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10 Jun 2008 : Column 44WH—continued
There is a further difficulty. Local authorities have a mix of leisure facilities—they may have football and rugby fields and so on, and changes in society may mean that local sports clubs change from football to
rugby or the other way around—and are constantly working to get the right mix. All too often, decisions on older swimming baths, which might need dramatic amounts of financial investment, are delayed year after year until it is too late to save them. That is why, even in central London, quite a few historic baths have closed. That is a shame, not particularly because the buildings were of enormous historical merit, but because some of those baths were in exactly the right place—in the centre of cities, where they were convenient for people to use at lunch time and other times of the day, and in the evening. We need to do more to ensure that local authorities have an ongoing, rolling programme of investment in their swimming pools so that they do not suddenly realise that they have a dramatic problem and must find £5 million or £10 million, with the result that they decide that they cannot afford to keep their pools open.
Large numbers of people go swimming, but the truth is that we could not survive without the volunteers who run the swim clubs. There are 300 volunteers involved in swim clubs in Wales, and they ensure that people can do not only the jumping-in-the-pool, messing-around kind of swimming, but the hard, up-and-down lane swimming—1,000 m of breaststroke, freestyle and so on. However, swim clubs are finding it increasingly difficult to survive not only because of the charges that local authorities levy on them for holding sessions, but because it is more and more difficult to get volunteers to commit themselves—particularly to getting the training that they need to act as coaches.
In that respect, I wholeheartedly support the introduction of the United Kingdom coaching certificate, which is an excellent measure that is increasingly professionalising the coaching that we provide in swim clubs. However, it is expensive to do the courses. A level 1 course, which takes 37 hours, costs £370 per individual, while a level 2 course costs £650 and requires 50 hours of commitment. That requires a significant investment from the individual, and I wonder whether there is a way of ensuring that Government resources can flow more readily down to the swim clubs so that more people can train as coaches, particularly in some of the poorer areas of the country.
As has been well attested in the Culture, Media and Sport Committee report on swimming in 2001-02 and in many debates in the House, one problem for elite swimmers in this country is that we have remarkably few 50 m pools—we have 19 in England and one in Wales, which is fewer than in Berlin or Paris. That is a problem not because everybody wants to swim 50 m all the time, but because we have only two venues where we can have an international-standard event. To hold such events, one must have not only a 50 m pool for swimming but a warm-up 50 m pool, and the pools must be 10 lanes wide, with a variety of adequate facilities on site. There is also the difficulty of training elite swimmers. It is difficult for Team GB to find somewhere for the whole team to swim continually for a fortnight or three weeks without completely disrupting everybody else’s ordinary swimming. That is why the Government need to think further about developing more 50 m pools.
The new 50 m pool in Wales is wonderful, and creative ways have been found to use it so that a variety of events can be held there—it is not used just for elite swimming or by people ploughing up and down the lanes. Everybody is proud of the new pool, but it would
be nice if we had more like it. Obviously, we will have the new aquatic centre for the Olympics, but it is important that the whole of London and, indeed, the whole south-east feel that it has a stake in it after the Olympics.
The next issue that I want to raise is one that affects volunteers and those involved in swimming. Fifty years ago, everybody would have been happy to take photographs of all the kids taking part in the annual swimming gala or the school swimming gala, but the sad truth is that most local authorities now understandably have strict rules about what photographs can be taken, and everybody has to have signed a form giving permission for their child’s photograph to be taken.
Similarly, it is obviously important that swimming coaches and everybody involved in teaching young people to swim have proper accreditation, so that parents can be secure in the knowledge that their child is safe in every sense. With the passage of the Criminal Records Bureau to the Independent Safeguarding Authority, it is important that the cost of checks, which may be quite significant for small swimming clubs, be met by the Government, not the clubs themselves. Checks should also be done swiftly. Furthermore, it should be possible to transfer a check that was made when somebody wanted to become a rugby, cricket or golf coach, should they then wish to become a swimming coach. One difficulty is that we are overloading the system by not allowing people to transfer checks from one sport to another.
There is another issue alongside that. When we move to the new points-based system of immigration, which I wholeheartedly support, it is important that we ensure that coaches—particularly in international sports such as swimming, which rely on coaches travelling around the world and working in different countries—can enter this country without facing an overly complicated process of immigration checks.
I wholeheartedly support what the Government are doing to ensure that more people swim. Swimming is one of the few sports in which everybody can engage, whatever their age or physical ability. My only concern is that if we simply make swimming free for those who already swim, we will have achieved nothing through our investment in swimming. We need to overcome some of the barriers to people taking up swimming. In particular, we need ensure that there are more coaches and volunteers and that it is easier for local swimming clubs to survive and prosper. We need to ensure that there are more swimming pools and that private pools are more available to the whole of society, while public pools are more engaging and pleasant places to go for a swim. If we can do that, the number of people who go swimming will significantly increase.
12.47 pm
The Parliamentary Under-Secretary of State for Culture, Media and Sport (Mr. Gerry Sutcliffe): I wholeheartedly support my hon. Friend—I do mean my hon. Friend—the Member for Rhondda (Chris Bryant) and I congratulate him on the timing of his debate. He talked about the announcements last Friday, but he has been keen on this issue for a long time, and he mentioned his exploits as a young child, on which I congratulate him.
I offer my support to swimmers in Wales, and particularly to those who will go on to represent Great Britain at the Olympics. Like my hon. Friend, I wish them well,
whether they are taking part in the Olympic games in Beijing or training and developing for the London Olympics in 2012. I particularly offer my support to Tom Daley, who has inspired many people not only with his diving exploits, but with his demeanour and the way in which he acts as a role model for many others.
It is a great pleasure to serve under your chairmanship, Mr. Pope. I think that this is the first time that I have done so, so I am delighted to see you in the Chair.
My hon. Friend rightly set out a number of issues, which we are aware of, to ensure that we are successful in our ambition of getting more people swimming. It is important that we get more people active in sport. My hon. Friend will be aware of the legacy challenge that we set ourselves of getting 2 million more people engaged in physical activity and sport by 2012, and swimming can play a key role in that.
I wholeheartedly agree with my hon. Friend’s points about swimming provision, the quality of pools and the need to make sporting experiences, whatever they are, credible and something that people want to pursue. If the sports superstructure is not up to standard, young people in particular will do other things, so we must ensure that the sporting experience that we present is enjoyable. My hon. Friend is particularly right about matters such as changing rooms and how confident people feel in the environment of the swimming pool. Those points are important and I hope that they will be dealt with when we consider the facility strategies that local authorities need for new and existing pools.
My hon. Friend’s timing is, as always, impeccable, given last week’s announcement by the Secretary of State. That really was joined-up government, with several Departments coming together regarding the aspiration for free swimming for the over-60s and making under-16s a priority by 2012. My hon. Friend is right to say that that has been happening in Wales for some time—I know that Rhodri Morgan and the Sports Minister in Wales are particularly pleased by the development—and that we must keep the initiative alive by encouraging more people to take part, not just the same ones who are now doing so. I hope that, with the support of the Amateur Swimming Association and British Swimming, it will be possible to offer good experiences of swimming, whether for people who want to enjoy the fun pool or for serious swimmers who want to get involved in competitive swimming. We want to ensure that there is a route all the way through, so that swimming is enjoyable and there is an opportunity for people to get involved.
The active people survey in 2005-06 showed that swimming was perhaps the nation’s most popular physical activity, with 17 per cent. of women and 12 per cent. of men swimming at least once a month. Swimming is the sport with the second highest rate of participation, after football, for children aged 11 to 16, with 38 per cent. participating in and out of school. It is also the most popular physical activity for the over-60s, with 7 per cent. taking part at least once a month. The Government are committed to good quality swimming and diving provision throughout the country. Since 1997 almost £250 million of public money has been invested in swimming—more than for any other sport. More swimming pools are opening than are closing, in both local authority and private sectors.
It is too simplistic, however, to look at sporting provision simply in terms of quantity. My hon. Friend touched on a very important point about where pools are, and whether those are public or private. I am engaged with several bodies in considering the spare capacity that private sector pools might have to offer swimming to others, at times when the private sector cannot fill the pools. I believe that we should, particularly through county sports partnerships, local area agreements and local authority facility strategies, come to a greater understanding of how we can bring public and private sectors together, and of the opportunities that exist in that context. What we envisage will not work unless there is a willingness to use the available facilities.
As part of the incentive, I am trying to ensure that we drive through a strategy to achieve world-class swimming facilities throughout the country. Local government has a key role to play in that. The offer of free swimming that we announced last week is, as I have explained, part of getting 2 million more people active by 2012. Swimming will make an important contribution to the meeting of our goals. In broad terms, we shall offer local authorities funding to allow them to introduce free swimming for people aged over 60 and further measures designed to promote increased participation in swimming, particularly for under-16s. We are also offering a capital fund for the renovation and maintenance of pools, including school pools, in support of such schemes.
I had a constituency issue regarding the closure of a pool in my constituency—the Buttershaw school pool. There is an opportunity now for Conservative-led Bradford council to put its money where its mouth is and support what we are trying to achieve through allowing greater access to swimming by making sure that the pool stays open. I should be happy at any time to meet the local authority to discuss future funding to do that. As my hon. Friend has said, swimming is an emotive issue. People want pools to be protected, and in some cases there is an opportunity for local authorities to shut a dilapidated pool in the hope of replacing it. In Bradford, pools have closed but have not been reopened elsewhere. I hope that that can be put right. My hon. Friend made the same point about pools in Wales. We must protect existing pools, and through the offer of the capital fund it may be possible to assist some local authorities in Wales and elsewhere to maintain pools that need attention.
It is important to consider the issue of elite sport and to take the opportunity to make sure that we have the right pools. Particularly relevant are the 50 m pools that my hon. Friend described. There are 18 indoor 50 m swimming pools in England, and a further nine, such as at Portsmouth and Hillingdon, are either under construction or proposed. Therefore, every region in England will have at least one 50 m swimming pool. We are told by Sport England that that will meet the demand that exists for quality and the right location.
School swimming is vital, and my hon. Friend is right to raise the issue of lessons and their cost. We want to include that in our discussions about how we fulfil the aspiration of free swimming, particularly in relation to hard-to-reach groups: people on low incomes who cannot afford to learn to swim, and people who do not think that swimming is for them. We want to open the access and opportunities as much as we can. My hon. Friend has pointed out that swimming is universal—it is an
activity that people can do together. Whole families at different levels of ability can go together and enjoy being in the pool.
We believe that the situation in Wales is a good example of how things can be done. To develop things further throughout the country, we need to learn some lessons from what happened in Wales. My hon. Friend is right to say that broadly, everyone is happy with the proposals and the development of the free swimming agenda in Wales. It is encouraging for me to see how leading local authorities such as Wigan, which now offers opportunities for free swimming, have learned lessons from what has been done elsewhere.
All hon. Members of all political persuasions will welcome the announcements that we made on Friday, on the basis that we have an opportunity to consider the health and well-being of the nation and the need to get people physically active. The foresight report revealed problems in relation to obesity and the horrendous challenges that we shall face if people do not become more active in future years. We all know the burden and the cost that there will be to society and Government because of the effect on health. Swimming gives people the opportunity to experience the delight and health benefits of being active and an increased heart rate, thereby becoming fitter.
Swimming is a key element of the sporting activity that we can enjoy. We need to be successful in what we propose and to make sure that we achieve our aspiration by 2012. The swimming authorities—particularly the ASA—have given detailed attention to the matter. My hon. Friend will be aware of the recent cycling championships and the 10 out of 17 available gold medals that were won; cycling is a sport that has been looked at right from the start. The same has happened with swimming at every level; there has been consideration of what is needed to improve participation levels at recreational sites, and of how to develop the sport all the way through. I was pleased a few weeks ago to be at the 50 m pool in Manchester to see swimmers—UK swimmers in particular—succeeding at the Paralympic World cup. It was inspiring to see them deliver championship performances.
Swimming, like most sports, connects people and is an inspiration to them. It can develop self-esteem and encourage teamwork. The timing of today’s debate is appropriate. I hope that my hon. Friend will continue to support our ambition of making sure that swimming is delivered according to the widest possible remit. I congratulate him on securing the debate.
NHS Co-payments (Mrs. O’Boyle)
12.59 pm
Mr. John Baron (Billericay) (Con): I am grateful for this opportunity to raise the case of my late constituent, Linda O’Boyle, who died earlier this year, sadly, after treatment for bowel cancer. Her case is both terribly sad and hugely frustrating. She was a warm-hearted woman with a great sense of humour who gave much of her life to the national health service and helping others. When she became ill, she had every right to expect that the NHS would be there for her, but it was not. The health service let her down in her hour of need.
Many patients have suffered because the NHS does not allow co-payments, which involve a patient paying privately for a drug not funded by the NHS while continuing to receive the basic NHS package of care. If patients want to top up their care, Government policy requires that free NHS treatment be withdrawn. Often, treatment is eventually delivered within the NHS setting, but the patient is presented with the bill for all aspects of care. Sometimes, as in the O’Boyle case, the patient is forced to go private for everything.
The facts of the case are straightforward. Linda was diagnosed with bowel cancer, and at first her treatment at Basildon and Southend hospitals went well. However, it was decided that she needed a second line of treatment with irinotecan earlier than planned. Then her consultant had to inform the family that treatment was not working, which came as a great shock. The desire to save or extend the life of a loved one is immensely strong. The family were desperate to find another treatment, and the consultant suggested that only cetuximab offered a realistic hope of extending Linda’s life.
However, as we know, cetuximab is not available on the NHS, as it was turned down by the National Institute for Health and Clinical Excellence on the grounds of cost-effectiveness. Whatever one’s views about NICE and the fairness of some of its decisions, the relevant fact is simply that state-funded health care was unable to provide Mrs. O’Boyle with the treatment that her clinician said she needed.
Mr. Frank Field (Birkenhead) (Lab): The hon. Gentleman talks about “free” and “state-funded” NHS care. I remind him of his Thatcherite roots. We taxpayers, including Linda, pay for our care.
Mr. Baron: I accept that point 100 per cent. Mrs. O’Boyle had paid for her care through her taxes, of course, which is why her care should have been free, to use my terminology. She should not have had to pay for it. That is the cause of the problem.
Mr. Field: If one accepts that we pay for our NHS care at a different time than we draw the benefit, the false dichotomy that the Government have erected falls to the ground. One wishes to top up the payments that one has already made. Given that the Government want to encourage public-private sector arrangements, I find it extraordinary that they do not want public-individual citizen projects such as the one Linda wished to do.
Mr. Baron:
I fully accept where the right hon. Gentleman is coming from. I take his point on board, particularly considering—I shall come to this point later—that in
many other areas of the NHS, patients can top up without having their care withdrawn. That is a contradiction that the Government need to resolve.
The family decided to pay privately for the drug. Mrs. O’Boyle had hoped to receive cetuximab at the family’s expense at Southend hospital while continuing to receive care as a cancer patient. It is worth emphasising that the family were exceptionally happy at that stage with the care that they had received within the NHS. The issue is not about doctors, nurses or consultants, for they did an excellent job of caring for Linda as far as they were allowed; it is about Government policy, which prevents them from doing their job.
One might have expected the NHS to do everything possible to help Linda O’Boyle—after all, its purpose is to extend life—but the family were told that that would not be the case. The family ended up paying for all the necessary treatment, including care that ought to have been available on the NHS. It is difficult to escape the conclusion that the NHS effectively walked away from a dying woman in her moment of need, a woman who had given most of her life to the NHS.
Naturally, the cost to the family was huge. They also had to meet the cost of private consultations, prescription charges and home nursing care and pay the full market price for irinotecan and cetuximab. Taking everything into account, the total cost was around £14,000. It would have been £50,000 if Linda had survived the full six months of treatment. Seeking to extend the life of loved ones is not an aspiration unique to the rich. People are prepared to make great sacrifices to hold on to someone they love.
With the family’s consent, I raised the issue with some newspapers, and it has received very good coverage during the past few weeks. Such publicity is never easy for the relatives involved, but Mr. O’Boyle and his sons took the decision to go public because they feel strongly that what happened to Linda was wrong and must not happen to other people. I commend them for that attitude. Mr. O’Boyle and one of his sons have joined us for this debate. Many other patients all over the country find themselves in similar situations. The Sunday Times, among others, has done splendid work to give them a voice. The best-known example is probably the breast cancer patient Colette Mills.
As for the arguments used by the Government to prevent patients from making co-payments, I have the benefit of anticipating some of the Minister’s remarks, as I wrote to the Secretary of State earlier in the year about the issue. The reply that I received was, in my view, confused and inhumane. Let us be clear: co-payments are not about taking care from any other patient in order to help another patient go private. A drug is paid for privately, not subsidised by the state. The arrangement represents a move to a Pareto optimum. One patient benefits without any other patient being harmed.
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