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Mr Bone: My hon. Friend is generous in giving way. I wanted to reinforce his point. According to emergency departments that see children, 90% receive injuries from non-vehicle-related accidents. We always hear, “Oh, it’s because you are going to be knocked over by a car”, but most accidents do not involve a vehicle and are cycling accidents alone.
Alok Sharma: I thank my hon. Friend for making that point and for reinforcing the fact that we are discussing wearing helmets not only on roads but off road.
We were discussing the understatement in police records compared with NHS records of injuries and why that could be. One of the key reasons, for children, is that many such injuries take place off road, as my hon. Friend has just pointed out. The total figure for cycle-related hospital admissions, however, includes only patients who occupy a bed. Those who attend A and E are not included in that 9,000. That, of course, does not include any gap between unreported and reported incidents involving only slight accidents, so the total number of cycle-related injuries receiving hospital treatment is likely to be much higher than any of the statistics that I outlined suggest. It is appropriate that the debate about cost includes not just the human and social cost, but the financial cost of cycling injuries and fatalities. We must look at the broader picture, and the larger figures.
Head injuries ranging from fatal skull fractures and brain damage to minor concussion and cuts are common in cyclists. I understand from the information published by the Royal Society for the Prevention of Accidents that hospital data show that an estimated 45% of child cyclists admitted to hospitals have suffered head injuries. That is a high percentage indeed. Undoubtedly, some of those injuries would have been reduced or may not have occurred if a cycle helmet had been worn.
A recent Transport Research Laboratory report, which was published in 2009 and commissioned by the Department for Transport, reached several conclusions about the efficacy of wearing cycle helmets. It concluded that helmets, assuming that they are a good fit and properly worn, are effective in reducing the risk of head injuries. They are expected to be effective in a range of accidents, particularly the most common accidents that do not involve a collision with another vehicle but, as my hon. Friend the Member for Wellingborough said, are falls or tumbles over handlebars.
The report concluded that a specialist biomechanical assessment of more than 100 police forensic cyclist fatality reports predicted that between 10% and 16% of fatalities could have been prevented if the cyclists had worn an appropriate helmet. Those who do not believe that we should have compulsory wearing of cycle helmets say that, at the end of the day, helmets will not save lives. It has been shown conclusively in an independent report produced by the Department that in some cases they do.
Most interestingly, the report concluded that cycle helmets would be particularly effective for children. I could go into the reasons for that, but I am sure the Minister, if he has time, will explain them. Yet a 2008 Transport Research Laboratory report, commissioned by the Department for Transport, estimated that only 18% of children and 35% of adults wear helmets on the road.
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Apart from the terrible human and social cost of cycling fatalities and serious injuries, there is a financial cost to the country and to society. According to the Department for Transport’s own report, the total value of preventing reported road accidents in 2010 was estimated to be £15 billion. Let me put that in context. The entire transport budget for 2010-11 was just over £12 billion, and The Times manifesto calling for 2% of the Highways Agency’s budget to go towards cycle routes would amount to around £80 million. The average value of preventing every reported road accident was almost £1.8 million for a fatality, over £200,000 for a serious accident and over £20,000 for a slight accident.
One clear way of cutting down on the human, social and financial cost of cycling accidents, particularly those involving children, is through wearing cycle helmets. I am pleased that all hon. Members who have contributed to this debate so far agree. The time has come for the Government to consider very seriously the case for introducing the mandatory wearing of cycle helmets for children. I know that this is a controversial issue, and the right hon. Member for Exeter (Mr Bradshaw) shakes his head, so I presume that he does not agree.
The hon. Member for Dumfries and Galloway (Mr Brown) said that a private Member’s Bill in 2004 did not make progress, but it was supported by a wide range of organisations including the Royal College of Nursing, the Royal College of Paediatrics and Child Health, the safety charity Brake, the Child Accident Prevention Trust, the Child Brain Injury Trust, and the brain injury association Headway. Last year, the British Medical Association welcomed a Bill in the Northern Ireland Assembly to make wearing helmets compulsory, but unfortunately it did not make progress. The World Health Organisation has also stated that laws mandating helmet use can be effective in reducing road traffic accident injuries.
Many countries in Europe have laws on wearing cycle helmets, and we would not be the first to introduce such a law. In Europe, it is mandatory in Finland, where all cyclists are required to wear cycle helmets; in Spain, it is mandatory outside built-up areas; in the Czech Republic, it is mandatory for children under 16, in Iceland, for children under 15, in Sweden, for children under 15, and in 2010, it became mandatory in Austria for children under 10. Outside Europe, helmets are mandatory in Australia, New Zealand, 20 states of the USA and some Canadian provinces. We would not break new ground by at least considering the introduction of such a law.
Introducing a cycle helmet law will not suddenly solve the problem of road safety, and many hon. Members in previous debates have made that point. That is why I started this debate by talking about other measures that need to be introduced to make our roads safer. They include segregated and dedicated cycle paths and routes.
Returning to the point that my hon. Friend the Member for Wellingborough made, we can make our roads safer, but that may not reduce cycling injuries in children, because many of their injuries occur off road. The argument that we would drive people off the roads and discourage them from cycling does not hold water.
Wearing cycle helmets saves lives and reduces injuries, and even the most hardened opponents of cycle helmets acknowledge that. A key argument by anti-helmet campaigners is that making them compulsory will put people off cycling, will therefore not help in reducing
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carbon emissions and will discourage a healthier lifestyle. Some organisations have produced statistics showing that the mandatory wearing of helmets might save tens of lives, but that a reduction in the number people cycling would result in people perishing earlier than expected because of obesity. I am not sure that that is a serious contribution to the debate.
International evidence suggests that mandatory helmet wearing, particularly for children, does not result in a long-term drop in cycling. Some studies have concluded—one in Australia is often cited, but it was about 20 years ago—that introducing compulsory helmet wearing may result in a temporary decline, but that the medium to long-term effect is likely to be negligible. Other studies have concluded from experience in the States and elsewhere, particularly where laws were introduced only for child cyclists, that there has been no reduction in cycling following the introduction of such laws. International experience suggests that the wearing of helmets can be introduced successfully without resulting in a long-term decline in cycling.
Logically, a rule affecting only children should not discourage adult cyclists. The right hon. Member for Exeter has in previous debates made the point that the more people cycle on roads, the safer it will be. Children of five, six, seven, eight, nine or 10 are not part of a group that consistently cycles on roads, so introducing a cycle helmet law for them will not deter adults from cycling.
One thing that puts children off wearing cycle helmets, of course, is peer pressure, especially as they enter secondary school. It is not always considered cool to wear a helmet, but if we can change attitudes by introducing a law, so that it becomes the norm—almost second nature—to wear cycle helmets from a young age, that will stick with children in adolescence and adulthood. I have two young daughters; we go out cycling fairly often, and they were brought up wearing cycle helmets. I must admit that I do not always wear one, but when I cycle with my daughters, the peer pressure works the other way, and they absolutely insist that I wear a cycle helmet, too. If we can get children into a mindset whereby they think it is absolutely the norm to wear cycle helmets, we will see a change in attitudes, and they will wear cycle helmets into adolescence and adulthood. That change will mean that we see significantly fewer fatalities and injuries, not only on the roads, but off them.
The hon. Member for Huddersfield (Mr Sheerman), who has left his place, made a good point about wearing car seat belts. I was a teenager when the law was introduced, and wearing seat belts certainly was not the norm. I was not a particularly rebellious teenager, but I did not always follow the rules. However, after a few months, when everybody else is doing it, we do it too, and it absolutely becomes the norm. Thinking back, people will say, “Wasn’t it astonishing that people railed against the introduction of a law on seat belts?” If we get to the point where we can introduce a law making it compulsory for children to wear helmets, I hope we will look back after a few years and wonder what the fuss was all about.
The Department for Transport’s report concluded that wearing helmets is beneficial, especially for children. I am asking the Department to commission a definitive, independent report on the benefits and costs of introducing
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a law requiring children to wear a cycle helmet. In particular, I want it to look at whether such a law would deter cycling in the longer term and whether parents would support it. I am a parent; I cycle, and my children cycle. I am not part of any lobby or group. There are millions of people like me and my children, and they are the ones we should be listening to and whose views we should be getting, before we decide whether it is right to introduce such a law.
The Department could make a pretty easy start by introducing a few extra questions in the Sport England Active People survey. It could ask cyclists whether they regularly wear helmets or ask their children to wear helmets. It could ask them whether they would support a law making it mandatory for children to wear helmets.
The Horses (Protected Headgear for Young Riders) Act 1990 made it mandatory for young children riding a horse on the public highway to wear protective headgear. If such a law makes sense for young horse riders, surely it should make sense for children on bicycles. We are talking about a measure that will save lives, and prevent injuries and unnecessary cost. I look forward to the Minister’s response.
Mr Dai Havard (in the Chair): Order. Before Members start, I should point out that it is 3.13 pm, and four Members have indicated that they wish to speak. To help you manage your time, I should say that that is roughly five or six minutes each, if we are going to have interventions. If Members could bear that in mind and help one another, it would be appreciated.
3.13 pm
Mr Ben Bradshaw (Exeter) (Lab): Thank you, Mr Havard. Let me say at the outset that, given the time the hon. Member for Reading West (Alok Sharma) has taken for his speech, I do not intend to take interventions.
I congratulate the hon. Gentleman very much on securing the debate, which is one of a number we have had recently on cycle safety. This is a very important issue, not least given the worrying news that this year, for the first time in many years, there has been an increase not only in deaths and serious injuries on the road, but in cycle deaths and injuries. The hon. Gentleman made a brilliant speech about a whole range of measures that could be introduced to help take those figures back in the right direction, and I was absolutely with him until he came to cycle helmets. I was even with him, to start with, when he talked about encouragement and exhortation, but I am afraid that as soon as he used the term “compulsion”, he lost me, and I will outline briefly the reasons for that.
I urge those hon. Members who press for compulsory cycle helmets, and the organisations that have lobbied them, to study the evidence. The hon. Gentleman said he wanted a policy that was based on evidence, and we should study not only the evidence, but the myriad debates we have had in the House since I came here in 1997. We should also talk to the organisations that represent cyclists. I speak as a lifelong cyclist, a former chairman of the all-party group on cycling, a former Health Minister and someone who cares deeply about the safety of cyclists and young cyclists in particular.
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The reason why the House has repeatedly rejected the idea of compulsory cycle helmets is that, overall, it would create a public health disaster, and I will explain why. Wherever cycle helmets have been made compulsory —whether in Canada, New Zealand or Australia—that has had such a detrimental impact on cycling rates that the overall impact on children’s health and the health of society as a whole has been deeply negative. The hon. Gentleman used an important statistic, which is essential to the whole subject of cycle safety, when he said that the benefits of cycling outweigh the risks by 20 to one.
In Western Australia, which has had a lot of experience of this issue because it has had a law on it for more than 20 years, cycling decreased by more than 30%, and it decreased faster among young people. That has been the experience in every country that has made cycle helmets compulsory. By all means encourage, by all means exhort and by all means have campaigns, but please do not, based on the best intentions, pursue a policy that is deeply counter-productive and that will cause more premature death, more obesity and more ill health among young people.
This is completely different from the seat belt issue. The last time the British Medical Journal was asked for its opinion on this issue, its board of education and science concluded:
“Cyclists are advised to wear helmets but legislation to make them compulsory is likely to reduce the number of people choosing to cycle and would not be in the interests of health”.
The BMJ added that research suggested that
“non-cyclists tended to be most in favour of helmets. In fact, a much greater number of lives would be saved if pedestrians and car occupants were encouraged to wear helmets.”
An analysis of the experience in Western Australia, which was the first place in the world to impose uniform mandatory cycle helmet legislation, showed that the legislation increased hospital admissions per cyclist on the road, reduced the popularity of cycling, damaged public health and increased all road casualties.
I therefore urge the hon. Gentleman to go back to the evidence and the debates that we have had in this House, and to pursue with all his energy and time the many measures that will help to protect children and improve child health and cycling safety. He himself cited the excellent campaign by The Times and its eight-point wish list. I gently suggest that The Times took great care in assessing the most important things that needed to happen to save the lives of cyclists and young cyclists. Compulsory cycle helmets were not among them, and there is a reason for that.
3.18 pm
Mr Peter Bone (Wellingborough) (Con): It is a great pleasure to follow the right hon. Member for Exeter (Mr Bradshaw), although I am afraid I agreed with virtually nothing that he said. I welcome the new Minister, for whom we have great hopes. He is following on from an excellent Minister, who is now in the Northern Ireland Office, and whose work on cycle helmets we certainly appreciate.
I congratulate my hon. Friend the Member for Reading West (Alok Sharma) on being brave enough to introduce this really important debate. By the time he leaves this
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room, the Twittersphere will be filled with hate mail for him. It is extraordinary how members of the public and cycling groups can object to anyone who suggests that we recommend wearing a helmet; that is so wrong.
There is a simple statistic that always amazes me: 15% to 21% of young people wear a helmet and 35% to 40% of adults wear one. So parents are happy to go out and put a helmet on their heads to protect themselves, but will not do it for their children. I do not think anyone would regard me as a pinko lefty liberal. That is not the view of me in the House. Yet it is clear to me that the right thing to do is to bring in the mandatory wearing of cycle helmets for young people. I introduced a ten-minute rule Bill to that effect. The reason for that is simple. Children’s skulls are not developed, so the protection of a helmet is even more important for them than for an adult. Children cannot assess the dangers as an adult can. If adults freely decide to wear helmets it is absurd not to tell children that they must wear them.
My hon. Friend talked about horse riding. We now require children to wear helmets on the cricket field when they are batting and if they are keeping wicket. That has worked well, and now more adult players wear helmets, both when they keep and when they bat. If I had been wearing a helmet when I tried to hook this guy for four off a bouncer, I would not have lost most of the sight in my right eye. I was old enough to make that decision, but when it comes to cycling, surely we should protect children by law.
I know that that is not the Government’s view, and I entirely understand their point of view. The previous Minister made it clear; but he also made it clear that he would do anything outside legislation to promote the wearing of cycle helmets, and in the past few months I am afraid that things have gone backwards from that. I want to read from a letter to the Prime Minister, from the Bicycle Helmet Initiative Trust, which is a splendid organisation. I deal with many charities in my role as a Member of Parliament, and there are those that do something at grass roots, and care about something, and those that just talk about things and are worried about their next grant. The trust is a small charity that cares and does something about it. Angie Lee is a feisty lady who has been fighting on this question for a long time. She is a trauma nurse and sees the results of dreadful injuries. I think she needs to be supported. She has written a powerful letter to the Prime Minister, which is dated 16 October, and which unfortunately has not been replied to or even acknowledged by him, but she puts the case much better than I can. She says:
“When we last communicated back in March this year, you conveyed to me that the Government and the DfT encouraged the use of cycle helmets, especially for children. This offered me some assurance along with the confidence we had in the then Roads Safety minister, Mike Penning. I have not had the opportunity to meet his replacement, Stephen Hammond, as yet.
However, what you conveyed to me is in reality not the case. There is a fundamental conflict between sectors of the DfT, the road safety sector and the sustainable transport unit, with helmets being the ‘sell off’. Over the last two years we have seen a systematic move to undermine helmet use and its benefits and to exclude stakeholders, like ourselves, from being included on forums where cycling and helmets are discussed. It was only through the commitment of Mike that helmets remained high on the agenda.
Your coalition minister, Norman Baker, has publicly voiced his negative views on helmets and their use. Mr Baker’s personal choice and opinion have been widely used by cycling trainers and organisations to legitimise opposition to helmets. The attached
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document used by the UK’s largest provider of Bikeability training, Cycle Training UK, demonstrates this. This organisation also uses your picture to support its stance. We understand that Mr Baker has set up and leads a forum of selected cycle stakeholders. This is not open to all, but only a selected few who appear to us to be of a similar opinion. Mr Baker appears to be using his ministerial position to support his personal preference not to wear a helmet.
This is not the only conflict to be of concern to us. Last month the DfT launched a new Think! Campaign. The poster design is dreadful. It depicts a ‘green man’ cyclist without helmet, bike lights or reflector band. The ‘green man’ car driver has no seat belt on. These fundamental safety actions were all identified by a group of ten year olds whom I showed the poster to. I also understand that the DfT had discussed using Olympic cyclist, Bradley Wiggins, to launch this campaign but the CTC objected and Mr Wiggins was excluded because of his positive views on cycle helmets. If this is the case, then there is a serious strength of bias that is undermining the independence and impartiality within the department.
These conflicts, bias and segregation are damaging the work of organisations like ourselves, who have little or no access to DfT funding. We had drawn up a business case following a meeting we had with Mike Penning but since his departure, this, not surprisingly, has not progressed as we were expecting. We have invested vast amounts of energy, conviction and hard earned funds in the attempt to protect child and youth cyclists and support the road safety agenda. We have the skills and knowledge to take child cycle safety forward. However, we are not able to overcome constructed obstacles, bias and use of poor science.
Both adult and child cycling casualties are increasing. This is down to poor guidance, personal obstruction and a failure to be open and objective to all views in the interest of a holistic approach to this issue.
I have had the support of the DfT for 20 years, working with changing Governments and numerous ministers over this period. It is, however, the first time that I truly believe that children and young people are being ‘sold off’ in the interest of sustainable transport. Who are the winners? Who is gaining the most and what checks and balances are in place to evaluate this?
You know how hard our charity works. We have been held up as the true ‘big society’. Child cycle safety needs people who are in tune with child and youth needs, who are not financially driven and who are determined to lead on this issue despite external negative extremists.”
Mr Dai Havard (in the Chair): Order. This is a very long quotation. Quotations are meant to be quotations rather than essays.
Mr Bone: I am conscious that I may be running over time, so I will not complete it, but I think the Minister has got the flavour of what Angie says. The issue is important; if possible would he nudge the Prime Minister to reply on that vital issue? I know that the Minister’s sympathies are with people wearing helmets, but I think that there has been a movement away from that in his Department in the past few weeks.
3.28 pm
Rosie Cooper (West Lancashire) (Lab): It is a pleasure to serve under your chairmanship today, Mr Havard, on the first of two occasions. I congratulate the hon. Member for Reading West (Alok Sharma) on securing the debate, which comes after some high-profile cycling incidents, and today’s report in The Times.
The hon. Gentleman mentioned Bradley Wiggins being knocked off his bike on 7 November in Wrightington in my constituency. For obvious reasons the case received significant national media coverage and highlighted the
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dangers for cyclists on the roads. Prior to the incident Bradley Wiggins had often spoken about the need to improve road safety for cyclists. Our roads grow ever busier, and there is an absolute need for all road users, whether cyclists or motorists, to take individual responsibility for being as safe as possible on the roads. That responsibility means not behaving in a way that endangers other road users, but for cyclists it also means taking the appropriate precautions to keep their bikes and themselves safe, including always wearing a helmet. For motorists it would include not speeding, and being cautious when passing cyclists.
Today The Times not only showed the serious dangers that cyclists face, but referred to the fact that this year, which is unparalleled in terms of the success and popularity of cycling, the number of cyclists killed on British roads is sadly on course to reach a five-year high. According to analysis by Transport for London, which was quoted in the article, 56% of cyclists’ deaths are caused by motorists’ “unlawful and anti-social” manner, yet only 6% of collisions are caused by cyclists behaving in the same way. Some people argue that we need to consider how properly to integrate cycling into the modern transport network. I would not, however, encourage anybody to follow the example of West Lancashire borough council, which has invested section 106 money building a cycle path to junction 4 on the M58. We certainly do not need to encourage cyclists towards the motorway network.
It is important to discuss whether making cycling helmets compulsory can improve cyclists’ safety. It does improve it, but the reality is that there are times when a helmet does not offer enough protection from dangerous driving. In such cases, we need to consider how motorists who cause fatal collisions are dealt with through the judicial process. At present, a view is that the inconsistencies in the charging and sentencing of motorists involved in collisions with cyclists is very worrying.
Everybody knows of Bradley Wiggins, but people will not know of Christine Favager, who was another cyclist involved in a collision in my constituency. Tragically, this time it was a fatal accident. Sixty-nine year old Christine was cycling along a rural road, Asmall lane, in Scarisbrick. The accident happened at about 7.40 pm on a July evening in 2011—not on a dark, wintery night. The 19-year-old driver was travelling between 59 and 63 mph as he raced into a bend. He was travelling too fast and too close to another car as he entered that bend, and witnesses saw the car swerve right across two lanes. In over-correcting, the driver was forced across the road to avoid hitting the car in front, which meant that Christine was hit head on. She had been cycling in the opposite direction. Initially, the driver was reported as being arrested under suspicion of causing death by dangerous driving. He subsequently pleaded guilty to causing death by careless driving. A 20-month custodial sentence in a young offenders’ institute and a three-year driving ban were handed down to him. Christine’s family lost a very dear member.
That case highlights one of the complaints from cycling groups, which is that often the lesser charge of death by careless driving is pursued, as opposed to the charge of death by dangerous driving.
Mr Bradshaw: My hon. Friend gives an example of someone receiving a custodial sentence. I am sure she is aware that in a great many cases, drivers who kill cyclists and pedestrians do not even get that.
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Rosie Cooper: I appreciate my right hon. Friend’s point. The case I described happened in my constituency, which is why I referred to it, but there truly is great outrage out there at the sentences being handed down to motorists who kill in such circumstances.
If we are to improve the safety of cyclists on our roads, there has to be an extensive range of measures that will offer protection and act as a deterrent to erratic and dangerous behaviour on our roads. All road users, whether they are cyclists, pedestrians or motorists, depend on us getting the law right.
3.34 pm
Annette Brooke (Mid Dorset and North Poole) (LD): I will move fairly quickly over some of the issues that have been raised, and I start by congratulating my hon. Friend the Member for Reading West (Alok Sharma) on securing the debate. He comprehensively covered the whole range of measures that we need to take to improve cycling safety. With cycling, there must be a package of measures, right through to dealing with those important instances highlighted by the hon. Member for West Lancashire (Rosie Cooper), when we are all concerned about sentences perhaps not matching the incident in question. I understand the points that she made.
For a long time, I have been involved, in a fairly small way, in promoting cycling. It is so important—environmentally, for transport purposes, for health and leisure, as well as for family activities. In the early 1990s, I was chair of planning and highways at Poole borough council, where we introduced a big network of cycleways. We are moving forward; how exciting it was this year with the Tour de France, Bradley Wiggins, the Olympic success, and then seeing all those youngsters out on their bikes. It was absolutely amazing. I am still staggered walking the streets in London to see the number of people on bikes. It is all absolutely fantastic. I wholeheartedly support TheTimes campaign, which has driven this issue much further forward than we could have hoped to do by ourselves as parliamentarians.
I want to touch briefly, however, on the issue of cycle helmets. I, too, have worked with the Bicycle Helmet Initiative Trust, and I have also worked with local organisations. I am a patron of Headway Dorset and in Dorset, we have an organisation called Streetwise. It is a safety centre that covers all aspects of safety education, but it and the volunteers who work there are very concerned about cycling safety. A competition has recently been promoted among schools to design cycle helmets to raise awareness of how important it is to wear them. Raising awareness of that issue is crucial, and if we could achieve all that was needed to be achieved by doing that, we would not have to look any further.
I sometimes wonder why we need to go further. I look at BMX cycling on the television, and they are all wearing helmets, as, for the most part, are the children at the local skate parks. However, there does seem to be a common issue that it is not quite cool enough to wear one. It is certainly not good for a young person’s hairstyle at the age of 12 or 13, and it does not help if their friend is not wearing one. I have spoken to so many parents who say, “If only there was a law about this, I would feel happier about my child cycling.” When I raise such issues—I am thinking of this from the children’s standpoint—I have only ever looked at the possibility of
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a law for 14-year-olds and under. There is an issue of freedom of choice, but it is a vulnerable age group, and are we doing everything that we can?
It is suggested that my comments will result in the next generation of children being obese, but I find that difficult to believe. I would like to join the call made by my hon. Friend, not for the setting up of the law, but for a review of the evidence. I have heard the Australian evidence quoted to me so many times, but we need to know whether we would be deterring children in large numbers from cycling. There must be a lot of evidence out there; we should look at it and at the end of the day, ensure that we put our children first.
3.38 pm
Lilian Greenwood (Nottingham South) (Lab): I congratulate the hon. Member for Reading West (Alok Sharma) on securing the debate, which comes at a time when cycle safety is so high on the public agenda, and on the compelling case that he made for improving cycling safety.
The work of campaigning organisations, coupled with high-profile accidents, has raised awareness and led to demands for better protection for cyclists. It is heartening to see Members on both sides of the House here today, and I hope that anyone watching the debate will be left in no doubt that MPs are taking cycling safety seriously. Politicians have a duty to promote cycling and to help create environments in which cycling can flourish. The health benefits of cycling are well known, and we now have a better understanding of how high levels of cycling can lead to cleaner and stronger communities. However, safety concerns are a serious barrier, especially for those people considering making the switch to cycling. It is imperative that those barriers be lifted. I pay tribute to the cyclists’ organisations that have lobbied for higher standards for many years, as well as to the Cities Fit for Cycling campaign by The Times.
Although cycling is generally a safe activity, there are still issues to be tackled. There are many areas where cyclists’ safety can be improved, but it is equally important that we do not undo the progress that has been made. Cycling casualties rose by 12% last year, with serious injuries rising by 16%, as we have heard. The Times reports today that fatalities are now set to outstrip last year’s toll, making this year the worst for cycling deaths since 2007. Although that tragic rise may not have a single cause, the abolition of national safety targets was condemned by many in the cycling community, and my hon. Friend the Member for Huddersfield (Mr Sheerman) was right to raise that issue today.
National targets had been in place in one form or another since 1987 and had enjoyed cross-party support. Although there is scope for reform of national targets, I wanted to highlight their importance early in this debate, because I hope that this is an area where a new cross-party consensus can be achieved. Indeed, the need for national safety standards is a theme that should be emphasised. Better training for both cyclists and drivers would cut accidents and fatalities, but local programmes are too often dependent on bids for central Government funding. Labour has called for long-term dedicated funding for cycling proficiency training under the Bikeability programme to be restored, along with the restoration of
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school travel plans to raise awareness of walking and cycling among children. Cycle safety should also become an integral part of the driving test.
Cyclists would also benefit from dedicated funding for improvements to existing infrastructure. That is why Labour has called for a portion of the roads budget to be ring-fenced—so that communities can build up networks of cycleways. Too many junctions are dangerous for cyclists and need to be redesigned. That approach has been highly successful in northern Europe, and we should seek to replicate that success. Those improvements can be delivered, but planners need to know that funding will be available.
We also back the call by The Times for cycling commissioners in every city, to encourage local initiatives. They would benefit from a cycle audit, which would help to map out danger spots, as well as a new planning toolkit that drew on the lessons of the successful cycling city and towns programme, which was axed by the current Government. A new test—a cycling safety assessment—should be met before new road and major transport schemes are granted planning approval. Our existing roads were not designed with the needs of cyclists in mind, but we can at least correct that historical imbalance in the future. The “Manual for Streets” guidelines, which placed pedestrians and cyclists at the top of the user hierarchy, represented a good start. We should look to build on that principle.
Everyone agrees that reducing speed will improve road safety and save lives. Real progress has been made on lowering speed limits in residential areas, with a city-wide 20-mph limit being introduced in Portsmouth and many additional schemes in other towns and cities. We are looking at ways to support more local authorities to make the switch to 20 mph, but the removal of funding for speed cameras and the possible raising of the motorway speed limit mean that we have had mixed signals on road safety from this Government.
We also need to see action on one of the major safety hazards for cyclists—heavy goods vehicles. They account for a disproportionate number of deaths and serious injuries on the roads—a risk that was brought home to us last year when Mary Bowers, the young Times reporter, almost lost her life after being crushed by a lorry. A collaboration by Queen Mary, university of London and Barts and The London NHS Trust looked at the effect of heavy goods vehicles on cyclists’ safety. The conclusions that they reached are startling. Of patients brought to the Royal London hospital, cyclists hit by a car suffered a mortality rate of 6%. For those hit by HGVs, the rate was 21%. Of the most seriously injured cyclists, 82% had been hit by some form of motorised vehicle, but the overwhelming majority—73%—had been hit by a heavy goods vehicle. According to Transport for London, goods vehicles now account for half of all cyclist fatalities in the capital.
There is a clear need for action, and we have set out our support for reform. We would work with the industry to equip lorries with safety equipment, including blind-spot mirrors and side protection to help to stop cyclists falling under their wheels. Those upgrades could be funded through the proposed HGV road-charging scheme. We would invest in on-street infrastructure, including Trixi mirrors at junctions. More rigorous and comprehensive training is needed for lorry drivers, and we would work with the industry to achieve that as a priority.
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According to the Department for Transport’s own figures, rail freight use would have gone up by 732% by 2025 if the decision had not been made to allow longer HGVs. Rail freight is now projected to go up by 262% instead. I hope that, in the interests of tackling congestion and improving road safety, the Government will look again at the issue, with a view to reversing that change.
All the measures that I have described would have safety benefits in their own right, but the overall impact is of vital importance as well. The wider effect would be to normalise cycling. I have seen for myself how cycling is a way of life for a striking number of people in Copenhagen and Malmö, where the long-standing determination of national and local politicians to deliver investment has reaped dividends. We need the same quality of leadership on cycling in the UK. We should not accept the Government’s retreat from promoting national standards.
That leads me to the issue of helmets and the case that some people have made for them to be compulsory. I have no doubt that helmets can effectively protect cyclists, particularly in low-impact collisions, and I would encourage their use, particularly by children, but I do not believe that compulsion is the answer. As my right hon. Friend the Member for Exeter (Mr Bradshaw) explained, where compulsory helmet laws have been introduced, they have been associated with a decline in bicycle use, including by children. After helmets became mandatory in Australia in 1991, cycle use in Perth dropped by up to 40%. In New Zealand, cycling levels halved between 1994 and 2006. Compulsory helmet laws in both Israel and New Mexico were deemed to be unsuccessful, with cycling levels dropping to the point at which the viability of bicycle-sharing facilities was put at risk.
Any substantial drop in cycle usage can in itself have a serious impact on safety. The safety-in-numbers effect means that when cycling levels increase, so does driver awareness and demand for infrastructure investment; conversely, when levels fall, individual cyclists may be at greater risk. An example of the safety-in-numbers effect can be found in the Netherlands, where cycling levels are high and relatively few people wear helmets. British cyclists are three times more likely to be killed on the roads than their Dutch counterparts.
There is simply no quick fix for these issues. If we want more people to take up cycling, we need sustained investment and a more supportive attitude to cycling in general. British Cycling has said:
“Helmets can help save lives in many incidents and we recommend they are worn…What would contribute much, much more to making cycling safer is better road infrastructure.”
My hon. Friend the Member for West Lancashire (Rosie Cooper) noted that there have been some unhelpful comments in the media about the causes of accidents, and I would like to deal with that point. Everyone on the roads has a duty to act responsibly. For cyclists, that of course includes using lights at night and cycling in a safe and law-abiding way. However, the truth is that cyclists are at fault only in a minority of collisions. That is why alongside training for cyclists, we urgently need better training for motorists and lorry drivers in particular. As I said, we need dedicated funding for infrastructure improvements. We need the Times Cities Fit for Cycling manifesto to be implemented in full and we need national standards to be upheld.
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As a regular cyclist myself, I appreciate the importance of cycle safety standards. If we are serious about modal shift and tackling inactivity levels, we must make our roads safer and more attractive for cyclists and pedestrians. This debate has provided another vital opportunity to highlight the work that has been done and the work that we still need to do. Labour will continue to advance proposals to make our roads safer, and we will keep the pressure on the Government to strengthen their position on cycling safety.
Mr Dai Havard (in the Chair): Mr Hammond, would you like to give all those answers to Mr Bone’s 10-year-olds and on behalf of the Prime Minister?
3.49 pm
The Parliamentary Under-Secretary of State for Transport (Stephen Hammond): I am delighted to speak under your chairmanship, Mr Havard. I think that it would be presumptuous of me to provide an answer on behalf of my right hon. Friend the Prime Minister, but I certainly listened to what my hon. Friend the Member for Wellingborough (Mr Bone) said and I will come to his comments in a moment.
I particularly thank my hon. Friend the Member for Reading West (Alok Sharma) and congratulate him on the debate. He made an excellent speech—a serious speech. A number of questions came up, and I will try to tackle as many of them as I can in the short time available. I am sure that if I do not respond to them all, he will want to write to me, and I will be happy to put the replies on the record. I particularly welcome the debate.
I listened carefully to what the hon. Member for Nottingham South (Lilian Greenwood) said, and yes, of course there is more to do, but I hope that she recognises the great deal that the Government are doing. We take the promotion of cycling, the ability to cycle safely and our responsibilities seriously. Cycling is not just a convenient, healthy and green way to travel, as hon. Members have said, but relatively inexpensive, and therefore accessible to many. There has never been a better time for people to get on their bikes, and that is exactly what we are seeing.
The trend started after Beijing 2008, which reignited the passion for cycling for many people. As my hon. Friend pointed out, after the heroics of the Olympics, Paralympics and Tour de France, not only have we seen thousands more people cycling, but we expect hundreds of thousands more people to take to two wheels. In some parts of London, cyclists already seem to outnumber other vehicles.
I commend The Times’sexcellent cycling campaign; we have taken much of it on board. The hon. Member for Nottingham South was right to commend also British Cycling, Sustrans, the Bicycle Association of Great Britain, London Cycling Campaign and C2C, all of which lobby heavily, carefully and thoughtfully for cycling. It is distressing that, although the number of cycling fatalities has been falling—fatalities decreased between 2010 and 2011—the number of serious injuries has increased. As road safety Minister, I am determined to ensure that our roads are as safe they can be for everyone who uses them, whatever the mode of transport.
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The Government have invested substantially in road infrastructure and other safety angles, as my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) pointed out. The local sustainable transport fund is targeting £600 million of investment over four years to look at local networks. Almost all the projects funded so far include infrastructure improvements for cycling. I could give examples, but will not due to the time. Improvements include landscaping, resurfacing, repainting, new lighting and adding new parts to junctions to improve the safety of cycle routes.
The Department is working on other ways to reduce risk. We have made it considerably simpler for councils to install Trixi mirrors to improve the visibility of cyclists at junctions and to put in place 20 mph limits and zones. I strongly encourage councils to consider the greater use of such 20 mph zones in residential areas, because they clearly have an impact on the safety of cyclists and pedestrians. We have also made it easier for councils to introduce contraflow cycling by changing signage laws, so fewer signs need to be used. I am working closely with cycle safety stakeholder groups on other issues and infrastructure measures that the local sustainable transport fund can bring forward. We have made £30 million available to local councils up and down the country to tackle the most difficult and dangerous junctions.
My hon. Friend the Member for Reading West mentioned HGVs. The hon. Member for Nottingham South is right that training is crucial for HGV drivers, operators, transport managers and employers. That is why I am pleased that the Freight Transport Association, with Government support and backing, introduced a cycling code last year. I was delighted to be at the launch of the Mineral Products Association’s new drivers’ awareness campaign. It targeted young cyclists at Hyde park, where a number of them stopped to see how difficult it is for even the most well trained drivers to spot cyclists, even in the most well equipped lorries with a blind-side mirror and other safety implements. The Government are behind that awareness campaign, and I support the investment from the MPA and the FTA.
All EU member states have implemented the European legislation, which applies to almost all HGVs used in domestic and foreign trade. We continue to drive that agenda in Europe, to ensure that mirrors are required for new vehicles. We have provided £30 million to make potentially hazardous junctions across England safer for cyclists. Of that, £15 million is going to London, because we recognise that in London in particular there has been a huge increase in cycling and in the number of people wishing to access the roads more safely.
We are working with partners, through the Department for Transport cycling stakeholder forum, on a wide range of issues, including safety. I will meet the group in the near future. It is inclusive: it includes cyclists, motorists and representatives from local authorities and the Freight Transport Association, because not having all those people on such a body would mean missing out on opportunities. We strongly encourage local authorities to follow the example of some of the schemes that we have set up and those set up previously to consider actions to improve safety for cyclists
In the short time available, I shall touch on helmets, because the issue has come up a number of times today. In 2009, the Government commissioned and published
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a report entitled, “The potential for cycle helmets to prevent injury”. It concluded that helmets could be expected to reduce fatalities and injuries in the event of an accident, particularly if a vehicle was not involved. No evidence was found of helmets adding any additional injury risk. Let me make it clear that the Department for Transport supports the promotion of cycle helmets, through measures such as Highway Code rule 59. I was also pleased to initiate the recent THINK! campaign in September. The Government are putting more money into Bikeability cycle training and have committed more money to it over the next three years. The Department also makes its support clear on its webpage and through other schemes.
We equally accept that helmets are a matter of exhortation rather than compulsion. My hon. Friend the Member for Wellingborough made a powerful speech. He is right that the former Minister was excellent and showed strength on this matter—I am not sure that I will live up to my hon. Friend’s hopes. I entirely agree with him; anything outside legislation to promote and exhort the wearing of cycle helmets, I will do in my role as road safety Minister. I am happy, first, to nudge the Prime Minister to ensure that he answers my hon. Friend, and, secondly, to accept his invitation to a meeting. I am sure that he will write to my officials about that.
One of my first acts as road safety Minister was to announce the first THINK! Cyclist campaign. Many will know that we have used the THINK! label for a number of road safety campaigns, but we have not had a campaign dedicated to cycling for 10 years. It concentrates on the behaviour of cyclists and motorists, by getting those who cycle, who are often motorists as well, to think about how they behave on the road as motorists and how they want people to behave towards them as cyclists. I would like to go into more detail on that campaign, but I accept the comment that the little green man should have been wearing his helmet. A number of cities have taken up the campaign and I continue to spend time promoting it. I am convinced that THINK! Cyclist can have a beneficial effect on road safety.
I am acutely aware that we are coming to the end of our debate. Cycling offers huge benefits to both the individual and society. The challenge, which remains a challenge for the Government, is to continue to ensure that our roads are as safe as we can make them. Investment is therefore going into infrastructure and the training of young people, and we exhort people to wear cycle helmets. I hope that when we have a debate on this subject in a year’s time, as I am sure we will, the trends will not only seem to be downwards, but be proven to be downwards.
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Dyslexia (Prisons)
4 pm
Rebecca Harris (Castle Point) (Con): It is a pleasure to have the opportunity to raise this important issue. I am doing so because of a whirlwind or, as some might say, a force of nature, who entered one of my constituency surgeries earlier this year—my constituent, Jackie Hewitt-Main. She came to tell me about a project she had undertaken in Chelmsford prison, “Dyslexia Behind Bars”.
During that project, she assessed more than 2,000 offenders for special educational needs, and attempted to work with them to help them understand their learning difficulties and to succeed where the education system had so far failed them. The effect on the re-offending rates of the inmates who took part is truly astounding, and I want to bring that to the full attention of the House and the Government. I believe that Jackie’s work gives an invaluable insight into how we can break down the barriers that prevent offenders from becoming safe and productive members of their community, once they have repaid their debt to society.
I will explain Jackie’s project and her findings later, but first I want to analyse the extent of the special learning needs among our national inmate population. The sad truth is that no one is at all sure how many people in our prisons actually suffer from dyslexia or other learning difficulties. In most cases, the information accompanying people into prison is unlikely to show whether learning difficulties or learning disabilities have been identified.
Rehman Chishti (Gillingham and Rainham) (Con): I congratulate my hon. Friend on securing this important debate. On collation, is she saying that the Government should collate information on offenders with dyslexia who go to prison?
Rebecca Harris: There is good reason why that information should be collated nationally. I am aware that the Government are moving to a system of payment by results, under which market mechanisms might pick up such issues and ensure that we address them properly.
Rehman Chishti: On that point about payment by results, does my hon. Friend agree that when an offender enters prison and has a health needs assessment looking at speech and language communication, a dyslexia assessment should be undertaken at the same time?
Rebecca Harris: I absolutely do, and given what I will be saying, I hope that many others will agree with my hon. Friend and me about that.
According to the Prison Reform Trust report “No One Knows”, fully half the offenders in British prisons have problems with basic literary skills. It notes:
“The most consistent information about the number of offenders with learning difficulties or learning disabilities is that no one agrees on how many exist.”
With regard to dyslexia, for example, estimates of prevalence among offenders range from 4% to 56%. However, the general average in prison-based studies is about 30%, although rates of serious deficit in literacy and numeracy generally reach up to about 60%. According to Ministry
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of Justice figures published earlier this month, we currently have more than 86,000 prisoners, so we can estimate that about 26,000 offenders in UK prisons suffer from some form of dyslexia, but we do not know for certain.
I was surprised and disappointed to learn that, historically, the Government have kept no data whatever centrally on the numbers or percentage of the prison population who have special educational needs, such as dyslexia, or even on how many are illiterate. I was surprised and disappointed because the two main aims of our penal system are to punish effectively and to rehabilitate offenders. “The Oxford Dictionary of Law”—my learned colleague, my hon. Friend, will know more about it than I do—defines rehabilitation as:
“Treatment aimed at improving an offender’s character or behaviour (including education, counselling, employment, training, etc.) that is undertaken with the goal of reintegrating the offender into society.”
All Members would agree that one of the most basic necessities effectively to integrate into our modern society is the basic ability to read and write.
With that in mind, I find it hard to see how the Government can allocate and target rehabilitation resources, or commission them effectively, if those data are not collected. Similarly, the Government cannot properly analyse any causal link between the lack of basic literacy and offender behaviour, or assess how far educational failure or the failure to pick up dyslexia in schools leads to offender behaviour in later life.
Rehman Chishti: On literacy and dyslexia, does my hon. Friend agree that prisoners’ literacy skills are lower than average, which reflects their social background, and that greater emphasis must therefore be placed on that?
Rebecca Harris: There should be a great deal more scrutiny on all factors, because there are others. In addition to literacy problems, there is a huge number of social factors, as well as the fact that many members of the prison population have had head injuries or personality disorders.
If we are to drill down, deal with our re-offending rates and our prison populations and, ultimately, achieve what we want by keeping our streets safer, all those factors need proper consideration. We always want to hear that people have been locked up and put away, so that they cannot be on the streets to offend, but they come out again and if we do not stem the tide, we will not address the problem. The issue is not new. For many decades, various social commentators have explained that there is a link between educational attainment and the propensity to commit crime. That only underlines my dismay that we are not doing more, and do not have a proper audit.
As I have said, one key advantage of having payment by results for rehabilitating offenders is that, through the introduction of market mechanisms, organisations—whether third sector or charitable ones—will put greater emphasis on identifying the causes of educational failure in our prisons and ensure that such factors are brought to bear on rehabilitation, whereas under previous Governments, we had one-size-fits-all solutions, particularly for education and training in prisons.
I speak as a dyslexic myself. That is why, when my constituent came into my surgery, everything she told
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me rang a bell and struck a chord. She came to the right Member of Parliament, because I was extremely interested. I know exactly how embarrassing and frustrating it can be to work very hard in school on a piece of work—coming up with all sorts of fantastic ideas and arguments—only for the teacher to hand it back with red marks all over it because of poor spelling or grammar. That is soul-destroying, actually. I also know what it is like to be told that I am stupid or lazy, or both. It does not take very long for someone in that situation to feel that they cannot trust their own judgment about themselves or about their peers and others around them.
Even worse, such people—perhaps to save face or from confusion and frustration—find it easy to begin to act up to the very labels they are given. Young men in particular often become difficult and disruptive, and that can lead them down a nasty and dangerous path from which it is hard to turn back. I was lucky enough to be diagnosed with dyslexia before I sat my A-levels, but, in fact, a large number of people with dyslexia have always slipped through the net of our education system. For those who leave school hampered by their dyslexia to the extent that they still cannot properly read and write, the frustration and embarrassment they felt in the classroom too often becomes a part of their daily life.
Many dyslexics, if not most, are very good at creating coping strategies and at adapting their day-to-day life to avoid situations in which they are hampered by their dyslexia. Certainly, the vast majority of them never become criminals; I have become a Member of Parliament—I am well aware that many members of the public think that the two are very similar. It is also true that a significant number of dyslexics try to avoid altogether any situations in which they have to read or write. If that aversion to reading and writing is severe enough to make it daunting even to fill in a simple form, they are really lost. Basic literacy is essential for interacting with the rest of society, while illiteracy can be a source of immense frustration and impoverishment and, of course, a factor in crime.
I will talk about the detailed findings of Jackie’s report in a moment, but one fascinating insight that she discovered was that a number of the dyslexic prisoners whom she interviewed were locked up for offences relating directly to their aversion to reading and writing, and specifically to form filling. She found that 10% of dyslexic offenders were serving sentences that were related to strings of driving offences involving driving without a proper licence or insurance. When Jackie asked them why they were not properly licensed, she found that most either could not pass the theory test or simply had not bothered trying because they knew that they would fail. If it is difficult to get through life without reading and writing, it is also quite difficult to get through life without driving a car.
Rehman Chishti: At the moment, education providers use a hidden disabilities questionnaire, which has been developed by Dyslexia Action, to test anyone who shows signs of having a learning difficulty and/or disability. Does my hon. Friend think that test is working?
Rebecca Harris:
The evidence from the insightful review written by my constituent, who is a dyslexic herself, seems to show that it is not working. We are not
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picking up people and, more to the point, we do not know how to reach them and treat them when we do pick them up.
The examples that I have given show not only how important it is to identify dyslexia in prison but why we should improve dyslexia screening provision throughout the education system, but that is a debate for another day and another Minister. I seriously believe that a greater focus on dyslexia will lead to a fall in reoffending rates and that the report from the “Dyslexia Behind Bars” project provides enough evidence and insight for the Government to look at the matter more seriously.
The project took place in Chelmsford prison and, on first glance, its methodology seemed simple—first, to assess the level of illiteracy and special educational needs related to dyslexia in the prison and secondly, to set up a stage-by-stage, one-on-one mentoring scheme among the offenders using Jackie’s teaching tools and methods to teach them outside the traditional classroom setting.
Jackie began work with 20 prisoners with exceptionally low literacy levels. They were generally prisoners who would never have engaged with the prison education service because they saw it as the same pen-and-paper classroom experience that they had previously hated and been failed by, which is why the approach of Jackie, a fellow dyslexic who was undiagnosed until her 40s, was so different. I can entirely identify with the relief simply of being diagnosed dyslexic, let alone being diagnosed by a fellow dyslexic who has overcome the condition. It is a huge opportunity for someone to reappraise how they view themselves and to give them an incentive to try again.
The prisoners who had been taught to read and write by Jackie offered to share their experiences with other prisoners. Literate prisoners also came forward, wanting to learn how to teach and mentor greater numbers of inmates. Jackie trained 40 of them to support fellow prisoners through the project. In that way, her unique, multi-sensory and original teaching and mentoring programme spread to all wings of the prison. More than 200 prisoners were individually taught and supported over the first part of the project by Jackie and her trained mentors, but that figure quickly grew as the project developed and spread. A further 70 prisoners were successfully helped by mentors who transferred to Wayland prison to extend the reach of the project to another part of the prison estate.
Fifty male prisoners went through learning workshops with Jackie. Their literacy levels were at the lowest pre-school level, and they needed to develop early learning and life skills. They discovered that they had a range of strengths which they could build on to develop their learning and to gain self-esteem. They were all helped to create their own highly individual learning plans to understand how to manage their own life, attitudes and behaviours.
Overall, 53% of the 2,029 offenders interviewed at Chelmsford during the project were diagnosed with dyslexia, which is a huge statistic. When they came out of prison, the great majority of them were either working or in education. Within weeks, several prisoners with the literacy skills of an average four-year-old had learned enough to write their first letters home and to read the letters that they received back.
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A testimonial from Prisoner J said:
“Jackie has shown me things that no one else has ever been able to do before: reading, writing and sums. I have learnt more in 8 weeks than in all 41 years of my life.”
Jackie and the mentors helped prisoners to learn how to read and fill in forms, to take and pass the driving theory test and to take and pass the building site construction skills test, which meant that they could legally work in construction. That helped to give a sense of optimism and direction to prisoners in preparation for their release.
The project also transformed the prison as a whole—I am sure that the Minister would like to know that. Prison officers commented on how much calmer even the most violent prisoners became as their self-esteem rose along with their progress, resulting in a calmer and happier atmosphere across the whole prison. In the two years, prisoner-on-prisoner and prisoner-on-staff assaults fell dramatically—the figures really are quite dramatic—which prison officers have attributed to the “Dyslexia Behind Bars” project, although, unfortunately, they rose after the project ended.
All prisoners involved in the project improved their literacy skills to a level advanced enough to extend their choices of work and leisure activities and prepare more effectively for their lives outside. Of the 17 prisoners in Jackie’s first two groups who were released four years ago, only one has reoffended. That represents a 5.9% proven reoffending rate within four years, compared with the national rate of 55% within two years, or 68% within five years. Clearly, that sample is too small to be statistically reliable. However, it is a useful indicator that shows that the reoffending rate of the project participants is less than a tenth of the national average. An example of that reduction in recidivism is the case of three serial offenders who had each been in and out of prison more than 40 times—none of them has reoffended since their release four years ago.
Of the first 17 prisoners to be released, four are employed in trades, two in building, one a fork-lift driver and one a film producer; two are employed by charities, one teaching disabled people the skills to get into work and one mentoring young offenders; two are voluntary workers, one mentoring adults with learning difficulties and one supporting men on probation; two have started their own businesses; five are currently unemployed; one is at a top university doing an engineering degree; and just one went back into prison.
Moreover, of the first 40 offenders to become mentors, 10 were also trained in PTLLS—preparing to teach in the lifelong learning sector—qualifications. All 10 finished the course and passed with those qualifications. Chelmsford prison has now received many personal requests to transfer, as prisoners and their families hear on the grapevine of the success of the project.
I should like to extend my thanks to the Minister. I wrote to him on this matter earlier this month and received an extremely helpful letter and an offer to meet me and Jackie, for which I am grateful. Moreover, I also welcome the announcement yesterday by the Secretary of State for Justice that he will be reviewing the educational approach taken in the youth custody estate, where we are currently detaining about 1,800 young people, with a 70% likelihood of reoffending. It seems highly likely that among that cohort, there will also be a large proportion with undetected learning needs. There is an opportunity to use an innovative method of reaching
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and teaching them before they are released back into society. I am quite certain that that will dramatically reduce their reoffending figures.
Historically, education in prison has not been held in high regard by the public as an effective tool to rehabilitate offenders—a fact that was mentioned in an Education and Skills Committee report in 2005. Sadly, I do not believe that that perception has changed in the minds of the public today. The public does not have much confidence or belief in the educational work of the prisons and their ability to rehabilitate. The first role of our prison system should always be to punish offenders and so act as an effective deterrent to reoffending. My aim is not to raise the plight of dyslexics or in any way to excuse any form of offending behaviour but to highlight a way in which we can drastically reduce reoffending rates and ultimately keep our streets safer for the British public.
4.18 pm
The Parliamentary Under-Secretary of State for Justice (Jeremy Wright): I congratulate my hon. Friend the Member for Castle Point (Rebecca Harris) on securing this debate on a very important subject. I am grateful to her, too, for introducing me to the work of her constituent, Jackie Hewitt-Main. I look forward to meeting her and my hon. Friend on 5 December to discuss this matter further.
It is clear that Ms Hewitt-Main’s project, “Dyslexia Behind Bars” contains some interesting approaches to a substantial problem. Using a multi-sensory and mentoring approach, she has offered a great deal to the inmates of Chelmsford prison, and there is a great deal there that we will wish to explore. As far as I know, this work has not yet been assessed or reviewed by an independent organisation and although its initial results are promising, further work will be necessary to ensure that they are as good as they appear to be. It seems sensible to explore with my hon. Friend the ways in which we can change things to improve what is on offer.
It is also worth saying that the National Offender Management Service is considering a review of the evidence on effective working with offenders with learning difficulties and disabilities, and I will come back to what is already being done in a moment.
The particular areas of Ms Hewitt-Main’s work that my hon. Friend highlighted, and that are particularly interesting in the context of what my hon. Friend said we are doing more generally in the Justice Department, include peer mentoring. I have seen very good examples of peer mentoring in the prison system, with older, more established prisoners assisting younger and newer prisoners in a variety of ways. The work that my hon. Friend described is only one of those ways.
As my hon. Friend also said, teaching and learning in a non-classroom environment are important. We must recognise that the classroom environment did not work for a great many of the prisoners we are talking about at school, and it probably will not work for them in custody either, so we have to find new and imaginative approaches that, as she said, involve the whole prison.
It is also worth noting that, as I understand it, Ms Hewitt-Main’s programme involved some mentoring of people after they leave prison. As my hon. Friend
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will have picked up from the speech yesterday by my right hon. Friend the Secretary of State for Justice, that is also an area on which we wish to focus.
It may be helpful if I set out some of the work that is already being done, at which we are having another look to ensure that it is being done in the best possible way. Since taking up this post, I have been very keen to ensure that the importance of learning and skills within the prison estate and beyond is high on the agenda. Indeed, my hon. Friend will have noted that the Prime Minister also mentioned learning and skills in his recent speech on offenders.
In particular, of course, the low levels of literacy and numeracy among prisoners as a group should concern us all, not only because of the impact on those individuals and their ability to function in a world where reading and writing are essential skills, but because a lack of sufficient literacy and numeracy skills excludes people from the vast majority of employment opportunities. I am sure, as are many others, that having a job can make a significant impact on reducing reoffending, and that skills such as organisation, communication, teamwork, writing, speaking and listening are necessary to perform effectively in most, if not all, work roles.
Prisoners with dyslexia are, of course, disadvantaged in that respect, not only because dyslexia presents them with particular issues in terms of competence in reading and writing, but because dyslexia is recognised as impairing organisational skills. My hon. Friend obviously has a clear personal perspective on dyslexia and its effects, which has been extremely valuable in the debate.
Of course, engaging with prisoners on learning and skills can be difficult, as my hon. Friend recognised. Some prisoners may have had negative experiences in their education and even been excluded, and consequently they see little value in education. Statistics that I have seen recently suggest that nearly half of prisoners identified themselves as having left education with no qualifications at all. Dyslexia magnifies that problem. It can be very difficult to recognise and is often masked. Not all schools will have had the specialist provision to support children and young people who have this difficulty.
Since reading and writing are “gateway” skills that enable children and young people to engage confidently with their wider educational experience, as well as in many basic social relationships, poor educational experiences can create reluctant learners. The experience of being excluded from positive experiences of learning to read, write and communicate more widely remains with many prisoners into adulthood. That presents an additional challenge in custody, where engaging with reluctant learners can be particularly difficult if memories of the classroom act as a barrier to taking the opportunities that education can provide.
Dyslexia is only one condition in a range of learning difficulties and disabilities that prisoners may present with, and that require specialist and systematic approaches. We need to provide as much support as we can to prisoners with LDDs, to improve their chances in the workplace as well as their confidence, self-esteem and social skills. Without dedicated input, the impact of much learning support in reading and writing may be reduced or lost.
The NOMS learning disabilities and difficulties working group exists to oversee the national implementation of an LDD screening process for prisoners, and to develop
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a broader LDD strategy across prisons. Apart from various officials from NOMS, membership of the group includes officials from the Department of Health, the Department for Business, Innovation and Skills, and the Prison Reform Trust. I welcome, as I am sure my hon. Friend does, the contribution made by the group, as these issues can be resolved only by partners across Government and the voluntary sector working together. The group is involved in the development of NOMS guidance for better outcomes for offenders with LDDs. It is also developing guidance on reasonable adjustments for prisoners with LDDs, to ensure that they are integrated into the prison community and that they have the best opportunity to participate in activities that support their rehabilitation. Further commitments for the current year include improving staff awareness, as well as prisoner and peer training.
Returning to a point that my hon. Friend made about the crucial importance of our knowing how many people in prison have dyslexia and other learning disabilities, a learning disability screening questionnaire has been piloted on three sites, and NOMS is considering whether it should be used across the prison estate. The Youth Justice Board is using a similar tool—the comprehensive health assessment tool—with young offenders. That will go some way towards addressing the point that she raised and on which my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) focused: identifying the number of people we are dealing with.
My hon. Friend and also mentioned the Skills Funding Agency and its hidden disabilities screening tool, which of course identifies issues wider than LDDs. It has been used by all the SFA’s custodial Offender Learning and Skills Service providers since August 2009. Our aim is that this tool will eventually be adopted and used by all OLASS providers, both in custody and in the community, and ultimately by all mainstream providers.
We are also making radical changes to the way that learning and skills are delivered in prisons, which will encompass the support that we want to be made available to all prisoners with LDDs. As part of that radical programme of change, we have published a document that my hon. Friend the Member for Castle Point may have seen—if she has not seen it, I commend it to her—called “Making prisons work: skills for rehabilitation”. That is the new offender learning strategy, which was published jointly with BIS. The strategy recognised that improving prisoners’ literacy skills was central to rehabilitation, as we have discussed today, and we are taking steps to ensure the implementation of the report’s recommendations.
To give an idea of the scale of the problem that literacy and numeracy difficulties present in prisons, in the academic year 2010-11 almost 30% of prisoners had such low levels of reading and writing skills that, in
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order to bring them up to a basic functional level, individual learning aims for literacy and numeracy had to be set for them. Overall, 65% of prisoners enrolled on literacy and numeracy programmes were successful in achieving the literacy and numeracy functional skills goals that had been set as part of their individual learning plans. For some, it meant learning to read and write, while for others it meant improving their basic literacy and numeracy so that they could operate with more confidence and competence.
The revised Offender Learning and Skills Service, which is OLASS 4, was implemented as a result of the “Making prisons work” strategy, and it will make additional provision against assessed need. OLASS 4 requires education providers to identify the support needs of offenders with LDDs or special educational needs through a learning difficulty assessment, or LDA. Requirements identified through the assessment should be addressed through personalised, customised programmes delivered by specialist qualified staff. My hon. Friend will recognise the importance of that approach, because not all offenders have identical needs. OLASS 4 providers understand, and are able to deliver, the specific and systematic approaches to learning that are required by prisoners with such difficulties.
Crucially, however, through OLASS 4 and the work that we are doing more widely with other Departments, we are more strongly linking skills to employment, and I believe that there is still more work to do in that regard. Arrangements are also in place to allow OLASS 4 providers to draw together funding to support prisoners with LDDs, through a specific adult learning support allocation that is designed to match the support that mainstream learners in colleges or training organisations receive. A budget for additional learning support of £7.1 million is available to the OLASS 4 providers, to enable the introduction of specific assessment processes to identify offenders with LDD needs and to provide those offenders with the expert teaching and support that they require.
In addition, my hon. Friend may be aware of the work of the Shannon Trust’s “Toe by Toe” reading scheme, which is also available in prisons. Again, this scheme uses peer mentors, supported by volunteers, teaching staff and prison officers, and it is based on best practice developed through teachers’ experiences of enabling children with dyslexia to read. That is enormously beneficial to many offenders.
In conclusion, I welcome today’s debate, and I thank my hon. Friend for raising this issue. I assure her that, although we believe that much good work is being done already, there is still a great deal more to do, and we are certainly open to new and good ideas, including those that I look forward to discussing with her and her constituent.
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Mobile Technology (Health Care)
4.30 pm
Rosie Cooper (West Lancashire) (Lab): It is a great pleasure to serve under your chairmanship for the second time today, Mr Havard. I welcome the Minister to his place. We were occupants of neighbouring offices in this House, but I tend not to see him quite so much now, with his promotion to the Government ranks.
In every aspect of our lives, technology is driving innovation, improvement and increased efficiency. Health care is no different, where the use of mobile communications technology is becoming increasingly important. We are reaching a point where mobile technology can take an increasingly strategic role in meeting today’s health care demands. That is because a number of critical factors are converging, including several extremely demanding health care challenges that, taken together, require new approaches and solutions; the remarkable computing power now available on portable devices such as tablets and smart phones; and the development of specific mobile technology-based health-care focused solutions that can improve quality, efficiency and a patient’s experience of their care. I shall cover each of those in turn.
Our health service faces unprecedented challenges that go way beyond the £20 billion cuts to national health service spending, and most health care systems across the world face similar situations. We are, as a population, living longer. That is undoubtedly a good thing, but it brings with it demands. Older people with multiple and complex health care needs constitute the majority of interactions with the NHS, and their care consumes the majority of health care expenditure, to the extent that health care costs are growing faster than gross domestic product. New drugs, diagnostics and treatments mean that we can treat conditions that years ago were simply considered beyond the reach of modern medicine. They are welcome developments, but they inevitably involve significant financial cost.
A less welcome reason for increasing health costs relates to the increase in long-term and chronic diseases. Over recent years, we have seen the rise in the prevalence of obesity, type 2 diabetes and other conditions that have a significant lifestyle-related component. They contribute directly to health care requirements and lead to secondary complications. For example, the single most significant risk factor to the development of dementia is cardiovascular health. The NHS needs to address all those challenges while delivering an unprecedented 4% year-on-year compound efficiency savings. The Minister, as a former member of the Select Committee on Health, on which I still sit, will be aware that the Committee has correctly pointed out that such a level of savings has not been achieved by any other health care system.
I think we can accept that the face of health care and the challenges it faces are changing. How can mobile communications technology help deal with the challenges? It is worth reflecting that the power of today’s mobile communications technology—they are long words, but we would just call them tablet computers and smart phones—is comparable to some of the faster supercomputers of just a decade or so ago. I was interested in what is termed “always on” connectivity, which means that one can always be reached if devices
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are switched on, through secure wi-fi, 3G and the emerging 4G technology. Such devices can connect instantly with extremely powerful networks. That means that working practices established 10 or more years ago can be radically transformed. Through harnessing the power and capabilities of mobile communications technology, the health service can better support its health care professionals. Technology can reduce the time spent on administration and give professionals much more needed time to care.
Specifically, modern mobile communications technology can help patients and the public make healthier decisions, enabling individuals to manage their conditions more effectively and therefore to live independently. It can also help health care professionals collect information more effectively, which leads to improved efficiency, patient safety and care quality. I will draw on a few examples that relate to those areas. Mobile technology can help patients take more control of their health by encouraging healthier lifestyle choices; by giving patients more control and information to manage their conditions effectively; and by supporting more comprehensive remote monitoring.
I think the Minister is aware that there is already extensive clinical evidence that shows that patients who take an active role in their care do better. For example, a study in Toronto showed that diabetic patients who monitored their blood pressure using smart phones experienced a 25% drop in cardiovascular mortality. The Government have committed to giving patients the right to book general practitioner appointments, order repeat prescriptions and talk to GP practices online. That represents just the tip of the iceberg. The effect on the population’s health would be much stronger if patients were encouraged to monitor their care with support from their health care professionals.
Much closer to home, Leicestershire’s nutrition and dietetic services and the university of Chester in the UK have pioneered a secure smart phone solution to enhance the approach to adult weight management services. Achieving sustainable weight loss is hard, yet their service, known as LEAP—lifestyle, eating and activity programmes—weight management groups, based on national guidance, has achieved just that. They have found that the key to long-term weight loss is to provide follow-up support. After finishing the initial programme, patients take part in a three-month follow-up programme, focusing on self-monitoring with encouragement from staff via text messages. I understand that they are not alone in doing that kind of thing; the all-party group of which I was formerly chair, Slimming World, does something similar. To ensure patient confidentiality and data security, a BlackBerry smart phone is used with an application that converts text messages to e-mail and vice versa. That creates an accurate record of patient-practitioner dialogue. The results include statistically significant weight loss compared with a control group and an improved quality of life.
Those two simple examples show that by supporting individuals to use smart phones and tablets already at their disposal, people can take more control of their lives and make healthier decisions. There is scope for the NHS to become more proactive in encouraging such approaches without incurring significant cost.
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Bill Esterson (Sefton Central) (Lab): I congratulate my hon. Friend on securing this important debate. She is making a point about the importance of technology in preventing health care problems. As she will know, the preventive public health role is being transferred to local government. Does she agree that it is vital for the technology to have the funding needed when the preventive role is transferred, and that it is not left to local government, given the scale of the cuts that local government has suffered?
Rosie Cooper: A serious point is being made here: public health is being transferred to local government, and the funds that go with it need to be spent on public health and preventive means. I am worried that councils might use some of the money to do work to which they are already committed. So, yes, they do need support, and we need to ensure that the money they get is spent correctly and wisely. Mobile technology can help to improve public health.
One of the perennial challenges of modern health care is to keep accurate, comprehensive records without detracting from the care-giving process, which is quite difficult. Too often the supposed solutions feel burdensome. As a result, clinicians can sometimes be difficult to engage—in fact, there is a view that sometimes clinicians rarely engage—and the accuracy and completeness of records suffers as a result.
We can show that there are tried and tested solutions developed by and in partnership with NHS organisations that have been shown to work. For example, digital pen-and-paper technology, supported by mobile connectivity, can be used to complete patient records. In turn, that can improve patient safety, care quality and efficiency. That technology is pioneered by Portsmouth Hospitals NHS Trust and allows mums-to-be to keep their paper records as normal, and because the records are made using a mobile-enabled digital pen and paper, the maternity department instantly receives an easily accessible electronic copy of the expectant mum’s paper records. That happens while the midwife is still with the expectant mum in her home. As well as improving safety when mums arrive at the hospital without their notes, the technology’s deployment has brought about real efficiency by halving the time that midwives spend on administration.
As well as solutions that can help health care professionals in the community, we need to recognise that most acute hospitals are large complex buildings that, all too sadly, often span several sites. There is strong evidence that the accuracy of patient records and the quality of clinical decision making may be improved if clinicians record information themselves and have access to it when they are with their patients, rather than leaving the process to administrators who are removed from the care. Realistically, that can be achieved only by making it easier for clinicians to record and access information wherever they are.
I am told that organisations such as University Hospitals Birmingham NHS Foundation Trust are making real progress in mobilising information so that clinicians have real-time, secure access to patient records. The foundation trust is using tablet devices and smartphones to achieve such improvements. As the NHS looks to implement new solutions, we need to encourage people to focus on secure approaches that patients and clinicians
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trust, which means designing privacy into the entire system, with security measures built into mobile devices. We also need reliable connectivity, which is fundamental for effective mobile working. Even in areas with the most advanced mobile infrastructures, bandwidth can sometimes be limited, so it is essential to choose hardware that can switch seamlessly between different mobile protocols and wi-fi connections. Such functionality would minimise bandwidth-related costs. We need to focus on approaches that complement patient-clinician interactions and that make the most of existing technology. Mobile solutions that can be rapidly deployed and that integrate with existing infrastructure would ensure investments that have already been made can be enhanced rather than discarded.
As the former chair of Liverpool Women’s hospital, I know there are now solutions to some of the problems in enabling midwives to spend the maximum amount of time out on the front line. Such improvements are a godsend and enable our professionals to deal with patients efficiently and effectively. I am aware of the Government’s plan to introduce a fund for technology to improve midwifery and nursing care, and I very much welcome that. As the plans for the fund are developed, it is essential to learn from those trusts that have already pioneered new approaches. I ask the Minister, therefore, to meet me and some of the professionals who have been involved in developing the examples I have cited so that he can hear about their experiences. That might help future implementation. The truth is that mobile communication technology will be a core strand in the 21st-century health service. We very much need it, and working together we can deliver for all the people who depend on the health service to deliver their care.
4.45 pm
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): It is a pleasure to serve under your chairmanship, Mr Havard.
It is also a pleasure to respond to this debate, and I congratulate the hon. Member for West Lancashire (Rosie Cooper) on securing it and on highlighting an important focus of future health care policy. She is right to highlight the Nicholson challenge: for the NHS just to stand still and to continue performing at the same level so that patients continue to receive the high-quality care that we all believe and know they deserve, it needs to make £20 billion-worth of efficiency savings and to put that money back into front-line patient care. A key part of the debate is that better IT will improve the way we communicate with patients and keep people well and better supported in their own home and community, on the basis that preventive health care is much better than curative health care, both for the patient and, financially, for the NHS. Of course, I would be delighted to meet the hon. Lady and people involved in the IT industry at a later date to discuss things further.
Although we know that simple things such as in-ear thermometers, improved hoists in hospitals and better-quality equipment in operating theatres has improved the quality of patient care over many years and driven down the cost of providing health care, the hon. Lady is right to highlight the fact that we need to harness and better utilise more modern types of technology such as telehealth and mobile technology to support people better in their own homes and to drive down the cost of care.
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Last week, my right hon. Friend the Secretary of State for Health outlined the NHS mandate, in which he set out the vision for the NHS and addressed some of the key challenges that we face. In her speech, the hon. Lady rightly highlighted that we have an ageing population with many people living a lot longer with long-term medical conditions such as diabetes, cancer, heart disease and dementia. The challenge for the NHS is ensuring that we deliver care in a better way that meets people’s care needs while ensuring that, where we can, at the same time as producing high-quality care, we reduce costs so that there is more money to go around to look after more people.
My right hon. Friend the Secretary of State announced in the publication of the mandate that a real priority for the NHS is to improve the management of long-term conditions by helping people to better understand their conditions and to take control by supporting them to self-care, thereby realising the massive potential benefits offered by information technology both in supporting people to better understand and look after their conditions in the community, and in their own homes, and in supporting, better educating and better looking after the people who look after patients—the carers. That is an important part of providing high-quality health care.
We already know that there are 15 million people with long-term conditions, accounting for some 70% of all in-patient beds. We also know that many such hospital stays could be avoided through better management, including the better use of mobile technologies to prevent people from becoming so unwell in the first place that they need to be admitted to hospital. That would also help to prevent the revolving door of hospital admissions that sometimes happens when people do not necessarily have the support that they need and deserve when they are discharged from hospital, perhaps after a hip operation or similar stay.
Improving access and the quality of health care available to all patients is a key aim for the NHS, not just in meeting the Nicholson challenge but in improving day-to-day quality of care. Increasingly, technology will play a part in that: not just breakthroughs in simple day-to-day medical devices but changes in how we reach people in remote rural settings and in their homes and communities through the use of telemedicine, telehealth and mobile devices. We can and should take advantage of the deeply interconnected nature of modern society to improve people’s experience of health care and significantly increase our efficiency in delivering it.
There are infinite ways in which technology can transform how people access health and social care services. “Digital First”, a report published in July by the Department of Health, estimates that the NHS could save up to £2.9 billion by implementing just 10 simple actions to transform how people access health care. Those savings could be made almost immediately and with minimal investment by making use of existing technologies to reduce inappropriate face-to-face contacts.
There are many examples of simple things that can be done, such as having a doctor or nurse talk to a patient on the phone when they call to book an appointment or as an initial assessment. About one third of patients do not necessarily need a face-to-face GP appointment.
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Such conversations can reassure callers that they are okay and not that unwell, and that perhaps they should see how things go overnight or later in the day and call back if they need further help. They also help the patient access health care in the most appropriate way, as the GP triages the patient remotely.
Texting and e-mailing people to remind them of appointments has already been shown throughout the NHS to reduce the number of people who fail to turn up to their medical appointments. One big challenge in health care is getting patients to attend and comply with treatment, particularly those with longer-term conditions who must make multiple trips to a hospital or care setting. E-mails and texts are an effective way to remind people about their appointments and help educate them, removing the burden from the acute setting by ensuring that they understand how better to manage their conditions.
Those are simple changes, using the technologies that people use every day and are already familiar with, that can free hundreds of millions of pounds and provide more convenient access to NHS services, particularly for patients who live in more remote and rural parts of the country.
Technology can also improve the working lives of professionals. The funds that we are making available to nursing staff will enable them to access information faster so that they can spend more face-to-face time with patients, an important point that the hon. Lady made in her speech. Doctors, nurses and all health care professionals want to spend time looking after their patients. They do not want to be bogged down in paperwork. Technology, whether used on the ward or to access and look after patients remotely via telehealth or mobile technology, is a good way to ensure that front-line health care professionals have more time to do what they want to do and what they are trained to do: care for and look after the sick and patients.
I have seen at first hand the potential of telehealth and telemedicine to transform and save people’s lives. Earlier this month, I visited the telehealth hub at Airedale NHS Foundation Trust, which I know is on the other side of the Pennines from the hon. Lady’s constituency, but I am sure she will not mind my using it as an example. The hub is staffed 24 hours a day, seven days a week, by skilled nurses specialising in acute care. A consultant is also on hand if needed.
The aim of the service is to care for patients closer to home and keep them there whenever it is safe to do so. In other words, it ensures that people are properly supported and well advised in their own homes and other care settings, such as residential homes, so they do not become as unwell as they might otherwise. They are given appropriate health care advice, guidance and support in their homes and care settings, which helps reduce the burden on acute services in the area. It is particularly important in more rural areas, where the distances that professionals must travel to look after patients are so great that the only effective way to get around to as many patients as possible, in both financial and human care terms, is to use the benefits that telehealth brings to Airedale and the surrounding areas.
Evidence suggests that many patients are admitted into hospital when, as we have discussed, that is not always the best environment or the most appropriate place for them. Using telemedicine allows patients to manage their conditions with the hospital’s support.
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It can prevent time-consuming, costly trips to hospital for outpatient appointments. The patient’s GP is instantly informed and kept up-to-date about any consultations that occur via the telehealth care hub.
Importantly, the Government do not want such initiatives to take place in isolation. We believe, as I know the hon. Lady does, that we must ensure that they become day-to-day occurrences in the NHS as the years go on. Technology and the better use of information provide immense opportunities for improving the quality and accessibility of NHS care, not just in remote rural settings but in every care setting that we can think of.
The Government’s information strategy for health and social care, “The Power of Information”, is another example that highlights the importance of harnessing innovative new technology and delivering better health for patients. The strategy, of which I know the hon. Lady will be aware, was published in May, setting out ambitions for people to be offered online and mobile access to records, electronic communication with professional teams, online health and care transactions and the ability to rate services and provide feedback about how effective and convenient they were for the patient.
A small number of actions will need to be led nationally, such as setting common standards to allow information to flow effectively around the system. More detailed implementation planning will be led by organisations including the NHS Commissioning Board to ensure that current good localised initiatives in different parts of the country are rolled out nationally. We learn from areas such as Airedale, where looking after people in their own homes through the better use of technology is going well. Those examples should be rolled out to become the norm in the NHS. I know that the NHS Commissioning Board will be central to driving that through, which is why improving information technology was at the heart of the NHS mandate launched last week.
Mainstreaming assistive technology across the NHS is particularly important. As we have discussed, it is not good enough to have high-quality localised initiatives; we need a systematic, NHS-wide approach that embraces technology. My right hon. Friend the Secretary of State for Health announced at the Age UK conference last week that plans have been agreed that will ensure a further 100,000 people will be supported by telehealth
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in 2013, a sixteenfold increase in the number of people being helped by telehealth and telecare. It will make Britain the largest market in the world behind the USA, which is something that we can all be proud of.
The recently published results from the whole system demonstrator programme are potentially game-changing. We now have robust academic and scientific evidence that such technology can drive improvements not only in quality and value in the NHS but in patient satisfaction levels and outcomes. We all know that the most important people in all these discussions are the patients whom the clinician looks after and the telehealth provider wants to look after. Importantly, when we are designing telehealth services, like all other NHS services, we need feedback from patients in order to ensure that where services are working well, they can be rolled out elsewhere in the NHS, and that where improvements could be made and things are not going so well for patients, the NHS can learn from that and adapt technology to improve care in future.
At the Age UK conference last week, my right hon. Friend the Secretary of State announced some significant steps on the road to supporting the 3 million people who stand to benefit from telehealth and telecare by 2017. As the hon. Lady said, the key is improving care for older people. They are the biggest users of NHS services, so they will see the most immediate changes and feel the most immediate benefits from telehealth. We have a growing elderly population and growing numbers of people with multiple long-term conditions. In order to meet the challenge of looking after them properly and providing dignity in elderly care, we must ensure that we keep them well at home and in their communities. One significant part of the answer is doing more for telehealth. The Government are well on the road to doing so. I welcome further discussions with the hon. Lady about what more we can do to look after people, particularly the frail elderly, in their own homes.
Mr Dai Havard (in the Chair): Thank you, Minister. I am sure that you will have interesting discussions with your colleagues in the devolved Administrations about interconnectivity as well.