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12.6 pm
Jim Shannon (Strangford) (DUP): I thank the hon. Member for South Northamptonshire (Andrea Leadsom) for bringing this issue before us, and I totally support her point of view. We live in an age of high teenage pregnancy, sexually transmitted infections and multiple partners. No man is judge of how people live their lives as adults, but there must be safeguards in place to protect the innocence of children and to keep them as children for an appropriate time.
I questioned two mothers about their children’s education in primary school. One was a married mother of three, who also had a grandchild, and the other was a single mother of two, who had one child in primary school. Both told me the same thing: “Teach my daughter what is appropriate touching and what is not. Do not teach my daughter about sex when she is not even old enough to stay up past 9 o’clock.” No matter what their religious background, most parents agree that primary school is much too soon to be teaching these things.
When my three boys were young, they played with their G. I. Joes—I think that was the thing at the time—and little girls played with their Barbie dolls to encourage their imagination. Now children are told that that is babyish and that they should be playing on computers and hanging about with their friends. We now have six to seven-year-old girls wanting to wear padded underwear, wearing full faces of make-up to school and wearing high heels that harm their backs, all to look like their favourite TV stars.
As we know, Primark announced it was to stop selling padded bikini tops for children as young as seven, after criticism from the general public and politicians. The company, which was criticised for its £4 bikini sets, apologised to customers and said it would donate any profits to child welfare organisations. Penny Nicholls of the Children’s Society said:
“There is a big distinction between children dressing up for fun and retailers producing items of clothing that target children and encourage premature sexualisation.”
There is a clear difference, and I want to develop that point.
Last week, I attended a Prayer for Parliament and the Nation meeting in the House, as did other Members here. We were given a presentation about sex education at primary school level. It was very graphic, very physical and very technical. I am not a prude by any means, but I felt uneasy sitting watching it, and I suspect many others in the Room would probably feel uneasy, too. Thirty to 40 people were present at the meeting, and they gave examples of how their children had come home from school and told them that they could not get their heads round the sexual act; they were fearful. Let me just say, therefore, that it would be wrong to take sex education out of the hands of parents, schools’ boards of governors and teachers without the agreement of parents.
In Northern Ireland we have an organisation called Love for Life, which my hon. Friend the Member for Upper Bann (David Simpson) mentioned. It talks about not the technical details but emotional relationships; and that is what we must try to do. Love for Life in Northern Ireland has been able to affect 30,000 people in their school education. That is an example of what can happen. I urge hon. Members fully to support what the hon. Lady proposes.
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12.10 pm
Kevin Brennan (Cardiff West) (Lab): We have had a good-natured, interesting and informative debate. I am the father of a 17-year-old daughter, so I think about the issues in question as a parent, as well as a politician. I congratulate the hon. Member for South Northamptonshire (Andrea Leadsom) on securing the debate. She raised some interesting new ideas, including using the British Board of Film Classification to put a kind of health warning on to materials that could be used in schools for sex and relationships education. Departmental guidance about such education is clear; the hon. Member for Congleton (Fiona Bruce) read some of it out, and I wonder whether we need to nationalise—that in effect is the proposal—the classification of materials for use in schools. That seems to be the opposite of localism.
The hon. Member for South Northamptonshire said she knew of schools in her constituency that use inappropriate materials, and she went on to cite the materials, but did not say who produced them or name the schools where they were being used. There is a problem in the debate, which reminds me of the debate going on when I was a teacher in the 1980s about the teaching of homosexuality in schools, and the encouragement of children to engage in homosexuality. It was often said that that went on all over the place, and that homosexual lifestyles were being encouraged. With no evidence, the Government of the day turned that into legislation—section 28 of the Local Government Act 1988. I talked with a young male teacher who was gay, and he lived in fear of revealing his sexuality because of such legislation. If we are to have this debate, let us cite the evidence, and make that evidence clear. If inappropriate things are happening and inappropriate materials are being used for young children, that should be stopped. We can all agree about that.
Andrea Leadsom: The hon. Gentleman will recall that I said that I have the evidence but was not prepared to mention specific schools in the Chamber. He will know that the relationship between schools and parents is delicate. I can provide evidence, but will not do it on the record, for good reasons. He is being mischievous in suggesting that no evidence exists, simply because I am not prepared to have it mentioned in Hansard.
Kevin Brennan: My view is that the hon. Lady should put it in the public domain. If she thinks that inappropriate practices are going on in our schools, wherever they are in the country—my or her constituency, or anywhere else—and that children are being exposed to materials that could damage them, that is an important matter, of public concern, which should be in the public record. I am sorry to disagree with her, but that is how it should be.
The hon. Lady also suggested that parents should be able to exercise an opt-in with respect to sex and relationship education. My hon. Friend the Member for Kingston upon Hull North (Diana Johnson) has pointed out that there is an opt-out, which extends to the age of 18, which is an anomaly. My hon. Friend, who was an able and successful Minister in the Department for Children, Schools and Families, tried to address that anomaly, by reducing the age to 15—although she did not quite get the relevant measure passed at the end of that
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Parliament—so that children could have the opportunity of a year of sex and relationship education before reaching the age of consent and what was at that time the school-leaving age. That seemed to me to be an entirely sensible proposal, but it was lost in the wash-up, as my hon. Friend pointed out, along with the proposal to make sex and relationship education a compulsory part of the primary curriculum.
An opt-in system would be inappropriate. The opt-out is available, and it provides parents with the necessary protection if they are concerned about what their children are being taught. Some argue that there should be no opt-out, and I think that the hon. Member for St Austell and Newquay (Stephen Gilbert) was arguing that, but I do not agree.
My hon. Friend the Member for Kingston upon Hull North said that we need to source the evidence if we are to make accusations about the material being used in schools. If there is an accusation of widespread use of inappropriate materials for sex and relationship education we should know about it. She also pointed out the danger that, if there is insufficient sex and relationship education, young women will not be taught sufficiently to be confident about themselves and their ability to take control of their relationships, whether sexual or other personal relationships. I would add—and I am sure that my hon. Friend would agree—that it is important for young men to be taught about appropriate behaviour. When I was a Minister in the Department for Children, Schools and Families, we heard a lot of evidence from charities about the effect of the more widespread availability, in the age of the internet, of hardcore pornography, and its influence on the practices of young men, and their expectations of young women in a sexual relationship. If young men see that material in their daily lives they need to be taught that that is not necessarily how a relationship should develop. That is where sex and relationship education in school can be important—in helping young people to develop healthy, good relationships.
Jim Shannon: Is the hon. Gentleman aware of the national opinion poll, which showed that six out of 10 parents are concerned about any sex education in primary school? Those 60% of the ladies and gentlemen who were questioned suggested that sex education should start at 13. Does the hon. Gentleman accept that they too have an opinion, which needs to be taken on board?
Kevin Brennan: I do accept that they have an opinion. I am glad that the hon. Gentleman clarified the statistic, because when he spoke earlier he did not mention that it related to primary education. I am afraid that it all depends, in such situations, on how the question is asked. I think most people would understand the appropriateness of teaching children about relationships, which is what we are talking about, at an appropriate level at primary school. I know that the Minister was not very keen when the previous Government introduced social and emotional aspects of learning, but it had a huge impact on improving relationships between children. When parents are given an explanation of what is in mind, and of the scare stories and unsubstantiated scaremongering about sex and relationship education, they will change their mind.
I pay tribute to other hon. Members on their speeches. The hon. Member for St Austell and Newquay made some important points and gave some important statistics
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about sexually transmitted diseases and the prevalence of sexual activity among young people. It was not necessarily wise of him to quote The Specials. I could tell him the whole lyric, which I know by heart, and it is not necessarily entirely helpful to his case, but I thank him. My hon. Friend the Member for Airdrie and Shotts (Pamela Nash) told us about her role as the chair of the all-party group on HIV and AIDS, and she too mentioned the importance of evidence in discussing the topic. She told us that the inspectorate has said that SRE is patchy and inadequate. That is not good enough, and we need to do something about it. There were also good contributions from the hon. Members for Congleton and for Strangford (Jim Shannon). The hon. Gentleman said that we should teach what is appropriate, and went on to talk about the sexualisation of young people. Sex and relationship education can help to counter such sexualisation of young people by teaching them what is or is not appropriate, and about the relevant issues. He should reconsider the issue and see the opportunity to counter the sexualisation of children.
The Opposition are disappointed that in the review of personal, social, health and economic education, the Government have made a U-turn. When we criticised the Conservatives in the wash-up for forcing the then Government and the Liberal Democrats, who supported them, to drop the sex and relationship education issue, they criticised the then Secretary of State for suggesting that they were not in favour of extending sex and relationship education. However, it turns out that they have ruled out in their review any change to the law on sex and relationship education. That is highly disappointing. There is plenty of evidence, certainly from the recent Brook study, of young people’s ignorance about sex and relationships. There is also plenty of evidence from the inspectorate about why we should do something about it.
I have praised the Minister, and I praise him again, for tackling head on homophobic bullying in schools, as we tried to do, and for being the second Minister from the Department, after me, to address the Schools Out conference. He should show the same kind of vision when it comes to sex and relationship education.
12.20 pm
The Minister of State, Department for Education (Mr Nick Gibb): It is a pleasure to follow the hon. Member for Cardiff West (Kevin Brennan). I congratulate my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) on securing a debate on such an important and sensitive issue. Today’s debate has highlighted a wide range of views on the subject, and genuinely reflects the divergent views on the issue among the public and parents.
I fully understand the concerns of some parents, particularly those with children of primary school age, who do not want their children exposed to materials that they feel are harmful and show images that are simply too explicit for the child’s age. Parents want to protect their children and preserve their children’s innocence. I know that a number of hon. Members share those concerns. My hon. Friend is right when she says that we must ensure that any materials used in schools are properly scrutinised to make sure that they are suitable for young children and do not add to the sexualisation
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of children instead of protecting them from it, a point that was also made by the hon. Member for Strangford (Jim Shannon).
We want all young people to have high-quality personal, social and health education, including sex and relationship education. SRE is not compulsory in primary schools and we have no plans to make it so.
Although we are currently conducting a review of PSHE—I thank the hon. Member for Airdrie and Shotts (Pamela Nash) for her welcome for that review—my right hon. Friend the Secretary of State for Education has said clearly that its remit does not include making PSHE as a whole a statutory requirement. There will be no change to current sex education legislation or to the parental right of withdrawal from SRE. We believe that the current statutory arrangements strike the right balance and reflect the range of public views on a sensitive issue.
Diana Johnson: Will the Government consider tabling amendments to the law on the issue of the age of 18 and the opt-out up to that age?
Mr Gibb: No. We have made it clear that we do not intend to change legislation on the matter. When children are in full-time education, the rights of parents are important in how their children are brought up.
The review of PSHE fits within the schools White Paper strategy of devolving power and responsibility to schools and of trusting professionals. The vast majority of primary schools provide SRE, and it must be done in a way that provides the right teaching at the right time.
In developing policy, we have looked at the evidence available. In 2010, Ofsted published a report on PSHE, which found that some aspects of SRE were less well taught, particularly relationships. More positively, it found that in about two thirds of the primary schools visited, teachers used a range of resources effectively, including computers and story books, to enable pupils to discuss issues without embarrassment. Previous inspection evidence reported by Ofsted in 2007 showed that schools judged as being particularly effective providers of SRE had developed successful and constructive links with a range of support services, which could advise young people on a variety of issues and respond to their needs.
Many schools draw on expert help, as was alluded to in the debate, for aspects of PSHE in which they do not have expertise, inviting professionals such as school nurses to give sex education lessons, or external organisations that use drama to explore sensitive issues. Research from Sheffield Hallam university found that school nurses were involved in the teaching of SRE in 45% of primary schools that taught it, and other external organisations were involved in 22% of schools. That research looked into different aspects of PSHE in primary and secondary schools, including SRE.
The researchers conducted a nationally representative survey with more than 900 primary schools and around 600 secondary schools. The study looked at which aspects of PSHE were taught and how frequently. In primary schools, more than 50% taught all elements of PSHE and 40% taught some elements. More than three quarters taught emotional health and well-being every week. Other aspects, such as diet and safety, were taught at least once a term by two thirds of primary schools.
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Three quarters taught SRE once a year or less often, with similar coverage on personal finance, enterprise and drugs education.
The study also examined aspects of PSHE in depth with nine primary schools. It found that the schools most valued official sources of support for planning or for signposting other resources. Teachers valued resources that were easy to use, enjoyable and engaging for pupils, which responded to pupils’ needs and were relevant to the context of the lessons. One of the key aims of the PSHE review is to identify the support that teachers need to provide high-quality teaching. The use of resources and expert support for schools are critical in that regard.
I am aware of the Christian Institute’s booklet, “Too much, too young”, which was referred to by my hon. Friend the Member for South Northamptonshire. It raises the question of which teaching materials are appropriate for school children. A search of a number of the local authority websites cited in the booklet did not reveal any that had a list of SRE resources recommended for primary schools, although some had an intranet that could not be accessed externally by officials.
Local authorities tell schools about available resources in a number of ways, which may include directing them to websites where SRE resources are listed. The Sex Education Forum website has a list of resources, which includes some of those cited by the Christian Institute booklet. The Sex Education Forum website clearly advises professionals to make their own choices about which resources to use and does not endorse the resources on the list. The website also provides a list of questions to help teachers choose and use a resource.
Andrea Leadsom: Does my hon. Friend acknowledge that unless one happens to have a seven-year-old who has exactly the same mental capacity as every other seven-year-old, one cannot decide what is absolutely right for all seven-year-olds in a class? It is extremely difficult for an adult to decide what might terrify a seven-year-old, particularly as children are not all the same. Does my hon. Friend agree that some form of uniformity, by making better classification, would be extraordinarily helpful in decision making?
Mr Gibb: I will come to that and the other points made by my hon. Friend in a moment.
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The questions on the website include the following. Is the resource consistent with the values set out in the school’s SRE policy? Is it appropriate for the age, ability and maturity of the children? Have parents been consulted? Will the resource be used in its entirety or will it be more appropriate to adapt it and select from it?
The hon. Member for Kingston upon Hull North (Diana Johnson) asked whether such material was being used in schools, so I will talk to the Sex Education Forum and to my hon. Friend about the materials, how their content is decided and how they are used in schools. I think the SEF, with its wide range of member organisations, including those representing children and youth, faith groups, health, parenting and families, should have a perspective on such matters. I also want to explore how the range of resources available influences practice in schools, and I will talk to the makers of BBC Active and Channel 4’s “Living and Growing” resources to understand how such resources are selected for particular age groups and how parents are involved.
My hon. Friend and others raised entirely legitimate concerns in the debate, and we must ensure that parents are listened to. There are safeguards in place to protect children from inappropriate materials. First, governing bodies have a statutory responsibility to ensure that schools have a policy on sex education, which, as a minimum, should give information about how sex education will be provided, any sensitive issues that will be covered and who will provide it. Secondly, local authorities, school governing bodies and head teachers must have regard to the Secretary of State’s statutory, “Sex and Relationships Education Guidance”. Paragraph 1.8 states:
“Materials used in schools must be in accordance with…the law. Inappropriate images should not be used nor should explicit material not directly related to explanation. Schools should ensure that pupils are protected from teaching and materials which are inappropriate, having regard to the age and cultural background of the pupils concerned. Governors and head teachers should discuss with parents and take on board concerns raised, both on materials which are offered to schools and on sensitive material to be used in the classroom.”
My hon. Friend also proposed the licensing of materials, potentially by the British Board of Film Classification. I can readily understand her wish for materials—
Mr George Howarth (in the Chair): Order. It is time for the next debate.
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Community Groups (Lottery Funding)
12.30 pm
Barbara Keeley (Worsley and Eccles South) (Lab): It is a pleasure to have this 30-minute debate with you in the Chair, Mr Howarth.
I want to talk about one of the most deprived communities in my constituency and about problems in the distribution of lottery funding in general. I also want to talk about delays in using the lottery funding that could and should be helping that community but has not been doing so.
The constituency of Worsley and Eccles South is in the west of the city of Salford and it contains the ward of Little Hulton. Salford is the 18th most deprived local authority in the country, and Little Hulton is one of the most deprived wards in Salford.
Many issues need to be addressed in the area, including low levels of qualification and high levels of worklessness and child poverty. The ward also has higher than average numbers of people with limiting long-term illness, which leads to higher caring work loads for unpaid family carers. An area such as Little Hulton needs support to address such issues and to build the capacity of its community groups.
Historically, my constituency has not benefited much from lottery grants. We are ranked 624th of 650 constituencies in the award of grants for community arts and sports groups. Indeed, since 1995, lottery distributors have allocated only £6 million of funding and 262 grants to Worsley and Eccles South. By comparison, the Cities of London and Westminster constituency has benefited from £914 million and 2,231 grants, which is more than 150 times as much lottery funding to more than nine times as many groups. I notice that the Minister’s Faversham and Mid Kent constituency has also benefited from at least £15 million of funding. I am sure he would agree that there is probably not as much need in Faversham and Mid Kent as there is in my Salford constituency.
This disparity in funding is unacceptable. On a number of occasions, I raised with the Big Lottery Fund my concern about how few grants were being made to community groups in my constituency. Some redress of that grossly unfair distribution was promised in July 2010 with the announcement that Little Hulton ward was to benefit from £1 million of Big Lottery funding due to its having been “previously overlooked” by the lottery. I was pleased about that, but I was somewhat concerned to hear that it might be some time before the community in Little Hulton actually started to benefit from the funding being allocated to it.
At the time of the announcement, it was said that a charitable trust would be set up. The BBC news item said:
“It is expected that the charitable trust responsible for the lottery money will be in place by October and that projects will begin to receive funding from June 2011.”
It is now nearly the end of October 2011, 15 months after the announcement of the funding for Little Hulton, yet not one penny of the lottery money has gone to the local community.
There are plenty of ways that the funding could be used to good effect, and there are people with excellent knowledge of the area who could help to suggest them.
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The council has a competent neighbourhood team, headed by the excellent Vincent Nash, which has a really good grasp of the issues and opportunities in the area. Indeed the announcement of the grant to Little Hulton said that the neighbourhood team,
“played an important part in ensuring Little Hulton received the money, conducting a two hour tour for representatives from the Big Lottery Fund and explaining to them what some of the key challenges are in the area.”
There is also an outreach and engagement forum, which is a network of agencies in the area. It includes community representatives who live in the area, represent local people and understand local issues. They come from different residents associations, and I have worked with them on a number of local issues. Also included is Sylvia Phillips, the chair of the community committee covering Little Hulton.
Sylvia is a life-long resident of Little Hulton and she has substantial knowledge of local issues. At the announcement of the Big Lottery funding, she was bubbling with ideas. She said:
“One of the things we feel we’d like to do is have some sort of community resource in the centre of Little Hulton, so it’s accessible to all the residents. Maybe we could have it for the old and the young, like a recording studio on one side and then there could also be a meeting room where the older people could meet...we have a good park which could be used for lots of things and the community spirit in Little Hulton is alive and kicking.”
I should like to report that some of those ideas had been examined for feasibility over the past 15 months but I cannot. The 15 months have been characterised by false starts and by long periods when nothing appeared to be happening.
In August 2010, the neighbourhood management team met lottery representatives to see how they could support them in getting local people involved. It was six months later, in February 2011, that a Salford-based voluntary organisation was appointed as the lead organisation. An initial meeting was held. Twenty residents, the neighbourhood team and other partner organisations gave their views on what the trust’s development funding should be used for. Sylvia Phillips tells me that she knocked on people’s doors to get them to come along to that meeting. Months then elapsed with nothing happening. The residents who came to the meeting used to stop Sylvia in the street to ask her what was happening, but she was unable to tell them.
The allocation of £1 million to a deprived area that has missed out on funding should be good news, but all we have seen for 15 months is false starts and lack of progress. The Big Lottery has been unable to get a scheme going effectively, which could be because the area does not have an established infrastructure of voluntary and community organisations. Existing structures and individuals were ignored by the Big Lottery, which seemed to be looking for further community networks that do not exist in Little Hulton. The structures that exist are centred on the local council, the Churches and the schools. Salford council has established ways of reaching out to the community and engaging local residents.
I shall list the issues that I believe have caused the delays and false starts: ignoring existing structures and key individuals; searching for a lead organisation to establish the trust—that caused at least nine months of the delay; and appointing staff from outside the area
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rather than recruiting a paid staff member to work in the area. I have seven years’ experience of the constituency and I, along with people from outside Salford, have had a lot to learn about how to work with local people. In September, a Manchester-based organisation was put forward as the lead agency and a Leeds-based consultant was appointed as the representative for the Big Local Trust in Little Hulton. What we have seen even over the past few weeks is a lack of understanding by people who come from outside the area. I do not blame them for that; it is difficult being brought into an area for the first time. It was not a brilliant start. The newly appointed people scheduled meetings for the residents in a different area of Salford. That appeared to be for the convenience of the organisers, but it confused people. There was suspicion that it meant that the funding was to be used over a wider area.
I understand the need for consultation in establishing a charitable trust such as this, but the consultation has been repetitive. A sizeable group came together in February to give their ideas and input. None the less, the agenda for the meeting in October included “involving community organisations.” As I said, we do not have a vast network of community organisations.
The appointed consultant sent me a report before this debate. He said that
“community associations in the area will be approached and involved in the next phase of consultation and community visioning work.”
Clearly, he is adopting a particular approach to community development that ignores the context he is in. I do not know who briefed him but such an approach will not work. At a recent meeting with residents, he suggested that they go on away-days. The residents are frustrated. They have contributed a lot to this process and they do not want to go on away-days. In fact, being taken out of their own ward made them feel as though they were on an away-day.
However, I can report some better news. The view of Sylvia Phillips and other local representatives prevailed at that meeting. They conveyed some understanding of what would work in an area such as Little Hulton. They had their own sensible ideas, including holding meetings in Little Hulton itself and not in other venues. They suggested that consultation should be done at existing community events, such as the upcoming bonfire night. They also suggested using an empty shop in the district shopping centre as a way to make better contact with local people. As I heard about these things, it seemed to me that much of the process is about basic good practice in community development. If people coming from outside the area do not understand the local context, they must listen and learn from local residents.
Even at this point, 15 months into the process, and even with the recent developments in the scheme, the focus is still on the seemingly small item of how to bid for and spend £30,000, which is a small amount of development funding, and on how to get consultation going again. It really is time that the scheme got past that stage and that residents started to see their ideas being taken more seriously. Although the £1 million has been sitting about, inflation is at 5% and the £1 million allocated to Little Hulton has already eroded in value.
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If we go too many months down the road, it will be worth less than the £1 million that it was worth last year.
Little Hulton is an area where unemployment, including youth unemployment, and child poverty are getting worse. We had riots in Salford this summer, although I probably do not need to remind people of that.
I understand that the Big Lottery Fund is independent, but the Government give them directions, and I believe that the Cabinet Office is currently consulting on changing those directions. In fact, I hope that the problems that the Big Local Trust has had in getting started in Little Hulton—problems that I am reporting today—can serve to inform the consultation.
The Big Lottery Fund’s mission states:
“We are committed to bringing real improvements to communities and the lives of people most in need.”
It also says that the Big Lottery Fund will “give money” to neighbourhoods that have failed to access cash and will let them
“decide where and how it can be put to best use.”
I must say that that is not what we have seen with the Big Lottery Fund’s work in Little Hulton during the last 15 months. In a flurry of criticism earlier this year, the Big Lottery Fund was criticised for spending a reported £71 million each year on its own running costs and wages for its 988 staff. The high staff salary levels were justified by the Big Lottery Fund, which said they reflected the fact that their employees were graduates who did not do “routine clerical jobs” but jobs that require
“skill and judgement, managing 26,000 ongoing projects.”
Again, I must say that we have not seen much of that “skill and judgement” being exercised in the last 15 months in relation to our scheme in Little Hulton.
I hope that this report of a local situation—I admit that it is very local—is useful in showing what can go wrong. It provokes some questions about how the Big Lottery Fund is running its Big Local Trust scheme.
I have a few remaining points to make and I also have a question to put to the Minister. I believe that a better way to establish a Big Local Trust scheme in an area such as Little Hulton is to start by utilising all the existing structures in the area, including the neighbourhood management team and the Churches. I have not talked about the contribution that the ministers of our local Churches make, but it is substantial; they do a lot of work in the community. Other existing structures and representatives include ward councillors, local residents and even the local MP. I have not been consulted and nor have the local ward councillors. I would be happy to meet representatives of the Big Lottery Fund to ensure that the fund is finally going to start working effectively on the scheme in Little Hulton.
Some of the approaches used for community capacity building that I have described today, such as talk of “community visioning”, may not be the way to start that work in a community such as Little Hulton. They are more suitable for areas with an established voluntary sector and where individuals are more used to going on away-days and using all those training development techniques. I do not decry those methods. In the right place, they can be very useful, but people in Little Hulton are impatient to see something get off the ground.
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Does the Minister agree that a distributor such as the Big Lottery Fund, which has nearly 1,000 staff and running costs of £71 million, should understand how to establish a project to distribute funds of just £1 million in an area with fairly minimal community capacity? Also, can the Big Lottery Fund look at what has happened in Little Hulton and learn some lessons that it can apply in other deprived communities?
12.43 pm
The Minister for Sport and the Olympics (Hugh Robertson): It is a pleasure to serve under your chairmanship, Mr Howarth.
I congratulate the hon. Member for Worsley and Eccles South (Barbara Keeley), both on securing this debate and on the way that she has put her case across. Having said that, I must say at the outset that I owe her two apologies. First, I am not the Minister in the Department for Culture, Media and Sport who has been responsible for the national lottery. That is the Under-Secretary of State for Culture, Olympics, Media and Sport, my hon. Friend the Member for Weston-super-Mare (John Penrose) and I am afraid that he is away at a European meeting today. Secondly and probably even more fundamentally, because it took the DCMS some time to make contact with the hon. Lady’s office and establish the precise points that she wanted to raise, we are no longer even the Department that she needs to answer her questions. As she knows, the responsibility for BIG—the Big Lottery Fund—has now transferred to the Cabinet Office. So she really wants the Minister for the Cabinet Office and Paymaster General, who is now responsible for BIG.
Needless to say, I have a wonderfully drafted speech, but it answers very few of the hon. Lady’s questions. The best thing that I can do is to give her an undertaking that I will write to the chair of BIG. She can either write me a letter that I will send on to him, or I am very happy to get officials in my Department to write to him and ensure that the questions that she has put today are taken on board and that something is done about them.
At the end of her speech, the hon. Lady asked me if I thought that what has happened in her area was an acceptable way to operate. The honest answer is, “No, I don’t think it is.” I am not an expert on the exact administrative charges that apply to BIG. However, when BIG was administered by DCMS, as part of the comprehensive spending review we set all our non-departmental public bodies—including the two that I am responsible for directly, which are UK Sport and Sport England—a target of bringing their administrative costs down to 5% of their spend. I would be very surprised if BIG was allowed to be an exception to that at any stage in the future.
I absolutely share the hon. Lady’s analysis of what has gone wrong here. It is very likely that the lottery distributor looked to an existing pattern—a form of working—that, for the reasons she has perfectly outlined, simply does not exist in Little Hulton. Therefore, having promised this money, it was imperative for BIG to find some other way to deliver it, because there is nothing more frustrating and draining for community groups than to be offered the opportunity to bid for a pot of money such as this one, which, as the hon. Lady correctly said, could and should be very profitably used in the
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local community—indeed, that is exactly what the national lottery was set up to do and it is why ticket sales have increased year on year, as they have done—and then the promise not to be delivered on over a protracted period of time. I am absolutely with her on all of that.
Barbara Keeley: In fact, we did not even have to bid for this money. The important thing about this element of BIG funding is that it is meant to redress the imbalance. Clearly there is a big imbalance to be redressed, whereby the constituency of Cities of London and Westminster has received £914 million of lottery funding and my constituency has received only £6 million, which is a very small amount.
What has happened in Little Hulton is an absolute indication that we do not have a community infrastructure, whereby groups are ready, able and full of the sort of people who can put bids in. There is a sort of double disappointment, that this is a scheme like the previous scheme, Fair Share, to try to redress that imbalance a little bit, but what happened is that a series of new barriers were erected. The right thing to do would have been for BIG to send someone in with some experience of community development in an area such as Little Hulton—there are people up and down the country who have that experience—and they could have tried to work with local people to develop their agenda.
Having looked at this project in Little Hulton, it seems crazy for BIG to have a scheme to distribute money in areas that have failed to bid for lottery money but then to look for a bidding organisation in those areas. That is the point, really. There will be 50 of these projects and the Big Local Trust really needs to have a different path that, as the Minister says, helps those projects to get started in areas where there is no community infrastructure. Instead, people could use councils, churches, schools and those sorts of bodies.
Hugh Robertson: I can only say to the hon. Lady that I agree with her absolutely. As she correctly said, the problem points to the fact that much of the infrastructure that would normally be needed to apply for lottery grants is simply not present. Therefore, if money is to be delivered effectively—no one wants to see money promised but not translated into projects on the ground—alternative delivery mechanisms to the normal ones will be needed. I suspect, without wishing to over-egg the pudding, she will find that that is the case not only for the areas for which BIG is responsible but for sports, arts and heritage, which are the three other beneficiaries of lottery funding, falling outside the allocation to BIG.
I can give the hon. Lady some small words of comfort: the problem is probably better understood than it was 10 years ago or at the start of the lottery in 1994, and a pattern can now be clearly established. All the national lottery distributors are aware of that. I spent an hour before I came to respond to the debate talking to Sport England about community sports grants, in connection with London 2012 and the inspired and iconic facilities, specifically concentrating on how we might get more of that money into areas where it is needed. We talked about the riots and about how we might increase the capacity for people to play sport, not only by putting in coaches and officials but by doing something about the facilities. The process has been lengthy but, slowly, some understanding has come about.
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Barbara Keeley: I want to mention StreetGames—I am sure the Minister knows it—which, in my experience, has a wonderful model for going into deprived communities and getting projects off the ground. Perhaps BIG needs to be talking to StreetGames about how it does things.
Hugh Robertson: Let me immediately give the hon. Lady some comfort. It would probably be invidious of me not to name them all, but in our meeting we were talking about three organisations in that regard and StreetGames was one. When the party conference was in Manchester a few years back, I went to see a number of its projects, and I have seen it sponsor things here. Absolutely, StreetGames is that sort of provider organisation. I suspect that the problem she is facing with the Big Lottery Fund is that BIG has not recognised that other local organisations such as StreetGames in the voluntary and community area could deliver the sort of improvements for which she is looking.
I could test everyone’s time in the period before lunch by reading through my speech but, given what the hon. Lady has said this morning, I am not sure that it will add greatly to the nation’s sum of knowledge. By far the best thing that I can do to help her and her community is to give an undertaking. If she is prepared to write a letter to me, I will write on her behalf to the chairman of the Big Lottery Fund, telling him that I have given her an undertaking that he will meet her. We will arrange a meeting with him at which she can take up the issues directly. We might then achieve what we all want to see, which is that her community gets the money promised to it—which it clearly needs—as quickly and as efficiently as possible, commensurate with the need to account for the money correctly.
Barbara Keeley: That is a useful way forward, Mr Howarth, and I am happy to do what the Minister suggests.
Hugh Robertson: With that, I need detain the Chamber no longer.
12.52 pm
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Fire and Rescue Centres (North-West)
1 pm
Tim Farron (Westmorland and Lonsdale) (LD): I am extremely grateful for this opportunity to discuss the future of Cumbria’s fire and rescue control centre. The proposal to close the control room and regionalise it in Warrington is of deep concern to my constituents in south Cumbria. It is a threat to public safety and a waste of public money.
It is a pleasure to serve under your chairmanship, Mr Howarth, and to see the Minister in his place. After our discussions about Cumbria county council’s botched single-status project, he might think that this is the latest in a long line of concerns over which he has no direct jurisdiction that I have brought to him. To add to his consternation, I am here in part to praise his actions and those of the coalition Government in this matter.
The previous Government proposed a centralised series of regional control centres for fire and rescue services, which would have led to a programme of forced closures and amalgamations of fire control centres, but after the coalition formed in May 2010, the new Government called off the project after a Public Accounts Committee report labelled it an expensive white elephant. That wise decision by the Government was welcomed in Westmorland and throughout Cumbria, and it should have been the end of the matter.
Sadly, however, Cumbria county council decided to ignore the Government’s sensible conclusions and proceed with the project anyway, planning to close the excellent control room in Cockermouth and keep faith instead with the white elephant in Warrington. The county council proposes in 2014 to merge all north-west fire and rescue service control centres into a single control room in Warrington, although the plans have received a severe setback after the announcement that the Merseyside services would be withdrawing from the project.
Merseyside’s decision does two things. First, it undermines even further the viability of the regional model and plays havoc with the project’s finances. Secondly, it provides an entirely sensible alternative model. Merseyside has chosen instead to pursue a merger within the county with the control rooms of other Merseyside emergency services. Merseyside has recognised, as must we, that there is a financial imperative. It is completely necessary to make efficiency savings in a time of financial crisis, but Merseyside, unlike Cumbria, has demonstrated a bit of lateral thinking by choosing an option that saves money and keeps the service securely within the area, protecting public safety.
Although many are concentrating on the proposal to set up the regionalised centre in Warrington in 2014, we must remember that the closure of the Cockermouth control room will come much sooner, in June next summer. The county council plans pre-emptively to close its control centre in Cockermouth and outsource its work to the Cheshire fire authority. From next summer, 999 calls from Cumbria for fire and rescue emergency support will be answered in Winsford, more than 100 miles from most places in Cumbria—that is, if we are lucky. The Cheshire service, like many other authorities, has a resilience partner, its neighbouring service in north Wales. However, as hon. Members might be aware, the Welsh services plan to co-operate in
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a single service, meaning that Cheshire is looking for a new resilience partner. The favourites at the moment are Humberside and Buckinghamshire. That is where Cumbrians can expect their emergency calls to be answered by next summer, unless the county council changes its mind.
That is desperately worrying for all of us who believe that there are extremely good reasons for having a local control centre. I have no doubt that the people and technology in Winsford, Warrington, Wycombe or wherever Cumbria’s 999 calls might be answered will be excellent. I am in no way suggesting otherwise. However, it is also the case that the team at the Cockermouth centre are outstanding professionals who have shown immense dedication to our county week in, week out, particularly recently, when they have made an amazing difference by responding to catastrophic floods in 2009, the Grayrigg tragedy in 2007 and various other tragedies and near-tragedies off Cumbria’s coast, especially in Morecambe bay. It is peculiar for Cumbria county council to say thank you to those who have played a huge part in saving lives by outsourcing their jobs and moving their entire operation to the other end of the region.
The main reason why we must resist centralisation is that it will damage public safety. In more than 90% of cases, the regionalised system will provide an excellent response to people in emergency situations. Capable call handlers with a modern mapping system will scramble the right team to the right address swiftly and with the right result. However, some occasions seriously require local knowledge. For example, there are two Staveleys in my constituency and two Troutbecks and a Troutbeck Bridge in the county of Cumbria. Finsthwaite, where I was on Saturday, has three houses in the same postcode called Rose Cottage. A person sitting in Warrington or wherever, taking a panic-stricken call from someone in one of those places who cannot give an exact postcode or grid reference, will not know to ask critical supplementary questions such as “Which Staveley?” or “Is that the Rose Cottage by the church?” Such questions could save a life.
Even the best systems can only pinpoint a grid reference based on the nearest mobile phone mast when someone is out of range, which means that a grid reference given to the fire crew could be up to 18 miles away from the address where the emergency is taking place. I am not sure whether you have visited the Lake district recently, Mr Howarth, but getting a mobile phone signal is not always simple. Having a human being at the other end of the line who knows that there are two Staveleys 20 or so miles apart will save lives. There is no training like on-the-job training. Working in a control room where 100% of work relates to Cumbrian emergencies provides call handlers with the expertise needed to ensure a safe, specific and speedy response.
If Cumbria were to follow Merseyside’s lead and consider creating efficiencies by consolidating the control rooms of Cumbria’s emergency services, it could improve safety by exposing call handlers to the full range of Cumbria’s communities and to the geographical uniqueness of a county teeming with mountains, lakes and mountain passes, some of which are misnamed, being impassable. Meeting the needs of people in distress in our county involves understanding the county, the nature of road communications and the time distances as well as mileages involved.
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This week, we started the inquest into the tragic death of Mrs Margaret Masson, who died in the Grayrigg derailment in February 2007. The emergency services’ response to that tragedy was instant, and one reason was that the Cumbria-based control room staff knew the nature of the area and, crucially, that it was right, for instance, to call out volunteer mountain rescue teams, which had the kit and the expertise to respond the most quickly. That is why the mountain rescue teams got there first. Would a call handler in Warrington have pictured the scene in their mind’s eye and have had enough experience of our area to know automatically that it was a job not just for the professionals of the fire service but for the expert volunteers of mountain rescue? I am not sure, but I am sure that that quick response, based on the call handlers’ local knowledge, prevented a worse tragedy and saved lives.
John Woodcock (Barrow and Furness) (Lab/Co-op): I congratulate my neighbour, the hon. Member for Westmorland and Lonsdale (Tim Farron), on securing this debate. He makes some strong points. Does he agree that part of the problem is the impossible position in which local authorities such as Cumbria county council have been put by the scale of the reductions that they are being forced to make across the piece? They are being forced to consider efficiencies such as the £300,000 saving that the proposals will generate.
Tim Farron: The hon. Gentleman makes a fair point. Without doubt, all local authorities face huge pressure, because of the pressure on public finances. I simply make the case that the situation in Merseyside is no harder than that in Cumbria, and Merseyside has thought of an intelligent way through it. I am sure that all involved are not jumping for joy at having to make a difficult decision—merging control rooms is never easy—but, even at the hardest of times, whoever is to blame, it is possible to think laterally and to try to ensure that the service in the county is protected. The hon. Gentleman makes a fair point, but that does not let Cumbria off the hook, given Merseyside’s rather more intelligent response.
Having spoken to members of the Fire Brigades Union in Cumbria and to other fire and rescue staff, I know that they strongly oppose the proposals, because, as I am sure we all know, it is the firefighters themselves who rely more than anybody else on the accuracy and professionalism of the Cumbrian-based call handlers to get them to the right place, with the right information and at the right time. They know that a control centre 100 miles away, however fantastic and professional it will be, cannot be as reliable or responsible as a centre committed to Cumbria, focused on our county and understanding its quirks.
This is a rare opportunity for me to be critical of the coalition—the Labour-Conservative coalition in Carlisle that runs Cumbria county council. I will qualify that, however, by saying that I am proud to represent a county where six MPs—only two of us are present—from all three parties work closely together, not just on this issue but on others. I know that my colleagues share my deep concern on the issue, even if we might not always come to exactly the same conclusions. I think that there is exasperation across the county—including all three
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parties and, more importantly, in the community—about the county council’s decision to resist all attempts to get it to rethink.
The recent decision of the Merseyside authority to turn its back on this wasteful project seems to have been ignored. Only a fortnight ago, the county council’s own overview and scrutiny committee, chaired by Jo Stephenson, the county councillor for Windermere, discussed the project, objected to it, for the reasons that I have outlined—the objections came from all three parties—and strongly recommended that the cabinet of the county council think again. The cabinet responded in less than 24 hours, without any time to consider the committee’s recommendations, and obstinately proclaimed that it was not for turning. I am sure that the Minister will understand our extreme frustration. There are intelligent, safer and more efficient alternatives, yet the county has so far refused to countenance them.
As someone who believes that decisions such as this should be taken at a local level—not least because it means that voters know exactly who to blame at the next local election—I do not want the Minister to intervene and override the county council. He could not, even if he wanted to, and even if he could, he absolutely should not, in the interests of democracy and localism. I would, however, like him to help us all the same.
The Government rightly withdrew their backing for the national programme of regionalised control centres. The logic behind that decision was right. I would be immensely grateful if, as a result of this debate, the Minister wrote to the leader of Cumbria county council to explain why he feels—indeed, why this Government feel—that such a move is inefficient, wasteful and a threat to public safety. If it wants to ignore his advice, as well as that of many of the county’s MPs and the vast majority of Cumbria’s citizens, it can do so, but it will, of course, face consequences. An intervention by the Minister would do no harm and would be very welcome, especially given that all I am asking him to do is restate what he said about this flawed proposal last year.
We are not saying no to any reform or restructuring, but we want the county to use its imagination and value the unique nature of our county. It is a county where fire and rescue means a lot more even than our excellent fire brigade—it means mountain rescue, such as the teams in Kendal, Ambleside and the Langdales, and inshore rescue, such as the bay search and rescue team in Flookburgh. Ours is a county in which understanding all that is essential in responding to people in acute distress. By all means, let us look at how we can consolidate our emergency control centres in Cumbria, but do not go down a route of regionalisation that will cost more money and could easily cost lives.
1.14 pm
The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill): It is a pleasure to see you in the Chair, Mr Howarth. I congratulate my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) on securing this debate. I appreciate that the subject is important for his constituents. Indeed, the whole issue of fire control centres is one of real importance.
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It is worth setting the issue in its full context. My hon. Friend has rightly referred to the failure of the previous Government’s fire control project, and to the incompetence, inefficiency and waste highlighted by the Public Accounts Committee and the National Audit Office. I have seldom seen a more ringing condemnation of a Government policy than that given to the project that was embarked upon by the now Lord Prescott as part of an enforced regionalisation agenda. There is common ground between my hon. Friend and me in that regard. It is clear that lessons needed to be learned.
My hon. Friend is right to say that, when the coalition Government—by which I mean the Westminster coalition Government—came into office, we discovered that the project was already running 19 months late and experiencing problems. That was the situation that confronted me when I became Minister with responsibility for the fire service in May 2010. As my hon. Friend has rightly said, the NAO report, which was published on 1 July 2011, and the PAC report, which was published on 14 September 2011, highlights a litany of failings. That catalogue of problems led to the project wasting some £469 million of taxpayers’ money on an over-ambitious, over-complex and essentially imposed solution for fire control rooms that, frankly, was not proportionate to the risk faced and that failed the fire services themselves.
Two key failings were identified. The first was the lack of any consultation or involvement with the fire and rescue services at the beginning, which was highlighted by both reports, particularly that of the PAC. It was a top-down, imposed solution, and originally part of a broader regionalisation agenda that was killed off by a referendum in the north-east. The project under discussion was the last bit left hanging around. Secondly, the principal failure related to incompetence in the procurement of the IT—the software and the computer works. Part of the overall scheme involved the procurement of the nine regional control centres, and it is ironic that that was the one bit of the scheme that was actually delivered on time and pretty much to budget—the centres were there, but the properly working kit to put in them was not. That was why this Government took the view that we should negotiate with the suppliers, and we eventually concluded that a pass had been reached whereby we could not guarantee sensibly the delivery of the scheme to time, to budget or to the proper specification. Ultimately, therefore, we terminated the contract.
John Woodcock: Will the Minister put on record how much public money was wasted by that decision to terminate the project part way through?
Robert Neill: Although the matter was subject to commercial confidentiality, the hon. Gentleman should be made aware that damages were paid to the Government by the suppliers of the scheme, so we in fact recouped some money as a result of our actions.
Robert Neill:
The figure has been put in the public domain at about £22 million. The Government respected that confidentiality agreement, but since the figure is now in the public domain, I will not shirk from it. The Government got some money back. I say to the hon. Gentleman that his Government poured £469 million
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down the drain before we could prevent it from happening, so I do not accept any criticisms whatsoever of the decision to terminate the contract.
What we now have to do, sensibly, is find a solution that deals with the ongoing needs of the fire service for their control centres—that will vary from place to place—and that finds uses, as far as practically possible, for the nine control rooms that are left and in which a certain amount of public money has been invested. To that end—this is the background to the decision that Cumbria has taken—we determined that we would not go down the route of imposing a centralised solution. That is what went wrong before and is where I have common ground with, for example, the Fire Brigades Union, which is also very critical of that scheme.
We have decided that decisions on improving the efficiency and resilience of local control room systems are best made at a local level because, as my hon. Friend the Member for Westmorland and Lonsdale fairly says, that is where the risks are best understood. In addition, if it is practical to do so, we want to make good use of the buildings that are available. Frankly, it is preferable that fire and rescue services should take them over because they are purpose built for that service, but if they do not do so, other emergency services could also be appropriate users. We have said that we will not force fire authorities down such a route and that it is a matter for them to decide. If there is no fire and rescue or emergency service use for a particular centre, we will consider other uses to try to minimise the damage incurred to the public purse by past failings.
To that end, in July this year, I announced an £83 million scheme to build the national resilience that we all want to encourage through locally determined solutions and collaboration and innovation. Every fire and rescue authority—in Cumbria we are talking about the county council and in other places about stand-alone or combined fire authorities, for example, Greater Manchester and Merseyside—can apply for up to £1.8 million to improve the resilience and efficiency of their fire and rescue control services. The funding will cover the installation of improved communication equipment to give the enhanced voice and data services that are a priority for the sector. We consulted widely with the sector before introducing the scheme and the people we spoke to said that the ability for fire and rescue services to talk to each other—the transfer of voice and data, so that they can mobilise across boundaries and so on—was a key priority. We have therefore concentrated on that.
Fire and rescue services can either apply for the funding individually or collaborate by pooling their funding and providing further enhancements across a group of fire authorities. That is a decision that four of the authorities in the north-west have decided to take. As has been rightly observed by my hon. Friend, that area is not the same as the old north-west region because Merseyside has decided it does not want to be part of it. The scheme is not steered by the Government: it is a collaboration of sovereign authorities coming together to decide that they want to go down that route. Those authorities have been advised by their chief fire officers, who are their principal professional advisers.
Cumbria will be able to use its pot, either jointly or alone. As well as enhanced voice and data services, some of the things we want the funding to be used for include common standards to underpin collaboration
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and interoperability, and the facilitation of improved overload and fallback arrangements. My hon. Friend referred to the catastrophic floods in Cumbria. There are circumstances in which an individual control room can become heavily weighed down with the burden of such matters and it is sensible to have some resilience not necessarily physically in the same area. In fact, there are occasionally some advantages in having what is called a remote buddy system, whereby one control centre is able to rely on the support of another that is not affected by the same physical events. All those things can be in the mix. The Chief Fire Officers Association has indicated that it intends to apply for funding under our scheme to disseminate that sort of good practice.
Of course, my hon. Friend is right: the Merseyside fire authority decided that a north-west consortium was not an option that it wished to pursue. That is entirely its right and it will therefore pursue its own arrangements. However, I understand that the chief fire officers of the remaining authorities—Greater Manchester, Lancashire, Cheshire and Cumbria—have indicated that they are keen to proceed. That is the professional judgment that the chief officers have made, which I respect and do not seek to second-guess. They are also accountable to the elected members of their fire authorities, which in the case of Cumbria is the county council. As my hon. Friend indicates, the county council must ultimately make a decision on the matter. I will not second-guess its decision because it is on the ground and the decision is a local matter. What it is doing is not out of line with decisions being taken elsewhere in the country as a number of collaborative arrangements of one kind or another are taking place.
My Department is determined to be supportive and work with consortia where that is what people on the ground want. Where people think that a stand-alone solution is appropriate, again, they can bid to enhance on that basis. Inevitably, there are local concerns when such changes are made, but it is worth saying that whatever arrangements any fire authority makes with its control room, that does not alter the fact that it is the local fire crews on the ground who will be responding to the emergency calls, wherever they are directed from. Their local knowledge remains available. I just observe that the arrangements for a collaborative approach going beyond one county are not unique to the fire service. It is fair to say that the North West Ambulance Service mobilises on a much more regionalised basis from a control room in Preston. So the fire authority is not going out on a limb in that regard.
Tim Farron: The Minister makes some very good points. I thank him for mentioning that matter because it takes us down the road of where we might end up if we have a regionalised fire control room. Since the North West Ambulance Service went to a regionalised system based in an urban area, at least initially the number of times the volunteer first responder unit in Cumbria and north Lancashire was scrambled by the call handler dropped significantly. The urban-based call handlers did not have experience relating to first responders. The analogy I would make is with the mountain rescue teams. If somebody—wonderful as they may be—has no direct experience of the quirks of living in a rural area, those volunteer services will not be scrambled when they could save a life.
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Robert Neill: With respect to my hon. Friend, I would not go down the route of saying that that is automatically the case, because much depends on the briefing and the knowledge of the people in the control centre. At the moment, within the large county of Cumbria, calls are taken at a county-wide level. That is not as local as doing something at a fire station level, which we know would not be practical. Frankly, the appropriate level is a matter of professional judgment. It is also fair to say that a number of other fire authorities have similar arrangements. Suffolk and Cambridge, which cover a very large geographical area, are due to merge their control rooms. I have not seen evidence to suggest that that would pose an enhanced risk.
The key thing is that there is proper input from the fire authorities. The north-west consortium is being overseen by a project board and has very straightforward governance arrangements. The project board is led by a chief fire officer—a professional—as project director and there are senior representatives from each of the fire services in the consortium area on the board. Ultimately, they have reported to their authority. The decision has been scrutinised through the county council’s scrutiny procedure and the cabinet has concluded that that is the route it wishes to go down.
Tim Farron: The Minister pointed out earlier that the Government kyboshed the previous Government’s regionalised programme for two reasons, one of which was the lack of consultation. The consultation across Cumbria has been absolutely appalling. The Minister talked about the overview and scrutiny committee. It considered the proposals and rejected them, and the cabinet ignored that. Will he make a comment on the failure of consultation in that respect?
Robert Neill: The Government do not run those consultations centrally; it is for the county council to use its processes. I say again that the county council was advised by its chief fire officer. Often support for collaborative arrangements comes from professional fire offices, who frequently take the view that a modern and viable control centre can work well.
We are talking about a matter for local decision, which is why, with every respect to my hon. Friend, I will not be tempted down the route of telling the county council how to run its business. I have made it very clear already that we thought a centrally imposed solution was wrong, but that a locally developed solution—whatever it may be; it will vary from place to place—is the right one.
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Ritalin
1.30 pm
Mr Pat McFadden (Wolverhampton South East) (Lab): It is a pleasure to see you chairing the debate, Mr Howarth. I secured the debate because I want to talk about how we treat behavioural problems such as attention deficit hyperactivity disorder in children, and, in particular, about the increasing use of drugs to treat those problems.
I have been tabling questions on this issue for some months. I am sure that it is a complete coincidence that this morning, just a few hours before the debate, the Government announced an extra £32 million for children’s mental health therapy, including talking therapies. That news will be welcomed by parents and professionals, because it is important—a point that I want to stress—to have a range of treatments available for young children who suffer from this condition. Will the Minister confirm whether that is new money, or whether it is part of the wider £400 million announcement, made in February, on mental health? If it genuinely represents extra resources for mental health therapy for children, that is of course welcome. I also welcome its happy coincidence with this debate today.
My main focus is on the use of drugs to treat ADHD and similar conditions. The main drug that we usually talk about in this field is Ritalin. Ritalin is a brand name for methylphenidate hydrochloride, and it is this whole family of drugs that I want to talk about. I want to set out the trend of increasing use of these psychotropic drugs to treat ADHD, and the growth in their use for very young children—sometimes in breach of National Institute for Health and Clinical Excellence guidelines. I want to spell out why many in the field believe that this trend is likely to continue. Finally, I will issue a plea to the Minister to carry out a proper, comprehensive review of the use of these drugs involving professionals from the medical, psychology and teaching fields, as well as the families of those who have been prescribed the drugs.
Paul Flynn (Newport West) (Lab): Had the young Mozart been on Ritalin and the young Beethoven been on anti-depressants, we would probably never have heard of them. Does my right hon. Friend agree that trying to drug children into conformity and uniformity is the enemy of creativity?
Mr McFadden: My hon. Friend makes an eloquent point. I do not take the view that the drugs cannot work. I am not qualified to say that, but there are serious questions to be asked about the growth in their use.
The increasing use of these drugs has not just happened in the period since last year’s general election. I am not here to make a party political point. This has been going on for many years and is part of an international picture, so it is not the responsibility of a single party or a single set of politicians. Some professionals and parents believe that these kinds of drugs can be effective and have a role to play where ADHD is correctly identified, although it is also true that some psychologists believe that there is significant over-identification and diagnosis of ADHD in children. The real question is whether the drugs are considered alongside other appropriate treatments,
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and are used as a first option, or only after alternatives have been properly explored and considered. Let us look at the trend in the number of prescriptions in England in recent years.
A written answer in July showed that between 1997 and 2009 there was a more than sixfold increase in the number of prescriptions for methylphenidate to the point where, in 2009, 610,000 prescriptions were issued. The number had almost doubled in five years. There is no doubt that there is an increasing reliance on these drugs to treat behavioural problems in children. Methylphenidate is not always used on its own. It can often be combined with other drugs, so that the child ends up taking a cocktail of powerful drugs to control their behaviour in different ways during the course of the day.
What lies behind this trend towards the medicalisation of child behaviour problems? Why are we prescribing more and more drugs to treat such problems? Do we really believe that there has been a sixfold increase in the occurrence of ADHD and similar disorders in recent years, or are these drugs being used to treat behavioural patterns that were dealt with in different ways by parents and teachers in the past? Is the increasing labelling and categorisation of behavioural problems increasing the tendency to treat children with drugs?
Sue Morris, director of professional training and educational psychology at the university of Birmingham, recently said:
“It’s not uncommon for the diagnosis of ADHD to be based on parental reports - without observation of the child in a home or school environment. The prescription of drugs certainly shouldn’t be the first step in treating the disorder. Sometimes drugs are being used in the absence of talking therapy and psychological assistance, and that is wrong.”
There is clear guidance from NICE on the use of these drugs:
“Drug treatment should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis.”
NICE also makes it clear that methylphenidate
“is not currently licensed for use in children less than 6 years old”.
NICE makes it clear that it should be discontinued if there is no response after one month, and that treatment should be suspended periodically to assess the patient’s condition. What evidence does the Minister have that this guidance is being adhered to? Are these drugs always used as part of a comprehensive assessment and diagnosis? Are they used as the first option, or only after alternatives are considered? Are they given only to children aged six and over? Are children routinely taken off them after one month if they are not effective? Is their use periodically suspended to assess the patient’s condition?
I suspect that the Minister does not know the answers to many of these questions. In fact, when it comes to the number of children under the age of six being prescribed the drugs, I know that he does not know because the Department of Health has already told me. That is not a reflection on him personally, but it exposes a gap in our knowledge that must be filled. Why is it, despite the clear guidance from the Department of Health about the appropriate age for use of these drugs, that the Department does not know how many children under the age of six are being prescribed the drugs?
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Evidence from the Association of Educational Psychologists suggests an increase in the use of methylphenidate for very young children. An informal survey of their members in the west midlands suggests that more than 100 children under the age of six in that region alone are on some form of psycho-stimulant medication. As we do not ask for someone’s age when a prescription is written, the Department of Health has told me that it cannot say whether its own guidance is being adhered to. I am sure the Minister would agree that that is an unsatisfactory situation. We have clear guidance from the Government, but no clear knowledge about whether that guidance is being breached on a regular basis. That is not an acceptable situation and the Government must establish a clear picture of what is going on.
I am not asking the Minister to ask the age of every person issued with a prescription, but it would be possible, through a proper survey of practitioners, to establish how much prescribing involves very young children. Will the Minister commit today to carrying out a proper research survey of professionals in the field to establish the degree to which the guidance from NICE is being adhered to and to establishing a clearer picture, particularly with regard to the use of these drugs by children under the age of six?
The question of age is not only about the youngest children. The sharp increase in the use of these drugs in recent years means that we now have a generation of teenagers who have taken psychotropic drugs for years. What happens when they reach adulthood? What are the long-term effects and what is the appropriate alternative treatment for people trying to come off these drugs after a number of years? In its review, NICE concluded:
“Given that ADHD is a chronic condition which may require long-term treatment, there is a need for further data on long-term outcomes of drug treatments.”
There is significant regional variation in prescribing patterns, with the BBC reporting a few years ago that the highest prescribing area prescribed 23 times more than the lowest. I can understand that in any health system in which people are asked to use their judgment prescribing patterns will not be uniform, but 23 times more is a very large difference, and there is similar variation abroad. In the United States, for example, the closer someone lives to the east coast the more likely they are to be diagnosed with ADHD and prescribed these kinds of drugs.
An important feature of the growth in the use of methylphenidate to treat behavioural disorders is the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition”—DSM-IV. The manual breaks down and categorises various psychological and behavioural disorders and has significant international influence. In 2013 it will be replaced by DSM-V.
Some people believe that such publications exacerbate a trend towards the over-medicalisation of behavioural problems. The British Psychological Society, for example, has expressed serious concerns about DSM-V. Its response to the impending introduction of the fifth edition states:
“The Society is concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.”
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“Diagnostic systems such as these therefore fall short of the criteria for legitimate medical diagnoses. They certainly identify troubling or troubled people, but do not meet the criteria for categorisation demanded for a field of science or medicine”.
What is the Department of Health’s response to those serious concerns? How does the Department intend to work with the professions on the introduction of DSM-V, and does the Minister share the concerns of the Association of Educational Psychologists and the British Psychological Society that it might exacerbate the trend towards the medicalisation of behavioural problems?
It is for all those reasons—the growth in the number of prescriptions, the evidence that they are being given to very young children, the wide regional variations in their use, and the lack of firm data and evidence about the long-term effects of combining these drugs with others—that the Association of Educational Psychologists has called for a review of the use of the drugs. The review should involve paediatricians, child psychiatrists, GPs, teachers, parents and other relevant voices. We must get to the bottom of what lies behind the increased use of the drugs, and establish whether we are dealing with childhood behavioural problems as best we can.
The association’s call for a review is a call I echo today, and I hope that the Minister can confirm that the Government will undertake such a review, before the introduction of DSM-V in 2013. I hope also that he will be open-minded about my questions. I welcome the money for children’s mental health therapy that has been announced today, but it does not mean that we should ignore the questions raised in this debate. If recent trends of growth in the use of the drugs were to continue, we could end up with more than 1 million prescriptions for them, each year in England. Would the Minister be comfortable with such an outcome?
Having highlighted the growth in the use of the drugs and raised concerns about their being taken by very young children in particular, I am essentially asking the Minister to do two things. First, will he commit his Department to carry out a proper research project into the use of the drugs, including the age of the children receiving them? Secondly, in the light of the huge growth in prescriptions, will the Government carry out a proper review of practice in the field, as called for by the Association of Educational Psychologists, before the new guidance comes into effect in 2013? Those requests are moderate and measured, and I look forward to a positive response.
1.45 pm
Mr Frank Field (Birkenhead) (Lab): I am grateful to my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) for securing this debate and for allowing me to address a simple question to the Minister.
Like my right hon. Friend, I am not qualified to say whether people should be on treatments or not, but I am struck by the increasing number of children in Birkenhead who are given what a group of teachers has referred to as “medical coshes” to keep them quiet. In some instances the drugs are no doubt necessary, and
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they work, but along with my right hon. Friend I question the growth in the number of prescriptions.
Will the Minister work with his colleagues in the Department for Work and Pensions to consider the moral hazard of someone ensuring that their child is on Ritalin so that the prescription gives them access to disability benefits? Clearly, that was never the Government’s intention, but we now have a system in which, if someone can prove that their child is ill, and keep them ill, the likelihood of the child being passported on to disability benefits increases. I know that this is not in the Minister’s sphere of influence, but in his response to my right hon. Friend’s most detailed points will he tell us whether he will co-ordinate with the relevant Minister in the Department for Work and Pensions to look at the moral hazard of someone proving their child needs to be on Ritalin to increase their chances of getting disability living allowance for that child?
1.47 pm
The Minister of State, Department of Health (Mr Simon Burns): I congratulate the right hon. Member for Wolverhampton South East (Mr McFadden) on introducing a particularly interesting and sensitive subject. He made his points very fairly and very well. In passing, I should, I suppose, declare an interest because a member of my family has for a number of years been on Ritalin and, contrary to the observations of the hon. Member for Newport West (Paul Flynn), the benefits to that person’s education have been immense—the decision was taken on clinical advice, not on the advice of parents.
I am pleased that the right hon. Gentleman has welcomed the announcement by the Minister with responsibility for social care, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), of £32 million to help with children’s mental health. The right hon. Gentleman asked whether that was new money. It comes from within the £400 million that was identified by the Treasury in the spending review last year.
The right hon. Member for Birkenhead (Mr Field) asked about the link between disability allowance, and other entitlements, and children on Ritalin. The entitlement is based not on having a specific health condition diagnosis or treatment, but on what help is needed with personal care as a result of the disability. Nevertheless, I will certainly draw his comments to the attention of my right hon. Friend the Secretary of State for Work and Pensions, whose Department will hopefully get back to him.
Let me set out some of the background to this issue. According to NICE, between 3% and 9% of school-aged children and young people in the UK meet the broad criteria for mild to moderate attention deficit and hyperactivity disorder, and between 1% and 2% suffer from severe ADHD. Methylphenidate, commonly known as Ritalin, and similar drugs are used to treat a range of mental health conditions, including ADHD. The NICE guidelines, published in 2008, recommend that medication should always form part of a holistic package of care, which might include talking therapies. I fully appreciate the concerns raised by the right hon. Member for Wolverhampton South East about the increase in the number of prescriptions for Ritalin and similar drugs. We need better to understand the reason for that. It is
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always wrong for doctors to prescribe medication inappropriately, and medication should not be the sole response to an individual’s condition.
I fully appreciate the concerns of those worried about the growth in prescriptions for Ritalin. We do, however, need to acknowledge the fact that too many young people and their families are not getting the support they need. The NICE clinical guidelines on ADHD said, at the time of their publication in 2008, that a minority—fewer than 50%—of all individuals who should be receiving medication and/or specialist care were in receipt of such care. If left untreated, mental health problems can lead to low attainment in school, antisocial behaviour, drink and drug misuse, worklessness and even criminality in adult life. Getting things right for children and their families—through a broad range of support to promote good mental health from the start of life, through the school years and into adulthood—can make a real difference to young lives.
The costs of doing nothing are simply too great. Across hospital and primary care, the prescribing of drugs for ADHD increased by around 12.5% between 2007 and 2010, the latest four years for which data are available, and by around 6% in 2010 alone. Prescribing in primary care alone increased by 22% in that four-year period, reflecting a significant shift in prescribing activity from a hospital setting and into primary care. Looking back further, one sees that prescribing in primary care has tripled in the past 10 years. Some variation in the prescribing of ADHD drugs around the country must be expected in the light of the distribution of specialist services, which might be more likely both to diagnose children with ADHD and to support GPs in taking responsibility from hospital teams for repeat prescriptions; the different local patterns of prescribing across primary care and specialist settings; and demographic factors, such as deprivation, which might be correlated with ADHD.
We do not, however, have good-quality data on the number of children and young people assessed with ADHD, against which prescribing patterns could be compared. If we had, it would be possible to gain a true measure of variations in clinical practice. Prescribing data are not routinely collected by age, but we do need better to understand the position. In the shorter term, we are investigating whether further helpful information can be derived from prescribing research databases. As a result, the data we do have must be interpreted with care and in the context of all the evidence that suggests under-diagnosis and under-treatment of this distressing behavioural disorder.
Mr McFadden: The point about age is important. The NICE guidelines on children under six could not be clearer. The Minister acknowledges that the Government do not know—I will leave aside whether that is a good state of affairs—how many children are prescribed these drugs. His Department has a research budget, so, rather than trawling other research projects, why can it not commit to research to find out from professionals how many children under six have been prescribed such drugs?
Mr Burns: The right hon. Gentleman anticipates my remarks on the NICE guidelines, and I hope that once he has heard them the situation will be clearer.
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The 2008 NICE clinical guidelines on the treatment of ADHD are clear that medication is an appropriate treatment for severe ADHD, but that it should be initiated only by a specialist and should form part of a holistic care package that may include talking therapies. The guidelines do not recommend drug treatment for pre-school children, and health care professionals are expected to take the guidelines fully into account when exercising their clinical judgment. They do, however, have the right to prescribe the drugs if they feel it is clinically justified and in keeping with specialist consensus, given the individual circumstances of the child and in consultation with the parent or guardian. Such prescribing can include so-called off licence prescriptions, which means a prescription of medication outside its licensed age indications.
The right hon. Gentleman has asked the Department of Health to conduct a review of the prescription of drugs for the treatment of ADHD, working with families, teachers, medical and mental health professionals. It is, however, for NICE, as an independent organisation, and not for the Department of Health, to review the evidence and to provide national clinical guidance. Between 30 August and 12 September, NICE consulted stakeholders on whether to update its 2008 clinical guidelines. The review is a thorough assessment of the ways in which evidence on ADHD, including pharmacological treatments, has since developed. It will announce a final decision on its review shortly.
In June 2007, the UK led a European review of the risks and benefits of Ritalin and sought advice from independent scientific advisory groups on the available evidence. As a result of that review, the prescribing guidance for patients has been updated to ensure that it contains clear, comprehensive information about the effects of Ritalin and the importance of monitoring children and adolescents throughout their treatment. The safety of Ritalin remains under close review. In addition, the findings of research continue to inform the field and a number of bodies may commission such research, including the National Institute for Health Research. The Government are committed to improving mental health outcomes and have laid down important principles for the future in the strategy, “No health without mental health”, published earlier this year.
The emotional well-being and mental health of children and young people are vital to them as individuals, to their families and to wider society. A principle of the Government's mental health outcomes strategy is the importance of prevention and early evidence-based intervention. Half of those with lifelong mental health problems first experience symptoms before the age of 14, and three quarters of them before their mid-20s. Indeed, today, the Minister with responsibility for social care, my hon. Friend the Member for Sutton and Cheam, has announced £32 million of funding to improve access to psychological therapies for children and young people over the next four years.
Psychological therapies can in some cases form part of the holistic package of care that NICE recommended for children and young people with ADHD. It is important that a range of clinicians—paediatricians and GPs as well as child and adolescent mental health service professionals—are well informed on the diagnosis and treatment of mental health problems in children and young people. I am pleased to tell the right hon. Gentleman
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that the chief medical officer and the NHS medical director plan to write to clinicians to remind them of the full range of NICE guidelines on conditions—including ADHD—that affect children's mental health. They will highlight the opportunities to support rigorous use of evidence-based treatment through the improving access to psychological therapies programme. High-quality, evidence-based treatment is central to our programme to transform mental health services for children.
The right hon. Gentleman referred to DSM-V. This point goes much wider than ADHD alone and touches on the appropriateness of diagnostic categories that are the subject of international professional consensus through the American Psychiatric Association and through the World Health Organisation. The Association of Educational Psychologists and other concerned professional organisations might wish to make their representations on this issue through the American Psychiatric Association and the World Health Organisation.
The right hon. Gentleman asked what the Government’s response would be, but it is not the responsibility of the Department of Health to respond. The professional bodies respond and reach a broad, scientific consensus on the way forward.
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I fully appreciate the concerns of those worried by the increasing number of prescriptions for Ritalin and similar drugs. We are investigating whether further helpful information can be derived from prescribing research databases. It is of course for NICE, not the Department, to review the broader evidence and to consider the case for updating the existing clinical guidelines. That is what it has been doing and we await its conclusion. Furthermore, the NICE clinical guidelines on ADHD state that drug treatment for children and young people with ADHD
“should always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions.”
The NICE guidelines do not replace the clinical judgment needed to treat individual cases, but health care professionals are expected to consider fully the guidelines alongside professional consensus when exercising their clinical judgment.
2 pm
Sitting adjourned without Question put (Standing Order No.10(11)).