Tracey Crouch:
The hon. Gentleman will be delighted to know it was Sami I was thinking of when I wrote those words earlier. I thought she was a fantastic singer
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and that it was an inspiration to everyone watching to see someone of a bigger size be talented, and have the confidence to go up on stage and sing well.
It is a shame we do not see as much coverage of female as of male sporting heroes on our televisions. I hope that that will be addressed during the Olympics next year, and that serious consideration will be given to how to achieve balance in broadcasts and writing. The lack of women on the shortlist for BBC sports personality of the year is in the news today. Some superb sportsmen are on the list, and I would not want any woman to be included on it for anything other than merit and excellence, but it might be easier for females to be considered if they had a higher profile in the coverage in the first place.
I am proud to have co-signed with the right hon. Member for Leigh (Andy Burnham), earlier in the year, a letter to Mark Thompson, director-general of the BBC, which helped to secure coverage of the women’s football World cup quarter final on terrestrial TV. It was an important step forward in achieving wider interest in women’s football, but it is now time we looked at how broadcasters cover women’s sport in general. At the moment coverage is dominated by men’s sport. I do not suggest it should be 50:50, but I would like a bit more coverage, especially at peak times.
We have some brilliant sportswomen at the moment, and I will quickly plug Kat Driscoll, from Chatham, who has just secured her place in team GB, for trampolining. I cannot think of anything more inspiring for girls from Chatham than to see someone who grew up in the same street or went to the same schools as they did representing their country. Girls who play sports learn to set goals and develop discipline. Often they learn about teamwork. Those skills are good not just for sports but for life. We heard earlier, from my hon. Friend the Member for Wirral West, that confidence is hard to define. However, participation in sport and physical activity develops friendships and relationships and a passion for something that can stay with people for life, building the strength of mind and body that perhaps encapsulates what confidence should be about. I hope that the legacy of the Olympics and future sporting events will be to identify female role models, inspire greater participation in various sports and, ultimately, build confidence in girls, which in turn will stand the next generation of women in good stead.
3.29 pm
Kevin Brennan (Cardiff West) (Lab): I congratulate the hon. Member for Wirral West (Esther McVey) on securing the debate. It has been excellent, ranging far and wide on the issue of confidence and in particular on the confidence of girls in education.
As someone with two older sisters and a teenage daughter, I am aware of the importance of the subject and, particularly as the father of a teenage daughter, of many of the issues that hon. Members have discussed in relation to the way in which girls grow up and develop, what happens to their confidence over that time and the impact of culture, the media, school, education and friends on confidence, self-image and self-awareness. In fact, I had a conversation with my daughter about this debate when I found out about it.
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Chris Ruane: She wrote my hon. Friend’s speech!
Kevin Brennan: She would be quite capable of doing so, having recently got through to the next stage of a debating competition with her school. Members may be interested to know, however, that she is not particularly interested in following me into politics—I think that she has higher ambitions than that.
The contribution of the hon. Member for Wirral West highlighted the work that she has done on the subject. I commend her for her work with girls to try to build their confidence and make sure that they have opportunities. She spoke about the National Youth Theatre project in which she is involved with her book and her work with Girlguiding UK, an excellent organisation with which I had many dealings as a Minister in the old Department for Children, Schools and Families. Girlguiding UK is a superb organisation that does great work with young women and girls, and it is also extremely progressive and forward looking. I commend some of its publications to hon. Members, if they have not had the chance to look at them and see the work that it is doing with young women. It is a modern organisation doing a great deal of good work, and the hon. Lady gave an extremely thoughtful and thoroughly researched speech on the subject.
The hon. Lady then talked about the English baccalaureate and the role that it might play in building confidence, but that is one point on which my opinion might differ from hers. The reason why I intervened on her on the matter of music—another hon. Member said that it is a subject that can give confidence to young people and to girls in particular—is that, when I asked the Minister of State, Department for Education, the hon. Member for Bognor Regis and Littlehampton (Mr Gibb), who has responsibility for schools, a question recently, I was unable to ascertain an answer from him about the survey to which the hon. Lady has referred as to what has happened to those subjects not included in the E-bac.
Esther McVey: The hon. Gentleman is making a good point—we have all said that music, drama and sport are vital in developing confidence—but my point was about the ability of a person to have confidence and choice in their career later in life, so that they have the skeleton of a very good, sound education that does not limit them later. That is what we found to be the case for so many girls who limited their choices and future avenues early on.
Kevin Brennan:
That is a valid point. I completely accept that it is important that, when it comes to those crucial points in school when choices are made, young people and young girls in particular are aware of the choices that they are making and given good advice and mentoring about their consequences. My personal view is that the English baccalaureate does not serve that purpose particularly well and that it demonstrates that more young people are choosing the subjects that the Government want them to choose at a particular level. It is a self-fulfilling prophecy that that will happen when schools are told that that is how they will be measured. Inevitably, they will then change their timetables and resources in order for that to happen. My point is that that does not necessarily deal with the issue of having
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the confidence to take those subjects in the first place. I am concerned that we still do not know, because the Government did not ask the question thoroughly in the survey, what impact that has had on the other subjects that are outwith the English baccalaureate, such as religious education and music and drama, both of which have been referred to as confidence-building subjects.
The hon. Lady was followed by the hon. Member for Hastings and Rye (Amber Rudd), who made some important points about confidence in relation to teenage pregnancy and the rates of teenage pregnancy in this country. She is absolutely right. Teenage pregnancy fell by about 13% during the period in which the previous Government were in office, but the figure is still far too high in this country. All hon. Members want to figure out the best way to tackle that, because it is far too high. There are sometimes differences of opinion on the best way to approach the matter in relation to sex and relationship education and other such issues, but I have no doubt that the hon. Lady is absolutely right that building girls’ confidence and self-esteem is key to lowering that all-too-high statistic.
The hon. Lady also mentioned the issue of self-image, weight and obesity. I commend to hon. Members, if they have an opportunity to read it, the Foresight report, which was produced during the previous Government’s time in office, although it is not a political report. It centres on obesity and was published about four years ago. It is a key document to understanding the subject and its importance, particularly in relation to some of the issues under discussion.
The contribution of my hon. Friend the Member for Vale of Clwyd (Chris Ruane) was also very thoughtful and well researched. He made the point, which I think all of us strongly recognise, about the confidence that young girls have at about the age of 10. I have always thought that if someone wants to find common sense on legs, they should talk to a 10-year-old girl and they will get the common-sense answer to any question on any subject. Something happens, however, during the course of secondary education, puberty and the teenage years, and, often, girls who were tremendously confident, articulate and able to speak up for themselves, and who had ambitious ideas about what they wanted to do for their future, become withdrawn all of a sudden.
I was a secondary school teacher for 10 years from the mid-’80s to the mid-’90s, teaching children between the ages of 11 and 18, and I saw that for myself when I observed their progress during that period. I was lucky enough to be a form tutor for one form group for seven years, so I saw the boys and girls who stayed for each of those years grow up during that time. It can be depressing to see what can happen to young girls in particular at the crucial age mentioned by my hon. Friend, although I did everything that I could as their teacher and form tutor to try to instil in them the kind of confidence that they should have had. My hon. Friend also mentioned the importance of networks and the frightening statistic that the only group in which smoking is increasing in the country is 15-year-old, white, working-class girls.
My hon. Friend was followed by the hon. Member for Gosport (Caroline Dinenage), who spoke with a great deal of passion and commitment about the importance of science and engineering, and about encouraging girls to take up those subjects and to have the confidence to do so. I listened recently, while driving,
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to Jocelyn Bell on Radio 4. She was, of course, denied the Nobel prize for science. Many people think that that would not have happened to a man if he had discovered the pulsar, but because she was a relatively junior scientist at the time she never got the recognition, through the Nobel prize, for her achievement. She still went on to be an extremely distinguished scientist, but her description of the sexism that she faced as a young scientist working in the scientific community was disturbing. That was back in the 1960s, which is quite a long time ago, but there remains a certain attitude towards girls and science that we need to make sure is overcome.
The hon. Lady was followed by the hon. Member for Chatham and Aylesford (Tracey Crouch), who spoke about the importance of sport and physical activities in instilling confidence in girls. When I was a Minister with responsibility for school sport, I was fortunate enough to work with Dame Kelly Holmes and Baroness Sue Campbell on this subject. The hon. Lady is absolutely right. I had the wonderful experience of witnessing my daughter’s one and only brief experience on the hockey field at the age of 11, but then, somehow or other, she disengaged from sport and physical activity, so I think that the hon. Lady is absolutely right that we need to do more to encourage a wider range of activities for girls.
I want to mention one sporting heroine of mine, Nicole Cooke from south Wales, who won the gold medal for Great Britain in the cycling road race at Beijing. She won the world championship in the same year, which is something no other cyclist has ever achieved. If she were a man, I am sure that the recognition would have been absolutely enormous. It is a shame that there is not a female sports person on the sports personality of the year shortlist this year, as the hon. Lady has rightly said.
As I have said, I was a school teacher for 10 years until 1995 and became an MP in 2001. There is rightly a focus on standards and on the need for high achievement in the curriculum. However, I am absolutely convinced that we should not lose sight of some of the things that I fear might be regarded in some quarters of Government as the softer, wishy-washy liberal aspects of our discussion today. For example, one of the things that I was responsible for when I was a Minister was the social and emotional aspects of the learning programme in school. That dealt head-on with the problem that some children, particularly girls, were sometimes coming to school with a lot of baggage—emotional baggage rather than the bag in which they carried their school books—because of the nature of modern society, which some hon. Members have described today.
As my hon. Friend the Member for Vale of Clwyd has said, girls can come under pressure in the home, from the media or from the pace of modern life. As was mentioned earlier, the social and emotional aspects of learning programmes and subjects such as dance, drama and sport, or extra-curricular subjects such as debating, group work or the Duke of Edinburgh award can build self-esteem, confidence, resilience and the ability to take risks.
As the hon. Member for Wirral West has rightly said, those things are extremely important. I sometimes fear—it is entirely possible that when we were in government, we gave this message as well—that, in our desire rightly to say, “We want to raise standards. We want academic standards to improve. We want this to be the country
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that is the best place to go to school in the world and that has the highest academic achievements,” we lose sight of the importance of some of the social and emotional aspects of learning. Such subjects actually promote better academic achievement. Anyone who has worked in education will know that children who are well-balanced, well-rounded and emotionally stable will do better in the classroom.
Kevin Brennan: I will give way briefly before I finish.
Mrs Anne Main (in the Chair): Order. I am sure that the Minister would like to have a few minutes to respond to this important debate.
Chris Ruane: I do not give credit to the Prime Minister for many things, but he is introducing the index of well-being, which is being dealt with by the Office for National Statistics. Will my hon. Friend pay tribute to the work that is being done by the Government to measure well-being as well as academic standards?
Kevin Brennan: It is important to measure well-being, because welfare in the economic sense is not entirely related to the level of gross domestic product. There is nothing particularly new in that concept, but it is important to have a measure of well-being. It is also important for there to be such a measure in schools. That is the point I am making. If we are going to have such a measure for society as a whole, let us make sure we have it for schools, too.
Many books have been mentioned today. Hon. Members may have read the interesting book, “Grit: the skills for success and how they are grown”, by Yvonne Roberts, which talks about how to build social intelligence, emotional resilience, enterprise and discipline skills in girls and the importance of social and emotional intelligence. It also mentions how crucial reinforcement, mentoring and building resilience are. Some of the work done on that in schools by organisations such as the Young Foundation is extremely valuable and important.
Today’s debate has been extremely informative and of a very high standard. The subject is probably not highly politically controversial, but it has provided a useful opportunity to explore what the Government are doing to try to instil greater confidence among young women and girls in our schools and colleges.
3.44 pm
The Minister for Further Education, Skills and Lifelong Learning (Mr John Hayes): As the shadow Minister, the hon. Member for Cardiff West (Kevin Brennan), has said, this has been an interesting and important debate, and I congratulate my hon. Friend the Member for Wirral West (Esther McVey) on securing it.
I do not have daughters; I have two young sons. However, women have been very important to me throughout my life. My mother was a woman and, curiously, my wife is, too. Therefore, what I learned literally from the cradle is that women—mothers—shape our character and form our ambitions. We gain the confidence that has been described by so many of the
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speakers in this debate—it was highlighted by my hon. Friends the Members for Hastings and Rye (Amber Rudd), for Chatham and Aylesford (Tracey Crouch), for Gosport (Caroline Dinenage) and, indeed, by the hon. Member for Vale of Clwyd (Chris Ruane)—very early in our lives. Governments, schools and others can do much—I will talk a bit about what we are trying to do—but, in the end, the familiar influences, particularly maternal influences, are critical to subsequent progress.
I learned from my mother and my father, who were both wonderfully archetypically male and female. I think of my mother and I think of her softness and the smell of talcum powder; I think of my father and I think of how bristly he was and how he smelled of tobacco and work. They were certainly both archetypically male and female and were both wonderfully demonstrative and loving. They gave me the feeling that I was the most special little boy in the world—a feeling that has never left me, by the way. I feel that now, at this very moment, so my ambitions were reinforced by not only their direct support but the sentiments that they instilled in me.
I entirely appreciate the points that have been repeatedly made in this debate. As the shadow Minister has said, they have been made on the basis of good information and a shared determination across the Chamber. I entirely recognise that the challenges people face as they turn their own ambitions into reality are affected by many influences. In the short time left, I will try to deal with some of those influences, some of which are benevolent and some of which are malevolent, as the hon. Member for Vale of Clwyd said.
The hon. Gentleman made a wonderful contribution that underpinned the fact that this debate is as much about values and attitudes as it is about education. I reassure the shadow Minister that we understand—at least, I understand—that education is more than utilitarian. It is about values and attitudes, and ethos and sentiments. Although the work done by parents in instilling both ambition and the capacity to realise ambition in children is critical, the work done by our schools matters so much, too. Indeed, it matters more for those children who are not as fortunate as I was in having a stable, loving and supportive family.
In respect of girls and women, we need to go the extra mile. We need to take further steps to ensure that they are able to fulfil their potential. In the brief time available, I will talk about some of the steps that the Government are taking, but before I do so I will just say a word about Plato because I know that hon. Members would be disappointed if I did not. Some 2,500 years ago, Plato said:
“Nothing could be more absurd than the practice that prevails in our country of men and women not following the same pursuits with all their strengths and with one mind, for thus, the state instead of being whole is reduced to half.”
How interesting that the classical world understood what so often in the modern world we forget.
My hon. Friend the Member for Wirral West, who initiated the debate, has not forgotten because she has dedicated a great deal of her considerable skill and energy to the promotion of the interests of young women. I pay tribute to the work she has done. I was pleased to be able to support it in a room close to here, when she was able to launch her magazine, Chloe Can, which is aimed at young women. She was able to articulate some of the points that she has made today at greater
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length then. The work we do to establish role models in these terms is important, and my hon. Friend is indeed a role model for young women whose interests she has championed with such vehemence and to such effect.
We have learned much—I defer to the two former teachers who have spoken—about what characterises good schools in this respect. Schools with little or no gender gap in achievement tend to be characterised by a positive learning ethos—we have heard about that today, have we not?—high expectations of all pupils, high quality teaching and learning, good management and close tracking of individual pupil’s achievement. Teachers know all their pupils well and plan their resources and teaching accordingly, rather than conforming to preconceived views about what those pupils might achieve, whether that relates to gender or any other particular characteristic.
We can do three things in particular to support teachers in their efforts to fuel social mobility and achievement. The first concerns advice and guidance. It is very important that young people get the right quality advice and guidance. In truth, one of the principal inhibitors to social mobility is this: I suspect that our children will become socially mobile because of us. Our children will benefit from the fact that we, in the Chamber, are reasonably well informed about the opportunities that might exist, be they boys or girls, and will impart an understanding of how to turn those ambitions into opportunity. That is not true for all young people, however. The advice and guidance that we can provide through the new national careers service will, to some extent, ameliorate the disadvantages of many young people who do not have either advice from a family or social networks.
Kevin Brennan: Is the Minister concerned, in the light of the debate, that the lack of face-to-face guidance in the careers service will be a hindrance to girls gaining confidence and being able to make the right choices?
Mr Hayes: It is important to appreciate the value of face-to-face guidance. The hon. Gentleman will know that the Education Bill establishes the new statutory duty on schools to secure independent, impartial advice and guidance. When it was debated in the House, we agreed, in the statutory guidance accompanying the Bill, to ensure that face-to-face guidance was available in particular to people with the greatest disadvantage, those special needs and learning difficulties. We also said that schools should make the most appropriate provision for their pupils. I emphasise that it is vital that that should include a range of provision, and that that provision should be linked to the quality standards that are being developed by the profession itself.
As well as changing the law, we have worked with the careers profession to establish a new set of qualifications, with appropriate training and accreditation. That means that we will re-professionalise the careers service after the disappointing years—I put that as mildly as I can—of Connexions. We are on the cusp of a new dawn for careers advice and guidance, with a professionalised service, a new set of standards, a new statutory duty and the launch of the national service co-located in Jobcentre Plus, colleges, community organisations, charities and voluntary organisations. I do not say that the task will be straightforward, but it is a worthwhile journey.
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The destination to which we are heading will be altogether better than the place we have been for the past several years. That advice and guidance will assist young women, in particular, to fulfil their potential in the way I have described and, as a result of this debate, will re-emphasise the significance of opportunities for girls and young women in the establishment of the national careers service this spring.
The second issue I wanted to speak about was apprenticeships. I made a point—the hon. Member for Cardiff West knows this subject well too—when I became the Minister of challenging the National Apprenticeship Service on the under-representation of particular groups. The obvious example in relation to this debate is women in some of what might be called the traditional apprenticeship frameworks: engineering, construction and so on.
Esther McVey: I conducted some surveys and analysis on that, which was very interesting. For young girls who took science apprenticeships, it fitted in far better with their family life because they could achieve a job and status far more quickly than the slow process of going through university. It fitted in much better with the cycle of a woman’s life and child-bearing age.
Mr Hayes: How interesting. I defer to the greater expertise of my hon. Friend, but what I have done is ask the National Apprenticeship Service to run a series of pilots, building competencies and understanding on how we can make the apprenticeship system more accessible to those who are currently poorly represented. That is not to say that women are poorly represented in apprenticeships per se. More than half of all apprenticeships are taken up by women, but they tend to be in areas such as care and retail. The effect of that, because of the wage rates in those sectors, is to exaggerate the difference in wage-earning potential among successful apprenticeships between men and women. I have asked the NAS to work on a series of pilots. Bradford college is prioritising action to increase female representation in the energy sector. Essex county council is focused on women in engineering and on acting as the prime contractor for a regional provider network. West Notts college, whose representatives I met recently, is also looking at increasing female representation in engineering. There are a number of others, but I want to give the Chamber merely a flavour of what we are trying to do.
The third issue I wanted to speak about is women and science, technology, engineering and maths. Basically, not enough girls study STEM after the age of 16, as has been mentioned a number of times, including by my hon. Friend the Member for Gosport. There are several things that we can do. The Department for Education has worked closely with the Institute of Physics. Its stimulating physics network incorporates many of the recommendations of the Girls into Physics report, which the hon. Lady will know about. The STEM ambassador scheme, co-ordinated by STEMNET, is arranging for working scientists and engineers to visit schools to support teachers, and engage and enthuse pupils to continue studying science. The hon. Lady will know that a large proportion of the STEM ambassadors are women. We want to focus that energy on what we can do to encourage more girls to study STEM subjects. By making different choices early, they cut off some of the
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routes that might be available to them later. So much of this is about early intervention and changing perceptions about what choices can be taken to facilitate subsequent progress. I will happily give way before I come on to my exciting conclusion.
Esther McVey: Will the Minister congratulate the new president of the Royal Society of Chemistry? For the first time in 300 years, it has a female president. In the next year, she will try to increase the number of female teachers becoming ambassadors and the number of girls taking chemistry.
Mr Hayes: I not only add my voice to that congratulation, I suggest that we invite her here to a tea party with the hon. Lady and myself, which, needless to say, she will be funding.
This debate has brought to the attention of the House the important subject of opportunities for girls and women. I do not take the orthodox view, by the way, that men and women are more alike than is often supposed. I think that they are rather less alike—my life has taught me that. However, that does not mean that the opportunities available to them should not be just as demanding, just as exciting and just as exhilarating. We should work tirelessly to create those opportunities in the way that my hon. Friend the Member for Wirral West has done for so long, beyond old frontiers to new horizons.
I learned at my mother’s knee first, and I learn from my wife every day, as Yeats said:
“That Solomon grew wise
While talking with his queens”.
In that spirit, I assure the Chamber, and all those who have contributed to this important debate, that the Government will go the further mile that I described at the outset to achieve the ambitions of my hon. Friend, which reflect the ambitions of so many girls and young women.
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Park Homes
4 pm
Caroline Nokes (Romsey and Southampton North) (Con): It is always a pleasure to serve under your chairmanship, Mrs Main.
As a new Member of Parliament in 2010, I did not expect park homes to feature large on my radar. I freely admit that I did not know a great deal about them and that, although I knew that a significant number of park homes were dotted around my constituency, there are more than 200 spread over seven sites. To some colleagues, especially those from the south-west, that will seem a tiny number, but in Romsey and Southampton North it represents a significant and at times vulnerable minority.
I pay particular tribute to my constituent, Tim Deacon, a member of the park homes residents association, who has made it his mission over the past 18 months to inform me of the issues facing park home residents. He has endeavoured to educate me and, along with many of his fellow residents—in particular, with another whom I will mention later—he has highlighted their issues and encouraged me to apply for the debate.
I am conscious of the fact that the subject affects a lot of hon. Members, many of whom will have far greater expertise than I do. I congratulate the mobile homes all-party parliamentary group on its hard work in drawing attention to the issue and on seeking resolutions to the problems of park home owners. I am also aware that this is only a 30-minute debate, which is a disappointment to some and will not allow all of those Members who have an interest to take part.
Many owners of park home sites are fair and upright, especially the deputy leader of my local authority in Test valley, who owns a site in Ampfield. Unfortunately, however, others are not.
Steve Brine (Winchester) (Con): I congratulate my hon. Friend on securing the debate. There are many good park home owners throughout the country, including in my constituency. Does she agree that they have nothing to fear from a fit and proper person test?
Caroline Nokes: I entirely concur with my hon. Friend: good park home site owners have absolutely nothing to fear from a fit and proper person test. I certainly did not wish to criticise those who treat their residents fairly and with respect; it is the others on whom I wish to focus and about whom something needs to be done.
Last November’s mass lobby of Parliament brought several of my constituents to Westminster and they outlined in detail their prime concern—that they could not sell their homes freely, without the consent of the park owner.
Jack Lopresti (Filton and Bradley Stoke) (Con): I congratulate my hon. Friend on securing the debate. Before she continues with specific details, will she agree that the unscrupulous practice of park owners vetoing sales so that they can, in effect, buy the properties at a knock-down rate and sell them on, while getting a commission of up to 10% on top, ought to be stamped out in any way possible?
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Caroline Nokes: That is exactly what I was about to come to—namely, park home owners not being able to sell their homes without the consent of the park owner. In the intervening 12 months there has been progress, not least by the all-party parliamentary group and, earlier this month, when the hon. Member for Mid Dorset and North Poole (Annette Brooke) asked the Prime Minister an important question about the actions of unscrupulous park owners. However, I and many of the hon. Members present at the debate today believe that action must be not only robust but swift. Many park home owners are elderly, and they fear that they are running out of time.
I am extremely impressed by the phenomenal work of Sonia McColl, the leader of the Park Home Owners Justice Campaign, who has campaigned tirelessly for the rights of park home owners and worked unceasingly to collect and collate the national statistics on park homes, which the campaign presented to the Prime Minister in October. The statistics are sobering: 63% of residents reported living under unacceptable conditions, with 48% living under the regime of an unscrupulous park owner.
Brandon Lewis (Great Yarmouth) (Con): Does my hon. Friend agree, as my hon. Friend the Member for Winchester (Steve Brine) has already said, that there are a number of good park owners, such as in Great Yarmouth? An important feature of the problem is that the bad park owners give the entire industry a bad reputation, while negatively affecting the good park owners who deserve the credibility that they should have for providing a good environment in which people live.
Caroline Nokes: My hon. Friend makes an important point. The good park home site owners are unfairly gaining a poor reputation because of their less scrupulous counterparts, many of whom are reported to be not only dishonest in their dealings with park home owners but aggressive and abusive. It is sad that only a third of residents felt that their park owner was good. That clearly needs to change.
Jim Shannon (Strangford) (DUP): I represent an area containing a significant number of park home owners, with some 300 in one location. They are a very active group, with an active residents association, and have worked with elected representatives to help effect legislative change in Northern Ireland. Is the hon. Lady aware of that and, if not, perhaps the Minister will examine and investigate it to help in today’s study of the subject?
Caroline Nokes: I thank the hon. Gentleman for his comments. One of our problems is the lack of a level playing field or of consistency in the different parts of the UK, which can lead to a measure of resentment when some residents see other parts of the UK treated differently from them.
Dr Sarah Wollaston (Totnes) (Con):
Was my hon. Friend struck at the meeting of the all-party group by the relatively small number of names cropping up all over the country? The thickest file in my constituency filing cabinet is that for Beechdown Park, with its unresolved problems of water leaks and water meters. An owner has not only failed to deal with the leaks but collected money by holding people to ransom—holding
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up the sale of their properties unless they hand over money. We discovered that he has not passed any of the money to South West Water and has run up colossal bills. My constituents’ appliances have not been working, thanks to Mr Small, which I am sure is a familiar name.
Caroline Nokes: As I said, I attended the mass rally last November and listened to many of the stories from around the country, and my hon. Friend is absolutely right that the same small number of names occur time and again at various locations—always, sadly, involving the same story and modus operandi.
Time is pressing and the issue is not new, although I am new to it. Media reports can be found going back 20 or 30 years, commenting on the difficulties of park home residents when selling their properties or gaining reasonable access to services without being charged over the odds for them. The single biggest issue, however, is the blocking of sales by site owners. If park owners refuse to approve a sale, the home owner is left in an almost impossible position. There are reports of owners of properties worth £100,000 having to sell to the park owner for as little as £5,000 as all other sales have been blocked. The home owner currently has recourse to a residential property tribunal but that not only costs the owner about £150 but has limited powers of enforcement and places no binding conditions on the park owner. The situation is being addressed by the Government, and I am eager to hear what assurance the Minister can give that it is subject to a rigorous timetable.
Nicky Morgan (Loughborough) (Con): I congratulate my hon. Friend on securing the debate. I am interested to hear what the timetable is from the Minister. The problem has been going on for a number of years, as my hon. Friend said, and has been raised a great deal since the 2010 election. We have waited some time now to hear what the Government are proposing for a licensing regime. We understand the Government’s reluctance to legislate on everything, but it is unacceptable that vulnerable residents, often in park homes, are left less protected than people in registered social landlord accommodation or in other social housing. Does she agree?
Caroline Nokes: I certainly agree with my hon. Friend’s comments. It is not right that park home residents are left more vulnerable and exposed than those in many other types of property tenure. It is important not to forget that park homes can provide an important element of reasonably priced accommodation—I will not refer to affordable housing, using the technical term that we all understand from various connections with our local authorities, but to less expensive housing. Such housing is almost inevitably a choice for some of the most vulnerable people in our society, including the elderly, those who want to downsize, and those who find housing in other parts of our constituencies too expensive.
A further injustice facing park home owners is that of landlords imposing administrative charges for the supply of services such as water and sewerage. Those charges should be reasonable and not out of the ordinary for residents, but many find they are charged fees that are well over the odds, in addition to site owners taking advantage of a monopoly in supplying canisters of liquefied petroleum gas for heating and cooking. Some
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residents were subjected to dreadful intimidation and harassment when they challenged the prices, and had no choice but to pay up to heat their homes.
I have heard many horror stories of unscrupulous park owners overcharging for basic services. Some major LPG providers do very good deals with park owners and provide the canisters at a significantly cheaper cost than for those living in bricks and mortar houses. However, dishonest landlords often use that loophole to charge park home residents exorbitant sums to heat their homes. Residents are at liberty to buy gas canisters elsewhere without the risk of being overcharged, but the recurring theme is that many of them are elderly and more vulnerable, so they are less able to travel and to haul the heavy canisters into their car, if they have one, let alone to offload them at the other end and to install them safely.
One of my constituents, who sadly has specifically asked not to be named, contacted me to explain that he is fully reliant on purchasing gas canisters from his landlord at a significant mark-up. He thinks his lack of mobility and his vulnerability are being exploited so that the site owner can make a profit. Needless to say, he feels cheated, but helpless to do anything about it.
Consumer law provides protection for park home residents, and I encourage them to refer such incidents to Consumer Direct, which will invariably take them up with trading standards officers on their behalf, and ensure that they are reported. However, yet again, vulnerable and elderly residents need to know that they can go to Consumer Direct and have the case taken up on their behalf.
Annette Brooke (Mid Dorset and North Poole) (LD): I congratulate my hon. Friend, who is making the case exceedingly well. The mainly elderly, vulnerable residents are often terrified of reporting some of the incidents that happen. More and more evidence, beyond anecdotal, is emerging, but I suggest that it is still the tip of the iceberg. Consumer Focus is doing a survey, and I believe that it will provide the Government with the ammunition to introduce strong legislation as soon as possible. Will my hon. Friend join me in urging the Minister to take back that message today? We must have not only proposals but time for legislation.
Caroline Nokes: My hon. Friend makes an excellent point, and she is right. We must have legislation, and we must have it soon. During a conversation with Consumer Direct earlier today, it told me that it is making progress in taking on cases. As my hon. Friend said, the problem is not just anecdotal because there is now evidence. It is crucial that we have time to legislate so that these poor, vulnerable residents receive the action and outcome that they have sought for so many years.
Guto Bebb (Aberconwy) (Con):
I congratulate my hon. Friend on securing this debate. Park home residents are also dealt a harsh hand by park owners in their electricity supply. An electricity supply in my constituency breaches the Electricity Safety, Quality and Continuity Regulations 2002, but the problem is that compliance rests with the Department for Energy and Climate Change, whereas the safety issues rest with the health
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and safety boards. A further complication in the Welsh context is that other aspects of park homes legislation are devolved to the Welsh Assembly, making it difficult for residents to know who to go to with their complaints.
Caroline Nokes: My hon. Friend makes a good point. There is complexity in knowing who residents should go to with their complaints. There is no consistency throughout the United Kingdom, and that is what people are calling for.
My constituent, Tim Deacon, like many other park home residents, has been party to establishing a park home residents association. Such groups must meet several requirements to qualify as a residents association, the last of which is to obtain the park owner’s acknowledgement. Even when park home residents have completed all the required steps, park owners may refuse to acknowledge a residents association and thereby deprive the residents of the rights that becoming an association provides. A last resort is recourse to the county court, but many residents are scared or do not have the will, the energy or the know-how to do that.
In an era of localism, when the Government are seeking to disseminate power downwards, I hope that they will look favourably on the growth of residents associations on park home sites. Such associations can seek to resolve issues locally without having to turn to the courts. However, the situation at the moment leaves too much power in park owners’ hands, limiting accountability and the community’s ability to exert sufficient pressure on their landlord.
Statistics published by the Park Home Owners Justice Campaign show that the majority of park home owners are in their 70s or older. It is clear that unscrupulous park owners are taking advantage of elderly and vulnerable people, many of whom in my constituency live on their own. I thought it would be interesting to see exactly how many of the 200-plus park homes in my constituency are occupied by single people, and it transpires that it is the vast majority of them. The electoral roll shows that 250 residents in 212 park homes are registered to vote. That clearly shows that those people are mainly not living as couples or families. Sadly, in many cases, they are living alone, and my argument is that that increases their vulnerability, and susceptibility to feeling intimidated by unscrupulous park owners. It is vital that the Government establish robust measures to protect residents because current legislation is clearly failing them.
I would be grateful to hear the Minister’s comments on how his Department is addressing the problem of sale blocking—a prime concern of park home residents in my constituency—and preventing unscrupulous park owners from wielding disproportionate power over this part of the property market. That would be unacceptable in an ordinary residential community. I would welcome steps being taken urgently to prevent overcharging for basic services such as electricity and water.
My hon. Friend the Member for Aberconwy (Guto Bebb) made a valid point about different parts of the electricity market having responsibility for safety, and it is truly terrifying that some park home residents may be receiving an electricity supply that is less safe than we would want. It is important for the establishment of residents associations to be made as simple as possible, and to ensure that they receive proper recognition. I welcome the Department’s consultation on this important
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issue, and hope that the timetable for action is suitably short. As I have said, many park home residents are elderly and feel that they have been waiting far too long.
I fully acknowledge that there are many honest and excellent park owners, and I emphasise that, as my hon. Friend said, those who are not acting responsibly are giving the others a bad name. It is wrong that all should be tarred with the same brush. But some people live in parks where that is not the situation and where an unscrupulous landlord seeks to exploit the vulnerability of park home residents, to take a percentage of the proceeds of any sale, or to block a sale. Those people deserve greater rights, and a future free from exploitation and abuse from dishonest landlords. I hope that the Minister will outline at least a partial timetable to assure us that any proposed legislation will be forthcoming as soon as possible, and that he will tell us what action the Government are taking. I know that they are taking action, but it is important to understand it clearly so that we can give our constituents some reassurance.
4.19 pm
The Parliamentary Under-Secretary of State for Communities and Local Government (Andrew Stunell): It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) on bringing this important subject to the attention of the House this afternoon, and I commend the many Members who have contributed to the debate. I hope that it is not out of place if I mention that my hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) has played an active part in the all-party group and has met my right hon. Friend the Minister for Housing and Local Government to talk about these matters.
I absolutely agree with my hon. Friend the Member for Romsey and Southampton North that a park home is an affordable choice for many people. She described it as less expensive housing, which is how estate agents describe it. It is an economical and very successful choice for many people, and there are 85,000 such households in England. Fortunately, only a minority of households and site owners give rise to the anxieties that we have heard about today. Many sites are properly managed and maintained, and decent, honest and professional site owners deliver a good service for people on their sites. Unfortunately, the good work is masked by the unacceptable conduct of others. If one reads the debates held in this House, one would get the impression that this form of tenure and these sites are collectively completely unacceptable. I do not think that it is right for us to leave that impression unchallenged.
Rogue site owners certainly cause misery to communities by not maintaining their sites properly. We have heard reports about the bullying of residents and unreasonable and sometimes unlawful interference when residents try to exercise their statutory rights, and we have heard about problems when residents want to sell their homes. The park homes sector needs to be cleaned up. There is no place for such behaviour. It is not right for the sector or the residents, and it is certainly not right for a minority of site owners to exploit the situation that they find themselves in. The Government share the concerns that have been reflected in previous debates and in the work of the all-party group.
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Sale blocking, to which several Members have referred, leads to the unjust enrichment of site owners. That is not an acceptable practice, and the Government are committed to eradicating it. We propose to introduce sanctions for those who continue, without good reason, to try to prevent residents from selling their homes in the open market to people who meet the appropriate rules. That is why my right hon. Friend the Minister for Housing and Local Government proposes to consult on a range of measures that will prevent such practice. We are also committed to improving residents’ rights more generally and to closing loopholes in the legislation that allow unscrupulous site owners to exploit residents or deny them their rights.
We are also determined that local authorities should be adequately resourced and have appropriate powers to allow them to protect the health and safety of residents through robust and enforceable site licensing.
Steve Brine: While the Minister is on his list of things that he is determined to make happen, may I make a plea that he works with his colleagues in the Department of Energy and Climate Change? Now that we have established that the green deal is applicable to park home owners, will he work with his colleagues in DECC to make sure that park home owners—and indeed many other home owners—many of whom are trapped in fuel poverty, are aware of the green deal and are in a position to take advantage of it? It could revolutionise their fuel poverty.
Andrew Stunell: I will certainly undertake to write to my hon. Friend and other Members when I have had the opportunity to discuss the matter with my colleagues in DECC. Members will be aware that the Energy Act 2011 has now passed into law and the green deal is due to start next autumn. Some of the necessary statutory instruments to support that are currently under consideration. My right hon. Friend the Minister for Housing and Local Government will be publishing the consultation early in the new year. I hope that it will provide a timetable and framework for the debate. Following that, we will bring forward the necessary legislative measures at the earliest opportunity.
On the calls for a fit and proper test for site owners, the Government are not convinced that the protection of park home residents requires a complex and costly national licensing system. We have to strike a careful balance that protects the vulnerable and targets the worst in the most effective way. That is what our consultation seeks to achieve, and I look forward to Members’ responses when that consultation is published.
We have already begun the process of enabling residents to enforce their rights and to challenge unreasonable behaviour through the residential property tribunal. Since it started dealing with park home issues in May, it has received 31 applications up to the end of October and it has determined 13 of them. Not everyone will be satisfied with the outcomes of those cases, because in judicial proceedings there will always be a winner and a loser. However, the number of applications shows that residents have been empowered to challenge unreasonableness on the part of site owners, something that few were prepared to do previously through the regular courts. I am certainly not suggesting that
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the residential property tribunal is the solution to all the disputes, but it is a first positive step, and, I hope, an earnest of our good intentions.
Several Members have raised the issue of service charges for gas, electricity, water and sewerage. It is important to put on the record that existing rules already strongly limit the powers of site owners to impose unreasonable charges. They are not allowed to charge an illegal rate of VAT or to control the service supply. I want to make it clear that if site owners provide services, they will be entitled to recover the cost from residents under the agreement. Sometimes that cost will be recoverable only through the pitch fee. In that case, any charges will be limited to the retail prices index at the next rent review, regardless of the actual charges that the site owner has incurred. For that reason, pitch agreements will often contain a provision permitting the site owner to levy a separate charge for the provision of services. It is important for Members to be aware that the charges are governed by orders made by Ofwat and Ofgem respectively. Under the rules, a site owner cannot charge residents more than the cost he incurs in purchasing water, electricity or gas from the supplier.
In some cases, the site owner can charge a reasonable administration charge. How that recharge is calculated and apportioned between the homes has to be fair and transparent, and residents are entitled to see the bills on which the recharge is based. It is also important to be aware that the site owner can recharge only for the supply to the home and the pitch and cannot include any amount relating to his own supply—for instance, for street lighting or heating of offices or communal buildings. VAT is payable by the home owner at the 5% domestic rate for electricity and gas, not the 20% business rate, even if the supply to the site owner is commercially rated. Water, of course, is zero-rated.
If a resident believes that they have been overcharged for the resale of the services, they can recover the charges in the small claims court. Administration charges on top of the actual cost of energy are also strictly limited. In the case of water, administration charges cannot exceed 1.5p per day for non-metered supplies and 2.5p per day for a metered supply. That effectively means that £5 or £10 per year is the maximum administration charge. I hope that all those measures give some comfort to Members that home owners have some protection. Our next step following the consultation will be to bring forward, when parliamentary time allows, the legislative measures needed to tackle the abuses that have been so eloquently set out today.
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HIV
4.30 pm
Pamela Nash (Airdrie and Shotts) (Lab): I am grateful to have secured this debate during the week in which world AIDS day is marked. The HIV virus was discovered 30 years ago, since when it has claimed the lives of more than 30 million people throughout the world, including 20,000 in the UK. Over the past 20 years, we have seen remarkable progress in the medication available to people living with HIV, including today’s welcome approval of a drug that will provide triple antiretroviral therapy in a single tablet taken once a day. That does not, however, diminish the fact that there is still no vaccine or cure for HIV, and more efforts must be made to prevent the transmission of the virus.
Let me take this opportunity to pay tribute to my predecessor as chair of the all-party group on HIV and AIDS, the late David Cairns. One year ago in this Chamber, he spoke on this topic with eloquence and passion, and he consistently spoke out against the stigma and discrimination faced by people living with HIV both in the UK and overseas. I am glad that his work continues in the all-party group and through the David Cairns Foundation set up in his name, which was launched last week.
The House of Lords Committee on HIV and AIDS, led by the vice-chair of the all-party group and former Health Minister, Lord Fowler, recently published a report on HIV in the UK. Lord Fowler has done much to champion the cause over his long and distinguished career, and I believe that many owe their lives to the work he carried out as HIV began to take hold in the United Kingdom. The needle exchange programme that he introduced is a good example of that work, and it changed the course of the epidemic, particularly in Edinburgh and the rest of Scotland. In September this year, the Committee concluded that the Government’s current policies on tackling HIV in the UK are “woefully inadequate.” I will focus on some of the report’s recommendations, and I look forward to the Minister setting out the Government’s response to that report.
I will start with some startling headline figures. Some 30 years after the virus was discovered, almost 100,000 people in the UK live with HIV. Newly diagnosed cases of HIV among young people have risen by 48% over the past decade, and it is estimated that about a quarter of those living with HIV in the UK do not know that they have the virus. Half of all cases of HIV in the UK are diagnosed late, meaning a greater cost to public health and the public purse. HIV is spreading for many reasons, but principally because of high levels of undiagnosed HIV, too few people with HIV receiving stable treatment, persistent risk-taking behaviour, and a lack of HIV awareness. That is set against a dangerous backdrop of inconsistent sex and relationships education in our schools and beyond.
Early diagnosis of HIV for one person can obviously translate into prevention of the disease for their future sexual partners. People diagnosed with HIV are far less likely to pass the virus to others, as they can take steps to prevent transmission such as using a condom. Once diagnosed, people can receive HIV treatment that dramatically reduces levels of the virus in the body, so that the risk of transmission can be reduced to almost
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zero. This year I was surprised by the results of a remarkable clinical trial in South Africa that proved that putting people on medication for HIV can reduce the risk of transmission by an enormous 96%. That has extraordinary ramifications for efforts to tackle the HIV epidemic around the world and makes the need for the early diagnosis of HIV all the more pressing.
It is estimated that 51% of all people with HIV in the UK have undetectable levels of the virus. That is great news, although the UK should aim to increase that percentage to at least 65% over the next four years.
Mike Weatherley (Hove) (Con): I congratulate the hon. Lady on securing this important debate. Does she agree with the recent remarks made by the US Secretary of State, Hillary Clinton, who said that an “AIDS-free generation” should be a policy priority for all Governments, including that of the UK?
Pamela Nash: I completely agree with the Secretary of State’s remarks. I raised the issue during Deputy Prime Minister’s questions last week. I hope that the coalition will take that aim on board and that it will be raised by the Prime Minister. The all-party group on HIV and AIDS is a member of the “Halve It” coalition that campaigns for levels of late-diagnosed and undiagnosed HIV to be halved in five years through more testing. That will help to stop the spread of HIV, improve health outcomes for those living with the virus, and in the long term save the Government money.
Patients and doctors have a large role to play. A study of people of sub-Saharan African origin in the UK who were diagnosed late with HIV found that three quarters had visited a doctor in the year preceding their diagnosis. Doctors and patients must be more aware of the primary infection symptoms of HIV. Incentivising HIV testing, particularly in areas with a high prevalence of HIV, is vital to ensure that people are diagnosed in time. One powerful incentive would be to ensure the inclusion of the late HIV diagnosis indicator in the Government’s revised public health outcomes framework. We have heard several times that a decision on that will be made later in the year. Will the Minister assure hon. Members that that indicator will be included, or at least say when the Department will reach a final decision?
As I understand it, the Department is investigating the possibility of legalising home-testing kits. I look forward to the outcome of that investigation. It is clear from the House of Lords report that home-testing kits ordered from overseas, usually over the internet, are already in use in the UK. If legalised, that practice could be regulated and allow people to test themselves securely and safely in their own home, again producing savings for public health and the public purse.
How else can we prevent the transmission of the HIV virus? The House of Lords report stated:
“More resources must be provided at national and local levels… The current levels of investment in national HIV prevention programmes are insufficient to provide the level of intervention required.”
Hon. Members may be surprised to learn that the Department of Health currently spends just £2.9 million a year on two national HIV prevention programmes for gay men and black Africans. That compares with an enormous £762 million spent on treatment. Preventing one infection avoids lifetime treatment costs for HIV of
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between £280,000 and £360,000, but as local service cuts kick in throughout the country, HIV prevention programmes are being reduced.
Under the new NHS structure, local HIV prevention work, campaigns and testing will be commissioned by local authorities, leading—we hope—to additional national campaigns, but I am concerned about the possible fragmentation and subsequent prioritisation of prevention work between HIV treatment that is commissioned nationally by the commissioning board, prevention and testing work commissioned by local authorities, and national campaigns overseen by Public Health England. Within local authorities, HIV prevention work is likely to face strong competition for funding within constrained budgets. A fragmented health care system will not deliver the results that we desperately need, or enable us to make headway against the rising tide of new HIV infections. We do not want a postcode lottery, or for sexual health services to be sidelined because of local sensitivities.
Guto Bebb (Aberconwy) (Con): I congratulate the hon. Lady on securing the debate. In my north Wales constituency there is an HIV respite centre, which is extremely well supported by the local community. The problem that the centre has is that many of the people who take advantage of the respite care are coming in from north-west England and are therefore not funded by the local health authority in Wales—health is devolved. A centre that is able to serve people from north-west England therefore finds it very difficult to secure funding, because it is based in Wales, but its patients are from England. Is that the type of postcode lottery problem that the all-party group could deal with?
Pamela Nash: We can certainly campaign on the matter. I will be happy to discuss that with the hon. Gentleman outside the Chamber. He makes a very important point: this issue is not just about the NHS and the Health and Social Care Bill in England, but about achieving agreements with the other Assemblies and Parliaments in the United Kingdom to ensure nationwide consistency in the treatment and support for people living with HIV.
I shall now discuss public awareness in the UK. Twenty-five years ago, Lord Fowler led huge public health campaigns about the virus. Leaflets were sent to every household in the country and there were very visible television campaigns. However, public awareness of HIV has undoubtedly fallen during the past 10 years. For my generation, it is just not a priority any more. Despite the very high increase in the number of young women contracting HIV, when I speak to my friends about this issue I find they rarely regard themselves as at risk.
Unbelievably, earlier this year, an Ipsos MORI poll found that one in five people do not realise that HIV is transmitted through sex without a condom between a man and a woman, and the same proportion do not know that HIV is passed on through sex without a condom between two men.
Stuart Andrew (Pudsey) (Con):
I congratulate the hon. Lady on securing the debate. It is a shame that it is only a half-hour debate, because the last time that we debated the issue, we had an hour and a half, I think,
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and even that was too brief. The figures that she is giving now are shocking, certainly for my generation, who are getting older now. I remember the HIV debate and campaign that she refers to and how phenomenally successful it was and how aware we all were of the dangers. Something needs to be done so that the younger generation realise the very severe dangers of having sex without protection.
Pamela Nash: The all-party group has consistently campaigned for the Government to put more funding into another national 1980s-style campaign. I hope that today’s debate and the events taking place throughout the week will get the message across to the Government that it is necessary to have that style of campaign again.
An increasing proportion of adults—about 10% at the moment—incorrectly believe that HIV can be transmitted through impossible routes, such as kissing and spitting. That is not helped by scaremongering media reporting. There was recently a report in Edinburgh about a couple who, when being arrested by the police, had bitten a police officer. Both members of the couple were HIV-positive, and that was the primary headline in the Scottish media, much to my disappointment. Misinformation fuels stigma and discrimination, which are still a daily reality for many people living with HIV.
Naomi Long (Belfast East) (Alliance): The hon. Lady has rightly referred to the importance of people being tested, but she has also referred to stigma. Does she agree that unless we overcome the stigma surrounding simply having been tested for HIV and for AIDS and not having the disease—the stigma that still exists in society about going for those tests—that will decrease the number of people who come forward to submit themselves for testing and take care of their health as they should?
Pamela Nash: Yes, that is a crucial point. I hope that any future public campaign would incorporate looking at the stigma about the virus. Unfortunately, in the meantime, it persists. That is why I would also push for the home testing kits to become available, but that is not the ultimate solution.
In a recent study in east London, one in three people living with HIV said that they had been victims of discrimination, but most alarmingly the study showed that half of all that discrimination was in the health care system. The Department of Health must take a lead on tackling stigma and develop training resources for its staff that are aimed at stopping such discrimination. Those resources must be used by all current and new NHS and professional bodies.
4.44 pm
Sitting suspended for a Division in the House.
4.56 pm
Mrs Anne Main (in the Chair): I remind hon. Members that there are 16 minutes of this interesting debate left. Members who make interventions should do so briefly.
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Pamela Nash: Since I took on the role of chair of the all-party group, I have been extremely surprised by the high levels of inaccurate and sensationalist reporting in the UK’s press on HIV. That reflects a wider lack of public awareness.
The lack of basic information fuels prejudice and leads to the exploitation of people, as was tragically illustrated in recent weeks by the frightening cases of HIV-positive patients being told by evangelical pastors that they could be cured of HIV through the power of prayer alone and that they should stop taking their antiretroviral drugs. The BBC has reported at least three deaths resulting in London, which I am sure the Minister will agree is a grave tragedy on her own doorstep. I am aware that the Department already funds work through its partners to raise awareness among religious communities, but in light of the shocking revelations and the relatively small budget that is allocated to HIV prevention in the UK, does the Minister think that that is enough? Is the Department planning to do more to tackle that issue?
The Government must take a lead in acting to improve the understanding of HIV. It is vital that all young people learn about HIV in school, and HIV must be included in local and national sexual health promotion campaigns and information. Such measures will help not only to tackle HIV stigma, but to enable people to protect themselves and others to improve public health.
HIV treatment services in the UK are generally of a high calibre, but access to other elements of care, such as primary care services, social care and psychological support, can vary widely. Unfortunately, time and time again, individuals living with HIV have contacted the all-party group to tell us that the social impacts of HIV on their lives are much greater than the health impacts. Generic services are often ill-prepared to meet the specific needs of people living with HIV. Individuals can be apprehensive about accessing services because of concerns about confidentiality or lack of expertise. Numerous clinical guidelines relate to care and support for people with HIV, but there is no coherent and authoritative guidance that integrates clinical, social and psychological care and covers the different stages and eventualities of the condition. Integrated guidelines from the National Institute for Health and Clinical Excellence or a national care pathway would help to make the responsibilities of different bodies and professionals clearer and make service provision more consistent and cost-effective.
The House of Lords’ report recommended that NICE develop treatment and care standards for HIV patients, and the Government’s response acknowledged that they should consider the value that NICE could add in developing standards for HIV. The Government also cited the British HIV Association’s clinical guidelines, but the guidelines do not address the need to co-ordinate specialist HIV services with other services. We in the all-party group urge the Government to act on the Lords’ Committee’s recommendations.
People with HIV live with a fluctuating, long-term condition. However, like many other people with long-term conditions, with the right support, people with HIV can play a full and productive part in society. Social care services are being cut across many local authorities and are often limited to the most severely disabled people. It is not acceptable to limit social care only to the most acute cases. Social care has a vital preventive function,
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particularly in treating fluctuating conditions such as HIV. Social care can also play a crucial role in dealing with the new phenomenon of the increasing number of older people who are living with HIV.
It is clear that the Government understand the value of HIV social care. That is shown by the inclusion of a specific funding line for HIV/AIDS support in the formula grant. However, local authorities are no longer required to report on the spending of that grant to the Department of Health and we have heard of several cases—for example, in Hertfordshire and Leicestershire—where money for HIV/AIDS support has been siphoned off into other areas of spending. Once that expertise in HIV/AIDS support has been lost, it will be difficult to recover. The Government must ensure that the performance of HIV social care is effectively and consistently measured, and that the needs of people living with HIV are reflected in the social care outcomes framework. It is also clear that NICE must prioritise a social care quality standard for HIV.
To conclude, I am proud that the UK has nobly led the international community during the last 30 years in the response to AIDS, advocating universal access to HIV treatment throughout the world for all those who need it. It is my great hope that that leadership role will continue to be performed by the current Government, particularly at a time when we have such an incredible opportunity to improve the quality of life for those living with HIV, to make a dramatic impact on the number of new infections and to stamp out this epidemic for good.
5.1 pm
The Parliamentary Under-Secretary of State for Health (Anne Milton): Thank you very much, Mrs Main, for calling me to respond to the debate. It is a pleasure to serve under your chairmanship for the first time.
I want to begin by congratulating the hon. Member for Airdrie and Shotts (Pamela Nash) on securing today’s debate. She rightly started her remarks by referring to the issue of stigma, and it has been raised by other speakers. I also want to pay tribute to the significant contribution that has been made to fighting HIV/AIDS by my noble Friend Lord Fowler. Political leadership is not often spoken of these days, but it was precisely that leadership from Lord Fowler that made the progress in the UK against HIV/AIDS so remarkable. However, the issue of HIV has been dogged over the years by stigma, and it is disappointing for people as old as me to realise that stigma is still alive and well in our communities and even in some aspects of the delivery of services.
HIV remains a serious global issue that must always be at the top of our priorities, particularly now, of course, as we approach world AIDS day in a couple of days’ time. I also congratulate the hon. Lady on her appointment this year as chair of the all-party group on HIV and AIDS. I know the work of the group well. It deservedly has an excellent reputation within Parliament and it tirelessly works to raise awareness of HIV, both globally and within the UK. As is the case with many of the things that she mentioned, that work needs to continue.
World AIDS day provides an excellent opportunity to reflect on the progress that has been made and on the continuing challenges that we face. There is much to
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celebrate. Globally, new HIV infections have fallen by 21% since 1997 and new infections have stabilised in many regions, including sub-Saharan Africa, the Caribbean and south and south-east Asia. Nearly 7 million people are on anti-retroviral treatments, which is an increase of more than tenfold in the past five years. However, nearly 8 million people still need treatment and are not receiving it. I have responsibility in the UK for global health matters, and I have taken the opportunity to speak to the South African Health Minister.
Thanks to effective treatment, in developed countries such as the UK people who are diagnosed early with HIV can expect to live to a near normal life expectancy. As the Health Protection Agency says in its annual report, which was published today, in 2010 87% of people who were diagnosed with HIV were accessing treatment services within a month of being diagnosed and 85% were reporting an undetectable viral load within 12 months of starting treatment. That is excellent; it is not the end of the story, but it is a good start. However, the challenges remain at home and overseas. There are 34 million people living with HIV globally. The title of the recent report by the House of Lords Select Committee on HIV and AIDS in the UK says it all, really—there is still “no vaccine, no cure”. That report comes many years after Lord Fowler led the national response to HIV and AIDS in the UK, and I remember that time well.
In October, we published the Government’s response to the report from the House of Lords Select Committee, and we made it clear that we agree with many of the Committee’s recommendations. The Committee’s report will be critical in helping to inform the Department of Health’s sexual health policy framework, which we will publish next year. It will be a vital source of information and current evidence.
Hon. Members and hon. Friends have rightly mentioned the challenges presented by late and undiagnosed HIV. In the UK, there are an estimated 91,500 people living with HIV, of whom around 25% are undiagnosed, which means that those people cannot benefit from treatment and, of course, they risk transmitting the virus to others. Late diagnosis is the most significant cause of HIV-related death in the UK and we cannot say that often enough. The 25% of people with HIV who are undiagnosed are more likely to die than the other 75% of people with HIV who have been diagnosed, and we all need to do absolutely everything we can to promote the benefits and the uptake of HIV testing. I will come on to some of the specific issues that the hon. Lady raised in that regard.
The Department of Health is considering the findings of the final report by the HPA, “Time to test for HIV”, in developing the new sexual health policy framework. That HPA report presented the findings of eight pilot projects that were funded by the Department, which assessed the feasibility and acceptability of routinely offering HIV testing in general practices and some hospital settings. It showed that testing was acceptable to most patients, and I am really pleased to see that some of the pilots have led to changes in local practice in high-prevalence areas, which is quite a significant step.
We are also funding the Medical Foundation for AIDS and Sexual Health to help it to develop ways of getting GPs and primary care staff to offer HIV tests
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more routinely. Both the Terrence Higgins Trust and the African Health Policy Network actively promote HIV testing as part of the national HIV prevention programmes. Also, we have asked the UK National Screening Committee to provide evidence-based views on increasing routine HIV testing. As the hon. Lady rightly commented, we are reviewing our policy on the ban on HIV home-testing kits and we will ensure that we consult on any proposals to remove the current ban.
We are considering the consultation responses to the public health outcomes framework, which include a proposal for an indicator on late HIV diagnosis, and we will publish that framework very soon. We want to get it right, as it will be an important driver of what happens locally.
I am aware that some primary care trusts are already funding new HIV testing initiatives in both primary and secondary care, in line with guidelines from NICE and the British HIV Association. However, more work is needed to capture data through the HPA’s current HIV monitoring and surveillance programme.
Twenty-five years have passed since the first Government AIDS awareness campaigns in the UK, and who can forget those iconic TV adverts? At that time, we did not really know much about the virus and how it would evolve, and we certainly did not know very much about people’s sexual habits. As I say, I remember that period well and I want to pay particular tribute to the gay community and the terribly responsible attitude that it took to this issue at that time.
As our understanding of the virus has increased, our approach to it has changed. Our national prevention programmes focus on men who have had sex with men and people from sub-Saharan Africa, because they are the groups in the UK who are most at risk of developing HIV; the risks they face are significantly greater than those faced by other groups in the UK. We have invested £2.9 million in programmes of HIV prevention for those communities, delivered by the Terrence Higgins Trust and the African Health Policy Network, but of course that is only a fraction of the sum that is spent. A great deal more money goes in locally.
The programmes by the Terrence Higgins Trust and the African Health Policy Network both use evidence
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and a range of approaches to support responsible sexual behaviour and to reduce risk-taking behaviour. For example, to promote HIV testing they use social media and the internet, and for African communities they work with faith leaders. It is quite an uphill struggle in some areas to promote awareness, to reduce stigma and to encourage people to come forward.
Finally, it is vital that the public health system is versatile and sufficiently proactive to deal with HIV. Our modernisation of the NHS and the priority that we attach to public health provide an opportunity to reinvigorate HIV prevention and improve outcomes for those with HIV.
The hon. Lady is absolutely right to say that we need to bring everything together. What we do not want, although we sometimes have it, is fragmentation of services, not only for services dealing with prevention and diagnosis of HIV but, as she mentioned, for services dealing with the social and psychological impacts of HIV. Health and well-being boards and the joint strategic needs assessment will be critical. For the first time, ring-fenced public health funding is central to the NHS and to public health, and it will allow us to plan spending on prevention. In today’s restrictive financial climate, the fact that we will have a ring-fenced public health budget will be critical.
There is still a great deal of work to do, and everyone, in this House and outside, must work together to keep HIV at the very top of our list of priorities, because only by doing that can we improve the lives of people living with HIV. The hon. Lady is right to mention that young people’s awareness has slipped. Their awareness of the dangers they face and of the part they can play in ensuring that they maintain their sexual health is not as great as it should be. They need the skills to make some very difficult choices.
I finish by congratulating the hon. Lady on securing the debate. I am very keen to work with the all-party group to ensure that we get this right, and that the sexual health strategy reflects all the work that needs to be done to ensure that we decrease the level of late diagnosis of HIV, raise awareness and reduce stigma.
5.11 pm
Sitting adjourned without Question put (Standing Order No. 10(11)).