My final point is about the interface between users and the Government, and the requirement for feedback and for the Government to realise what the reality is for users on the ground. It is vital that Government initiatives

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fulfil their goals. Advice, support and assistance for small businesses particularly could help to transform the manufacturing sector. SMEs, however they are defined, are the great growth area for employment. They are the backbone of local economies, and they can be the engine for growth in our economy.

I look forward to hearing other contributions and what the Minister has to say about his views and intentions in supporting the world of manufacturing SMEs.

2.54 pm

Mr Adrian Bailey (West Bromwich West) (Lab/Co-op): It is a pleasure, Dr McCrea, to serve under your chairmanship. I congratulate the hon. Member for Carlisle (John Stevenson) on securing this debate and the cogent and well-reasoned way in which he spoke. There was very little to disagree with. I will keep my comments brief as quite a number of hon. Members want to speak. It is a reflection of the importance of the matter across parties that so many hon. Members want to contribute.

In the past couple of weeks, there has been euphoria about manufacturing. There has been a revival, but we must put that in context because the current level is below what it was in 2010, when it was described as a disaster. There are welcome signs of a significant upturn that might be sustained, but the situation is still not good.

In so far as it is possible to discern what has provoked the sudden surge in confidence and production, it is led partly by an increase in confidence in the housing market, which is rising largely because of the funding for lending scheme, and an improvement in exports. Both are welcome, particularly the increase in domestic construction in the housing industry. However, exports are particularly difficult at the moment with the problems in the eurozone, although there are welcome signs of revival. There is a danger in basing a rise in domestic consumption and confidence on a housing boom that may be temporary and is fragile. Many of the criticisms levelled at the previous Government were that consumption was based on that.

I will not reiterate our debates at that time, but although there is a welcome revival, the long-term sustainability of a manufacturing industry must be based on two things, or three if exports are included. First, a sustained and rising standard of living domestically will underpin demand for manufacturing products in this country. Secondly, an appropriate level of investment in the manufacturing industry in the private sector will ensure that we remain competitive, that value is added to improve exports and our domestic consumption, and that cheap foreign imports are resisted.

The hon. Member for Carlisle rightly outlined investment issues. The funding for lending scheme is generating confidence in the housing market, but the indications are that, like the enterprise finance guarantee scheme and other well-intentioned Government schemes designed to boost bank lending to small business, that is not yet happening. When I talk to banks about that, their reaction is that they want to lend and they have the money but companies will not come forward. When I talk to companies, they say that they do not have the confidence to invest because of the current economic situation.

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The recent improvement in confidence may stimulate further demand from small manufacturing businesses, and may make the banks look differently at the risk parameters on which they base their loans and improve bank lending.

Mr Blunkett: I will not detain the Chamber long. Surely one of the difficulties with the enterprise finance guarantee scheme—which, in theory, is an extremely good idea—is that many major banks are asking of small businesses, and particularly of the owners, far more than they can give in personal guarantees, given that the banks can recover not only from the individual owner, but the 75% from the guarantee scheme, if they believe that the business is no longer viable. I think that the term is the “going west route”, whereby the banks end up owning the business. That is bound to put the fear of God into entrepreneurs, no matter how brave and confident they are.

Mr Bailey: My right hon. Friend raises a valuable point. I talked about the risk profile. A huge body of evidence demonstrates that banks are excessive in the security they demand in order to lend to businesses, and that is one of the main barriers to businesses wanting to apply for loans. If there is a criticism of the Government, it is that while the Government have provided cheaper money for banks to lend to businesses, I do not think that has addressed the obstacles that are far more significant in terms of getting the money out where it is needed, into investment in small businesses.

Caroline Dinenage: Will the hon. Gentleman give way?

Mr Bailey: Certainly. I have to give way to my colleague from the Select Committee on Business, Innovation and Skills.

Caroline Dinenage: I apologise for interrupting the hon. Gentleman’s brilliant speech. Does he agree that it is also up to the local community to look at ways in which they can help businesses grow and invest? In my area, the local newspaper, The News, made a regional growth fund bid, which they used as a “bridging the gap” fund for small start-up businesses and those that wanted to grow, as a way of helping them to get access to the finance that they needed. Will the hon. Gentleman join me in welcoming that sort of initiative?

Mr Bailey: I certainly join the hon. Lady in welcoming that. In fact, one of the unintended, beneficial by-products of the problem has been the resourceful and inventive ways that communities and businesses have got together to overcome it. Peer-to-peer lending is an example of that. In my area, we have the Black Country Reinvestment Society, with which my fellow west midlands MPs will be very familiar. However, the scale of the entrepreneurial alternative lending sources still does not match what is needed for our manufacturing base as a whole.

I turn to a specific issue that applies not only to my constituency, but to the whole of the west midlands and the black country—other west midlands MPs may refer to this, too. First, I pay tribute to the Tata brothers for their investment in Jaguar Land Rover, which, I think it is fair to say, has transformed manufacturing prospects

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in the west midlands in a way that we have not known for 30 years. It is an indication of the value of our relationships with the Indian subcontinent and that growing market and growing access of capital, and of the historic association between the Indian diaspora in this country, and of course, the native India.

Jeremy Lefroy: I entirely agree with the hon. Gentleman. It is also testament to the wonderful co-operation between Wolverhampton city council and Staffordshire county council, which, together, put £40 million forward to build a motorway junction on the M54, without which that project might not have been able to go ahead.

Mr Bailey: I pay tribute to both of them. All the players in the i54 development on the borders of Staffordshire and Wolverhampton deserve credit for the united way in which they have seized the opportunity. For the benefit of non-west midlands MPs here, it is a huge expansion in the engine production capacity of JLR that will result in 1,400 jobs. It has really transformed the supply prospects of foundries in the area. In that context, I would also mention the £45 million that the Tata brothers have invested at Warwick business school’s centre for research and innovation. Collectively, they have transformed the prospects for manufacturing in the west midlands.

My constituency still has the highest number of foundries—I think—of any constituency in the country, but there are plenty in the surrounding areas as well. The prospect offered to them of being part of the supply chain to Jaguar Land Rover is very significant. In the regional growth fund applications, there have been a number of successful bids from JLR and companies locally. However—I mention this to the Minister, because it highlights some of the problems that we have with the support that the Government give industry—I understand from the Cast Metals Federation that the engine blocks for the new Jaguar Land Rover development at the i54 will have to be made in Germany, because there is not, would you believe it, the capacity for foundries to produce them locally.

I also understand that Jaguar Land Rover is happy to look at repatriating some of its supply chains, where it has to source from abroad at the moment, but obviously, that will depend on the capacity of local SMEs to deliver. Despite all the Government sources of support, the regional growth fund and the grants that it has given, a crucial gap still remains in the potential economic benefits that will accrue to the west midlands because of the failure to secure this vital market. Aluminium engine blocks for that development will be crucial.

The Society of Motor Manufacturers and Traders has identified something like £3 billion-worth of potential extra business in the supply chain—if the Government and the industry can get together to maximise that potential. Although I do not condemn any of the attempts that have been made to provide finance for business and for SMEs so far—but certainly with the regional growth fund, there are all sorts of issues relating to length of time and so on—I ask the Minister to look at working with the Automotive Council to develop some sort of package that would enable the existing gaps in provision to be filled. The potential benefits, both for regional policy and for our overall national economic situation, are absolutely enormous.

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I have spoken for longer than I intended, partly because I have taken interventions, so I will cease my remarks with that plea to the Minister.

Dr William McCrea (in the Chair): Six Members from Government parties desire to speak before we have the wind-ups, and there are 32 minutes before those commence. I therefore ask for Members to be considerate to their colleagues in order to allow them to speak, if possible.

3.8 pm

Caroline Dinenage (Gosport) (Con): It is a pleasure to serve under your stewardship, Dr McCrea. I join others in congratulating my hon. Friend the Member for Carlisle (John Stevenson) on securing this important debate and on introducing it in such an insightful and thorough way.

I should probably start by declaring an interest. I have been the owner of a small marketing business since I was 19 years old, which is sadly many more years ago than I would care to admit. I would like to echo my hon. Friend’s comments in welcoming the current resurgence in UK manufacturing. It is great news that after a debt-fuelled boom and bust, our economy is finally starting to rebalance, with manufacturing and exports playing an important role in our recovery.

The latest data show that we have seen the biggest jump in output and new orders for almost two decades. That is great news for Britain, but there is no room for complacency. Speaking as a business owner, I would say that the key things the Government need to facilitate to allow other small businesses to flourish are: a skilled work force, the availability of finance, a solid infrastructure, ease of access to both domestic and international markets, and the reduction in red tape and bureaucracy.

While I support the many steps the Government are taking to boost access to finance, and there has definitely been a marked improvement, many businesses, sadly, still find it difficult to obtain credit. A concern all too often voiced by local business owners in my constituency is that, despite their best efforts to weather the economic storm, and no matter how thriving their order book, the failure to secure meaningful credit and the regular hits to their cash flow that result from late payment leave them on the brink of collapse.

I am still concerned about the regulatory burden on small and medium-sized businesses. The country’s 5 million SMEs provide 60% of jobs and generate more than 50% of GDP, and we must do everything we can to ensure that their chances of growth are not strangled by bureaucracy. I therefore welcome the work the Government have done on cutting red tape; indeed, through the red tape challenge, they have committed to scrapping, improving or simplifying at least 3,000 regulations. The one in, one out rule has saved businesses about £1 billion in regulatory costs, and I am glad it has been stepped up so that it is now one in, two out, although I will resist any pressure to enforce that in my shoe cabinet.

My particular bugbear, and one area where we still need to see progress, is the procurement of Government and other public sector contracts. That is one thing I know about, because, as I say, I have owned a business for more than 20 years. The paperwork involved in trying to get considered for a Government contract can

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still be overwhelming. The tendering process for private sector contracts is still significantly less complex than for public sector contracts.

Although I warmly welcome the scrapping of many of the pre-qualification questionnaire requirements, as do businesses in Gosport, there is still room for such processes to become even more efficient. John Allan, the chairman of the Federation of Small Businesses, quotes research showing that only about a fifth of SMEs have bid for public sector contracts in the past year, in large part because it simply is not worth the effort and because of the intrusive amount of company information that needs to be supplied. A contract my business recently looked at bidding for required financial details of not only my company, but every company I was thinking of subcontracting to, which is hugely bureaucratic for a small business. There is still more to do on this issue.

Our SMEs are the drivers of prosperity in this country, and we should give them every opportunity to overcome obstacles and to expand. I welcome the Cabinet Office announcement in August that there will be a shake-up in Whitehall procurement and that the Government want to loosen the grip of an oligopoly of large suppliers and let in more SMEs. However, we must do more to cut bureaucracy in the application process. As we move from rescue to recovery, our economic success depends on a vibrant, innovative private sector.

That innovative private sector must have the Government’s backing when it develops new and exciting products. The Government rightly take great pride in our country’s innovation, and they invest heavily in R and D; indeed, globally, we are second only to the US in terms of our scientific knowledge base, but we slip down the chart when it comes to turning that innovation into economic prosperity and jobs. The Government’s enthusiasm for helping to develop new ideas is, sadly, not matched by an enthusiasm for buying the results. Unless we become earlier adopters of innovation, British R and D tax credits will continue to deliver German and American manufacturing jobs and profits, as those countries invest in making the things that originate in Britain.

SMEs are often cited as the lifeblood of our economy. We must match those words with action and eradicate the lethargic culture of bureaucracy, which sometimes clogs the procurement process and holds back British business. We must celebrate all that the Government and business, working together, have done in that regard, and we must ensure that SMEs continue to flourish.

3.13 pm

Mr David Ward (Bradford East) (LD): I will do my best to finish within five minutes or so, Dr McCrea.

Bradford is promoting itself as a producer city, but the truth is that it never ceased to be one. It sits alongside many other northern cities, including places such as Carlisle, and I congratulate the hon. Member for Carlisle (John Stevenson) on calling the debate; indeed, I thank him for doing so, because we cannot have enough debates on this subject, which is crucial not only to local communities, but the national economy.

As I said, Bradford never really stopped being a producer city. It suffered dreadfully in the 1980s recession, which almost decimated the city. Bradford did not

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always focus on textiles; it was, of course, the wool capital of the world, and it was a fabulously wealthy place. However, its manufacturing and engineering were devastated in the 1980s.

None the less, Bradford is still a producer city. Although we still lost 15,000, or 40%, of our manufacturing jobs during the 60-odd consecutive quarters of growth from 1998 to 2008—the golden years, in many ways—Bradford still exists, and it is a cruel rumour that Bradford is no longer a producer city. Some 1,200 manufacturing SMEs still provide employment for 15,000 people in the Bradford district.

With others, I recently set up the all-party group on textile manufacturing, because it is important to tell people that manufacturing, and particularly textile manufacturing in places such as Bradford, still exist, and spinning, weaving and scouring continue on a massive scale. There are no longer 2,000 people coming out of Salt’s mill or Lister’s mill, but many small businesses, particularly in the manufacturing and engineering industries, continue to thrive.

I wanted to speak in the debate because of two contrasting stories picked up in this week’s Yorkshire Post. The first concerns manufacturing. There is a really good story to tell across the whole Yorkshire region. The purchasing managers index for the latest quarter is 57.2, which is a staggeringly good figure. The previous figure—55—was thought to be really good. Fifty is what separates growth from decline; at 50-plus, however, we are talking about exceptional performance, so this is a really good story.

The paper carried out a survey, which tells us that employment has increased for the fourth month running, while output has risen at the fastest pace since July 1994. In addition, the paper included a Barclays survey showing not only that there is growth in output and employment, but that businesses have a real intention to invest for the future, with 54% planning to increase investment over the next 12 months. Some 63% plan to invest in new machinery, 62% plan to invest in new product development and 42% plan to invest in furniture, fixtures and fittings, and buildings. That is all really good news.

What, though, are the contrasting stories? On the same day, the Yorkshire Post included an article headed, “Optimism dims in the small business sector”. According to the article, a survey of 500 UK firms showed that most small businesses

“were still having problems accessing finance despite the introduction of lending schemes.”

A further article in the same paper, on the same day, was headed, “Funding plan still failing to help SMEs”. It says that although the Bank of England lent £1.6 billion through its funding for lending scheme in the last quarter, which is really good news, the bad news is that lending to SMEs continued to fall, shrinking by a net £583 million. The article continues:

“The scheme was revamped in April in a bid to boost the flow of credit to small businesses. But bank loans to SMEs shrunk 2 per cent during the quarter on a year earlier.”

Those are the two contrasting stories. We are all really excited about one, which is about the renaissance in manufacturing. That renaissance is taking place not

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just in certain sectors or certain parts of the country, but across the piece. It is showing itself strongly in domestic output, customer numbers and exports; that is the good news story. The worrying factor is that that is not getting through to our small manufacturing and engineering businesses, and they are still struggling. Despite Government schemes to provide finance for those businesses, they are waiting, their energy is pent up and they are ready to explode, but they are being held back by a lack of finance. The money is there, but it is clearly going to the bigger companies, which can always access finance from other sources. The companies that critically need the finance to enable them to carry out the investment intentions I mentioned are simply being denied it. Whatever the reasons for that, we need to crack this nut if these companies are to achieve their full potential and we are to carry out the rebalancing of the economy we are all so desperate to achieve.

3.19 pm

Jeremy Lefroy (Stafford) (Con): It is a pleasure to serve under your chairmanship, Dr McCrea, and I congratulate my hon. Friend the Member for Carlisle (John Stevenson) on securing this welcome debate.

Government support for business has always been crucial. My first job was as a production foreman at Ford Motor Company in Bridgend, a plant brought to the UK under Prime Minister Jim Callaghan in the late 1970s. I am glad to say that that factory has expanded since then; it is one of the largest engine factories in Europe, if not in the world, and is still exporting around the world.

In Staffordshire and Stoke-on-Trent there has been strong Government support for manufacturing business—for instance, through the regional growth fund to Alstom in my constituency, which has become a world leader for research in high-voltage direct current manufacturing. The hon. Member for West Bromwich West (Mr Bailey) earlier mentioned Jaguar Land Rover on the i54 site on the edge of Wolverhampton and South Staffordshire. South Staffordshire council has played a major role in that, and that was a great example of co-operation between government and the private sector.

However, that is all about the largest companies, which have access to the Government. We really want to talk more about smaller projects and companies. We have already heard talk about procurement, and how Government procurement from SMEs has increased substantially under the present Government. There is still a long way to the 25% target, but I welcome that progress.

My hon. Friend the Member for Gosport (Caroline Dinenage) talked about oligopoly in procurement. It is not just in manufacturing companies; among service companies it seems that the Government will procure only from a very small number. For instance, there are the big four consultancy firms. In my constituency, health administration is being carried out by Ernst and Young. I should prefer some specialist medium-sized consultancies to do that work if, unfortunately, it should become necessary for a Government to procure it.

We have heard about training and apprenticeships, and the 21.5% increase in engineering and manufacturing technology apprenticeships starts in the past year. However, there is still reluctance from smaller firms, as they do

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not necessarily have the facilities or expertise to allow those apprentices to start. I welcome the idea of training networks, which could operate under the employer ownership pilots that BIS has started in the past year. I look forward to more of that, with small businesses taking advantage of the facilities and expertise of larger manufacturing businesses in their area.

We have also heard about the supply chain in the debate. Yes, that is an area where small businesses can do things for each other, but there is an increasing realisation of the benefit of having suppliers on the doorstep. The previous Government supported programmes in relation to the automotive sector supply chain, and the present Government are considering the aerospace sector in that regard. I should like to know from the Minister whether there are plans to consider other sectors—and to bring major sectors’ supply chains back into the UK.

I want to spend a little time discussing exports. There has been an increase in the services offered by UK Export Finance. Indeed, just this week BIS announced a direct lending scheme of £1.5 billion under UKEF, in which foreign buyers can get access to support to buy UK products. It is the first time that that has happened, and I encourage all hon. Members to point it out to exporting companies in their constituencies.

UKEF is still very much focused on large businesses, although I was glad to see from its last report that it was used to enable British companies to export, for example, cheese to Greece, a hospital to Ghana and tractors to Israel. However, those were the exceptions rather than the rule. UKEF tends to be dominated by Airbus, Rolls-Royce and BAE Systems. That is welcome—we need those exports—but in the past year the total was only something like £4.3 billion, compared with €29.1 billion under the Hermes scheme in Germany. Under that scheme, Kenya had €156 million of credit, South Africa had €461 million and India had €1 billion. Those are all developing countries, to which our businesses need to export.

I shall cut my remarks short, because colleagues want to come into the debate, but I reiterate what has been said so many times about the importance of the availability of long-term, patient capital and equity finance. It is ironic that Britain has a major institution that deals with that, which has nearly £3 billion of investments throughout the world, in some of the most difficult situations in developing economies—it is called the Commonwealth Development Corporation—but that we do not have a similar development corporation for some of the more challenged areas in our country.

3.25 pm

Chris White (Warwick and Leamington) (Con): I thank my hon. Friend the Member for Carlisle (John Stevenson) for securing this important debate and giving us another opportunity to discuss this topic, as we have done over many years.

One of my concerns, given the welcome news about the upturn in growth in the UK economy, is that politicians—and we are politicians in this Chamber—may move away from a focus on manufacturing and the good results that it could produce for the rebalancing of the economy. We could move back to property booms and financial services, which I think all those present

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would agree would be a very bad thing. We have a window of opportunity to establish policies to get manufacturing growing strongly once more.

The key is small and medium-sized businesses. The Government need to take steps now to prevent manufacturing from being neglected as growth returns to the economy. They need to ensure that incentives are set up for lenders to support our manufacturers, rather than pouring investment into quick returns in sectors such as property or financial services.

One of the simplest and easiest ways to get support to those manufacturers is through changes to capital allowances. The Chancellor rightly increased the annual investment allowance, which will enable them to upgrade plant and equipment in the next two years. However, if we are to attract more significant manufacturing activity, and enable small and medium-sized businesses to integrate into supply chains, we need to make the capital allowance structure more competitive, and encourage larger manufacturers to base themselves in the UK, which will in turn help the small and medium-sized businesses.

According to the Oxford university centre for business taxation, the present value of capital allowances as a percentage of cost for capital investment is just 46.5% in the UK. That is lower than in Japan, Germany, the United States, Turkey, France, South Korea and virtually all our major competitors. It makes investing in the UK far more expensive for manufacturing businesses than it is elsewhere, and we should not be surprised that, despite a strong skills base and depreciation in sterling, manufacturers are still not flocking as quickly as they might.

Like the rest of the economy, manufacturing is an ecosystem that requires diversity. To increase the number of small and medium-sized manufacturers, we need to increase the number of larger manufacturers in the country, to create resilient supply chains that can weather global economic storms. That, I think, is the key to what has happened in Germany and the United States. We should not ignore small and medium-sized manufacturers while we go about it, but we will need to continue a generous regime of investment allowances for the businesses in question, so that they can compete and provide a base on which large manufacturers can build supply chains.

Another area where we can help businesses is through the availability of skills and apprentices. There has been a fantastic, massive surge in apprenticeship applications in the past 12 months, but manufacturing and engineering are still not the main destination. Business administration, child care and customer service are still the three most popular areas. Perhaps that has something to do with the image of manufacturing in society, which those present for the debate are trying to help to promote.

A way to combat the current situation might be through the creation of apprentice training agencies, similar to those deployed in Australia. Apprenticeships are advertised by the agencies, which then hire them out to small and medium-sized manufacturers. The agencies take on the burden of administration, payroll support and supervision costs, and merely charge the manufacturers something similar to normal agency costs. That will hopefully boost the supply of labour to SMEs and potentially attract young people to work with the companies in the long term.

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We need to put policies in place in the next few years so that we have an economy that does not just return to business as usual but is robust, creates sustainable jobs for the future and has manufacturing as one of its key pillars.

3.29 pm

Graham Evans (Weaver Vale) (Con): It is a pleasure to speak under your chairmanship, Dr McCrea. I add my congratulations to my hon. Friend the Member for Carlisle (John Stevenson).

I am deeply proud of Weaver Vale’s huge range of manufacturing enterprises. I personally spent more than 20 years working in manufacturing, starting off at BAE Systems making RAF Nimrods. I am delighted that EEF has announced that the domestic market is at its strongest in almost three years and export sales are at a two-year high. That marks a significant growth in confidence and provides some reassurance that the industry is on the right track. However, although that shows a short-term improvement, it is set against the long-term trend that has seen manufacturing’s share of the economy fall from 23% in 1997 to about 10% currently. That sits alongside the Government’s ambitious target to double UK exports to £1 trillion by 2020—manufacturing currently makes up about half the market. I would be interested to hear my hon. Friend the Minister’s opinion on that and whether he thinks that this country could once again have 20-odd per cent. of its GDP based on manufacturing.

How do SMEs fit into that pattern of ambition and decline? In 2012, SMEs—defined as companies with fewer than 250 employees—made up 99% of all manufacturing businesses, with a turnover of £167,455 million, less than a third of the whole industry’s turnover. However, not all SMEs are created equal. Clearly, the needs and capacity of a 249-employee company are very different from those of a nine-employee company. In 2012, there were 203,000 manufacturing business with nought to nine employees, which made up 88% of manufacturing businesses and 96% of all businesses in the UK.

What can we proactively do to support SMEs? There are two clear lines of support which could and should be better developed. Research and development is key to the UK’s manufacturing future. Manufacturing is responsible for three quarters of business R and D. That is a staggering amount and a credit to our world-leading universities and work ethic. The flexibility, adaptability and innovation of SMEs make them perfect leaders of R and D. To ensure our place in the world market, we need to be able to provide financial, research and trade support to SMEs at this crucial time.

First, we should consider finance. Simply put, without strong, reliable and consistent funding, we cannot expect SMEs to grow and thrive. There are some strong incentives to help SMEs involved in R and D. From April 2012, the tax relief for SMEs is 225%. For every £100 of qualifying costs, corporation tax is not paid on an additional £125 income that would be liable for corporation tax. It is worth noting that HMRC has extended its definition of an SME to companies of under 500 employees.

I have spoken previously in the House about the German political infrastructures set up to nurture industry and especially the Mittelstand—small and medium-sized

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companies. Foremost among those tools stands KfW, the state-backed bank that ensures that the Mittelstand can access funding, even when the commercial banks are unwilling to lend.

Certainly Government schemes such as the advanced manufacturing supply chain initiative and the high-value manufacturing Catapult, which is designed to bridge the gap between early-stage innovation and manufacturing, are helpful, but they do not address the industry’s concerns about simple access to finance. The right hon. Member for Sheffield, Brightside and Hillsborough (Mr Blunkett) ably pointed that out earlier.

Secondly, with 71% of manufacturers planning innovation to export to new markets and 73% planning to bring new products to the market, they require not only funding but research collaboration. I welcome the work of the Technology Strategy Board’s Catapult network on high-value manufacturing, which brings together SMEs and industrial investors to work together on the centre’s core research and on their own challenges and the knowledge transfer partnership. That form of business/research collaboration speeds up innovation. It is a credit to the Government that 62%—up from 44% in 2010—of manufacturing companies are now engaged in work with research institutions. I have seen that in action at the excellent Daresbury science and innovation campus in my constituency.

Once development has been completed, UKTI must take the innovations and provide a clear and supported route to market. I welcome the £70 million increase for UKTI and I believe that it is the role of those in this House to push the manufacturing agenda to the forefront of campaigns such as the GREAT campaign to demonstrate our unique and innovative industry to key and emerging markets.

It is clear that we need a blueprint for the long-term future of the manufacturing industry and especially SMEs that goes beyond general commitments to industry as a whole. That is why we are all waiting with bated breath for the report of the Future of Manufacturing project, which will set out the long-term future of the manufacturing sector to 2050. It is due in the next few months. I sincerely hope that much of what has been discussed today will feed in to that report in order to help to ensure that the powerhouse that is SMEs in the manufacturing industry is properly supported.

3.35 pm

Richard Graham (Gloucester) (Con): It is a joy to join the debate rightly won by my hon. Friend the Member for Carlisle (John Stevenson). The discussion of manufacturing has gone on for some years and will go on, because it is so important to all of us. It is especially important in constituencies such as mine, Gloucester, where making things has been what the city is all about. We are in fact arguably the bellwether for what happens to British manufacturing, because the narrative, as many hon. Members have noted, is a story of decline and recovery, and now the challenge is how to take it to the next chapter of success. My constituency, as a bellwether, is one to which my hon. Friend the Minister will want to pay attention. We make things, whether for the aerospace sector, the oil and gas sectors, nuclear power, consumption, health, dentistry or container ports; and when we export tea to China and valves to offshore Australian pipelines,

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the Minister will want to sit up and take notice and, indeed, come to visit the great city of Gloucester as soon as possible to see what can be done in modern manufacturing.

The story of decline we will gloss over, except to note that by 2010 new apprentices were virtually extinct in Gloucester. The specialist Gloucester training group was down to 20 engineering apprentices in one year. Small engineering companies were almost dying on their feet. Science was disappearing from school exams, and 6,000 jobs in business had been lost during the 13 years of the previous Administration.

Today, the story is rather different. We have created 2,000 new jobs in business—not all of them in manufacturing, but many—and last year alone 1,240 new apprentices started in our city. Nationally, of course, manufacturing is now going through its fastest growth, in terms of order books, for more than two decades. The output index is the highest since 1994, and non-EU exports have risen by 10% according to the latest figures. The rebalancing is full steam ahead, but we must not run ahead of ourselves. There is still much more reinvestment to be done to see a sustainable increase in manufacturing. We need confidence to spread more widely across the country and in manufacturing businesses, and of course we need banks to provide support and schools to give more time for manufacturers to tell their story and inspire youngsters.

I believe that the Government have played a useful role. I am thinking of what they have done on corporation tax, on capital allowances, which my hon. Friend the Member for Warwick and Leamington (Chris White) mentioned, on R and D and on apprenticeships, and about the renewed focus on engineering and sciences. All those things, linked to steps taken by my right hon. Friend the Secretary of State for Education on careers advice, have helped. They have been a stimulus to our manufacturers, who now have greater confidence than they used to and can see that this is a Government, finally, who are backing manufacturing and urging them to help with the rebalancing of the economy, which was so badly needed, away from finance, public service and property.

There is still, though, as I mentioned, much more to be done. As individual MPs, we can do our little bit. We can, for example, take on our own apprentice. I am delighted to pay tribute to my apprentice, Laura Pearsall, who has now completed her two-year apprenticeship with me, got her NVQ level 3 in business administration and won a good job in business. Clearly, that is not manufacturing, but manufacturers can also take on apprentices in non-manufacturing subjects, such as business admin. I am delighted that, for example, EDF Energy, whose operational headquarters for its nuclear power stations is in my constituency, now has apprentices working in finance, human resources and a variety of other sectors that are not directly running nuclear power stations.

We can also help by working with the media and our further education colleges. I congratulate Gloucestershire Media and Gloucestershire college, which were the first to launch the 100 apprentices in 100 days challenge, which so many regional newspapers have taken up. They went on to get places for 100 apprentices from companies that had never had them before. They have given huge support to the rebalancing of our economy and supported manufacturers by giving them a platform

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of encouragement. We can also help to create or support apprenticeship fairs and jobs fairs to highlight the opportunities in manufacturing. I have helped support three apprenticeship fairs and created seven job fairs in the past three years, and there will be much more to do over the next two years.

We can create job sections on our websites, highlighting opportunities for youngsters in manufacturing and other sectors. We can encourage all our employers to take more young people into manufacturing through apprenticeships. We can create export clubs and organise events with UKTI. We can invite Ministers to proselytise and give further encouragement. The Minister’s predecessor did that successfully at Kingsholm, and I invite the current Minister, who is full of enthusiasm, to come and encourage our businesses, many of which are micro-business and manufacturing subcontractors, such as the 500 members of the Gloucester branch of the Federation of Small Businesses. I am delighted to say that its chairman, Mark Owen, is leading from the front by taking on his first apprentice. We can also visit manufacturers ourselves, and help them to expand by assisting with council problems of additional space, parking and other local issues. There is much that we can do.

I finish by congratulating my hon. Friend the Member for Carlisle on securing the debate. I welcome the measures the Government are taking. I salute the success of our manufacturers and urge them to use their capital balances to invest more in new plant and equipment. I urge large manufacturers to look at their supply chains, our schools to engage with manufacturers, and our Ministers to help manufacturers that went abroad to return to Britain with help from the regional growth fund and local councils through waiving business rates for a period, so that we may see the brands “Made in England” and “Made in Gloucester” thrive and expand.

Dr William McCrea (in the Chair): Before I call the next speaker, may I thank all Members for the discipline shown, led by the excellent example of the hon. Member for Gosport (Caroline Dinenage), in allowing everyone who desired to do so to get in to the debate? I now have the pleasure of calling Iain Wright.

3.41 pm

Mr Iain Wright (Hartlepool) (Lab): Good afternoon. It is a pleasure to serve under your chairmanship, Dr McCrea. I join others in congratulating the hon. Member for Carlisle (John Stevenson) on securing this important debate. I am pleased that there have been so many contributors to a well-informed and consensual debate.

It is clear that manufacturing matters to this country and to the House. Indeed, manufacturing is essential to any advanced economy that wishes to maintain or enhance its living standards. An effective manufacturing policy, based on innovation, is the means by which productivity and wage rates will grow. It is equally clear from listening to hon. Members’ contributions that in every corner of the country we have dynamic, enterprising manufacturers—Mallinson Fabrications in Carlisle or Burgon and Ball in Hillsborough, among others—keen to expand, export into new markets, invent new products or processes and employ more people. An effective and proactive industrial policy will ensure that Government can work with industry for the long-term and tap into that huge potential.

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We warmly welcome recent increased output in manufacturing and order books, and the Opposition will encourage any sign of recovery. There is a long way to go however: manufacturing output remains 10% below pre-crisis levels and is still performing below the wider economy, which is 3% off its peak. Despite the positive news, manufacturing is still expected to contract by 0.5% this year. Despite the good news, we are not seeing the much-vaunted march of the makers that the Chancellor promised. Will the Minister comment on that and on today’s news that the World Economic Forum’s global competitiveness report shows that we have slipped down the competitiveness rankings from fourth to seventh and down the infrastructure rankings from fourth to 28th? It is a long-term concern for the productivity and innovation of our manufacturing base, so will he comment?

Every Member who spoke mentioned access to finance. It remains the most significant barrier to manufacturing businesses’ growth. Every initiative the Government have attempted to put in place, from Project Merlin to funding for lending and from the national loan guarantee scheme to the enterprise finance guarantee, has failed in its objective. Net lending to businesses has contracted in 21 of the past 24 months. Commenting on the funding for lending figures, Dr Adam Marshall, director of policy at the British Chambers of Commerce, said that

“the credit environment is not where it could or should be, and many dynamic, new businesses are still struggling to find the funds they need to fulfil their growth potential….A fully functioning Business Bank is essential to plug this gap, but it must be delivered with greater urgency and scale than is currently being proposed by the government.”

Will the Minister comment? Businesses are not confident that the Government’s business bank will help them. A recent survey by Bibby Financial Services showed that only 6% of small and medium-sized businesses believed that the business bank would benefit their firm. David Petrie, head of corporate finance at the Institute of Chartered Accountants in England and Wales, of which I am a proud member, stated:

“The proposals put forward don’t appear to address the needs that businesses have and the finance gaps that exist. It is shaping up to be a missed opportunity to make a real difference, especially to micro and smaller businesses.”

Will the Minister outline how he will ensure that the British business bank works for manufacturers to ensure that long-term capital is put in place to allow manufacturing firms to innovate and grow?

I think that every hon. Member also mentioned procurement, which can be an effective lever for Government to enhance skills, attract apprentices, improve and incentivise innovation and ensure that we have a resilient manufacturing base. What are the Government doing to ensure that smaller and medium-sized businesses, particularly in the manufacturing sector, benefit from Government contracts?

Mr Andrew Smith: My hon. Friend is making an excellent speech. Will he also ask the Minister whether he saw the report in The Daily Telegraph that quoted research by Opinion Leader? It said:

“Despite efforts to cut red tape and promote competition, only 6pc of small and medium-sized enterprises…believe it has become easier to win public sector contracts”

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in the past two years,

“and 26pc say it has become more difficult”.

Should the Government not explain why they think that is?

Mr Iain Wright: My right hon. Friend makes an excellent point. The article goes on to say that the Government have a target of awarding 25% of public contracts to small and medium-sized businesses, but the figure for 2012-13 is only 10.5%. We are a long way from the target. Is the Minister confident that he will hit the target and ensure that small and medium-sized businesses in the manufacturing supply chain have a chance of winning Government work?

Business investment is the means by which we can enhance and strengthen manufacturing growth, as the hon. Gentleman for Warwick and Leamington (Chris White) mentioned in his thoughtful, well-informed speech. Since 2010, Britain has experienced the biggest fall in investment as a share of national income of any G8 country, other than Italy. We have seen a 0.8 % drop in the level of capital investment. Our competitors, such as Canada, France, Japan, Russia and the United States, are improving their business rates. Most other nations do better than us; according to The Economist, we are ranked 159 out of 173 countries for investment as a share of GDP. We are on a par with Mali.

The situation is not improving. According to last week’s figures from the Office for National Statistics, general investment for quarter 2 of 2013 fell by 4.8% from a year ago and investment in machinery and equipment, which is probably most related to manufacturing, fell across the same period by 3.4%. To improve our competitiveness, our business investment performance must improve. Will the Minister acknowledge that the levels of business investment are unsatisfactory? They are getting worse on his Government’s watch and are inconsistent with the House’s and the country’s aspirations to being an innovative and competitive high-value manufacturing nation. What will he do to ensure an environment of better business investment?

Supply chain resilience is key. Over the past 30 years, with de-industrialisation, we have seen the hollowing out of the UK manufacturing supply chain, and that is hindering the potential of manufacturing and growth. In an excellent speech this afternoon, the Chair of the Business, Innovation and Skills Committee, my hon. Friend the Member for West Bromwich West (Mr Bailey), made that point in relation to aluminium foundings—I think I have that right. He pointed out that the Society of Motor Manufacturers and Traders stated that the lack of an adequate supply base is forcing some vehicle manufacturers, such as Jaguar Land Rover, but also Nissan and others, to limit their activities in the UK to final assembly operations, relying on foreign R and D and component development and manufacture. The Automotive Council concluded that at least 80% of components in vehicle assembly could be sourced from UK suppliers, but at present only about 36% are. There is enormous scope and potential for manufacturing here, and I hope that we can work together in the House to support it.

In that vein, I applaud what the Government were trying to do with the advanced manufacturing supply chain initiative: trying to improve the global competitiveness of UK advanced manufacturing supply chains, by

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supporting innovative projects where the UK is well placed to take a global lead. It is an important initiative, and I want to see it succeed for the good of the British manufacturing base. Will the Minister let the House know how much of each funding round—I think we are up to the fourth round—has been not just allocated but provided to the relevant firm, how much of each round has been spent, and how many jobs have been created or safeguarded?

In the short time I have available, I want to finish on skills. Several hon. Members have mentioned that manufacturing firms are finding it difficult to recruit appropriate skills, and a recent CBI/Pearson survey found that two fifths of employers who required employees with skills in STEM—science, technology, engineering and maths—found it difficult to recruit. The hon. Member for Carlisle placed the issue in the context of demographic changes—more and more workers will be retiring shortly. How are the Government dealing with that urgent issue? Does the Minister believe that recent changes, such as the downgrading of the engineering diploma and the dismantling of impartial information, advice and guidance, provide a co-ordinated, cross-Government approach to business and industrial needs? He straddles the Departments for Business, Innovation and Skills and for Education, so what is he doing to ensure that we have a co-ordinated approach to providing the skills that manufacturing needs?

It has been clear, in what has been an excellent debate, that manufacturing matters to this country as a means of improving our competitiveness and raising living standards. We all want manufacturing to succeed and a Government who support it, and I hope that the Minister can address the concerns raised.

3.51 pm

The Parliamentary Under-Secretary of State for Skills (Matthew Hancock): As everyone has said, this has been a stimulating debate, and I will take away from it several specific points. I will address the points as well as I can in the time available, but I start by saying that I do so in the context of someone who began their career in a small business, albeit a software business rather than a manufacturing one. I understand the difficulty of engaging with the Government—they are a large organisation—and the importance of putting in place an improved environment in which small businesses can succeed in a way that is appropriate to their size and to the amount of time that the people running them have. My hon. Friend the Member for Warwick and Leamington (Chris White) asked whether the return of growth would mean that the Government would stop pushing on measures for growth, and all I will say is that he certainly will not get that from me, or my Department.

The context for the debate is, as my hon. Friend the Member for Weaver Vale (Graham Evans) set out, the sharp decline over many years of manufacturing in the UK, from about 23% to barely more than 10% of the economy, but it is on the rise again. Having the debate this week is good timing because we have the welcome news that data show the sharpest rise in manufacturing orders since 1994.

The current level of manufacturing output is of course below the level it was at before what the Governor of the Bank of England has called the great recession, of

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2008-09, and there is a huge amount to do to recover that ground and go forward, but I think we can all agree that there is a new spirit and vision for the growth of high-tech, high-end manufacturing. Other countries, not least the United States, where energy costs have fallen sharply, partly due to new sources of unconventional gas, are bringing manufacturing back onshore, especially at the high-value end. That is a positive context for the debate.

The hon. Member for West Bromwich West (Mr Bailey) talked about the i54 development and the Jaguar Land Rover project, which I happened to drive past last week—there is a massive amount of building and earthwork going on. The Minister of State, Department for Business, Innovation and Skills, my right hon. Friend the Member for Sevenoaks (Michael Fallon), met Jaguar Land Rover only yesterday to discuss ensuring that we can keep the project moving forward. The links between the different local authorities have been an impressive part of its development.

In the context of the new growth we are seeing in manufacturing, I would be delighted to visit Gloucester and proselytise about manufacturing. I very much look forward to my visit.

My hon. Friend the Member for Carlisle (John Stevenson), who has rightly been congratulated on securing the debate, talked about the definitions involved in the Government approach’s to small businesses. It is important to ensure that we have as simple as is reasonable an approach across Government, and that each intervention is targeted at the right size and sector of business. Broadly defined, SMEs can run from a single-person business up to one employing 250 people. Those are hugely different types of business and we need to ensure that we segment properly.

The links between central and local government are important. Local enterprise partnerships play an increasingly vital role in bringing together local businesses and local authorities and providing a link to central Government, and we should push that forward further.

I want broadly to set out how we view the Government’s role, and to respond to some of the questions asked by the hon. Member for Hartlepool (Mr Wright). It is true that Britain fell down the league of competitiveness, not least on infrastructure, but now, finally, we have a national infrastructure plan, on which we are beginning to deliver. The earthwork along the M54 is not alone; across the country there is infrastructure development, not least for Crossrail, which is the largest construction project in the whole of Europe. It is vital that we turn the situation around and that is what we are doing.

The hon. Member for Hartlepool also mentioned finance. It is true that the funding for lending scheme, as the hon. Member for West Bromwich West said, has been helpful, and in April we announced that we were extending it to SME lending. I note that lending to small businesses rose by £262 million in July, which is positive news. On skills, the increase in engineering apprenticeships, which my hon. Friend the Member for Stafford (Jeremy Lefroy) mentioned, is vital and is something into which I personally have put huge effort. We have apprenticeship training agencies in the UK, but there is the potential for more because they can ensure that we draw together the needs of different companies to guarantee that training is co-ordinated and bureaucracy taken away from small businesses. We

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are also considering more radical changes to how we fund apprenticeships, to make them easier for small businesses to access, one option being to introduce funding through the tax system.

My hon. Friend the Member for Gosport (Caroline Dinenage) brought her own experience to the debate. The question of simplifying procurement bureaucracy is absolutely vital, and the hon. Member for Hartlepool made a point about procurement almost with the zeal of a convert. The target of awarding 25% of public contracts to SMEs is important and the fact that, according to his figures, only 10% of them go to SMEs at the moment just shows what work there is to do. I am glad that the Labour party is coming to the table on that.

Mr Andrew Smith: Will the Minister comment on the survey that I mentioned, which showed that, according to the perception of small businesses, things have got worse in the past three years rather than better?

Matthew Hancock: It is certainly taking time to turn the situation around, but there is no doubt that there is the enthusiasm to do so. Some Departments have already hit the 25% target, including the Ministry of Justice, so there is progress, and there appears to be cross-party support for it.

I will finish by saying that everyone who participated in the debate mentioned the scope and potential for the future of manufacturing in general and in small businesses, and we in the Government passionately support that. There is plenty more to do on tax and deregulation, the expansion of the R and D tax credit, the all-important funding and finance for growth and all the other issues we have talked about, but momentum is starting to build and we will not let up.

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School Starting Age

4 pm

Annette Brooke (Mid Dorset and North Poole) (LD): I am extremely pleased to have secured this debate. It follows from early-day motion 213, which I tabled in June, on the school starting age for summer-born pupils. The timing is particularly apt, given that most four-year-olds start their primary school education this week. A child born on 31 August 2009 will most likely be in the same year group as a child born on 1 September 2008. Indeed, I received information this morning that some three-year-olds—those born between 29 August and 1 September—have started school in an area where school re-started on 29 August.

The early-day motion notes

“the robust and consistent evidence from around the world on birth date effects, which in England shows that summer-born children can suffer long-term disadvantages as a result of England’s inflexible school starting age”.

To expand on such birth date effects, I will briefly refer to the Institute for Fiscal Studies report published in May. The study found that, relative to children born in September, those born in August are 6.4 percentage points less likely to achieve five GCSEs or equivalents at A* to C, and about 2 percentage points less likely to go to university at 18 or 19. It is staggering just how long term the effects appear to be.

Following the Rose review, the previous Government required local authorities to provide a full-time school place for all four-year-olds in the September following their fourth birthday. One could argue that that change tackled one problem faced by summer-borns—that they receive less time in formal education than their peers, which for some has a long-term effect on their school performance.

I argue that any such benefits are cancelled by the impacts on individual children who are simply not ready in their emotional, social and cognitive development to start formal school. A good nursery or pre-school can obviously help with school-readiness in some respects, but certain aspects of an individual child’s development can progress only when that child is ready. By definition, many summer-borns will not be as ready as their older counterparts. Furthermore, an unhappy experience may lead to behavioural problems and a lack of confidence and self-esteem as a child tries to cope within the school setting, and may therefore have further impacts on long-term achievements.

The statutory school starting age remains five. In principle, parents have a choice about which term their child starts school within that time span, but practice may be a little different. For many families, a child starting full-time school reduces the burden of child care costs. It is difficult to imagine that that would not impact on some families’ choices.

Where a parent chooses to defer their child’s entry to school, the child remains entitled to a funded early education place of 15 hours a week for 38 weeks, which prompts the question of the cost of any extra child care needed by working parents. There are also pressures on parents to do what is best for their child. A parent has to be confident and have full information if they are to decide to keep their child in nursery while others start school. Will the school and the local authority make sure that a school place is available part-way through

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the school year in an over-subscribed school so that parents can exercise their choice about which term their child starts school?

Over the years, I have received representations from across the country about parents who have struggled to be allowed to exercise that choice. I have asked questions and supplied details of cases, but I am not clear what the Department does to support parents experiencing problems in simply trying to have a place held open, so I would be grateful for clarification.

More recently, I have been contacted by parents who want to have the option of their child starting school at the statutory age, but in reception rather than year 1. It is pretty obvious that that makes sense for some children born at one minute to midnight on 31 August, and even more so for a premature baby born at that time. It is easy to extend that line of argument to include more children who would benefit from starting in reception class aged five.

I welcome the discussions between Bliss, parents and the Department for Education on schools admissions policy and that, as a result, new advice was issued in July. I congratulate Bliss on all its work representing families in which premature babies have been born.

Duncan Hames (Chippenham) (LD): My hon. Friend is making a strong case, and I congratulate her on securing the debate. Earlier this year, I was fortunate enough to meet the Minister’s officials and Bliss on that point. I want to put on the record my thanks for the fact that, in answer 4 in that advice, the Government specifically refer to premature children who would have been in the lower age group had they been born when they were due. That is a welcome advantage for parents who are having such conversations with local admissions authorities.

Annette Brooke: I thank my hon. Friend for his intervention. I not only congratulate Bliss, but I am grateful that the DFE has taken a big step forward. I particularly welcome the fact that the new advice states:

“There is no statutory barrier to children being admitted outside their normal year group”,

and that

“flexibilities exist for children whose parents do not feel they are ready to begin school”

in the September following the child’s fourth birthday.

The questions and answers provided in the advice on the DFE website are helpful, on the whole, but I particularly want to draw the Minister’s attention to answer 8, which states:

“Parents who are refused a place at a school for which they have applied have the right of appeal to an independent admission appeal panel. They do not have a right of appeal if they have been offered a place and it is not in the year group they would like.”

Parents may make a complaint, but the advice states that they cannot appeal. Surely, there should be a right of appeal. It seems to me that although there may be no statutory barrier to a child being admitted to a particular year group, there is no statutory right. That means that although some authorities work to help and support parents, others can continue to make it extremely difficult for parents to exercise a justified choice.

The other barriers that I have mentioned will also prevail—financial, in relation to child care costs; and parents’ confidence and empowerment in relation to

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requesting a different time of entry and possibly a different year group. I would be interested to know the Minister’s plans to monitor local authorities’ actions on the new advice, to promote best practice and to make sure that full information is available to parents.

I was contacted late yesterday—I have not had time to check this material, so I will refer to it only briefly—by someone who has looked at several London local education authorities’ admissions policies, of which 49% apparently did not conform to the new advice. I apologise that this is second-hand material, but it needs to be checked. It states:

“Admission Arrangements For…2014/2015—Request to delay entry to school (known as deferred entry). Parents of children below compulsory school age may defer their child’s entry to a Reception class…until later in the school year. However, a Reception class place must be taken up by the start of the summer term. If entry is deferred beyond the summer term, parents will need to reapply for a Year 1 place”.

That just shows that although the DFE has played its part, there must be follow-through if the system is really going to change.

In the case of premature births, I imagine that it will be possible to involve health visitors, as well as pre-schools and nurseries, and to use the new advice to secure a place in reception for a child aged five. I certainly hope that that will be much easier, but of course it will not be so unless all local authorities operate within the new advice, which is really important.

I want to mention one or two case studies. I need not give too many, because there are just so many and they are very similar. In a case of premature birth, a child born at 32 weeks struggled enormously with the transition to mainstream school after their parents’ application to delay entry to reception by a year was rejected by the local education authority. I also have a story of twins. The tragedy is that the parents felt that they had to put their children into the reception class. Sometimes the whole experience is of a totally broken down system. It is only when the children are withdrawn from school that it is accepted that they have to start reception in another school year. I am sure that everyone will agree that the experience of starting school and then being pulled out must be avoided.

Clearly, a lot of proactive work has to be done to ensure that the advice makes a difference. I repeat the question: how will the Department ensure that the questions and answers are promoted to admissions authorities and parents? That information should be available not just to those parents who are seeking information, but to all parents. Furthermore, there is a need to monitor published admissions policies.

I remain concerned about how a parent can succeed in exercising their choice when we are considering a child who is so immature, but not prematurely born, that he or she is not ready to start school until the age of five and then needs to experience a reception year. I want to hear the Minister’s views on this matter. What information does a parent need to supply to the local authority to provide a convincing case?

The advice given in answer 4 is far more open to individual interpretation than the one on premature births. It is quite likely that such a child does not have special educational needs as such—there is often misclassification. It is just that the child is not developmentally ready or mature enough at the age of

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four. By the age of five, they have simply had one year’s growth and maturity, and they need the experience in a reception class.

Mr Mark Williams (Ceredigion) (LD): Will my hon. Friend extend what she said earlier about the knock-on effects of not getting this right, and of not matching the learning experience to the child’s stage of development later on? Like her, I used to teach older children in the primary sector. The knock-on effects to a child’s confidence are repeated as they get older, with really damaging effects.

Annette Brooke: Absolutely. I thank my hon. Friend for reinforcing the case. It can be seen as an issue just for some middle-class parents who perhaps want to get their children to the top of the class. I want to reiterate that that is not the case. Unfortunately, it is about trying to shoehorn individuals into a one-size-fits-all system, and that is the problem. We must all love and make the most of the individual differences of our children both in our families and in our schools.

We must consider whether some of the issues of summer-born children can be overcome with a play-based curriculum and excellent teaching in the reception class, where the needs of individual children are being taken into account. I would like the answer to be yes, but we have changes in the primary curriculum and assessment and testing regimes, which put constraints and pressures on schools and teachers. Even with an excellent teacher, the individual interests of the child may require a start in reception at the age of five. I do not think that such a move would open floodgates because most parents want their children to fit into the system as it is. Not all summer-born children are adversely affected by being the youngest in their year and there will be variations in any effects. It is difficult to see that age-adjusting test results, as proposed by the Institute for Fiscal Studies, is an entirely valid approach.

Undoubtedly, the early start to formal schooling and the testing regime in this country compound the summer-born problems, which leads me to conclude that, ideally, we need to rethink our approach to the all-important learning settings and experiences for the four to seven-year-olds. The school experience should suit the individual child; the child should not be made to fit the school because of the potential adverse outcomes over their lifetime.

Meanwhile, we have to do the best we can. We must identify the problems and cope with them within the existing system. We must have more flexibility in school starting time, and parents need to be empowered and enabled to make the best choices for their child. Currently, what is in the best interests of the child can be ignored in favour of slotting everybody into an arbitrary 12-month period.

There are so many cases that I could cite, and I am happy to talk about them with the Minister—even those relating to the transfer from primary to secondary school. The whole matter needs to be considered carefully. We must assess the scale of the problem and monitor the impact of the new advice. Having monitored the situation, we must consider whether the schools admission code needs changing in the future.

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We also need to consider assessment within the early years foundation stage and how summer-born children are being assessed. This is a huge issue, but my message today is that if parents can demonstrate that they have a strong case that is in the best interests of their children, they should be empowered and enabled to allow their child to start school at the age of five as required, but in reception year.

Dr William McCrea (in the Chair): I will call Alok Sharma now, but let me just say that I will be calling the Minister at 4.20, because she needs to have time to respond to the debate.

4.15 pm

Alok Sharma (Reading West) (Con): I will be brief. Let me first congratulate my hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) on securing this incredibly important debate. It is an issue that is not aired or talked about enough, and we need to put it at the top of the agenda when we talk about education.

I want to raise the case of my constituents, Mr and Mrs Slade, who approached me two years ago because they wanted their daughter, Ava, who was born at the end of August, to delay her start to school by a year. I have some sympathy with such a view because my older daughter Isabella is also an August-born child. She is doing absolutely fine at school now, but when she first started, her age did make a difference. If she had started a year later, it would have made a difference, but in a positive way.

As I said, Mr and Mrs Slade approached me two years ago, and I wrote to the Department. The then Minister of State for Schools, my hon. Friend the Member for Bognor Regis and Littlehampton (Mr Gibb), gave me a prompt reply. He said:

“It must be the parent’s choice when their child starts school and the law provides flexibility for parents on this issue.”

That was absolutely great news, but he then went on to explain that the parents had to talk to the school, the head teachers, the governing body and the local authority. That was where Mr and Mrs Slade found the huge difference between the theory and the actual practice of getting a delayed start for their child. They battled for almost two and a half years with Reading borough council, which was not as helpful as it could have been.

Mr and Mrs Slade said to me that the local authority effectively hid behind some of the clauses of the admissions code. They admitted that even if their child started in the year when the local authority wanted her to start, she would cope, but no one wants their child just to cope; they want them to thrive in school, and that is what this debate is about. Parents are best placed to judge how well their child will do in a school setting, which is why we should do more to empower them to make those decisions, obviously in consultation with local authorities and governors.

I welcome the guidance that the Department has issued, and I congratulate the Minister on the work that she is doing. I also back my hon. Friend when she says that we need to monitor the advice that is being given and to see whether local authorities are complying with it. We need to give more information to parents, governors and governing bodies. I was a school governor many

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years ago and feel that this issue should be built into governor training, to explain to governors how they can help parents who want a delayed start for their offspring.

When the then Minister of State wrote to me in 2011, he stated:

“Ms Slade should also be aware that if her daughter were to be educated out of her chronological age group whilst at primary school, any secondary school which she later moved on to would not be obliged to continue this arrangement.”

We also need to consider that matter. I look forward to the Minister’s response.

4.19 pm

The Parliamentary Under-Secretary of State for Education (Elizabeth Truss): I congratulate my hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) on securing this debate and on her campaign, including the early-day motion, on the issue of summer-born children. I absolutely share the concerns that she has raised about the issues affecting those children. In the Department for Education, summer-born children are heavily represented—I was born in July and the Secretary of State was born in August, although we both went to primary school in Scotland, where the cut-off dates are slightly different.

My hon. Friend made a variety of points, encompassing some of the overall issues about the school system and the early-years system, as well as the specific issue of the admissions code. What we are seeking to do with our education reforms is to increase the level of flexibility that head teachers and teachers have—for example, over how they implement the school curriculum—so that children are not pushed through material that they are not yet ready for and so that more care is taken about the individual’s level of capacity at a stage of learning.

We are also trying to remove some of the barriers between early years and school, so that there is not a sudden jump between them but rather a continuum of age-appropriate learning for children. Those changes are also important in ensuring that each child is treated as an individual rather than as part of a block of children who are pushed through the system.

The statutory school admissions code allows for flexibility in school starting dates, as my hon. Friend pointed out. It requires school admission authorities to provide for the admission of children in the September following their fourth birthday, so that the maximum amount of reception education is available to all children. However, children do not reach compulsory school age until after their fifth birthday, and no parent is obliged to send their child to school before then.

As my hon. Friend pointed out, we released new guidance this summer, making it much clearer to schools about where their responsibilities lie and where the responsibilities of local authorities lie. We need to allow some time for that new guidance to filter through and to ensure that all local authorities and schools understand it. Nevertheless, in that guidance we certainly addressed some of the concerns that she has raised today.

What we want to do is to empower parents to be more demanding about how their child’s level of development is reflected in whether they join reception or year 1 when they enter school after reaching the compulsory school age. My hon. Friend made valid points about issues

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such as child care costs and other children in the family, which will also have an effect on the decision that parents reach, but I do not think that we can impose a solution from Whitehall.

The way to do things is to empower parents and ensure, first, that they have the complaints and appeals procedures at their disposal and, secondly, that the DFE is following up on those procedures. We have a working group on admissions, which is monitoring this issue. As a Department, we will also be monitoring any complaints made by parents, such as the one that my hon. Friend the Member for Reading West (Alok Sharma) mentioned in his speech, and following up to ensure that our guidance is being adhered to.

At the moment, we do not have data that would demonstrate how many parents of summer-born children request that their child is admitted to the reception class at the age of five, or how many of those requests are granted. That is something that I will look into, to see whether it is possible to get more information to understand what might be the scale of the problem. However, like my hon. Friend, we are concerned about the level of correspondence that we are having on this issue and the level of complaints about it, which is precisely why we issued the new guidance to clarify the situation for schools and local authorities.

The point about flexibility is important, because all children are different. Some children may benefit from entering year 1 as soon as they reach the compulsory school age, while others would benefit from entering reception. It should be the parents who are the primary decision-makers when it comes to deciding which route is most appropriate for their child and which environment will enable their child to thrive.

Annette Brooke: If someone sends their child to an independent school, it is clearly available to them to decide which year group they go into. When it is really in the best interests of the child, I want that flexibility to apply to all parents, right through to a situation where perhaps there are disadvantages in the background. So I welcome the Minister’s words, but I would just like her to be a little more proactive as well as responsive to the problem.

Elizabeth Truss: We are absolutely clear that parents should be able to say to a school, “We want our child, who is aged five, to enter reception”, if they feel that that is in the best interests of their child. That is what we are elucidating in the new guidance that we issued this summer and that is what we will be following up on with local authorities and schools.

One of the reasons why we issued the new guidance is that we felt that earlier guidance was misunderstood and that it was not necessarily clear enough. I also agree with my hon. Friend’s comment earlier about the “floodgates”. Like her, we do not think that the new guidance will open the “floodgates”; we think that it is about schools being responsive to parental needs and that there are not a massive number of complications in doing that. We want schools to be responsive to parental needs. However, only the parents of a limited group of children—those born between April and August—can lawfully delay entry by a full year. It is those children we are talking about in this debate.

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I agree with what my hon. Friend said about the research evidence on summer-born children. We know that they have lower average attainment than their older peers. The attainment deficit decreases over time as they progress through the key stages, but it persists throughout their schooling. Absolute age is the dominant reason for that but it is not the only reason, and there is a statistically significant effect from the starting age or the length of schooling. That is why we want to give maximum flexibility.

I have mentioned the non-statutory advice that we issued on 29 July. We make it absolutely clear that there is no statutory barrier to children being educated outside of their normal year group and that it is unlawful for an admissions authority to have a blanket policy that children are never admitted outside of their normal age group. We make that very clear in the guidance.

I note from my hon. Friend’s comments that she feels that some of that guidance should be clearer, and that is certainly something we can look at. However, the new guidance is considerably clearer than the earlier guidance. We say that the following factors should be taken into account when making a decision about entry: the impact on the child of entering year 1 without having first attended reception class; whether a prematurely born child would naturally have fallen into the lower age group if they had been born on time; and whether delayed social, emotional or physical development is affecting the child’s readiness for school.

Of course, the guidance has just been issued—no doubt partly due to the campaign by my hon. Friend and her colleagues—and we will need to see how it affects behaviour and the level of complaints that we receive.

Duncan Hames: I very much welcome the new advice. The Minister will know from a whole spreadsheet of

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evidence submitted by one of my constituents, Mr Graeme Vousden, that before the new advice was published, local authorities across the country were thwarting the wishes of parents. Subsequent to the publication of the new advice, will she collect evidence to see whether the behaviour of local authorities changes as a result of it?

Elizabeth Truss: The Department will certainly want to look at that, to see what the impact of the advice is and whether further advice to local authorities is required. I know that the hon. Member for Mid Dorset and North Poole may seek a change to the statutory admissions policy itself, but I think that we should look at what the impact of this new advice is.

In general, what we want to do is to encourage flexibility and responsiveness to parental needs. There is a wealth of evidence about the importance of following a specific child’s development. We are trying to encourage that development through more flexibility over pedagogy, based in the early years and in school, so that teachers can adjust teaching practice according to where the child is in terms of their level of development. A combination of empowering parents about deciding which year their child joins school and giving teachers the flexibility to teach in the best interests of the child, rather than jumping through hoops in a particular year, will help to ameliorate the situation.

Such decisions are best made at a local level. We have been clear with local authorities about where their responsibilities lie, and about the fact that we want to see them being flexible and giving the parents the choice for their five-year-old child of joining reception or year 1. Having too much central guidance the other way would be wrong. What we need to do is to ensure that local authorities are absolutely aware of their responsibilities.

Dr William McCrea (in the Chair): Order.

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Spinal Cord Injuries


Ian Lucas (Wrexham) (Lab): It is a real pleasure to serve under your chairmanship this afternoon, Dr McCrea. I am pleased to see that the Minister is here for this debate on the important topic of continuing health care for spinal cord injured people. The all-party group on spinal cord injury has had some difficulty engaging with Ministers over the past two years. The Health Minister with responsibility for quality, Lord Howe, and more recently the Minister for Housing, the hon. Member for Hertford and Stortford (Mr Prisk), have both refused to meet the group, which is very unfortunate.

The advantage of engagement is that it enables Ministers to understand better the needs and difficulties of individuals who have to deal with severe spinal cord injuries. Such individuals face great hardship and difficulty, and Ministers should at least be prepared to engage with them and hear what they have to say. I am sure that the Minister will do so today.

I first became aware of the difficulties faced by spinal cord injured people during my work as a practising personal injury solicitor before I came to the House about 12 years ago. I was particularly engaged with the Midlands Centre for Spinal Injury at the Robert Jones and Agnes Hunt orthopaedic hospital in Oswestry. Individuals were often admitted with severe spinal injuries from accidents, and the capacity of the—[Interruption.]

Dr William McCrea (in the Chair): Order. I apologise to the hon. Gentleman, but I must suspend proceedings for a Division in the House.

4.32 pm

Sitting suspended for a Division in the House.

4.43 pm

On resuming

Ian Lucas: I was just talking about the extraordinary work of the Midlands Centre for Spinal Injuries, which I witnessed some years ago and which continues. In connection with the immediate response to serious accidents where people have spinal cord injuries, a miraculous transformation can be carried out, provided that the right level of care is offered by specialists in the immediate aftermath of the accident.

The continuing effects of spinal cord injuries are important, and I want to concentrate on those today. Spinal cord injury results in a combination of the loss of motor, sensory and continence function, making it unique among long-term conditions. It is also a non-improving condition. Once rehabilitation is completed and health care needs have been identified, they are unlikely to decrease. Indeed, they are likely to increase over time, with complications brought on by ageing and as the condition continues. It is essential, therefore, that needs are well managed by a dedicated and trained team who understand spinal cord injuries. That will ensure that health complications and significant cost implications for the national health service are avoided or minimised.

How care is administered is a major concern to many people living with spinal cord injuries. It is not just the individual who is affected by the spinal cord injury;

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often, the family and the immediate community around that individual must cope with profound pressures. There is an increasing worry that health care provision is becoming a postcode lottery, with clinical commissioning groups interpreting the national framework differently to meet their budgets, rather than the specific needs of spinal cord injury patients.

The landmark legal case of Pamela Coughlan in 1999 set a precedent for how patients with a certain level of injury should expect to be treated. Ms Coughlan, a C5/C6 complete tetraplegic with no significant additional health needs, took her primary care trust to court when they attempted to transfer care provision responsibility from NHS continuing health care, within which health care is free, to the local authority, where charges may have applied.

Jim Shannon (Strangford) (DUP): The hon. Member for Wrexham and I spoke beforehand about this issue and I wanted the information to be recorded. Perhaps the Minister will take it on board as well.

We have a specialised 15-bed unit that looks after the whole of Northern Ireland and its population of 1.7 million people. That unit has everything: trauma, orthopaedics, neurosurgery, neurology and an intensive care unit. There are dedicated teams for physio, nursing, occupational therapy, social work, psychology, dietetics, art therapy and complementary therapies. All that happens under one roof for all the people in Northern Ireland. The hon. Member for Wrexham said to me, “That is the sort of thing we need in my area.” I wanted to put that case on the record. Perhaps the Minister could look to Northern Ireland as an example of something that has been done and done well.

Ian Lucas: I thank the hon. Gentleman.

Going back to Ms Coughlan and the issue of continuing care, the ruling found that patients with a certain level of spinal cord injury have health care needs of a “wholly different category” than can be legitimately provided for by a local authority. These are profoundly and almost singularly serious conditions. Even spinal cord injured people with greater health needs than Ms Coughlan are finding themselves assessed as ineligible or seeing their care packages severely restricted, without any evidence of reduced need.

As local health budgets for continuing health care are being squeezed and, in many cases, reduced, many of these people are experiencing reduced care packages and unfair, and potentially unlawful, decisions on eligibility for continuing health care. There are many examples of continuing health care packages being denied or dramatically reduced after reassessments, without evidence of clinical improvement.

One individual who has been affected is John Burns. He addressed the all-party parliamentary group on spinal cord injury last year, and it is occasions like that that show the importance of all-party parliamentary groups. They allow individuals such as John to speak to Members of Parliament and explain the difficulties.

John, who is married with three teenage sons, is a C2 tetraplegic following a water sports accident while on holiday with his family in 2007. Due to the extent of his injuries, John was initially put on a ventilator and awarded NHS continuing health care. After a period in

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a spinal cord injuries centre, John was discharged into a care home and was successfully weaned from his ventilator. Although he remained paralysed from his neck down, his continuing health care funding was consequently withdrawn, and he was told to expect to remain in a nursing home for the rest of his life. Without the appropriate funding, John was unable to receive the care and support he needed to be with his family and return home. He described that period as being like a “prisoner,” as he was denied time with his wife and sons in his own home. That is the type of individual that we, as a community, should be aiding, rather than denying them health care.

In a meeting with the Spinal Injuries Association, the then Minister of State with responsibility for care services, the right hon. Member for Sutton and Cheam (Paul Burstow), expressed concern about John’s case. Thanks to the involvement of the Spinal Injuries Association, an independent nurse was assigned to assess John’s case and immediately argued in his favour that funding should be reinstated. Yet John had to go through that process to restore the care that had been taken away from him. One can imagine the worry and distress experienced by John and his family during that period.

Despite the precedent of the Coughlan judgment, a large number of spinal cord injured individuals with health care needs demonstrably equivalent to or even greater than those of Pamela Coughlan are still denied NHS continuing health care. The culture of ineligibility continues. What action is the Minister taking to ensure that, where appropriate, spinal cord injured people have access to NHS continuing health care and that the legal ruling is adhered to? Is there a process for monitoring the level of care that individuals with severe spinal cord injuries are receiving from their immediate provider? How will the Department monitor the level of provision that is being given?

The Government must ensure that locally produced policies do not impose inappropriate and potentially unlawful care packages on a spinal cord injured person. Will the Government ensure that clinical commissioning groups adhere to the Coughlan judgment when deciding NHS continuing health care eligibility for spinal cord injured patients? Does the Minister believe that there should be a presumption of eligibility for tetraplegics when determining continuing health care? In addition to their injuries, such individuals and families should not have imposed on them the burden of worrying whether the care they received in the past will continue.

There is also concern that multidisciplinary teams assessing spinal cord injured patients for continuing health care frequently exclude health professionals with expertise in spinal cord injury when reaching their decisions. Along with the judgments that set legal precedents for NHS continuing health care, such as the Coughlan judgment, assessors and decision-making panels must carefully consider evidence from spinal cord injury clinicians and health care professionals from the NHS spinal cord injury centres. It is important that those individuals, who are so skilled in providing care, have input into the process of deciding what care the NHS is to supply in future. Will the Government take action to ensure that health professionals with expertise in spinal cord injury are included in multidisciplinary teams throughout the process?

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There have been instances in which local commissioners have introduced policies that randomly restrict the amount of money available for “care at home” packages to the cost of non-complex care in a nursing home, disregarding the special care needs of spinal cord injured people and their right to family life. In an increasing number of clinical commissioning groups, local implementation policies place restrictions on the size of “care at home” packages, often based on arbitrary caps set against the equivalent cost of a placement in an establishment such as a nursing home. That has happened, for example, in the Sheffield clinical commissioning group cluster and in north-west London despite Department of Health practice guidance outlining the rights of people to choose where to live and to take risks, and despite the court’s indication that an individual’s human rights need to be balanced against cost.

The excellent spinal research charity Aspire commissioned Loughborough university to independently consider the impact on people with spinal cord injury of being discharged to nursing homes. The research found that living in a nursing home has a damaging psychological and physical impact on people with spinal cord injury. Spinal cord injury patients should not be expected to live in institutions rather than with their families. Generally, such people view care homes as a last resort.

The individual must be at the centre of the assessment process. Improving the implementation of NHS continuing health care will benefit its members, the clinical commissioning groups and the wider spinal cord injury community. Such issues affect people across the UK. They cause families and individuals profound worry, and they must be addressed urgently. The legal ruling must be adhered to, and the culture of ineligibility must end.

4.55 pm

The Minister of State, Department of Health (Norman Lamb): It is a pleasure to serve under your chairmanship for the first time, Dr McCrea.

I congratulate the hon. Member for Wrexham (Ian Lucas) on securing this debate and on his persistence in pursuing the matter. I have noted what he said about his frustration in securing meetings with a couple of Ministers. At least we have had the chance this afternoon, albeit interrupted, to debate this important issue, and I am more than happy to talk to him if there are issues arising from this debate that he wants to pursue further.

The hon. Gentleman makes the point that how care is administered is incredibly important to the individual, and he also mentioned the profound impact that spinal injury has on the whole family and everyone involved. He talks about the emergence of a postcode lottery, but if we are honest with ourselves, the postcode lottery has always existed to some extent. The interpretation of rules has always varied somewhat across the country. Indeed, the Coughlan case was brought because of a failure to apply rules properly. I will return to that in due course, but it is essential that all areas of the country apply the rules properly, according to the guidelines, and apply the precedent that has been set.

I also pay tribute to the important work of the all-party group on spinal cord injury, which has had a major impact on issues affecting the estimated 40,000 people with spinal cord injury in the United Kingdom

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and Ireland alone. Every eight hours, a new person is told that they will never walk again, which is a stark reminder of the scale of spinal cord injury.

Thankfully, research is making important strides in developing new techniques to help spinal cord injury patients regain as much function and independence as possible. In 2011-12, the Medical Research Council spent £900,000 on research directly related to spinal cord injury. The Government also fund a wide range of research relating to spinal injury, and through the National Institute for Health Research, the Department of Health is funding research on spinal cord injury in biomedical research centres in Cambridge and London.

There is an increasing range of guidance available to provide advice on the causes, treatment and management of spinal cord injuries. Stakeholders such as the Spinal Injuries Association and Aspire provide information and support services for patients and their families following spinal injury, and we should pay tribute to the work of those organisations. In February 2008, the Royal College of Physicians published a guideline for GPs and other health professionals involved in the management of adults with spinal cord injury in the acute hospital setting. I am confident that that range of guidance will be useful for educating people and, critically, professionals on spinal injuries and how to manage them.

More work is taking place to develop guidance for the treatment of those with spinal injuries. The Department has asked the National Institute for Health and Care Excellence to produce guidance on the assessment and imaging of patients at high risk of spinal injury. NICE is developing five pieces of guidance relating to trauma, with expected publication dates in June and October 2015. Each piece of guidance will focus on a different aspect of trauma care. The guidance on spinal injury assessment will form one part of the wider work and is expected to be published in May 2015.

The hon. Gentleman appropriately raised NHS continuing health care for individuals with spinal cord injuries. NHS continuing health care is a package of health and social care that is arranged and funded solely by the NHS for individuals outside the hospital setting who have complex, ongoing health care needs. It is important to say that eligibility for NHS continuing health care is dependent not on an individual’s condition or diagnosis—it is important to maintain this point—but on the individual’s specific care needs. That must be appropriate, so that what is assessed is what the individual needs.

The assessment for NHS continuing health care is complex and involves a multidisciplinary team co-ordinated by the relevant clinical commissioning group looking at an individual’s needs across 12 care domains and assessing how those needs interact. The process determines whether individuals have what is called a primary health need. If they do so, they will be entitled to continuing health care.

The hon. Gentleman specifically referred to concerns about specialist involvement in continuing health care assessments. The national framework, which underpins the assessment and decision making for NHS continuing health care, makes it clear that someone with specialist knowledge is involved in the process, with other highly skilled professionals, such as doctors, nurses, social care staff and therapists. If that is not happening in an area,

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that is a failure to follow the national framework and should be challenged. I am interested to hear about cases in which that is not happening, because corners cannot be cut—things should be done properly. He made an important point.

The family or representative may also be involved, to ensure that a holistic picture of the individual’s needs is properly identified. After all, the family probably knows best about what the impact really is.

Individuals receiving NHS continuing health care will have their case reviewed three months after the initial decision and annually thereafter. It is important to remember that the focus of the review is not only whether the individual remains eligible, but whether their needs are being properly met and the package of care remains appropriate. Let me be clear, however, that an individual must be kept fully informed about the process and any proposed change to the care arrangement.

The hon. Gentleman expressed concerns about refusals of NHS continuing health care or the package being drawn too narrowly, suggesting that the Coughlan judgment was not being followed and that cases more serious than the Coughlan one were being refused—I think I have put that correctly, from what he said. I again make the point that if any areas are failing to follow the national framework, that must be challenged. I appreciate that families may not always understand or know how to go about challenging, or what they are entitled to, but we all have responsibility to disseminate that message and to encourage people to challenge decisions that cannot be justified.

Ian Lucas: The Minister is being very constructive in his response. Is there any process for monitoring the decisions? Organisations such as the Spinal Injuries Association can bring individual cases forward, but there needs to be some sort of system to ensure that the rules, which I am grateful that the Minister is stressing today, are being enforced as a matter of course.

Norman Lamb: The hon. Gentleman makes a fair point. I was about to say that I will ask NHS England to provide me with an assessment of how the work of CCGs complies with the guidelines. The very fact of that request for information will help focus minds and ensure that things are being done properly.

I am aware that there are some concerns about how autonomic dysreflexia is reflected in NHS continuing health care assessments. It is unique to spinal cord injuries and should always be treated as a medical emergency. The needs of individuals experiencing autonomic dysreflexia are to manage both the risk of episodes occurring and the risks involved if and when such episodes occur. Such risks, and therefore the needs, vary from one individual to another. It would be relevant to establish whether the individual has signs and symptoms of an advancing episode or whether the episodes are random and unpredictable.

It has been suggested that more people with spinal injuries are being placed in nursing home settings, rather than being offered a care package in their own home. The national framework is clear that NHS continuing health care packages should be as far as possible personalised—designed to meet that individual’s needs—and that the individual’s wishes should be taken into account. It is our hope that personal health budgets—a

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concept developed under the previous Labour Government, but strongly pursued under this Government—will give people more personal control over their care.

We recognise that it is more efficient for people with long-term conditions such as spinal cord injuries to have control over their own budget for health and social care, because they are less likely to duplicate services or to choose ones that are not right for them. Beyond being efficient, however, it is simply what we should be doing: we should be putting the individuals in charge and allowing them to determine their priorities. On that basis, CCGs are already able to offer personal health budgets to people on a voluntary basis, if they consider that it is cost-effective and will improve the individual’s quality of life.

We have also brought in legislation that will allow CCGs to offer direct cash payments as a way of managing personal health budgets. However, to make personal health budgets more of a reality for people, we have put measures in place to ensure that CCGs go further than offering them only on a voluntary basis. As of April 2014, those receiving NHS continuing health care will have the right to ask for a personal health budget, including a direct payment. Using a personalised care planning process, personal health budgets help people choose how to meet their health needs in ways that work for them.

I have just set out how the process for NHS continuing health care is intended to work. Let us not pretend, however, that it works perfectly in every case—it clearly does not. I am delighted that the Spinal Injuries Association continues to have a strong presence on the NHS national

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continuing health care stakeholder group. It is important that its voice and that of the people it represents are heard.

Eligibility for NHS continuing health care depends on a needs-based assessment. Therefore, some individuals will not be eligible, but they must still receive the appropriate level of care and support. Disjointed care is a source of complete frustration for patients and staff alike. To stay relevant to changing needs, different parts of the NHS and other organisations such as social services have to work more effectively together to drive joined-up care.

The first NHS mandate sets out a requirement to provide

“care which feels more joined-up to the users of services”,

and which

“ensures people experience smooth transitions between care settings and organisations”.

That is vital, and there is a total focus in Government on integrating and joining up care around the needs of the individual patient. On that basis, we have asked NHS England to make huge efforts to focus on delivering integrated care and support to improve outcomes for patients and for people who use those services.

I thank the hon. Gentleman for securing the debate. The issues that we have discussed this afternoon are important, because of their impact on people who have sustained a spinal injury which in itself is completely life changing. We must ensure that the care and support systems work to meet their needs and to enable the best possible quality of life and outcomes for those individuals.

Question put and agreed to.

5.9 pm

Sitting adjourned.