, we accept that there is a lot more to do, and that is why we will announce in the next few weeks a new 10-year strategy to enhance the support that we give to carers. It is also why we are going to hold an extensive public consultation on the future of the care and support system. It will look at the consequences of an ageing society and changing demographics, and seek to redefine a new, fair settlement for the funding responsibilities of the state, the family and the individual.

Mr. Graham Stuart (Beverley and Holderness) (Con): May I ask about another specific group—elderly carers? In my constituency, many people of considerable age spend a great deal of time looking after equally elderly relatives and friends. What plans do the Government have to support that group? The financial settlement to which my right hon. Friend the Member for North-West Hampshire (Sir George Young) referred means that the respite care and other support that they desperately need is not coming through. In future years, there should equal funding increases for both health and social care. That would be an example of joined-up government.

Mr. Lewis: I feel another Opposition spending commitment coming on—I hope that the shadow Chancellor has been consulted. However, the hon. Gentleman makes the serious point that, in an ageing society, more people will end up caring for a husband or wife who will often suffer from dementia. That is why
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the national dementia strategy to be published later this year will be so important. The consultation with carers will inform the development of that national strategy, and as part of that we have spoken to thousands of carers up and down the country. They have said that their priorities are income and access to short respite breaks, but it is not just the amount of respite that is important. Quality also matters because carers will not use the respite care available to them if they do not feel confident about it. Moreover, carers have told us time and again that they need better information and advice to help them make the incredibly difficult decisions involved in getting the care and support that they need. The 10-year strategy will address all those issues. We will not be able to change everything overnight—no hon. Member would expect that—but we will be looking to make significant progress over the next three years.

Mr. Stephen O'Brien (Eddisbury) (Con): Given that the Minister today announced that the updated strategy will be with us within weeks, and that he has also announced emergency respite care provisions, and given that he originally announced the new deal for carers more than two and a half years ago—and re-announced it five times—where is the £2.8 million for the carers information service that was promised? Where is the £4.7 million expert carers programme that we were promised? Those matters really do concern my constituents in Eddisbury, and indeed those in the neighbouring constituency of Crewe and Nantwich. It is important to recognise that if the Minister cannot give us an answer to those questions, perhaps the Prime Minister is out of touch, as the Minister said on an earlier occasion.

Mr. Lewis: Desperate, Mr. Speaker. There was no annual carers grant, nor even any distinct recognition of the fact that carers had their own needs, under the previous Government. [Interruption.] I will answer the hon. Gentleman directly: in the summer, the first expert carers programme training courses will begin. Later this year, the website for carers, offering them the kind of information that they tell us they need, will be up and running. Early next year, we will launch the carers telephone helpline, so that carers can ring one number and get high-quality information and advice. That builds on the unprecedented levels of resources that have gone to local authorities, year on year, to expand services and support to carers.

Barbara Keeley (Worsley) (Lab): Carers in my constituency say that what they need most is better quality respite care; that would give them more frequent chances to get a break from caring, which many of them really need if they are to avoid stress and health problems. What specific plans are there to improve the quality of respite care?

Mr. Lewis: My hon. Friend has done a tremendous job of championing the needs of carers since she became a Member of the House, and she continues to do so. She makes an important point. People who care for an ageing parent, a husband or a wife who has— [Interruption.] That is how important Opposition Members think the subject is. People who care for an ageing parent, a husband or a wife who has dementia, for example, have to feel confident that if they allow that
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person to go somewhere for a week or more, the quality of care and their safety will be guaranteed. We must therefore not only expand the range of respite care places available, but do more to improve quality, through regulation and inspection, and through the decisions that local authorities make about where they purchase respite care from. At the heart of that will be a greater use of individual or personal budgets, which will mean that we can give people much greater control over where they get the respite care from.

Finally, we should not forget the unprecedented level of investment that the Government are making over the next three years specifically to expand respite care for parents of disabled children; that is entirely separate to the extra commitment that we will make for those caring for adult relatives.

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