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The hon. Member for Rutherglen and Hamilton West (Tom Greatrex) referred to the National Audit Office report. I have had the benefit of having read that report, although I know that he has not. The reality is that the report highlights a number of what I regard as not particularly major areas of improvement. If he reads the report, he will see that it reflects a big and complicated contract. It makes some suggestions for improvement, but it is not as he portrays it.
When the hon. Gentleman talks about the performance of Atos during the last two years, the key point he must remember is that the recommendations that Malcolm Harrington made, combined with some fluctuation in volumes coming through to Atos, which are certainly beyond its control, have caused significant operational difficulties. I can give him my word that I have sat in meetings with representatives of Atos and put them under intense pressure. Atos has brought in extra capacity at cost. We have made sure that we deliver at every stage. However, it is not possible to change the goalposts totally and then expect the subcontractor to take it on the chin with no consequences.
We have seen some consequences of the introduction of the Harrington recommendations, particularly the personalised statement. However, as I stand here today, we are on track to close the backlog time to where it should be later this autumn. The numbers that the hon. Gentleman gave are already well out of date. We have brought down the backlog in the number of appeals that we inherited two years ago, but it is a big task. We are dealing with a large number of people and this is a big challenge.
Let me be clear that we want to get this process right and we want to do the right thing. I want people who need long-term ongoing support to be in the support group. The Government have no interest in doing anything other than looking after those people who need that, but we will also give encouragement and support—and a bit of a push—to those who can get back into work, because I believe that that is the right thing for them.
Mr Philip Hollobone (in the Chair): I thank those Members who have attended this important debate for coming along today, and I encourage everyone to leave Westminster Hall quickly and quietly so that we can proceed to the next important debate.
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Census (Local Government Funding)
12.30 pm
Mark Field (Cities of London and Westminster) (Con): I assumed there would be a large crowd interested in every word on this subject, but, unfortunately, I often have this effect when speaking in the House: the Chamber empties.
The census particularly affects one of the two cities I represent: the city of Westminster. Unfortunately, the hon. Member for Westminster North (Ms Buck) cannot be here today, but she associates herself with most of my speech. We have worked together throughout the 11 years that I have been in Parliament to try to ensure that the problems of previous censuses are ironed out. We have fears for the future, given the funding arrangements that have been put in place.
The city of Westminster is one of the most complex and diverse areas of the United Kingdom. As the cultural and political hub of our capital city, Westminster attracts a vast number of people each and every day, on top of the residential population, who come either to work or to visit Westminster’s wealth of attractions. Unsurprisingly, Westminster is a destination of choice for people arriving in the United Kingdom for the first time. Many plan to work or study for a short period before returning home; others hope to make a permanent new life here. The true extent of that population is unknown. Also hidden from official statistics are asylum seekers awaiting a decision from the Home Office, countless migrant workers from the European Union who are often willing to sleep in crowded rooms, illegal immigrants working in the black economy and those whose application for leave to remain has been rejected but who are yet to be removed. That huge tide of humanity must be catered for, no matter the unique difficulty of measuring its extent. For Westminster city council, that means funding services for a population well beyond that catered for by central Government money.
I made that point in Westminster Hall some four years ago. In 2008, Westminster city council, one of the two local authorities in my constituency, spent an estimated £6 million looking after that unaccounted-for population. The council had repeatedly warned the previous Government that methods of counting migration numbers were not keeping pace with modern patterns of population movement. That became especially problematic for the council after the 2004 accession of 10 new member states to the European Union, bringing a wave of immigrants to the capital that included Poles, Latvians and Estonians. Lessons were not learned and services came under renewed pressure when, only a few years later, a fresh influx of people came to London when Bulgaria and Romania were brought into the European Union fold.
There was enormous optimism that the 2011 census would at last provide an accurate indication of the numbers living in central London and ensure that the council’s funding settlement from central Government finally provided sufficient moneys to cover the cost of services for all those using them. Undoubtedly, the 2011 census was handled differently from the 2001 census. The Office for National Statistics made significant changes to address some of the obvious shortcomings of the previous population count, to which the hon. Member
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for Westminster North and I referred in the debate four years ago. We were pleased that Westminster was designated in the hardest-to-count category across all of its wards and received considerable resources to conduct the census.
Nevertheless, although the 2011 census estimate of 219,400 represents an increase in population since 2001, when the figure stood at 181,300, it comprises a large reduction of 21,800, or 9%, from the previous revised 2010 mid-year estimate of 241,100. The situation looks worse if one considers the figures used in the last local government finance settlement, which was based on 2008 mid-year estimates projected forward. Against those numbers, the 2011 estimate represents a drop of 43,500. Despite the resource given to counting Westminster’s population, the council understandably believes that the ONS remains wedded to a one-size-fits-all methodology that does not properly recognise the specific problems of areas such as central London.
Westminster city council believes that the 2001 experience set a precedent that should not be ignored by the Department for Communities and Local Government when determining which data to use when allocating local government resources. Westminster, with its thriving economy and world-class, highly regarded universities—Imperial college London, King’s college London and the London School of Economics, to name but three—is an especially attractive destination to live and work in. Westminster draws people from across London, the UK and the world and consequently provides services to the largest volume of non-residents in the country.
Historically, through a commitment to efficiency and innovation, Westminster has managed to soak up many of the cost pressures that go hand in hand with providing a high-quality cityscape. With the tightening of public finances, however, the council can no longer meet those costs. Westminster city council is underfunded by the revenue support grant and is unable to increase council taxes owing to the Government’s commitment to freezing the levy. I do not disagree with that commitment, but local authorities find themselves wearing that straitjacket.
The subsequent impact on services for people living in central London has been significant. The costs, however, are much wider and include deteriorating environmental services that affect almost 50,000 businesses, and the risk that the 22 million foreigners who visit the borough each year will form less favourable impressions not only of London but of the UK as a whole. That may seem a relatively trivial risk, but think of the impact of the magnificent showcasing of the capital and the UK during the Olympics that will fashion the world’s view of Britain for years to come.
I accept that there will always be a multitude of difficulties in collecting accurate population data in places such as Westminster compared with local authorities such as your local authority in Kettering, Northamptonshire, Mr Hollobone, or the relatively leafy suburb that the Minister represents in the south-east London borough of Bromley. Those problems include getting people to open their door—an estimated 89% of properties in Westminster operate multiple door entry systems. Westminster had the second-lowest response rate to the national place survey, and the profile of those who responded was overwhelmingly white, with almost every other ethnic group and those in the 20 to 34 age bracket under-represented. Similarly, in 2010, Westminster city council conducted a mini census coverage
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survey in four key areas. Some 54% of Edgware road respondents were found to be white, with only 35% identifying themselves as Asian despite the surveyed area being in the heart of London’s Arab community. In Soho, where Chinatown is based, one enumerator reported that she encountered many doorbells with Chinese names but few people answered the door. Yet, according to the 2009 pupil level annual school census, English was found to be the main home language for only three in 10 children attending Westminster’s schools. One consequence of an over-representation of white respondents is likely to be a reduction in average household size because migrant groups tend to live in larger households.
Although the estimated response to the 2011 census was better, at some 85%, than a decade earlier, when the response was only 74%, response rates still look very low for some demographic profiles, with a particular under-representation of young males. That is especially critical in Westminster, where those with the lowest response rates—males aged 25 to 44—are the most prevalent in the population and the most unlikely to register with comparator data sets such as GP lists.
Although I am sure that the Minister will update us, I understand that the ONS has not yet published the detail necessary for Westminster or any other local authority to evaluate and initiate the adjustment process, which strives to deal with the difficulties to which I have referred. However, Westminster city council is concerned about the methodology that is used. For example, part of the bias adjustment is the within-household bias, which refers to census returns that report a lower number of residents than are present, resulting in an under-count. To correct that particular bias, the ONS matches social survey data to the census data and makes an imputation based on the characteristics of respondents. However, it is not clear whether the data will sufficiently correct the bias for an area such as Westminster, where the number of visitors, migrants and large households is unprecedentedly high and unlikely to be accurately represented in voluntary social surveys.
The council also has concerns about administrative data. Although comparisons of administrative data to census outputs should be treated with a certain amount of caution until we are able fully to understand the ONS’s assumption, there are some anomalies that Westminster believes require further investigation. For example, 2011 census data claim that there are 4,800 fewer occupied households in Westminster than were identified on Department for Communities and Local Government council tax lists, meaning that almost 5,000 fewer households completed census forms than pay council tax. Why is the shortfall so large even after vacant and second homes have been formally accounted for? It is plausible that those properties are only partly occupied. If that is the case, it takes us back to concerns that the city is providing services for part-time people who are never captured in population counts and therefore never properly funded.
Other comparative data require close examination. The register of patients for Westminster GPs, for instance, listed 19,400 more people than the census outputs. GP lists in some parts of the country are deemed to be inflated, as people fail to deregister when they move out of an area, but Westminster is not like other parts of the country. It is likely instead that a substantial part of
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the population never registers with a GP due to population churn, migration and the prevalence of walk-in and accident and emergency services.
Department for Work and Pensions data on the number of people aged 80 to 84 in Westminster are 50% higher than the census output. The 2011 census estimates that only 3,100 over-85s live in Westminster, despite the fact that 6,800 claim a pension there. The census included questions on length of stay in the country for the first time, thereby providing some estimate of short-term migration, yet only 6,900 in that category were suggested as living in Westminster. Again, that is likely to be a massive underestimate, as it implies that a little over 1% of the number of people employed by Westminster businesses are short-term migrants. A cursory look at any restaurant or shop in the centre of London suggests that that is a underestimate.
Furthermore, the annual population survey 2008-09 estimated that 15,500 people aged 18 to 24 were full-time students in Westminster and might be here for only part of the year, adding a further burden to the issue of short-term migrants. Of the estimated 442,000 illegal migrants living in London, we believe—on a pro rata basis, although there is likely to be a bias towards central London—that 20,000 to 25,000 live in Westminster. All those uncounted and under-counted people are not represented in the funding formula.
For all those reasons, the council requested continually that the 2011 census be tested in Westminster, yet the ONS refused. If data based on the census are used in central Government’s calculation of Westminster’s funding grant, the local authority will be affected to its detriment. It is hard to grasp the exact financial implications, as the details of the revenue support grant model are not yet published. However, I believe that it is likely that Westminster’s RSG will drop substantially.
I calculate that Westminster’s new, substantially reduced census population, when compared with the population estimates used in the previous financial settlement for local authorities, could result in an estimated annual loss of £10 million to £15 million in funding, which will disproportionately affect the most vulnerable in the community. Although I am sure that the Government’s damping mechanism would mitigate some of that loss— the vagaries of the funding mechanism may mean that the estimates could change considerably—those sums are substantial, particularly in a time of tightening financial settlements, which I support, understanding the reasoning behind them.
As I see it, three options now face the Minister and DCLG. The Government can plough ahead with the 2011 census data and lock Westminster into perhaps seven years of underfunding via the business rates retention model. Alternatively, it can recognise that for a very few local authorities—a small number of special cases—the one-size-fits-all 2011 census model may not have worked well enough, and there should be an opportunity to discuss a population top-up. The third option is to continue to use the 2010 mid-year estimates for all authorities until the 2011 census can be adequately quality assured.
DCLG ought to give more recognition to the fact that modern population movement—many UK cities are hyper-mobile and hyper-diverse communities—means
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a constant turnover of people in inner urban authorities. Those people should be counted as part of the resident population. The Department should, after six years of ONS deliberation, include short-term migration in its funding formula. I must confess that I had hoped wistfully that the 2001 experience would have set a precedent that could not be ignored. I respectfully suggest that the coalition Government now seize the chance to rectify the situation. Otherwise, they face fundamentally undermining one of their flagship local authorities, which has for years served as a beacon of best practice in spite of its gargantuan task in managing this fine capital city of ours.
12.47 pm
The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill): It is a pleasure, as always, to serve under your chairmanship, Mr Hollobone. I thank my hon. Friend the Member for Cities of London and Westminster (Mark Field) for raising this issue, which is important for his constituents and generally. I recognise, as do the Government, that it is important to get the most accurate census data possible, because they are a key element that feeds into the distribution of public funding. As I will explain, they are not the only element, but they are important, so I understand his concerns.
I agree with and accept his analysis that it is more difficult to conduct a census in an inner-city area with population churn such as Westminster than in some parts of the country. I hope that I can demonstrate that efforts have been made to take that on board. It is worth starting with the situation that confronted us after the 2001 census, when there were concerns and steps were taken by the Office for National Statistics, which is a body independent of Ministers, to improve the methodology and quality assurance underpinning the figures.
Since 2001, as my hon. Friend recognised, considerable effort has been made to improve census returns, as has been demonstrated. He is right that particular resource was put into Westminster to reflect the difficulties, resulting in a significant increase in the response rate. Although it is less than in many authorities, the gap has diminished considerably. The response rate in Westminster in 2011 was 85%, compared with 66% in 2001. Both those responsible for the census and those on the city council are to be congratulated on the hard work that they did collaboratively to achieve that. I hope that gives a better starting point.
Generally, the 2001 census figures have been welcomed by local authorities. There have been a small number of areas—Westminster is one of them—where issues of concern have been raised.
Mark Field: I appreciate that these issues are sensitive and that the Minister will therefore not necessarily want to name each and every local authority, but would it be fair to say that the local authorities that have expressed concern tend to be urban and therefore have the particular characteristics I referred to in my speech?
Robert Neill:
Some, but not exclusively—some are inner city authorities, but some are district authorities. There may be other causes of churn, which we will continue to look at. Other urban authorities—for example, Newham—have welcomed what they regard as an
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improvement in methodology. I recognise that particular circumstances apply to each case, but it is worth putting the Westminster situation into that broader context. Where there are issues, ONS is working collaboratively with those authorities who have sought clarification. Westminster is one of those authorities, and a meeting recently took place between the officials of Westminster city council and ONS. Westminster—I hope I can put this fairly—has said that it would like to consider its position further, in light of the discussions that have taken place. Of course, ONS stands ready to continue those discussions, as does my Department.
It has always been our intention—given the nature of a census count, there are certain caveats—to use the most up-to-date and nationally consistent data available. We are consulting on proposals for the basis of calculating the next local government finance settlement. The consultation will close on 24 September, and I know that Westminster council will respond to it in detail. Population is one figure. As you will know from your local government experience, Mr Hollobone, a number of other factors are churned into the regression analysis—the bane of all of us who deal with local government finance—and the product then emerges. As my hon. Friend says, the Government intend to continue the protections of floor damping—we have made it clear that that will be the case.
We have consulted on the proposal to use the interim 2011 census base population projections. I confirm that it is the intention for them to be released by ONS on 28 September—they will be available in good time for use in the settlement. Of course, other factors will have to be taken into consideration: assessments of relative need and resources, as you will know, Mr Hollobone; the operation of the floor damping; and, because we are setting up a baseline for the new system of retained business rates, the calculation of the tariffs and the top-ups that will apply for the reset period. It is our intention not to reset those baselines until 2020 at the earliest, subject to wholly exceptional circumstances. The new system will be an incentive for go-ahead authorities such as Westminster—I am the first to recognise that Westminster is a flagship authority in many respects—and an incentive for those local authorities to drive growth in their area over the period of the seven-year reset period. It is estimated that this new means of financing local government, with 50% of the growth in the business rate being retained, will increase gross domestic product by approximately £10 billion. There will also be a safety net, which will protect local authorities from unexpected volatility in their rate base.
On quality assurance—a particular issue that has been discussed with Westminster—we have seen considerable improvement in the census take-up. The issues raised by my hon. Friend were discussed with officials of the city council and ONS—the officials in my Department will obviously want to continue to discuss them with ONS, too—to ensure that they were taken on board. As my hon. Friend said, what we have is not in fact a decline, necessarily, in the population, but an estimate based on the census that is less than a projection anticipated it to be. Therefore, the projection must be treated with some caveats, too.
After the 2001 census, there was an independent review of the means of quality assessment used to
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double-check the reliability of the census figures. The independent body suggested 23 actions to improve quality assurance, all of which were taken on board by ONS. Significant steps have been made to improve the quality, and other measures can be looked at. For example, my hon. Friend referred to patient registers. He is right to say that they must be treated with caution. I agree that the level and risk of inflation may vary from place to place, which is something that we can discuss. Across London, it is thought that GP registers can be inflated by approximately 8%. I am not saying that that is necessarily the figure in Westminster, but that is a reason why one must approach them with caution. Although that is a factor, there is not one single figure that can be used as an alternative benchmark.
It is worth saying that we have done checks, with that caveat, against the council tax data. The census estimates are in line with those sources, if allowance is made for some known differences, including an allowance made for the very high proportion of short-term residents, of which, as my hon. Friend says, Westminster has particular numbers. There is also a question concerning second residences.
The Department believes that this approach represents a considerable improvement on the methodology of the previous census. In the Westminster scenario, I agree that it is always difficult to get as high a return as one would wish—I think my own local authority’s return is approximately 95%; it is approximately 85% in Westminster. None the less, in sheer numerical terms the number of questionnaires returned increased from 134,200 in 2001 to 186,800 in 2011—a 39% increase thanks to the work both of ONS and Westminster city council. I hope that that demonstrates that we are going in the right direction—it has generally been well received.
The constructive way forward is this: I will take away the specific points raised by my hon. Friend and I will liaise with him. Westminster city council is going to come to ONS directly after it has reflected on their conversation. That liaison will continue, because we want to see what can be done further to explain and clarify apparent or potential differences between the census and other data sets. ONS remains confident that improved methodology more accurately captures the figure on the ground. Of course, the census is in effect a snapshot taken on one day. I understand my hon. Friend’s concerns. As a former leader of the Conservative group on the London assembly, I raised the issue when I was wearing that hat. The issue ongoing in London.
Mark Field: On the liaison to which the Minister referred, will he confirm that we can expect something in writing? I accept, given the representations I have made today, that he and his officials will want to consider this. I also accept that, in allowing a particular change to be made in relation to Westminster, there is a risk of setting a precedent. Can I expect a formal letter in relation to the liaison to which he referred?
Robert Neill: I am very happy to do that. My hon. Friend makes an important point. We must have methodology that can be applied consistently across the country. I can say both to him and to the hon. Member for Westminster North (Ms Buck) that if I remain in a position to do so, I am more than happy to continue to discuss this ongoing issue with them.
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Science and Public Service Broadcasting
1 pm
Chi Onwurah (Newcastle upon Tyne Central) (Lab): It is a pleasure to serve under your chairmanship, Mr Hollobone, and a pleasure to have the opportunity to discuss the important but oft-neglected subject of science and public service broadcasting. By “science”, I also mean engineering. I must declare an interest. For 23 years before coming into Parliament, I worked as a professional engineer, so the representation of science and engineering on the BBC, Channel 4, ITV and Channel Five is of some personal interest to me.
The Minister will be pleased to know that I shall not simply ask him to account for the representation of science and engineering. I shall set out their importance to our economy and culture and mention the role of public sector broadcasting and the general great contribution it is making to the popularisation of science and engineering, and discuss how it could do better.
Like many people, I was inspired by Danny Boyle’s wonderful Olympics opening ceremony, which brought to life the importance of science and the industrial revolution in our history. If it is possible, I was even more pleased watching the Paralympics opening ceremony, which Paul Nurse, the president of the Royal Society, said highlighted
“the achievement of human will in overcoming the adversity of disability and tackling the difficult problems of science.”
Science and engineering are an important part of our economic prosperity, especially now we are seeking to rebalance our economy, get out of a double-dip recession made in Downing street and at the same time address that grave legacy of the first industrial revolution: climate change. Research compiled by Josh Lerner of the Harvard Business School, looking at the last 100 years of growth in various economies, suggests that only 15% of growth in any economy can be accounted for by increasing inputs. That means that 85% of growth in economic output must come from innovation. Science and engineering drive innovation; without them, we will lose our place as a leading economy. Other countries know this. Some 1.5 million science and engineering students graduated from Chinese universities in 2006 alone. In the UK, more young people chose to study fine art than physics. Fine art is a fine choice, but so is physics.
In its 2009 review, Ofcom set out the purpose of public service broadcasting and said that it should stimulate our interest in and knowledge of arts, science, history and other topics through content that is accessible and can encourage informal learning. Ofcom said that public service broadcasting should be high quality, innovative, challenging and engaging. In addition, Channel 4 is required to support and stimulate well-informed debate on a wide range of subjects. I hope the Minister will say whether he believes that those criteria have been met in regard to science.
There are great strengths in our public service broadcasting science coverage, which has improved considerably over the past 10 years. We no longer see so much of the Q format. Q was the gadget man in the 007 films and all too often in the past science programming consisted of a man with a gadget explaining why it would get some Bond wannabe out of a tricky situation. Now on BBC radio we have the “The Infinite Monkey
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Cage”, “Saving Species” and “The Life Scientific” to name just three. BBC television has given us the “Secret History of…”. “Bang Goes the Theory”, “Stargazing” and “Frozen Planet”. “Horizon” continues to offer great science specials, such as “To Infinity and Beyond”, which discussed the science of endless time and space—something politicians have a particular problem grasping. Channel 4 also has a wide range of science programming, from “The Science of Seeing Again” with Katie Piper to “Brave New World with Stephen Hawking” and one of my favourites, “Dambusters: Building the Bouncing Bomb”.
Ofcom’s most recent survey, published in June, did not reflect general satisfaction, with 65% of respondents thinking that showing interesting programmes about history, sciences or the arts was important but only 46% saying that the public service broadcasting channels were doing that. The level of satisfaction varied highly: 71% for BBC 2, which is excellent, but a worrying 26% for Channel Five. The fact that science is lumped in with the arts and history makes it hard to see precisely where the problem is. Equally, it is difficult to get hard figures on the percentage of commissioned programmes on science and the viewing figures associated with them. I am not aware of any specialist programming aimed specifically at children. Perhaps the Minister will respond to those two points.
Although there is much to be proud of, there is still much to do. I watch and listen to science and engineering programmes with both a personal and professional interest, and I believe that there is one significant weakness. The BBC and Channel 4 have separate science programming, so if people want to watch science and engineering programmes—if they are already interested in infinity, arctic wildlife or how the bouncing bomb was designed, for example—they know exactly where to go. Science programming is heavily signposted, ensuring that those who do not already have an interest in science and engineering can easily avoid it. The Olympic and Paralympic opening ceremonies managed to integrate those subjects successfully, but public service broadcasters have not integrated science and engineering into general programming that can be enjoyed by all. I am afraid that the public service broadcasters have created high-quality, well-resourced science ghettos.
Andrew Miller (Ellesmere Port and Neston) (Lab): My hon. Friend may have visited the Royal Society exhibition on broadcasting science. It is interesting to note that the challenge she describes goes back to the beginnings of broadcasting in the 1920s. I should like the House to set up a working group to work with broadcasters and examine that challenge, because it has been around for a long time. My hon. Friend has raised an important point.
Chi Onwurah: I thank my hon. Friend for making that important point, and I pay tribute to his work as Chair of the Select Committee on Science and Technology. I have not yet visited the Royal Society to see that exhibition.
Andrew Miller: It runs until November.
Chi Onwurah: Excellent; I shall attend. Working together with broadcasters to address this subject is an excellent idea. I am by no means suggesting that the fault—such fault as there is—lies entirely with the broadcasters.
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Non-specialist science programming all too often displays a depressing lack of scientific literacy. I wrote to the outgoing director-general of the BBC, Mr Mark Thompson —the first of many letterss— and the correspondence is on my website.
I thought about reading it in all its Kafkaesque beauty, but I took pity on the Minister and decided that a summary would do. In a programme called “Foreign Bodies”, a BBC reporter said that there was a high proportion of Chinese students on engineering courses in the UK because engineering was more valuable in China. I pointed out that that was not the case: engineering is an excellent career choice for students concerned with material reward—I should know—as engineering degrees dominate the top 10 most well-paid graduate professions, with chemical engineering graduates earning the third highest wage in the UK on graduation at more than £27,000. As I said, in terms of UK plc, engineering is incredibly valuable.
What the journalist may have meant to say was that engineering was not as valued in this country, although that is certainly not the case in the north-east and in my constituency. That might be true for a certain section of the population and, perhaps, some of those people may find themselves commissioning public service broadcasting programming. Certainly only one member of the BBC Trust has a background in science or engineering, as against 11 humanists. In a famous 1959 lecture, the British scientist and novelist C. P. Snow warned of the dangers of two cultures—science on the one hand, and the humanities on the other—and of the limitations that that would place on our society. Only last year, Google’s chair Eric Schmidt used his MacTaggart lecture at the Edinburgh festival to condemn the same gap. The UK, he said, was culturally divided into luvvies and boffins. Schmidt called for art, technology and science to be brought together—a call endorsed by popular TV scientist Brian Cox.
All too often, public service broadcasting programmes present science and engineering as boring, freakish, immensely difficult, or all three. I have lost count of the number of times that interviewers have said something such as, “So you thought about going into science but then you decided to do something creative instead.” I sometimes imagine how broadcasters would react if a reporter treated Shakespeare as they often treat science. Imagine a reporter saying, “I dropped Shakespeare when I was 12—it was just too difficult,” or, “Oh, Shakespeare—I have to ask the kids to help me out with that.”
The consequences can be serious. The BBC’s approach to scientific balance seems to be culled straight from the world of politics, without any understanding of scientific method. Even though the vast majority of scientific evidence supports climate change, the BBC will put up one pro-climate change and one anti-climate change scientist and think that that constitutes balance. Equally, its general interest programmes will be chock-full of historians, artists, celebrities and journalists, but with few engineers or scientists.
Andrew Miller:
The point just made by my hon. Friend was central to the discussion of the Select Committee with Professor Steve Jones before his recently published review for the BBC Trust. I would welcome a response from the Minister about any discussions that he has
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had with the BBC about the implementation of recommendations on precisely the point made by my hon. Friend.
Chi Onwurah: I will certainly leave time for the Minister to respond on that and other important points.
The general interest programmes of the public service broadcasters are chock-full of historians, artists, celebrities and journalists, but include few if any engineers or scientists. I wrote to “Woman’s Hour” to ask if it had interviewed as many women engineers this year as women sex workers. Unfortunately that information was not available, but an admittedly unscientific Google yielded more hits for “Woman’s Hour” coverage of prostitution than for science and engineering. The fact that only 6% of engineers in the UK are women, compared with 30% in Latvia, contributes to an environment in which half our scientific and engineering talent goes to waste.
To go back to my original example, the opening ceremonies of the Olympics and Paralympics proved that it is possible to show scientific themes to a general audience successfully. Further, they showed that non-scientists can successfully represent scientific themes alongside other ones. Surely public sector broadcasters can do so as well.
Alun Cairns (Vale of Glamorgan) (Con): I congratulate the hon. Lady on securing the debate. I strongly support all that she has highlighted. In the spirit of what she has just discussed, the Royal Institution Christmas lectures are a fantastic example of bringing science to young people, and make it extremely interesting rather than focusing on celebrities. The BBC, however, has squeezed the lectures in recent years into a slot on BBC 3 and, bearing in mind that they are aimed at children, broadcast them at an obscure time of night.
Chi Onwurah: I thank the hon. Gentleman for that important contribution. Had I more time, I would certainly highlight the many great efforts being made by learned institutions and campaigning groups. It is clearly not acceptable that a show aimed at children should be broadcast so late at night. I hope that we can all work together to ensure that such examples of good, mixed-interest, general broadcasting are more widely available.
I do not imagine the Minister can or should wave his hand and change the culture of our public service broadcasters. Public service broadcasters are independent of Government and should be. It is right, however, that they should be held accountable for their adherence to the purpose of public service broadcasting and to the broadcasting code. It is also right that we debate what is important in our culture and society. I want the Minister to make it clear that we need a public service broadcasting culture that integrates scientific literacy. He is an opinion leader in the area, so his thoughts will be influential.
The gap can be addressed in a number of ways. Since it was announced that I had secured the debate, suggestions have poured in, and include new guidelines on the reporting of science, to be drawn up by science journalists and used primarily by news editors and general reporters; media organisations taking on more science journalists and journalists with scientific training; access courses, so that scientists and engineers can convert into journalists; and, to pick up on a recent point, learned institutions such as the Institution of Engineering and Technology
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or the Royal Society sponsoring scholarships. Certainly engineers and scientists, as well as broadcasters, need to do more to integrate science and engineering into popular culture.
Those are only a few suggestions. I am sure that the Minister will acknowledge the importance of science and engineering to our culture, to our economy and to our public service broadcasting.
Mr Philip Hollobone (in the Chair): I call the opinion leader and Minister, Ed Vaizey.
1.17 pm
The Parliamentary Under-Secretary of State for Culture, Olympics, Media and Sport (Mr Edward Vaizey): Thank you, Mr Hollobone. It is a pleasure to serve under your chairmanship, considering that you gave me an additional job in your introduction.
I am grateful for the chance to respond to an important debate that I would describe as unusual, albeit meaning to be complimentary. The hon. Member for Newcastle upon Tyne Central (Chi Onwurah) has raised an important subject that merits debate—it does not get debated often enough. I am also grateful for the contributions of the hon. Member for Ellesmere Port and Neston (Andrew Miller) and my hon. Friend the Member for Vale of Glamorgan (Alun Cairns).
I wish to be the first to congratulate my hon. Friend the Member for Basingstoke (Maria Miller) on her appointment as Secretary of State for Culture, Media and Sport—I should now hold the record for being the first Member to mention the reshuffle in Hansard—and I also pay tribute to her predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt). He was an excellent Secretary of State and it was a great privilege to work with him.
Although I am speaking as, in effect, the broadcasting Minister, the Minister for Universities and Science, or indeed an Education Minister, could have responded to the debate, given the points that the hon. Lady made. I hope that she will take some comfort from the fact that I represent a constituency that is stuffed with science. I am privileged to represent Harwell’s Rutherford Appleton laboratory, the Diamond synchrotron and many small and emerging businesses that base their success on the science that happens in my constituency. I hope that all hon. Members in the Chamber will join me on Wednesday afternoon when we celebrate the British contribution to the large hadron collider and the discovery of the Higgs boson particle. I am privileged to be sponsoring that event in my capacity as the constituency Member for Harwell.
Before I address some of the general points on public service broadcasting that were raised by the hon. Member for Newcastle upon Tyne Central, it is worth noting that my right hon. Friends the Minister for Universities and Science and the Minister of State, Cabinet Office, were instrumental in setting up the new engineering prize that is sponsored by the Government, as well as being supported through private sponsorship. The Government hope that it will rank alongside the Nobel prize in terms of prestige and that it will raise the profile of engineering. Although some might regard that point
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as slightly ephemeral, I certainly do not—it is an important example of the emphasis that the Government place upon science. It also demonstrates where the Government agree with the hon. Member for Newcastle upon Tyne Central. It is important to raise the profile of science as a career and to praise and celebrate its triumphs in this country.
Chi Onwurah: I, too, welcome the creation of the Queen Elizabeth prize for engineering, which was launched by all three party leaders. Far from regarding it as ephemeral, I think it is an important way to establish and promote the significance of engineering in this country and worldwide.
Mr Vaizey: Then we are as one on that point. The Science Minister was also instrumental in ensuring a freeze in our science budget, which, again, is an issue close to my heart because of the importance of science in my constituency.
The hon. Lady talked about last year’s famous MacTaggart lecture by Eric Schmidt, who is now the chairman of Google. That speech was also close to my heart because, as she may be aware, one of my first acts as a Minister was to commission a report on skills for the computer science industry. That very good report was completely ignored by the Government until Eric Schmidt stood up and said that computer science teaching in our schools was not up to scratch and could be improved. Following that speech, I was pleased that the Government promised to redesign the computer science curriculum, so look out for Mr Schmidt’s name in the reshuffle because he clearly has a great deal of influence.
I turn now to the subject of our debate: science in the media and broadcasting. I was glad to hear the hon. Lady say that science broadcasting has improved, but clearly her reason for securing the debate is that there is room for further improvement. I will not rehearse all the science programmes that are on the BBC, as many have been mentioned, but they are numerous and continue to come on stream. For example, BBC 2 will be launching a science magazine show in the autumn, and BBC 1 will broadcast programmes such as “The Genius of Nature” and “Generation Earth”. We all know about the success of the kind of programmes that Brian Cox has made, and there are many others.
I note the hon. Lady’s concern that there are not enough science programmes for children. On a personal note—having young children, I am now an aficionado of children’s television—I can point her to “Nina and the Neurons”. This is perhaps an opportunity for me to thank BBC Scotland, because after a recent visit there, at my instigation, it kindly arranged for signed photographs of Nina to be sent to my children. For those worrying about whether that appears in the Register of Members’ Financial Interests, the pictures are well within the value that is required, but they are priceless to my children. As I did not send a thank-you letter, I would like to thank BBC Scotland in Hansard.
We have not spoken about other public service broadcasters. I do not know how well ITV is doing, but my officials have come up with“The Alan Titchmarsh Show”, “This Morning”, and “Daybreak” as examples of science coverage on ITV, so there might be room for improvement. Channel 4 has “Brave New World with Stephen Hawking” as part of its scientific coverage. It is
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important to note that broadcasting science is one of the requirements that public service broadcasters must fulfil under the Communications Act 2003, which is being reviewed, as the hon. Lady knows. I will ensure that science is kept at the forefront of our thinking as the review proceeds.
I would also like to mention some foreign broadcasters that broadcast here, such as the Discovery channel. In a few days, we will be announcing record figures for inward investment in this country, and it is worth noting the contribution that foreign broadcasters make to science programming here.
Andrew Miller: One simple thing that could really help would be to ask the BBC directly what it is doing to ensure that the recommendations of Professor Jones are adopted, and that progress is maintained over time.
Mr Vaizey: The hon. Gentleman makes a good point. As the hon. Member for Newcastle upon Tyne Central pointed out, the BBC is independent of the Government. Ministers must be careful about how far they stray into being seen as influencing or directing the way the BBC programmes. I am sure, however, that the hon. Gentleman can approach the new director-general directly to ask how he intends to take forward the BBC Trust’s report, which, as the hon. Gentleman mentioned, was undertaken by Professor Steve Jones, the emeritus professor of genetics at University college London. The BBC’s science coverage was praised in that report, which noted that science was well embedded in programming and on a diversity of platforms. It is also important to note that the BBC’s science coverage was commended by a number of external scientific bodies, and it says in my notes that “Woman’s Hour” was also praised. The report raised some concerns and made recommendations on how the BBC could improve its science coverage, and the BBC Trust and BBC executives have responded to them. A key recommendation that was taken forward in January 2012 was the appointment of a science editor, who is David Shukman.
Another important report that is relevant to our debate was set up by the previous Government. It was produced in January 2010 by the science and the media expert group, which is chaired by Dr Fiona Fox, the chair of the Science Media Centre. The report outlined a number of actions and recommendations with the aim of supporting the accurate reporting of science and fostering an environment in which engaging science programmes can be made. Specifically on broadcasting,
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it found that more than two thirds of people had watched a science programme on television in the year previously and that almost one in five had listened to one on the radio. It concluded:
“Those heralding the death of broadcast science are clearly premature…Whatever the medium and however they are commissioned, science programmes will continue to be a significant part of the public’s engagement with science”.
The hon. Lady has raised an important issue through this debate. Being mindful of the independence of broadcasters, it is not for Ministers to dictate their day-to-day schedules. I am sure that every Member in the Chamber would like to be director-general of the BBC for a day and to shape its programming according to their passions. However, it is important that all hon. Members feel that they can contribute to the debate and engage with relevant broadcasters to raise concerns, as my hon. Friend the Member for Vale of Glamorgan did with his well-made point about the Christmas lectures, which I remember growing up with.
Alun Cairns: I pay tribute to the way my hon. Friend has responded to this important debate. He is absolutely right that it is not the job of any politician to dictate what the BBC should be doing, but does he agree that the role of a public service broadcaster should not be always to chase ratings with light entertainment programmes? Such programmes could well be provided for through the private sector, and issues such as science should be focused on more, given that public money is being used.
Mr Vaizey: My hon. Friend invites me to fall into the trap that I said no Minister should fall into, so I think that a period of silence from me on that point would be appropriate. All I will say is that every hon. Member can engage with this ongoing debate. We should be proud of our science heritage and the science that is happening now in this country. As a constituency MP, I am certainly aware that we are one of the foremost science nations in the world.
Finally, speaking as a Culture Minister, I am pleased that more people are talking about the link between the arts and the sciences. Again, the hon. Lady was right that we cannot have a society divided between boffins and artists. They are two sides of the same coin, and both flourish when they work together.
Mr Philip Hollobone (in the Chair): I thank hon. Members for taking part in that interesting and important debate.
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Rickets
1.30 pm
Kate Green (Stretford and Urmston) (Lab): I am very pleased to have been given the opportunity of and time for this debate and to introduce it with you in the Chair, Mr Hollobone. I start by acknowledging two Manchester GPs, Dr Hans-Christian Raabe and Dr Avril Danczak, who came to see me some months ago to draw my attention to the shocking rise in the incidence of rickets in this country over the past 15 years. A written answer that I received on 9 November 2011 contained figures showing that the number of reported cases of rickets had risen from 183 in 1995-96 to 762 in 2010-11. Earlier this year, it was reported that the chief medical officers of the UK had contacted health professionals to highlight the need for vitamin D supplements for at-risk groups. Therefore, the issue is clearly one of concern. I welcome the steps that the Government have taken so far to deal with it, but more needs to be done.
Rickets is a disease that affects the growing of bone in children and is associated with moderate vitamin D insufficiency. It is mainly characterised by deformed bones, bone pain, convulsions and delayed development, particularly in relation to height rather than weight. Current Government guidance is that most people can get all the vitamin D that they need by eating a healthy balanced diet and getting some sun. However, it is not at all clear that that advice is adequate. The national diet and nutrition survey found that 90% of people in the UK do not get enough vitamin D from their diets, and there is widespread confusion in the public mind about what constitutes an appropriate amount of exposure to sunshine.
Certain groups have particularly high levels of vitamin D deficiency. They include pregnant and breastfeeding women and their babies, young children, elderly people, those who are not exposed to much sun—perhaps because they cannot get out of the house or because they cover up their skin for cultural reasons—and people with darker skin pigmentations, such as those of African, African-Caribbean or Asian origin. Levels of air pollution may also have an impact on sunshine exposure levels, and there is certainly a gradient of rising incidence of vitamin D deficiency as we move north across the UK, so it is clearly a concern in the north-west region, where my constituency is located. When one member of a family has a vitamin D deficiency, it is also likely to be replicated among siblings and children.
It is therefore clear that steps need to be taken to deal with vitamin D deficiency in quite large sections of the population. I am pleased that the Scientific Advisory Committee on Nutrition is examining the issue, but it is not due to report until 2014, and it is likely that any recommendations made by the committee could take time to implement in any event. However, there are things that can and should be done now, not least in terms of informing and educating the public and health professionals.
A recent study by the clinical effectiveness unit at Stockport NHS Foundation Trust highlighted a quite surprising lack of awareness among health professionals about vitamin D. That study, across eight acute and six primary care trusts in the north-west, found quite poor knowledge among midwives and health visitors surveyed.
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Only 24% of health visitors and just 11% of midwives reported having had training in vitamin D supplementation. As a result, they felt less confident in discussing vitamin D with pregnant women and mothers, vitamin D was poorly promoted at the booking of appointments and 90% of the women were not provided with information about vitamin D. However, the study found that where trusts had good policies or expert personnel in place, staff reported greater confidence in discussing vitamin D and more women received verbal and written advice.
Last year, my hon. Friend the Member for Bolton South East (Yasmin Qureshi) hosted an event in Parliament, in conjunction with the Proprietary Association of Great Britain—the UK trade association for manufacturers of over-the-counter medicines and food supplements—at which it was suggested that doctors, nurses and pharmacists receive very little nutritional training at undergraduate level and that there is no obligation for health professionals to undertake such training once in practice. Therefore, I would like first to ask the Minister to comment on the steps that the Government are taking or planning to improve training, awareness and knowledge among health care professionals. I would also like to ask what steps are being taken to raise awareness among the wider pool of professionals working with families and children, and what discussions the Minister and colleagues in the Department may have had with Ministers in the Department for Education to ensure that staff in schools, Sure Start workers, child care professionals and so on are aware of the importance of vitamin D.
There are also concerns about financial incentives. I have looked at the quality and outcomes framework for GPs, and there is a lack of a clear financial incentive for GPs to address their patients’ nutritional needs. Will the Minister say what steps are being taken to develop the quality and outcomes framework to focus more GP attention on nutrition and vitamin D intake, and how she expects that that framework will be kept under review?
I come now to the question of vitamin supplements, which the Department of Health recommends for at-risk groups—the groups I mentioned in my opening remarks—and which are available free of charge to certain low-income families via the Healthy Start programme. However, that targeted approach has resulted in only very limited uptake, which unpublished PCT data suggest could be as low as 2% to 4%. Clearly, many at-risk families are missing out on the recommended vitamin D supplements; and although some families may obtain supplements, from over-the-counter sources, that can be expensive and the dosage may be inappropriate. I would be interested in the Government’s attitude to allowing food supplement manufacturers greater freedom to develop and market a wider range of vitamin D products, targeted at different population groups. I would also welcome the Minister’s view on how the European Food Safety Authority might make it easier for manufacturers to make legitimate claims about the role of vitamin D in good bone health.
I particularly hope that the Minister will consider a report published online, on 21 August, by the British Medical Journal that considers an initiative by the Heart of Birmingham PCT to provide universal vitamin D supplementation to all children from the age of two weeks to five years and to all pregnant and breastfeeding women. That provision of supplements was supported by a programme of continuing professional education
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of health staff, including GPs, health visitors, midwives, pharmacists, paediatricians and obstetricians and by a public communications campaign. In that initiative, uptake of vitamin D supplements rose year on year to reach 17% among children and pregnant women. That was still low, but considerably higher than the 2% to 4% achieved under Healthy Start. Public awareness of vitamin D also rose from just over 60% to nearly 90%, and a 59% fall was recorded in the number of cases of vitamin D deficiency.
Clearly, there are some important lessons to be learned from the Birmingham initiative. Although some problems were experienced with distribution through the NHS supply chain, limited opening hours at pharmacies and so on, and with the availability of trained staff, the initiative was very successful overall in reaching a considerable number of families who might be at particular risk of vitamin D deficiency by virtue of ethnicity, skin pigmentation or lifestyle, but would not be eligible for free supplements.
Jim Shannon (Strangford) (DUP): I congratulate the hon. Lady on bringing this matter to Westminster Hall today. I am of an age group, and others in the House may be of a similar age, that can remember that when we went out to play at school lunchtime, the milk was on the table when we came in. Is there a role for the Department of Health in the education of children to ensure that children’s health is better monitored and supervised?
Kate Green: I absolutely agree with the hon. Gentleman. Health professionals, and other professionals from across different disciplines, have pointed to the absence of a holistic approach that draws different practitioners and professionals together to ensure that the message is promoted and the education of children and families is pursued coherently.
The absence of trained staff was certainly seen as a factor that limited the effectiveness of the Birmingham initiative, but overall it was very successful in improving vitamin D uptake in families who would have been at risk. I am keen to invite the Minister to look carefully at the Birmingham experience. Is she willing to analyse the costs and benefits of a universal approach based on the study’s findings?
On food fortification, relatively few foods are naturally rich in vitamin D, and consumption of many of those that are, such as full-fat dairy products, eggs and oily fish, has fallen in recent years. Yet in the UK, we fortify relatively few foods, such as margarine, some processed cheeses and breakfast cereals. We do not fortify milk, which has been fortified in Canada and the US for many years. Finland, Jordan and the Irish Republic have all taken recent steps to introduce food fortification. Will the Minister indicate the Government’s attitude to statutory food fortification? There seems to be scope for a more robust approach. Can she confirm whether the work of the Scientific Advisory Committee on Nutrition will look at the experience of other countries? Will the committee’s report reflect an analysis of the effectiveness of food fortification measures in those countries?
Finally, there appears to be scope to make greater use of the public health outcomes framework, to focus attention on vitamin D. I looked at the framework, and, with the exception of some quite vague indicators on
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diet and hip fractures, there appears to be nothing specific to highlight the need for action to tackle vitamin D deficiency and its consequences, including the risk of rickets. I welcome the Government’s focus on public health, but we must ensure that the framework and the new health structures being put in place more widely achieve the best possible outcomes.
This is a crucial and, I have to say, challenging time of transition. We are settling into the new public health infrastructure against a backdrop of far-reaching changes in the NHS more widely. Although I appreciate that the public health outcomes framework will be kept under regular review, I would like very specific and early attention to be given to the issue in the framework and by the new health and wellbeing boards. I would welcome the Minister’s comments on that.
Jim Shannon: I thank the hon. Lady for giving way again. She is being very gracious. Is she aware of the statistics and figures that show a greater problem in the United Kingdom—England, Wales, Scotland and Northern Ireland—with not only rickets, but osteoporosis, from the lack of vitamin D? Is there a need not only for a pilot programme, such as the one she mentioned in Birmingham, but for a programme for the whole UK, working with all the regions?
Kate Green: The hon. Gentleman is quite right. The impact of vitamin D deficiency is felt in not only rickets and diseases in children, but osteoporosis and other diseases. Vitamin D deficiency inhibits the absorption of calcium, for example, which is important for bone health and growth.
Professionals have identified the lack of joined-up advice—for example, telling a woman recovering from a cancer operation and having chemotherapy that there could be an impact on her bone health and the steps that she could take to address it. It is right that professionals have expressed an interest in the development of a strategic approach, both geographically and across health conditions. Perhaps the Minister will comment on how the Government might react to that.
Rickets is a largely preventable disease that many of us thought had been left firmly in the past. Its resurgence is not in question, yet the distress and pain it causes are preventable, and we know what steps we need to take. What is more, the solutions are mainly systemic—within the control of public policy and health care practice. Although I acknowledge that some gaps in the evidence remain, the importance of vitamin D for at-risk groups—children, pregnant women and mothers—has been understood for many decades, as has the need for effective supplementation where intake is inadequate. There is therefore no need to delay working on and developing appropriate systems and a programme of public and professional education to maximise vitamin D intake. I hope that today’s debate raises public and professional awareness of the issue.
1.47 pm
The Parliamentary Under-Secretary of State for Health (Anne Milton):
It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone. I congratulate the hon. Member for Stretford and Urmston (Kate Green) on securing the debate. She is right that these are important opportunities to raise awareness. Although
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we sometimes underestimate our impact, such debates are sometimes picked up by the media, and anything is useful.
As the hon. Lady eloquently set out, with vitamin D, we are talking about children, strong and healthy bones, and bone health generally. Often, rickets occurs because a child is born without enough vitamin D due to the mother’s deficiency in pregnancy. Alternatively, it can be a post-natal condition due to a poor diet or lack of sun exposure. That is why successive Governments have long recommended that young children and pregnant and breastfeeding women take a daily supplement of vitamin D.
As the hon. Lady says, most people would imagine that rickets is something from the Victorian era. The incidence of rickets fell dramatically in the 1920s, and, in the past, several public health policies have helped to reduce its incidence further. The law now requires the addition of vitamin D to all infant formula, and vitamin supplements containing vitamin D are made available for pregnant women free of charge and to young children from low-income families via the Healthy Start scheme.
Unfortunately, we do not have good data on the national prevalence of rickets in the UK. The hon. Lady has been provided with data on episodes of rickets recorded by hospitals in England, but sometimes a problem when we produce data is that they are about episodes, not people. I believe that she was given that information through an answer to a parliamentary question. The figures appear to be slightly higher, and looking at the percentage increases, the statistics are startling, but episode data do not represent the number of patients, because a person may be admitted more than once in a year. The number of patients diagnosed with rickets is therefore a better measure, and that has increased from 134 to 395 in 2010-11. It is important to consider those figures in the context of increased population size and improved reporting and recording. Those numbers appear quite low when compared with other diseases, but rickets is still a problem, particularly since hospital episode statistics do not show the number of children who may have been treated as outpatients or those diagnosed by a GP. We are aware that over the past few years there have been several reports of clinically apparent vitamin D deficiency and rickets in children from doctors in Manchester, London, Glasgow and Burnley. That is not an exhaustive list; there will be other places.
As the hon. Lady pointed out, the tragedy is that rickets is preventable. That is why it is so important that at-risk groups such as pregnant women, babies and toddlers take those vitamin D supplements. As she also rightly pointed out, that is particularly important for women of south Asian, African, Caribbean or middle eastern family origin, because people with darker skin do not produce as much vitamin D in response to sunlight. It is also important for women who are not exposed to much sunlight, either because they cover their skin for cultural reasons or because they do not spend much time outdoors. The hon. Lady referred to older people who might, due to immobility problems, not be able to get out.
Our national infant feeding survey tells us that about half of mothers across the UK reported taking some form of vitamin or mineral supplement other than folic
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acid during their pregnancy. On the one hand, that is encouraging but on the other it means that 50% do not. There is a problem and clearly more needs to be done.
Kate Green: The Minister is right that we should worry about the 50% that may not be taking the supplements that they may need, but another concern is the lack of clarity among pregnant women and others about what supplements they should be taking and in what dose.
Anne Milton: The hon. Lady is absolutely right. A huge amount of data and confusing information are given to women. That is one thing we need to tackle in our public health changes. She also talked about joining up services and having a strategic approach. Given the many different information sources, particularly on the internet and some very reputable websites, it is hard for women to know exactly what to do.
The 2005 infant feeding survey found that only 7% of infants aged eight to 10 months were given any type of vitamin supplement. The hon. Lady talked about raising awareness, which is indeed what we need to do. We need to ensure that GPs, midwives, health visitors and other health professionals—she talked about schools—are fully aware of the need for those groups of the population to take vitamin D supplements. That is why in February all four of the UK’s chief medical officers wrote to GPs, health visitors, practice nurses and community pharmacists to reiterate the Department of Health’s recommendations. I would put particular emphasis on the role that pharmacists can play in informing the public, as they have quite a lot of contact.
The chief nursing officer for England also highlighted the issue in her February newsletter bulletin for all nurses and midwives in England. The Department of Health is liaising with the Royal College of Midwives to explore how we can work with them to spread advice further. It was also encouraging to hear that the Royal College of Obstetricians and Gynaecologists welcomed the CMOs’ letter and that it, too, promotes the importance of daily vitamin D supplement during pregnancy.
The National Institute for Clinical Excellence’s public health guidance on maternal and child nutrition, and clinical guidance on antenatal care—quite a mouthful—also support the Department of Health’s advice on vitamin D, reiterating the importance of consistent messages. We have also asked NICE to develop public health guidance on how to improve implementation of the advice on vitamin D and on safe sunlight exposure for the UK.
As the hon. Lady alluded to, there have been issues concerning the availability of prescribable vitamin D preparations. The NHS London Medicines Information Service has produced a document that lists the preparations with appropriate levels of vitamin D for different age groups, so health professionals know exactly what to prescribe. That list was sent to pharmacy organisations in March.
Healthy Start vitamins are not available on prescription, but the Department encourages NHS organisations either to sell the vitamins or consider supplying them free of charge to target groups who are not eligible for the scheme. I was pleased to see the positive effect of the CMOs’ letter—I do not know whether the hon. Lady is aware of this—on the number of orders placed. Orders for the children’s drops have increased from around
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72,000 bottles in quarter 4 of 2010-11 to more than 97,000 bottles in quarter 4 of 2011-12. That is a significant increase, which demonstrates, although we are starting from a low base, that we can have an impact. Similarly, orders for the women’s tablets have increased from around 58,000 to more than 105,000 in the same period—an 80% increase.
We all need to keep up our efforts. The hon. Lady raised the issue of awareness and training, which, I suggest, should apply to all the professions. There would be no harm in the person who takes blood from a pregnant woman also reiterating some of the simple advice.
The Department of Health has produced a leaflet entitled “Vitamin supplements and you” as part of its Start4Life campaign. That contains up-to-date advice on the importance of vitamin D. Health care and child care professionals can download it. On top of that, in May we launched what I think will be one of the most significant initiatives, the new NHS information service for parents. Through regular e-mails, online videos and texts, it gives parents information and advice as they progress through their pregnancy and beyond. The service is very new. About 47,000 parents have already signed up, and I would urge those who are reading or listening to this debate to encourage the people they know to do so, too. Members of this House can have a significant impact by raising the issue in their local press and getting people to sign up. This is about trusted advice from the Department, cutting across a lot of the confusion.
We have also asked the Scientific Advisory Committee on Nutrition to undertake a comprehensive review of the scientific evidence on vitamin D and health. That will include a review of the existing dietary recommendations on vitamin D for all population groups, as well as
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looking at the options to improve the amount of vitamin D we get as a population. The risk assessment is due to be completed in 2014. In the meantime, it is important to ensure that the existing recommendations are put into practice, which is what this debate is all about.
The hon. Lady raised a number of other issues. I probably cannot give them the time they deserve today but I am happy, if she would like to know more detail, to talk to her on another occasion. We strayed a little into EU legislation—worthy of a three-hour debate—about health claims of vitamin supplements. She also asked about universal access and food fortification. Some of those issues are quite tricky. One needs to be sure that what is done has the desired impact. There is also quite a lot of resistance to fortification of food from another quarter.
In the final minutes, I would mention the public health outcomes framework, which she mentioned, the health and wellbeing boards and the opportunities that lie ahead. To some extent we now have an opportunity we have not had before, with public health moving into local authorities. Local authorities will have a remit to do a lot more work in this area. The hon. Lady mentioned schools. I think we will see an opportunity for local areas emerging, particularly when the joint strategic needs assessment reveals some of the issues. There may be opportunities, for example, where there is a high proportion of people who may be at risk from low vitamin D, for local areas to take action. That can be across the board, involving not just GPs and midwives, but schools. We will see changes. We will keep this under review; we know how important it is. The numbers might be relatively small but the increase is significant.