As much as I love the Deputy Prime Minister—I adore him, I swear I do—I know that he is burdened by trying to cope with the problems of social mobility, which are being discussed in Westminster Hall at the moment. I am not sure that I would wish to give him older people to deal with as well, because he has to fit in trips to Rio; one man cannot do everything, surely. Rather than simply nominating one Cabinet Minister and tacking older people on to the end of their responsibilities, I would far prefer it if we created a new role that had a very specific remit, that had a positive ageing strategy behind it and that had only a handful of

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specific policy proposals to see through. In this country, we do not define the remit of a Government Department closely enough. We have aspirations, but often they read to me as waffle. A good example is HS2. One of the Department for Transport’s goals is to introduce HS2, which is fine, but it never says why that is particularly important. It states the goal, not the reasons for it. I would far rather we had a much narrower focus.

I welcome the debate and think it is an opportunity to put dignity at the forefront of everything we do in government. Sometimes, I am disappointed that Ministers do not always have dignity at the forefront of their minds in every decision they take. We should not need a new Minister to achieve that, but if that is what it takes then so be it. Once again, I congratulate the hon. Member for Portsmouth North on securing this important debate.

5.25 pm

Liz Kendall (Leicester West) (Lab): I start by thanking the Backbench Business Committee for enabling this important debate to take place, and I congratulate the hon. Member for Portsmouth North (Penny Mordaunt) on securing it. I know that she has been very committed to the issue and I am delighted that we have discussed it today. I also thank my hon. Friend the Member for Bolton West (Julie Hilling), the hon. Member for Stourbridge (Margot James), my hon. Friend the Member for Manchester Central (Tony Lloyd), and the hon. Members for Southend West (Mr Amess), for Central Suffolk and North Ipswich (Dr Poulter) and for Blackpool North and Cleveleys (Paul Maynard) for their speeches.

In particular, I thank Anchor for the superb Grey Pride campaign it has run and the 137,000 people who signed its petition, which made today’s debate possible. As hon. Members might know, the Leader of the Opposition created the post of shadow Minister for older people in the shadow Cabinet in October last year, and I feel privileged and honoured to have been appointed to the position. I hope the Government will follow suit and appoint their own Minister for older people in the Cabinet, and I will use my speech today to explain why.

My first point is obvious, but none the less important: older people are not an homogenous group. They have different views, needs and expectations, just as people in any other age group do. We would not treat everyone aged nought to 50 as a single group, yet this is exactly what we do for people aged 50 to 70, 80, 90, 100 or even beyond. Our discussions and debates about older people tend to be based on one image or stereotype, usually that of a very elderly person, frequently frail or dependent and in need of care and support. The need to develop a better, fairer system of care is a huge challenge and one that I will return to later, but the reality is that most people in their 50s and 60s are not frail or dependent and they want never to be so. Rightly, many do not regard themselves as old at all—my mum and dad certainly do not. Many older people are still in paid work, and local businesses and the economy benefit hugely from their skills, experience and incomes. They play a part in their local community, in voluntary groups or as councillors, and they help with local public services and in churches and faith groups. They also help to look after their grandchildren, and sometimes their own elderly parents; an increasing number do both.

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Before I came to the Chamber, I was at a very interesting event organised by Grandparents Plus where I was told that 28% of grandparents have parents still living. They are a sandwich generation, helping out with the kids as well as helping their own parents. We have what I would call the young old as well as the older old, and the young old want to try new things, especially when they have retired, to develop new skills and to travel to different places. They want to enjoy their lives. They want to have fun, if they have time to do so after all the other things they are doing.

The aspirations of today’s over-60s are in many ways quite different from those of previous generations. My parents have quite different expectations from their parents of the kind of life they want. My expectations, those of my niece and those of the one in three babies born this year who will live to be 100 years old will be very different in the future too.

If older people are not an homogenous group, if they have different views, needs and expectations, why have a Minister for older people? The first reason is that despite all their differences, one thing that the young old and older old frequently say is that they too often feel invisible to politicians, businesses, public services and the media. That is a key reason behind the Grey Pride campaign: to ensure that the needs and views of older people are heard and understood at the highest level, so that we can change attitudes about older people, challenge the stereotypes and put older people at the forefront of British political debate. Of course, a Minister for older people could not do that on their own: local businesses, councils, public services, voluntary groups and the media all have a vital role to play, but the Government can and must take action. The previous Labour Government’s Equality Act 2010 will be crucial in helping to turn the tide on some of the age discrimination we see, including in goods and services, but Governments must also take positive steps to ensure that older people’s needs and concerns are actively promoted in every area.

That leads me to the second reason why we need a Minister for older people: to ensure that all Departments understand the issues facing older people and that work is properly co-ordinated across Government. Many hon. Members have discussed the different Departments that need to understand the views, feelings and expectations of older people. Let me repeat some of those and add some more.

The Minister of State, Department for Work and Pensions (Steve Webb): I am listening to the hon. Lady with great interest and I congratulate her on her role. Does she think that because for 13 years the previous Government did not have someone in this role, they failed older people?

Liz Kendall: I think we made big improvements for older people, but far more needs to be done. One of the biggest challenges—transforming the care system for older people—requires action across Government. It is not something that a Minister for older people could do on their own. They would need the Treasury, No. 10, the Department for Work and Pensions and other Departments to be closely involved. It is a matter of having someone who can help to co-ordinate action across Government and provide a stronger voice at Cabinet level. That is the role a Minister for older people would perform.

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Let us consider some of the other areas in which we need to make sure that older people’s needs and concerns are heard. Take education policy, which some might not think would be relevant. We need to understand that as people live longer and need to work for longer, lifelong learning is essential to help them to develop new and different skills. In family-friendly working, we need to understand that a quarter of all grandparents— 3.5 million in total—are still working as well as helping to look after their grandchildren.

Several hon. Members have mentioned housing policy. We must ensure that there is a range of good-quality options for people as they get older, so that they are not given a choice between living in their own home or a care home; there should be various stages in between. Transport policy is also very important. I am sure that many hon. Members find that bus services are a big issue in their constituency. Making sure that services are linked up is a big challenge. Our energy policy must also take into account the needs of older people, many of whom have very high energy and heating bills, particularly if they have long-term health conditions.

Having a Minister for older people in Cabinet would help to ensure that all Departments were more aware of the issues and concerns I have raised, but the final and most important reason why we need the role is that, as a society and a country, we need to face up to the major economic and social challenges of demographic change. That is a key issue behind Grey Pride’s campaign and is highlighted in the motion. Many hon. Members have spoken about pensions, and I am sure the Minister will speak about them too, but I will focus on care and support.

That must be one of top priorities for the Minister for older people because it is one of the biggest challenges facing Britain today. That is why one of the options would be to have the Minister for older people in the Department of Health, because the key to transforming the care system is in transforming the NHS. Social care budgets have been under increasing pressure for many years, but the care system has now reached breaking point. Adult social care makes up around 40% of local council budgets—up to 60% in some areas—and it is their biggest discretionary spend. When the Government are cutting local council budgets by a third, it is inevitable that services for older people will suffer. Figures from the Department for Communities and Local Government show that more than £1 billion has been cut from local council budgets for older people’s social care since the coalition Government came to power. The result is that councils are raising their eligibility criteria: 80% now provide care only for those with substantial or critical needs, up from 50% only four years ago.

Margot James: Does the hon. Lady not accept that the phenomenon of councils changing their eligibility criteria to restrict care to critical level started way before the cuts to local government budgets?

Liz Kendall: I did say that social care budgets had been under increasing pressure for many years, but local councils are now facing cuts of a third in their overall budget. Adult social care is their biggest discretionary spend, so they face real challenges and are moving their criteria from modest to only substantial and critical need.

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Preventive services have all but disappeared in many areas. Fewer older people get free care; more end up having to go into hospital, or are unnecessarily stuck in hospital or more expensive residential care. Charges are increasing across the country and vary hugely depending on where people live. It is not just older people who are suffering, but their families. Carers suffer ill health and some have to give up work because the right services are not available. There are costs to the taxpayer if they are not in work and contributing financially. There are also increased benefit bills.

The fundamental problem, and another reason why a Minister for older people is important, is that our welfare state was established in a very different age. In 1948, average life expectancy was 66 for men and 71 for women; now, it is more than 78 for men and 82 for women. Some health conditions that are now common amongst older people, such as dementia, were almost unknown back then, and many disabled children died at a young age. Social expectations were very different. Disabled adults had fewer rights, and people automatically assumed that women would stay at home to care for their families.

Dr Poulter: Will the hon. Lady give way?

Liz Kendall: I have a little more to get through, but I will take the hon. Gentleman’s intervention.

Dr Poulter: I am going to be supportive. The hon. Lady is making some good points. Does she agree that not only the welfare state was set up for a previous era, but also the NHS? It is a crisis-management system built around acute hospitals, and the challenge has to be to deliver more care in the community.

Liz Kendall: I thank the hon. Gentleman. I meant welfare state in its broadest sense, including the NHS. That is the big challenge for us. We have to make a fundamental shift in the focus of services—out of hospitals, into the community and towards prevention and early intervention to help keep people as fit and healthy as possible for as long as possible. Services need to be more joined up and personalised to meet individual needs.

The previous Government made big improvements. We backed integrated care, including care trusts such as the one I recently visited in Torbay, which has made huge progress. We invested £230 million in extra care housing projects, which have made a big difference in older people’s health and physical condition, and we introduced personal budgets and direct payments. I hope that this Government will build on many of those developments in their long awaited White Paper, but we shall not be able to tackle the care crisis unless we reform care funding.

Several Members have talked about the Dilnot commission, which represents the best opportunity in a generation to reform the way care is funded. It is an opportunity that politicians in all parties must grasp with both hands. We tried to get cross-party agreement on social care funding at the last election. We did not succeed, but we are determined to try again now. That is why my right hon. Friend the Leader of the Opposition initiated cross-party talks when Dilnot’s recommendations were published.

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I am concerned about the fact that the Government have backtracked on their promise to legislate in this parliamentary Session for new legal and social frameworks for social care. The Queen’s Speech included only a draft Bill on reforming social care law. The Opposition want legislation on a new system for funding social care in this Parliament, and we are pressing for that in the cross-party talks, but that can only come about if there is commitment at the highest level—not just from a Minister or shadow Minister for older people, but from No. 10, No. 11 and other members of the Cabinet.

Our ageing population is something that we should celebrate. Older people make a huge contribution to their families and our society; I see that in my constituents’ lives, and in mine—as often as I get to see my parents. However, our society has barely begun to understand the implications of this vast demographic change. A Minister for older people would make a big difference, but it is incumbent on all politicians—local and national—across the spectrum to understand that we must work together to deliver a better, more dignified life for people, so that they can live a long, fulfilling life, and have more life to their years, as well as more years to their life.

5.41 pm

The Minister of State, Department for Work and Pensions (Steve Webb): There were just eight contributions—but eight high-quality ones, from Members on both sides of the Chamber—to this debate on an important issue. The unanimous view of all those who took part was that we should congratulate my hon. Friend the Member for Portsmouth North (Penny Mordaunt), who introduced the topic in a very effective way. I also congratulate her on the work of the all-party group on ageing and older people, which she chairs, and I congratulate the Backbench Business Committee—some of its eminent members are here today—on making sure that we had the time to discuss the crucial issue of how we best ensure that older people have an effective political voice. That would be the united perspective.

We have heard diverse views. We heard a suggestion that the Minister for older people should be an additional role for the Home Secretary. We heard it suggested that it should be the Chief Secretary to the Treasury, or perhaps another Cabinet Minister. My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) suggested that the Government were doing pretty well without a Minister for older people, although the post might be a welcome addition.

I assure the House, from my now extensive experience—two years—in government, that the idea that the views and priorities of older people are not in every room, in every discussion, is not something that I have ever encountered. To give just one example, the Department for Work and Pensions had to make some very difficult decisions as part of the comprehensive spending review, but if we look at the areas where savings were made—at the reduction in the growth in the budget for disability living allowance for people of working age; at the local housing allowance; at the employment and support allowance; at child benefit, tax credit, and social housing; and at the benefits cap—virtually without exception, those changes apply wholly or predominantly to those

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of working age. The benefits of those above pension age were protected, almost exclusively. As we have heard from a number of hon. Members, crucially, the basic state pension has been enhanced through the restoration of the earnings link and the triple lock. I assure hon. Members in all parts of the House that the political priorities of pensioners and older people more broadly—as we all know, they are the people who turn out and vote—are very much in the Government’s mind at all times.

My hon. Friend the Member for Portsmouth North suggested that there had been some discussion about who should reply to the debate, and she is correct. Part of the reason is that so many Ministers have a keen interest in the concerns of older people. There were many potential candidates, but I fought them off. I want to respond to some of her particular points, and in doing so, reassure my hon. Friend the Member for Southend West (Mr Amess), who was sceptical—I was shocked by this—that there is still joined-up government when it comes to older people. As I run through my response to some of the concerns of my hon. Friend the Member for Portsmouth North, I hope that it will be apparent that I am giving a litany of examples of joined-up government.

My hon. Friend raised the very important issue of loneliness. A number of people mentioned nobody visiting the care home, but everyone coming to the funeral for the reading of the will. That was a powerful point. There is a powerful cross-departmental partnership between the DWP and the Department of Health. The Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), the Minister responsible for care services, has pioneered work on loneliness. We have worked with the Campaign to End Loneliness. There was a summit on 15 March that I attended, which my hon. Friend chaired, on how Government and local government can act effectively on loneliness. Something that has emerged from it is the importance of equipment for local authorities that want to tackle loneliness in their area, including “how to” guides, websites and so on. We take the issue very seriously: too often, we talk about care, transport, health or pensions, but the fundamental issue of whether someone sees anyone from day to day and whether anyone cares whether they are there or not is a vital one, and I am grateful to all the hon. Members who mentioned it.

Something that has come out of our work is the age action alliance, which brings together more than 200 organisations, including Government Departments, private sector bodies, charities and voluntary groups. The alliance operates under the umbrella of Age UK, and is supported by the Department for Work and Pensions. It tackles a range of issues affecting older people in a joined-up way across sectors. Loneliness is one of the key themes that it is looking at.

My hon. Friend the Member for Portsmouth North mentioned taxation and older people. Let me say on the record that if tax and national insurance were brought together in a single operation, national insurance would not, I can assure her, be applied to pensions. There is no proposal to bring pensioners into that higher combined tax rate. In an example of joint working, the DWP and Her Majesty’s Revenue and Customs are working together on the recommendations from the Office of Tax

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Simplification. I can assure her that, as Pensions Minister, I will scrutinise exceptionally closely any suggestion that tax might be withdrawn at source from the state pension.

My hon. Friend and my hon. Friend the Member for Central Suffolk and North Ipswich raised the abolition of the default retirement age, and the position of older workers more generally. As I mentioned in oral questions this morning, that is something of which the coalition Government can be resolutely proud. There were years of talk about abolishing mandatory or forced retirement, but we have done something about it. There is still more to be done: employer attitudes to older people still need work, which is why the DWP and the Department for Business, Innovation and Skills work jointly on that. In fact, BIS-led legislation has been introduced. We have worked with employers and business organisations on the “Age Positive” initiative to challenge outdated assumptions about older workers and to encourage improvements in the employment and retention of older workers as part of a mixed-age work force.

Older workers are good business. I said this morning in the House that research evidence from McDonalds has found that McDonalds restaurants that employ over-60s have on average higher customer satisfaction than those that do not do so. Some people might find that surprising, but it is an example of enlightened employers who get it, and who do well as a result. We shall certainly spread the word.

My hon. Friend the Member for Portsmouth North raised the issue of someone who goes into a care home and wants to be able to get something from the value of their home. I think she referred to the Redbridge “FreeSpace” pilot, and spoke about it very positively. I can assure her that my hon. Friend the Minister for Housing and Local Government has encouraged other local authorities to look seriously at that innovative project, and is trying to promote it, as she suggests.

My hon. Friend suggested that we do more to communicate with people and that it was important to piggyback messages. I agree, which is why the DWP is working with the Department of Energy and Climate Change on a pilot scheme to promote the green deal. When we write to people about winter fuel payments, we take a target sample of 1.2 million letters, and those recipients will receive a separate flyer in the envelope promoting the green deal to encourage them to take up energy efficiency schemes. My hon. Friend the Member for Stourbridge (Margot James) mentioned excess winter deaths which, she is absolutely right, remain a scandal. It is not so much about giving people an extra pound to pay an exorbitant fuel bill but about trying to make sure that their home is properly insulated. She will know, as I do, that in Scandinavia, excess winter deaths are almost unknown, not because it is warmer—it obviously is not—but because people have properly insulated homes. We must make sure that there is more action across government on that issue.

The hon. Member for Manchester Central (Tony Lloyd) raised an important issue, and mentioned the very recent report on hospital care and the management of medicines. His home city is recognised as a World Health Organisation centre of excellence for the way in which it approaches older people—he will be aware of that—and that is something that has come out of cross-government working. He is right that the issue of

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medicines management in care and nursing homes is important, which is why early last year, the Department of Health agreed to fund a project to improve medicines management in residential care. The project is driven by the sector and led by the national care forum. The goal is to design and test a set of practical tools to help care-home staff, doctors, pharmacists and nurses to provide safer care and reduce the incidence of medication errors and what are known euphemistically as “near misses” in care and nursing homes. The hon. Gentleman is right to raise that issue, which the Government take seriously.

Coming back to the point made by my hon. Friend the Member for Stourbridge about excess winter deaths, she will be aware that in December 2011 the Department of Health published a cold weather plan for England and identified up to £20 million for 2011-12 to support local authorities to reduce levels of deaths and morbidity during cold weather. It is designed so that local government —again, a partnership approach—working with voluntary and community sector partners can address the risk factors of cold weather for vulnerable older people. I accept my hon. Friend’s point that we need to do more work on the issue.

We heard some powerful contributions, including a very moving one from the hon. Member for Bolton West (Julie Hilling). It sounds as though her mother is rather well known. My hon. Friend the Member for Southend West mentioned that he had met her on the Terrace, on an outing to see the flotilla, as I understand it, so she is becoming quite a celebrity. The hon. Lady spoke powerfully about both the excellence and, shall we say, the lack of excellence in the care that her mother had received. There is indeed too much variability in the quality of care. The hon. Lady also talked, rightly, about wrong attitudes to older people, which others mentioned as well. That is something we need to challenge, which we are trying to do in Government.

My hon. Friend the Member for Central Suffolk and North Ipswich mentioned Age UK’s five tests for a Government taking office, and he was generous enough to point to a number of things that the Government have already delivered on and others on which we are trying to make further progress. My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) mentioned that it was important that what happens is not fluffy or soggy. I want to assure him that there is a lot of unfluffy and unsoggy work going on, and to highlight the UK Advisory Forum on Ageing, which was set up just before the last election. It meets quarterly. I attend every meeting. The Minister of State, my hon. Friend the Member for Sutton and Cheam who has responsibility for care services, is a regular attender as well.

We co-chair the forum and it is attended by about 30 representatives of advisory forums for older people from the regions of England, the Welsh Commissioner, the Northern Ireland Commissioner, organisations that are not great fans of the Government, such as the National Pensioners Convention, Age UK and others. We come face to face with these groups once a quarter. I have attended every meeting since the election, and that group sets its own agenda and decides what it wants to talk about. One possible fruit of this debate might be that that work, which has been extremely effective, might be expanded and might bring in other Government

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Departments more systematically and perhaps other Ministers. That might be a response to some of the concerns that have been expressed.

I should mention that the Home Office is finally—in the sense that these things have been talked about for many years—bringing forward legislation to ban discrimination in goods and services for older people, which is long overdue and very welcome.

I was interested to see that Age UK had commented ahead of our debate. Its position on the proposal for a Cabinet Minister with separate responsibility was, perhaps, more nuanced than we might have expected. Although Age UK obviously welcomed the debate, it said that the appointment of a Minister would not be a panacea, which I do not think anybody suggested. It also suggested that it might create risks as well as opportunities. For example, it says that there is the potential that other Departments might decide that they are no longer responsible for thinking about older people. It says that there is a further potential risk of confusion over the responsibilities of the Minister for older people vis-à-vis those of other Ministers.

I was interested to hear my Labour shadow, the hon. Member for Leicester West (Liz Kendall), say that the important issues all related to care, and that what we need is a Minister in Cabinet responsible for those issues. The Minister of State, my hon. Friend the Member for Sutton and Cheam, who I am pleased has been able to join us at this point in the debate, is doing an excellent job. We do not need two Ministers doing the same job. The hon. Lady said that the issues needed to be discussed at the highest level in Government. I can absolutely give her the assurance that on a regular basis the very issues that she identifies are discussed round the Cabinet table with the principal players of the Government.

Liz Kendall: What I said was that, although a Minister for older people would make a big difference, responsibility must lie at the highest levels of Government—with the Prime Minister, the Chancellor and other members of the Cabinet. I am glad that the hon. Gentleman put that on the record.

Steve Webb: I am sure the House would expect the Prime Minister to take a very close interest in these matters.

Age UK says that a weak and ineffective post of Minister for older people could do more harm than good. None of my ministerial colleagues are weak or ineffective, so that is not something we need to worry about. It is clear that all Cabinet Ministers, even the Chief Secretary, have a pretty full inbox at present. It was generous of my hon. Friend the Member for Portsmouth North to give him an extra role. I will have a chat to him about it. The worry would be that if an additional role is given to an already stretched Minister, either it becomes marginal and is not done properly, or it ends up being duplicated. That is the challenge for us.

Responding on behalf of the Government to this important debate, I very much welcome the terms in which the whole debate has been conducted. We are united in the view that older people need a proper voice right at the heart and right at the top of Government. We need to think very hard about how we deliver that.

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I welcome the terms of the motion, which proposes that the Government should consider—we certainly should—whether that role would best be done by a Cabinet Minister with additional responsibilities. My proposition is that one response might be for the UK Advisory Forum on Ageing to have a more cross-government role. There are plenty more things we could do, but I stress that there are plenty of cross-government and co-ordinated things already being done. I hope that I have been able to give the House some reassurance on that point.

I can confirm that the Government are very happy to support the motion and look forward to further discussions, because I have a feeling that, if we do not make sure that older people have a proper voice right at the heart and at the top of Government, my hon. Friend the Member for Portsmouth North will not let us hear the last of it.

5.55 pm

Penny Mordaunt: I want to thank all Members who have taken part in this afternoon’s debate. I know that the Thursday afternoon shift is a tough one, so their constituents can be in no doubt about the importance they place on the issue or their commitment to improving the lives of older people and the services we provide to them.

The challenges we have discussed are great, but I am very encouraged by the breadth of support across the House and the quality of contributions that have been made this afternoon. I thank the shadow Minister and the Minister for their contributions. There is good work going on in Government and in all sorts of organisations across the country. The Department for Work and Pensions, in particular, is doing some very interesting things and has made great progress. I hope that the Minister will forgive us if we are being greedy, but we want more, and I was pleased to hear about his plans for the future.

My hon. Friend the Member for Southend West (Mr Amess) told us that he has been here before, and I am not so naive as to think that we will have a Minister for older people in post by tomorrow, whether that is a stand-alone post or a role attached to a Cabinet post, but I will be greatly comforted in my disappointment if the Minister takes up the issues we have raised this afternoon, as I am sure he will, and continues to improve cross-government working for the benefit of older people.

Finally, I would like once again to thank Anchor and the Grey Pride campaign for their achievements, especially all those care home residents who signed the petition. The objective was to have a debate in the Chamber, which we have done, but they have also started a debate outside the Chamber and I am sure that good will come of it.

Question put and agreed to.


That this House notes the concerns of the Grey Pride campaign; and calls on the Government to consider appointing a member of the Cabinet to be the Minister for Older People, to give a political voice to the older generation, to oversee the co-ordination of services which affect older people, and to focus on tackling the social and economic challenges of demographic change.

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Business without Debate

Draft Enhanced Terrorism Prevention and Investigation Measures Bill (Joint Committee)


That this House concurs with the Lords Message of 28 May, that it is expedient that a Joint Committee of Lords and Commons be appointed to consider and report on the draft Enhanced Terrorism Prevention and Investigation Measures Bill presented to both Houses on 1 September 2011 (Cm. 8166).


That a Select Committee of six Members be appointed to join with the Committee appointed by the Lords to consider the draft Enhanced Terrorism Prevention and Investigation Measures Bill (Cm. 8166).

That the Committee should report on the draft Bill by 9 November 2012.

That the Committee shall have power—

(i) to send for persons, papers and records;

(ii) to sit notwithstanding any adjournment of the House;

(iii) to report from time to time;

(iv) to appoint specialist advisers;

(v) to adjourn from place to place within the United Kingdom; and

That Mr Bob Ainsworth, Nicola Blackwood, Mike Crockart, Chris Evans, Rebecca Harris and Jesse Norman be members of the Committee.—(Sir George Young.)

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Young Offender Institutions (Speech and Language Therapy)

Motion made, and Question proposed, That this House do now adjourn.—(Bill Wiggin.)

5.58 pm

Seema Malhotra (Feltham and Heston) (Lab/Co-op): I am grateful to the House for the opportunity to speak today on this important topic and thank many hon. Members for their supportive comments this week and for sharing their own perspectives. I wish to raise several points in my contribution, which I hope the Minister will be able to address. If he cannot answer today, I would be grateful if he would ensure that he writes to me with answers or, if the questions relate to areas that are not his direct responsibility, agrees to forward them to the Minister responsible.

This debate was triggered by my recent visit to Feltham young offender institution and, indeed, my interest in youth justice as a member of the Justice Committee. Speech, language and communications needs have become an increasing area of policy focus. An inability to communicate effectively has a tremendous impact on the ability to learn, hold down a job and have a stable family life. I am pleased that the all-party group on speech and language difficulties, which was convened by my hon. Friend the Member for Swansea West (Geraint Davies), is undertaking an inquiry into the links between SLCN and social disadvantage.

The Marmot review of health inequalities in 2010 identified communications skills as being necessary for school readiness, and a Department for Education research report last year showed a clear association between social disadvantage and SLCN among primary school children. It stated:

“More of the low attainers were boys, more were eligible for free school meals and more had English as an additional language.”

Speech, language and communication needs are characterised by difficulties in understanding complex language, in explaining oneself clearly and logically and in responding appropriately to specific social settings. The Bercow report described those needs as including

“difficulties with fluency, forming sounds and words, formulating sentences, understanding what others say and using language socially.”

Paul Maynard (Blackpool North and Cleveleys) (Con): The hon. Lady mentions the impact of many forms of communication delay. Does she agree that one of the most dangerous forms is when young offenders, upon release, do not understand the terms of their release and are called back to prison because they do not understand what they cannot do, such as cross a road to reach a grandmother, for example? Does she agree also that that is why speech therapy is so important in our young offender institutions—to make sure that individuals understand what is happening to them?

Seema Malhotra: I thank the hon. Gentleman for his contribution. He makes an important point about the inability to understand what is going on in the justice system through an inability sometimes to read and, certainly, to understand what is being said. An important part of the argument is that we need better speech and language therapy services in order to reduce reoffending.

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Statistics from the Royal College of Speech and Language Therapists show that 10% of school-aged children and 1% of adults in the general UK population have speech, language and communication needs, but that 55% of children in deprived areas are affected by such needs. They suffer from a “word gap” of an estimated 30 million words when compared with children in wealthier households, and that limits their ability to use language to communicate effectively.

It is estimated that more than 60% of young offenders have speech, language and communication needs, and there is evidence of a vicious circle—of deprivation leading to reduced language development, leading in turn to communication difficulties. Children with speech and language difficulties are more likely to become frustrated at school, to play truant and to get involved with crime. Once they are involved, they struggle with the formalities of courts and of police interviews, and they come out worse because of it.

Nick Smith (Blaenau Gwent) (Lab): I, like my hon. Friend, have visited young people with communication disabilities in prison; I did so in Park prison, near Bridgend. Does she agree that it is essential to recognise as early as possible, at the point when young people enter the criminal justice system, whether they have communication difficulties? Does she agree further that the Asset tool should be updated so that needs can be identified without delay and the right help delivered?

Seema Malhotra: I thank my hon. Friend for his comment. He makes an important point about early identification within the justice system—particularly if somebody’s needs have been missed earlier in life—in order to help an individual to facilitate the rehabilitation that we hope is possible for them.

There is an important debate about the standards of provision in the education system, and I shall speak about that tomorrow at an excellent training conference on developing oracy and literacy, organised by Hounslow Language Service in my constituency.

My concern in this debate, however, is about the access to speech, language and communication needs assessment and services once young people have reached prison. When I visited Feltham young offenders institution recently, I met a 15-year-old boy who has been receiving speech and language therapy, and learning a few speech exercises had already made him more confident in speaking to his family on the phone—with a clear impact on his personal confidence.

The boy’s vocabulary was like that of a child, but this is not so surprising when we discover that 35% of offenders have speaking and listening skills below national curriculum level 1, equivalent to those of a five-year-old. A further 26% of offenders are estimated to have national curriculum level 2 speaking and language skills, which compare to those of an average seven-year-old.

I also heard the story of a young man who was recently at Feltham. He had a lisp, and when he was three his GP had told his parents that this was because he had a small tongue and nothing could be done. He proceeded to do poorly at school. He was laughed at, including by his own family; his mother would force him to speak when friends came round as a source of entertainment. When in prison, this young man came to

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accept some speech and language support, and within a matter of weeks he was becoming a more confident speaker, with an almost instant change in attitude to turning his life around. An ability to communicate better has been increasingly associated with reduced violent behaviour of young offenders, and that was indeed the case with this young man.

We know that it works to invest in communication skills and in the training of staff and officers in the justice system. The Royal College of Speech and Language Therapists’ briefing on youth crime of June 2012 quotes statistics from Red Bank secure children’s home in Liverpool. Five out of seven young offenders in one section had challenging behaviour. Staff were involved in physically restraining these young offenders on two to three occasions per day. After communication training and guidance from the speech and language therapist, staff were able to reduce the number of restraints to two per week. The Communication Trust has published in its booklet, “Sentence Trouble”, some useful suggestions about how youth justice professionals can positively interact with young people with speech, language and communication needs. It identifies an awareness and training gap in the youth justice work force, who are much better prepared to deal with mental health issues and substance abuse than with speech and language difficulties.

I am concerned that dealing with the speech, language and communications needs of young offenders is falling through the cracks between the Departments for Education, Health and Justice. It is probable that many young people in prison may not have been there had the education system or health system intervened effectively earlier in their life. In 2010, research with therapists conducted by the royal college in four areas of the country suggested that over 90% of young offenders with communication difficulties had not been known to speech and language therapy services prior to their contact with the criminal justice system. Yet the benefits of these services are clear in improving justice outcomes and reducing reoffending. It is feared that current education and rehabilitation measures in prison require a higher level of language comprehension than many young offenders possess. However, current provision of these services in young offender institutes is limited and patchy. Of the 21 young offender institutes, only Feltham has a full-time speech and language therapist, while four others—Hindley, Wetherby, Polmont and Cornton—provide some support on one to three days a week.

There have been moves to make this case and improve provision in the past. In 2006, Lord Ramsbotham, formerly Her Majesty’s chief inspector of prisons, said in a Lords debate:

“in all the years I have been looking at prisons and the treatment of offenders, I have never found anything so capable of doing so much for so many people at so little cost as the work that speech and language therapists carry out.”—[Official Report, House of Lords, 27 October 2006; Vol. 685, c. 1447.]

The Bercow report recommended that the youth crime action plan and work on young offenders’ health should consider how best to address the communication needs of young people in the criminal justice system, including those in custody. The youth crime action plan of 2008, produced under the previous Government, included recognition of the Bercow review’s recommendations. However, I am not certain whether any action has yet been taken by this Government, nor has the Under-

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Secretary of State for Justice, the hon. Member for Reigate (Mr Blunt), who is responsible for youth justice, commented on speech and language therapy.

The royal college has called for at least one full-time specialist in every young offender institute. The Prison Reform Trust supports this recommendation, and its report, “No One Knows”, recommended that

“prison healthcare should have ready access to”

learning disability expertise and

“speech and language therapy.”

Arguably, on the current evidence, there is a strong economic case for this. Secure children’s homes and training centres cost about £200,000 a year, while placement in a young offender institute costs £60,000 a year. This, the House may be interested to hear, is twice the cost of a year at Eton, which is £30,981. I thank the Minister for providing these up-to-date figures following my written question last week—excluding the Eton figure, of course, which were obtained from Eton’s website. In comparison, a full-time speech and language therapist employed under NHS “Agenda for Change” band 7 costs £30,460 a year—marginally less than a year at Eton. The funding of speech therapy is surely cost-effective, compassionate and necessary for an effective and intelligent youth justice system.

To conclude, I would be grateful if the Minister updated the House on a number of matters. First, what is the Government’s policy on the provision of speech and language therapy in young offender institutions, and on the call for there to be at least one full-time speech and language therapist at every institution? Secondly, will he clarify which Department is accountable for the provision of speech and language therapy in young offender institutions, and how the Department for Education, the Department of Health and the Ministry of Justice work together on this issue? Thirdly, is it true that Asset, the assessment tool used by police and the justice system, does not include a section that enables staff accurately to identify speech, language and communication needs? Fourthly, what assessment of speech, language and communication needs takes place when a young offender is sentenced to prison? Fifthly, is the existing funding secure and are there plans to increase the provision in young offender institutions? Finally, how do Ministers currently measure and review the effectiveness of such services?

I thank the House for the opportunity to speak on this topic today.

6.10 pm

The Minister of State, Department of Health (Paul Burstow): I congratulate the hon. Member for Feltham and Heston (Seema Malhotra) on securing the debate and on setting out the issues so clearly. I note that, curiously, my noble Friend Lord Addington is debating this matter with Ministers in the other place. It is clearly of importance to parliamentarians in both Houses. The work of the all-party parliamentary group on speech and language difficulties underscores that point.

It is important to recognise that speech, language and communication difficulties are part of a complex and multi-layered range of needs that young people between the ages of 15 and 21 may have, particularly those within our criminal justice system. I understand the concerns about speech and language therapy that the hon. Lady has raised and will try to address them.

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There have been a number of studies, mostly small-scale studies, on the prevalence of speech, language and communication needs. They place the prevalence of such needs in custodial settings at anything between 60% and 90%. One recent study found the 60% of young offenders screened on entry to custody had speech, language or communication needs. As has been said, among the general population the figure stands at 1%, although there are regional and local variations.

Much attention has been given to these issues over recent years. The hon. Lady made reference to Mr Speaker’s work on behalf of the last Government. The coalition Government are taking forward a number of the actions in the Bercow review. First, we had the Green Paper on special educational needs and disability, and the follow-up report that was published recently. Secondly, there have been pathfinder pilots to develop unified plans covering health, education and care needs, supported by the use of personal budgets. Thirdly, we have had the review of the early years foundation stage. The Department of Health is working closely with the Department for Education to join up health and care, sorting out one of the oft-stated criticisms of SEN provision for so many years.

I assure the House that speech and language therapy is available to young people, and in particular to those in the custodial estate. Currently, it is commissioned in the custodial estate through primary care trusts. It is meant to be commissioned according to local need. That means that in-house services are provided in some larger young offender institutions—not just in Feltham, but in Wetherby and Hindley. I urge the hon. Lady to look at the provision in those two other institutions.

From next April, the responsibility for commissioning prisoner health will move from primary care trusts, as they are abolished, to the new NHS Commissioning Board. That will help to ensure that people with health needs in custodial settings receive care comparable with that received by those in the wider NHS. Offender health lead commissioners will act for the board and determine the right level of service to be provided to meet the identified needs within the prisoner population. They will work at local level with health and wellbeing boards, children’s services, and police and crime commissioners.

Nick Smith: May I press the Minister? How many young people’s custodial settings have speech and language therapists working at them? Do some or all settings have them?

Paul Burstow: The hon. Gentleman will have heard me say that there is specific in-house provision at three settings, but there will also be referrals through NHS pathways for speech and language services, meaning that any young person in need of speech and language therapy should have access to it. That is one of the requirements of the commission—its responsibility is commissioning appropriate services to meet identified needs. I shall come to the identification of needs in a moment.

Speech, language and communications needs are just one part of an often complex picture. It is important that we acknowledge that there are complex interactions with, for example, mental health problems, learning disabilities, substance misuse and alcohol problems. Therefore, psychiatry, psychology, community psychiatric

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nursing, psychotherapy, and occupational and creative therapy can all play a valuable part—a bigger part in some cases—in treating and meeting the needs of young offenders.

The hon. Lady was right to highlight the contribution that speech and language therapies make not just in direct services, but in supporting colleagues in a multi-disciplinary team to ensure they have the necessary skills to provide the right communications support and so on.

Adopting a personalised approach is at the core of that. The hon. Member for Blackpool North and Cleveleys (Paul Maynard) rightly said that we need to ensure that people have the communications skills and understanding both when they are in prison or youth offending services and when they are released. That was an important point.

The hon. Lady spoke powerfully of her visit to Feltham and the conversations she had with the 15-year-old lad about his experience of speech and language therapy—he said it gave him more confidence. That is another reason why such therapy is an important component of the right health interventions to meet identified needs.

The hon. Member for Blaenau Gwent (Nick Smith) said in an intervention that early intervention is relevant as well as the change in commissioning responsibilities. Early intervention is a key part of the Government’s approach. Continuity of care and treatment is key. The average period of detention for a young offender is very short—80 days, often including remand. Custody therefore provides opportunities for health assessment and for identifying problems and needs, after which referrals can be made. It is therefore important that we have systems that allow those follow-ups to take place. It was right that the previous Government decided that the commissioning of prison health services should be an NHS responsibility, enabling those systems to be properly joined up, and this Government have maintained that.

We need to look right across the whole criminal justice pathway to provide health interventions that are appropriate to the individual presenting needs. In 2010-11 there were 2,040 10 to 17-year-olds in the secure estate at any one time on average. Sometimes, four times as many were on remand or awaiting sentence to custody, and 85,300 were being supervised by youth offending teams. There is a similar pattern in the 18 to 20 age group.

Seema Malhotra: It is important to talk about action across the justice system and recording and assessing, but where will that information be held, so that the records are kept and maintained as a person passes through the justice system?

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Paul Burstow: That allows me to talk about Asset and what we are dong. Asset is a tool used by the criminal justice system to risk-assess reoffending, whereas we are introducing a comprehensive health assessment tool that incorporates questions on speech, language and communication needs and is designed better to meet the complex range of needs of children and young people in the secure estate. I will send further details about that to the hon. Lady, but in a way the role of the NHS in our prison service is better supported through the second tool and the information systems that support an individual on their journey through the criminal justice system.

We also need to go further back up the criminal justice pathway. The Department is expanding the liaison and diversion services for all ages, and that includes tailored support for children and young people and appropriate referrals for those with speech, language and communications needs. Even further back up the criminal justice pathway is our programme to support troubled families, which tries to break the very cycles that the hon. Lady talked about—of school absenteeism, crime and antisocial behaviour—and which can exacerbate other presenting problems and lead to greater communications difficulties.

In conclusion, this has been an important debate. Speech and language therapy is a highly valued intervention, and the Government recognise the contribution it can make to the quality of life of young people and the potential for reduced reoffending as a consequence. It is clearly necessary that people in the custodial service and in contact with the criminal justice system can be referred and have access to those services. However, speech, language and communications difficulties are just one part of a complex picture of needs, which is why we are ensuring that a more holistic approach is taken that assesses the range of needs that an individual presents when they enter the custodial estate.

As a consequence, we have threaded right through the criminal justice pathway a more personalised mix of treatment and therapy that meets those individual needs. That is our goal. These changes build on the important reform of commissioning, using the strength of a national commissioning board leading on commissioning prisoner health services and working with local partners to make the necessary connections with local services. That is how we will improve the quality of life, care and treatment for young people in our custodial estate. I shall write to the hon. Lady with the details she requested.

Question put and agreed to.

6.22 pm

House adjourned.