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22 Apr 2009 : Column 97WH—continued
Last year’s child care and early years survey, conducted by the National Centre for Social Research, found that fewer than one in five older children were using out-of-school services at all. That figure was unchanged since 2004. I am sure that there will have been some improvement since then, but that is a cause of concern. In the
extended schools survey that was conducted for the Department for MORI, published in January, only 6 per cent. of the parents surveyed said that their children had attended an activity during the school holidays, whereas the demand for holiday schemes expressed in that survey was 60 per cent. There are therefore two problems: the relatively low and stable participation in the whole out-of-school programme for older children in particular, and the gap in holiday play schemes. Given that the Daycare Trust’s research, which it produces every summer, on the cost of holiday schemes found that last year alone the cost of holiday programmes jumped by 10 per cent., MORI’s finding of a relatively low level of participation is worrying.
Mr. Andrew Smith (Oxford, East) (Lab): As an enthusiastic advocate for the programme, I agree with everything that my hon. Friend says about its advantages and the importance of ensuring that it reaches the most disadvantaged. Incidentally, I commend the excellent work being done in Oxfordshire. Does she agree that one of the problems is that too many parents themselves feel alienated from an educational environment, partly because of their own experience? One way of tackling that is to have more intensive outreach work in the community, such as home visiting. We should also build on the excellent multi-agency work being done to ensure that people have every opportunity to take advantage of the facilities available.
Ms Buck: I totally agree; my right hon. Friend is spot on. His comments chime with my next point, which is that the MORI research also found that the people most likely to participate in the programmes were those in two-parent families and those with younger children. That is very welcome. The people less likely to participate were the parents of children in special schools—that is a great worry—and those with secondary-age children, especially parents of children in years 7, 8 and 9. Those are the years in which children make the transfer from primary to secondary education, and it is when they most need that level of intensive support.
Secondary school transfer is already a real cause of concern. The alienation to which my right hon. Friend refers is, in most cases, inadvertently compounded by secondary school transfer. The relationship between parents and schools and between children and schools is worse in secondary schools than in primary schools. That is often connected with secondary transfer. It is worrying that fewer services are available to those groups and participation is lower. It shows that there is a demand for exactly the work he describes. Intensive outreach to parents is, in a sense, parallel with the work of children centres and Sure Start. We know well that some schools are involved with that work, but not all are.
Worryingly, the MORI findings also show—it is not picked out in the executive summary—that the group that found it most difficult to fund out-of-school activities were families with no parents in work. That brings me to the heart of the dilemma: the question of co-payment and sustainability, of which my right hon. Friend the Minister is well aware. From the research, we know that one of the reasons participation is not as great as it should be is that, according to the children and parents surveyed, the activities on offer are not always what
children want. That brings us back to the menu. What is the menu of activities that can engage children, especially those who need it most? We need to give them not just catch-up classes, but enjoyable activities. Those activities should deal with the problem of alienation mentioned by my right hon. Friend the Member for Oxford, East.
The other issue is, of course, payment. Lone parents, parents of children in special education and parents who are not in employment find it most difficult to deal with the payments. Obviously, some schools—the disadvantage subsidy will help with this—provide cross-subsidies. The dilemma is that the schools with the smallest proportion of parents able to pay the charges are the schools that need the service most but are least able to draw upon co-payment. There are schools in my constituency that have large numbers of children on free school dinner entitlements and parents in low-paid work. The argument is that such schools would benefit the most from that rich menu of activities, but unfortunately they are less likely to be able to generate an income that makes such services sustainable.
My right hon. Friend the Minister is aware that I am concerned about the replies I get from her Department that say, “Well, this is, of course, what the child care element of the working tax credit should do.” However, hardly anybody gets the child care element of the working tax credit. There is no evidence—if she can point me to the evidence, I will apologise and back off from this line of argument—that parents of older, school-aged children are claiming the child care element of the working tax credit to pay for out-of-school activities and holiday schemes. It is precisely because they do not do so that we have this dilemma.
Although 80 per cent. of schools are ticking the box to say that they provide the full core offer—next year, the Government intend to have all schools ticking the box that says that they do so—if we look at the Department’s guidance for schools, it states in the small print that if a school has decided that there is neither the need nor the demand for the services, it can still tick the box to say that it is providing the full core offer. Slightly weirdly, therefore, it is entirely possible for a school to say that it is providing a full core offer when it is actually not providing a single service. That problem might well come back to bite the Government and it is something about which we need to be concerned. I do not think that many schools will play that game, but it is a concern because what we understand by the full core offer is a school that is providing a full menu of the four categories of activity set out in the guidance.
As I have said, further attention needs to be paid to those on low incomes, those with free school dinner entitlements and those who are out of work. Of course, we also need to recession-proof the measures to help all those who are in low-paid work, many of whom do not receive the child care element of the tax credit. How will we ensure that the full delivery that we are promising is there on the ground? How will we ensure that we are delivering sustainable and affordable services, particularly for the children who need them most?
As I have said, I am aware that the disadvantage subsidy will be a real help in that sense, but I am not convinced that the deep pockets of disadvantage, particularly in our expensive inner cities, will benefit
from a Government approach that delivers the support that is needed—that reaches out and genuinely offers a programme of activities that will enrich and improve the lives of our young people.
11.17 am
The Minister for Children, Young People and Families (Beverley Hughes): I welcome the fact that my hon. Friend the Member for Regent's Park and Kensington, North (Ms Buck) has secured another debate on this subject. I have no problem with the number of times that she raises the issue because she and my right hon. Friend the Member for Oxford, East (Mr. Smith) have demonstrated today that they are fully supportive of what the Government are trying to do in this regard. She has also shown that she understands completely why it is important to have extended services that are part of a range of changes in what is available for children and families in communities.
My hon. Friend the Member for Regent's Park and Kensington, North is right to say that it is not just, or even primarily, about enabling parents to work—although that is an important opportunity that we need to provide for parents of children in poverty. The matter is much more fundamental that that; it is about enabling children to have experiences that are not just nice, but essential for their development if they are to reach their potential. That is why the best public schools build in a vast array of enriching activities and opportunities for children to challenge themselves. If that is good enough for the best schools in the country, it is good enough for all our children. That is precisely what the Government are trying to do and why we have made an historic investment in supporting children from the nursery all the way through school.
We have tried to transform the landscape of family support over the past 10 years, so that parents no longer have to go it alone. More fundamentally—this is the core of the argument made by my hon. Friend the Member for Regent's Park and Kensington, North—the circumstances into which a child is born should not dictate where they end up in life. It is the role of important public services to help children who are born with a less favourable start to make up the difference during their early years, at school and beyond, so that they have the same opportunities to be as fulfilled as any other child.
My hon. Friend is right to say that extended services in schools are a key part of the panoply of change that we are trying to achieve, and that is why, as she recognises, we are backing the ambition with about £1 billion in investment in extended services in 2008-10. That includes extra support in the form of a subsidy for payment for the most disadvantaged children, which I shall come to in a minute.
My hon. Friend mentioned early in her contribution the pace of delivery in her own area. She commends the new director, who I am sure has played a part, but she herself, as a forensic scrutineer of what is happening in her area, has also played a significant part in the considerable improvement that we have seen in the Westminster and the Kensington and Chelsea local authorities. It was partly due to her pointing out the slow pace of delivery that the Training and Development Agency for Schools, which is our delivery partner, was able to get to grips with the problem.
The latest figures show that 86 per cent. of schools in Kensington and Chelsea and 77 per cent. of schools in Westminster now have the full core offer. There are some innovative programmes; for example, my hon. Friend may be familiar with the arts extend programme at six schools in Westminster, which has been a particular success. We want to see more of that. The programme is still in the process of delivery, and even when we reach a position in which all schools provide the full core offer, the job will not be done. There are issues about quality and access, beyond a school simply saying that it is delivering the full core offer. My hon. Friend rightly raises what I accept completely are two key challenges for us to continue to work on.
The first challenge—this is a vital part of our thinking—is to ensure that children from the most disadvantaged backgrounds in particular get some of the advantages of being in a school in which curriculum activities are enriched by a range of opportunities. In developing the sustainability of extended services, it is important that schools and parents are helped to bring in an appropriate charging regime for appropriate activities, but it is also important that that regime should not disadvantage the children who need the activities the most.
That is why we introduced the subsidy. As my hon. Friend said, it is being piloted in 18 authorities, including two in London—but not Westminster, although it will get some of that resource in the coming financial year. In preparation for this debate, I gathered some information from the pilots, which only started in September 2008. Early information from the 18 authorities is that the subsidy is beginning to transform the range of activities available, and access for the most disadvantaged children. I am told that schools are enthusiastic, and reaction from parents has been profound in some instances. They speak about the difference the programme has made; for example, a youngster is able through the subsidy to buy a Brownie uniform and attend Brownies every week, or to buy equipment to take part in an activity.
There is no division between my hon. Friend and me on this matter. I am absolutely with her, but if we do not deliver extended services to the most disadvantaged children, the scheme as a whole will fail. It is those children who stand to benefit the most, and therefore we must ensure that we enable them to access the services. The MORI survey did show a lack of holiday provision, and we are working on that. It also showed that at present a slight majority—about 60 per cent. of parents and 67 per cent. of young people—are satisfied with what is happening in their schools. That is heartening, but it is not enough. We need to ensure that those figures improve.
My hon. Friend raised a related issue which involves another distinct challenge. The extended services must be sustainable, but we also need to enable parents, particularly those who are not working, to access the activities. My hon. Friend has raised this issue with me, in respect of her local authorities in particular, on several occasions. It relates to the child tax credit and the child care element of the working tax credit.
My hon. Friend is absolutely right to say that although there has been some improvement in Westminster in the take-up of child tax credit, the improvement over the past year or so has been only half that of London authorities as a whole—9.5 per cent. in Westminster as
opposed to 17.5 per cent. in London. Whereas in other authorities the increase in child tax credit take-up has led to an increase in take-up of the child care element of the working tax credit, that has not happened in Westminster. It has seen half the rate of increase in child tax credit take-up, and that has not translated into take-up of the child care element of the working tax credit. I know that that is technical, and I apologise, but my hon. Friend understands this even better than I do.
Those figures are important, because tax credits—certainly the child tax credit—are one of the main ways in which parents who are not working, as well as others, can get resources to help fund activities. I am afraid to say that, without doubt, Westminster is one of the poorest local authorities for take-up of child tax credit and the child care element of the working tax credit, and has consistently been so. In addition to what colleagues in the Treasury and my Department are doing to promote resources for parents, other local authorities, including some in London, actively promote take-up of such resources, which has made a significant difference.
Ms Buck: Will my right hon. Friend give way?
Beverley Hughes: Let me just finish this point, which relates to what my right hon. Friend the Member for Oxford, East said. Other local authorities are much more assertive in the outreach work that they do from children’s centres, schools and Jobcentre Plus. They invest a great deal in their family information services and in training people so that staff on the ground really understand child tax credits and the child care element of the working tax credit. That is how take-up of both those things has been increased in other London boroughs.
Ms Buck: I am grateful for those statistics, some of which I did not know. Will my right hon. Friend agree to ask officials in her Department to approach Westminster to see what can be done to deal with the issue? As she rightly said, it is in danger of undermining delivery of the whole programme.
My right hon. Friend may not be able to answer this question now, but perhaps she could write to me. It is still unclear to me whether anyone knows the extent to which the child care element of the working tax credit is received by parents of older children. It is difficult to drill down for that information, but, unless we have it, Westminster and other boroughs will all be slightly in the dark about the best way forward.
Beverley Hughes: On the latter point, I will write to my hon. Friend. I am not clear myself at the moment whether the Treasury can disaggregate figures on take-up according to the age of children in the family. It is a valid point, and I will investigate and write to her.
I shall also write to my hon. Friend and clarify the figures that I used for the two authorities that cover her constituency. The Government office for London has regular conversations on performance with Westminster about this matter. In addition to the work of the TDA, that is partly how delivery of the programme has improved. I shall ask the office for a report on the outcome of those discussions and ensure that she is aware of it.
I am grateful to my hon. Friend the Member for Regent's Park and Kensington, North and to my right hon. Friend the Member for Oxford, East for the points
that they made about the scheme. They recognise its importance, and I very much welcome their support. Extended services are a vital part of a long-term programme to improve outcomes for all children and to ensure that we reduce the inequalities that exist for children from disadvantaged backgrounds.
11.29 am
Cardiac/Vascular Health
2.30 pm
Mr. Malcolm Moss (North-East Cambridgeshire) (Con): Mr. Pope, may I say what a pleasure it is to serve under your chairmanship for the first time? Normally, at this time on a Wednesday afternoon we are both in the Select Committee on Foreign Affairs. A change is as good as a rest, so they say, so I am delighted to have the opportunity to speak in this important debate. I am most grateful to colleagues for turning up on the busiest day, in parliamentary terms. I imagine that we have all had a rushed lunch. I thank all hon. Members for coming.
Let us first remind ourselves of the facts. Cardiac and vascular conditions are those affecting and related to the heart and to blood vessels throughout the body. They include heart attack, stroke, diabetes and chronic kidney disease, affect the lives of more than 4 million people in England, cause 170,000 deaths each year and are responsible for about one fifth of all hospital admissions. The challenge posed by those conditions is stark: cardiac and vascular disease remains the number one cause of death and disability in the United Kingdom. The death rate for coronary heart disease and stroke in men and women is still higher in the UK than in comparable western European countries. It was primarily to address that serious challenge that the national service framework for coronary heart disease, a 10-year plan of action, was launched in 2000. In England, it certainly has delivered significant progress in the fight against coronary heart disease.
The national framework for CHD, with the additional arrhythmias chapter added in 2005, led the way as one of the first national plans developed to take a root-and-ranch approach to improving the treatment and care of people with a particular condition and to take action on prevention. Progress reports have shown the following: first, the target of reducing deaths from cardio-vascular disease in people under 75 by 40 per cent. was met five years early; secondly, the number of people suffering a heart attack who received thrombolysis within 60 minutes of a call for help increased from 24 per cent. of patients in early 2001 to almost 70 per cent. in 2007; and thirdly, the waiting times for heart surgery dropped dramatically, from more than 5,500 people waiting more than three months for heart surgery in 2000 to none in 2007. However, we must not risk failing to build on what we have achieved to date. It is vital that these achievements and those of other strategies for stroke, diabetes and kidney disease are sustained and built upon. Simply to rely on a project-based approach is not enough.
Chris Ruane (Vale of Clwyd) (Lab): I thank the hon. Gentleman for not being party political and for giving the Government full credit for our achievements to date. Does he agree that they reflect the Government’s investment in increasing health funding from £33 billion in 1997 to more than £100 billion today, and that we need to keep that investment in place for the future to build on our successes?
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