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There are some strange inconsistencies around. I may have imagined it, but I thought I heard the Secretary of State for Business, Innovation and Skills extolling on the radio yesterday-several times throughout the day on the BBC-a policy that he claimed the Government would adopt over the next few years: providing pensions and giving the current rate of means-tested pension credit to everybody over pension age. I think that would be fantastic, especially if we could further reduce the dependence on means-testing. Many of my constituents, particularly those just over pension credit level, would feel that that was fair. There is a huge cost, however, which would have to be paid for. Is that really the policy
of the coalition Government, or only that of one party trying to distract attention from the comprehensive spending review? Can it be the policy when we have heard today all sorts of arguments against universal benefits being made very strongly by Conservative Members? I found it quite offensive to hear some Conservative Members describe what they thought people might use their health in pregnancy grant for-it is not necessarily eased by other benefits. That is why I have referred to incoherence in the policy, which needs to be sorted out. It is right for us to expose it.
We have different views on how the economy works and on how to get out of the recession. We could go into all sorts of history lessons. The 1930s are often mentioned, but we have to go beyond 1931, 1932 and 1934. There is a strong economic argument for saying that we did not get out of the recession until re-armament started before the second world war. It can also be argued that the UK went through a double-dip recession in the mid to late-1930s. Economists disagree, of course, but none of us should take such an absolutist position as to suggest that we are simply right. We have a view; you have a view- [Interruption.] I am sorry, Mr Speaker, you do not have a view. The coalition Government have a view, but we should be prepared to listen to alternative points of view.
Valerie Vaz (Walsall South) (Lab): It is always a pleasure to follow my hon. Friend the Member for Edinburgh East (Sheila Gilmore). Unsurprisingly, I shall speak against the Bill. As mentioned earlier, the Bill contains three main provisions: the abolition of the £190 health in pregnancy grant and the phasing out of the child trust fund and the saving gateway provisions.
The £190 pregnancy grant should be uncontroversial in its effect. It is a simple measure to ensure that, at this important time of their lives, women who face a huge physiological upheaval in their bodies as they nurture a new life, receive this additional money. They need it. We become deficient in many things-calcium and iron, to name but two-and this simple grant enables women to put back these vital foods to enable the proper growth of their unborn child and to ensure that they remain healthy when their baby is born. I have heard many Government Members, mostly men, say that we do not require decent food throughout the nine months, but in fact we do, because soon after that we have to feed growing children. The provision can be seen as an attack on women at their most vulnerable. As if that was not enough, the attack is on children as well.
By all accounts, the child trust fund has been a successful savings scheme, and I believe it will teach children to be fiscally responsible. The beauty of it is that every child, irrespective of the circumstances of their birth, has a trust fund. The facts are these: £2 billion is held in child trust fund accounts; 74% of parents have opened an account-sadly, in my constituency, the figure is down to 64%-and almost £470 million is paid in by grandparents. No one can touch that money except the beneficiaries, when they are 18. The money is there for them whatever their circumstances-whether they are looked-after children, the children of two-parent families, or the children of single parents-and no stigma is attached. It is not, as the Deputy Prime Minister said in 2009, a few hundred pounds in the hands of 18-year-olds; it is a solid account of savings over 18 years.
We want our children to grow up to be independent, fiscally aware and responsible. How much does the child trust fund cost? The answer is £524 million. In contrast, during four months in 2009, £2.3 billion was levied through the one-off tax on bankers' bonuses. The new levy coming into effect will raise £2.5 billion. As the slogan goes, Mr Speaker, you do the maths.
Above all, the child trust fund fosters a savings culture in which children know that something has been put aside for them. In my view, that will make them better citizens. To paraphrase a slogan that is used, we can say to them, "This is what the state has done for you. What can you do for the state?"
My biggest concern is that the proposal was not put before the electorate, and the people did not have a say. Our children are our future. Let us give them a future, for the good of the country. I urge all hon. Members to vote against the Bill.
Catherine McKinnell (Newcastle upon Tyne North) (Lab): Over the past few days, weeks and months, there has been a lot of talk about "fairness", which is an easy word to use. Who is the judge of what is fair? Whose standards of fairness are being applied? Many believe that the measure of a civilised society is how it treats its weakest members. If so, the Bill clearly fails the fairness test, because it lets down families and leaves our children to take the strain.
"I want the next Government to be the most family friendly Government we've ever had in this country".
"A fair Government make sure that those with the broadest shoulders bear the greatest burden."-[ Official Report, 20 October 2010; Vol. 516, c. 955.]
Anyone who has young children running around knows how expensive bringing up a family can be. As we are discussing the removal of a grant of £190 to encourage health in pregnancy, I want to talk about how expensive simply being pregnant can be. There seems to have been a lot of debate and misunderstanding about the value of the grant. My hon. Friend the Member for Walsall South (Valerie Vaz) made good points about the physical nourishment required by a pregnant woman, especially in the later stages of pregnancy. On a physical level, however, a pregnant woman needs clothes to go to work, shoes for her swollen feet, vitamin supplements-I craved fresh fruit salad. I know mothers who have suffered from chronic back pain and chronic pelvic pain. They have struggled to sleep because the later stages of pregnancy are so uncomfortable. All those conditions can be helped by customised cushions, back supports and other aids, none of which is available on the national health service, all of which must be purchased, and all of which I was fortunate enough to be able to purchase, although many on lower incomes would not be able to. The health in pregnancy grant was designed to ease the final stages of pregnancy, and to ensure that a child is not born to a broken mother.
All that arises before we consider the huge impact of the link between the health visitor, the midwife and the pregnant woman that is currently required for the grant to be obtained. The financial pressures during pregnancy are difficult for all women, but teenage mothers suffer a particular burden. The Institute of Education has found that they suffer a lifelong financial disadvantage, with a lifetime family income £12,000 lower-or an annual income 2% lower-than the family incomes of those who become pregnant in their mid-20s.
Toby Perkins: My hon. Friend is making a compelling case. Does she agree that, whatever we may have thought about the upper-class buffoons whom we may have considered to constitute the Conservative party, they always seemed to have a sense of gallantry? When they said "Women and children first", it was supposed to be a good thing. Nowadays, however, when they say "Women and children first", they mean that women and children should be in the front line, facing a battering from the cuts. It is women and children first who are losing the benefits, it is women and children first who are losing the payments, and, most of all, it is women and children first who are paying the costs for these upper-class buffoons.
Catherine McKinnell: My hon. Friend ably makes a point that I was about to make myself. Families are being asked to bear the brunt of the mistakes made by bankers. The Government plan to take £190 away from the pregnant mothers who need it most. I believe that that constitutes a shameful attack on the most vulnerable and needy in our society. The Government tell us that the banking levy would bring in £2.4 billion, but my hon. Friend the Member for Walsall South set out the economic case-the "you do the maths" case-very clearly.
How fair does the hon. Lady think it is that those with money in child trust funds pay £25 million a year in fees at the last Government's prescribed rate of 1.5% a year, which reduces the amount of money in the funds?
Thomas Docherty (Dunfermline and West Fife) (Lab): Does my hon. Friend agree that one of the crucial reasons the child trust fund is so important is that if a parent can save the maximum amount, the £18,000 or so would probably pay for one year's tuition fees under the Liberal Democrats' new plans?
I am grateful for all these interventions, but we had a discussion earlier about the benefits of the child trust fund scheme as opposed to the establishment of a potential ISA scheme. We dealt at length with the arguments in favour of the current
scheme, which is targeted at everyone, including the most vulnerable and disadvantaged. The ISA scheme would not necessarily achieve that. However, I fear that we are becoming lost in figures.
The point that I am trying to make concerns the real-life cost of the decision to remove the health in pregnancy grant, to freeze child benefit and to cut the child trust fund, tax credits and the Sure Start maternity grant. It is clear that, as a result of those and other cuts, low-income families will bear the greatest cost of many of the Government's policies. The average household income in the north-east is £12,543 a year. According to a recent report by Citizens Advice, the combination of the Government's proposed cuts could cause a low-income family with a new baby to lose up to £1,235 a year-10% of the average household income of someone in the north-east. Is it really fair that children should be paying this price, rather than bankers?
Because of the establishment of the child trust fund, both my young children have bank accounts, and that is the start of saving for their future. I know of lots of families who are saving through child trust funds, regularly topping them up with birthday and Christmas gifts. Many people have admitted to me that they would not have started saving without the impetus to set up the account. We have discussed at length the benefits of the trust fund in encouraging a savings culture in this country; I think Members on both sides of the House agree that that is a positive development.
Since the child trust funds were introduced in 2005 there has been steady growth in the opening of new accounts, from 3 million in 2007 to 4 million in 2009. The current number is about 5 million-that is 5 million families saving up for their children's futures.
The child trust fund was a universal and progressive policy that recognised the importance of children. It allowed families to open an account, but it gave greater assistance to those on lower incomes through additional payments from the Government. Abolishing child trust funds will lead to the next generation paying for the mistakes of the City bankers and financiers who caused the global economic crisis.
I beg the Government seriously to review this decision, and to accept the analysis of the independent Institute for Fiscal Studies that the spending review is regressive and that families with children will lose out the most. I also ask the Minister to consider some of the suggestions that have come out of the debate-such as keeping the savings mechanism in place while, perhaps, reducing the amount being put in, or means-testing if necessary-in order to hold on to this credit saving system that has already been so heavily invested in.
The Government are taking a terrible risk-reversing so much work that has been done to remove so many of our children from poverty. The Government have chosen to pursue this policy, and in my view and that of all Labour Members it is the wrong choice for our future generations.
Kerry McCarthy (Bristol East) (Lab):
It is almost obligatory for a Minister or shadow Minister rising at the Dispatch Box to respond to a debate to say that we have had a fascinating discussion, but I can genuinely
say that our debate has been very engaging with lots of issues discussed and clear differences expressed between Labour Members and those on the Opposition-or, rather, Government-Benches. If only they were still in opposition; then we would not be in this position of having to try to defend measures such as these against attack from them.
At least the hon. Member for Blackpool North and Cleveleys (Paul Maynard) was brave enough to speak in the debate, unlike many of his Conservative counterparts. I do not think a single Liberal Democrat spoke, and it was very disappointing to see the lack of interest from them.
Kerry McCarthy: Yes, we have to wonder whether the absence of so many Members from the Government Benches was due to a lack of interest or the fact that some of them have serious reservations about what is being proposed today. It was particularly noticeable that very few women Members from the coalition parties attended or spoke in the debate. I hope that that shows some concern on their part.
The hon. Member for Blackpool North and Cleveleys suggested that children would be better served by a piggy bank in their bedroom than a child trust fund, which shows a shocking lack of understanding of the issues. The hon. Member for Gloucester (Richard Graham) showed a similar lack of understanding by saying that an individual savings account was a better form of saving at zero cost to the taxpayer than a child trust fund. I gather from his CV that he worked for Baring Asset Management; I suspect that a background of working for Barings is not the best qualification for advising other people on how to manage their assets.
My hon. Friend the Member for Erith and Thamesmead (Teresa Pearce) made an eloquent speech in defence of the child trust fund. I want to congratulate her on becoming a grandmother today- [Interruption.] Has it not arrived yet? Well, I hope mother and baby do very well when it does finally come along. [Interruption.] Yes, there should now be a pregnant pause in my speech, as the shadow Chancellor, my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), says.
The hon. Member for Strangford (Jim Shannon) and his colleagues from Northern Ireland showed how important they thought the child trust fund was for the people of Northern Ireland. He mentioned that it is backed by the credit union movement, which is obviously well developed there, and that it has cross-party support. We very much valued his support on that point.
The hon. Member for Mid Norfolk (George Freeman) described the contributions of Labour Members as "hysterical". I have to say that that word is often used by a certain type of man when women express strong views. I am sorry if this makes him uncomfortable, but Labour Members are not desiccated calculating machines and we care passionately about defending the measures that the Government are trying to abolish in this Bill. My hon. Friend the Member for Stretford and Urmston (Kate Green) gave, as always, an awe-inspiring speech. She has impeccable credentials on this point and demonstrated the eloquence that comes from truly knowing her subject and caring passionately about it.
My constituency neighbour-in all other senses he is probably from another planet from me-the hon. Member for North East Somerset (Jacob Rees-Mogg), talked about these measures involving "pitiful" amounts that are "too small" to make a difference. It may be that in the world that he inhabits these sums are pitiful, but I ask him to cross the constituency border and come to meet some of the people whom I deal with in Bristol East, because he would then learn some lessons about how much difference these small amounts of money can really make.
That was something that my hon. Friend the Member for Walthamstow (Stella Creasy) showed in a well researched speech full of statistics. She described just how investing small sums can create substantial assets for a child in its future.
My hon. Friend the Member for Rochdale (Simon Danczuk) talked about how scrapping the child trust fund would heighten the contrast between the tax advantages for the wealthiest savers and the poorest and vulnerable slipping further and further behind. My hon. Friend the Member for Stockton North (Alex Cunningham) reminded the House of the old biblical tale of the widow's mite and the comparison with the poor being made to contribute to deficit reduction at great sacrifice while the very richest in society will not feel the same pain.
My hon. Friend the Member for Kingston upon Hull North (Diana R. Johnson) talked about how the saving gateway had been piloted in Hull. That measure was not mentioned as much during today's debate, but it is obviously important and it was praised by my hon. Friend the Member for Scunthorpe (Nic Dakin).
My hon. Friend the Member for Cumbernauld, Kilsyth and Kirkintilloch East (Gregg McClymont)-I think that I finally pronounced that right after several attempts-talked about how the child trust fund is about freedom and opportunity, and not about the nanny state. That is such an important point to make, because the fund is about creating the ability for young people to go out into the adult world with a little bit behind them that they can put to good use.
My hon. Friend the Member for Bolton South East (Yasmin Qureshi) rightly pointed out that those on the Government Benches have been using specious arguments against universalism all afternoon, yet they are not arguing that the health in pregnancy grant should be targeted, although that would be the logical conclusion of their argument. They are also not using the same argument to say that the winter fuel allowance, for example, should be targeted.
We heard a passionate defence of the health in pregnancy grant and the child trust fund from my hon. Friends the Members for Walsall South (Valerie Vaz), for Newcastle upon Tyne North (Catherine McKinnell) and for Edinburgh East (Sheila Gilmore). The latter described some of the language used or some of the suggestions made by those on the Benches opposite about what the health in pregnancy grant could be used for as quite offensive. The suggestion that ladies, as my neighbour, the hon.
Member for North East Somerset, would say, cannot be trusted to spend the money wisely in a way that would benefit their health and their child is quite offensive.
Jacob Rees-Mogg: I thank the hon. Lady for giving way, because I want to clarify that I had not made the point that people did not spend their money wisely. It may have been made by somebody else, but I would not like people to be confused.
Earlier today, after a heavy morning spent in the Finance Bill Committee, by way of light relief I watched a video that had been posted on the ConservativeHome website in January this year. It was one of those videos that the Conservative party was very fond of when it was on a mission to convince the British voters that it really had changed and was no longer the nasty party. It featured the then Leader of the Opposition, now the Prime Minister, of course, in his shirt sleeves talking with well-rehearsed spontaneity to an audience carefully chosen to seem like a random cross-section of the general public. He said that he wanted this Government
"to be the most family friendly Government we've ever had in this country and that is about everything we do to support families and it's about supporting every sort of family."
What have this Government, in collusion with their friends from the Liberal Democrat party, done to support families? For a start, what have they done to support children? The so-called emergency Budget and the spending review take away almost £7 billion from funds to support children, three times the amount the bank levy is estimated to raise. According to the Institute for Fiscal Studies, families with children will lose the most from what this Government plan to do by 2014-15. The poorest 10% of families will lose 7% of their income. The Government are freezing child benefit, cutting child care tax credits, restricting the Sure Start maternity grant to just the first child and, of course, axing the child trust fund and the health in pregnancy grant under the Bill that we have considered today.
What about when the children get a bit older? Education maintenance allowances are being abolished, school spending per pupil is being cut in real terms and the IFS has said that the pupil premium could widen funding inequalities. As the End Child Poverty campaign said after the comprehensive spending review, it was
"a dark day for any family struggling to stay out of poverty, or deep in it already and fearing things will get worse still."
What about the impact on women? Our research has shown-we have had to do our own research, because this Government seem to have abandoned any notion of doing real and meaningful equality impact assessments,
and I pay tribute to my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) for her work on it-that the cuts hit women twice as hard as men, without considering the impact of cuts to public services. We know that 65% of public sector workers are women and that two thirds of the public sector redundancies arising from the spending review are expected to be women.
Of the £16 billion cuts in total, £11 billion comes from women. Some 72% of the emergency Budget cuts will be met from women's income, and in the CSR cuts £5.7 billion will be taken from women compared with just £2.7 billion from men. A million more women claim housing benefit than men, 70% of tax credits are paid to mothers, 94% of child benefit is paid to mothers and 90% of lone parents are women. So much for being family friendly. So much for looking after every sort of family. So much for doing everything they can to support the family.
My hon. Friend the Member for Chesterfield (Toby Perkins) stole my line earlier when he talked about the Government believing in women and children being first when it came to cuts. The phrase "women and children first" comes from a mariners' saying when a ship is doomed to sink, and what we are discussing today is just the tip of the iceberg.
The Bill might be tiny in terms of written content-it is just three pages and four clauses-but it does a huge amount of damage. It scraps the support that we have given to families to help them save through the saving gateway. It scraps the chance a child from a poor family had to enter adult life with a little pot of money to help them fulfil their dreams and ambitions, something that hon. Members on the Government Benches, with their multi-million pound trust funds, could never hope to understand. It snatches away money from pregnant women-money that was designed to help them have healthy, happy pregnancies and healthy, happy babies.
The Economic Secretary to the Treasury (Justine Greening): As we have heard, this has been a vigorous debate and I am very grateful to all the Members who have contributed. The discussion has been wide-ranging and I want to start by addressing some of the wider arguments that have been made before moving on to some of the more detailed points about measures in the Bill. I shall try to cover all the speeches, although they were numerous.
My hon. Friend the Financial Secretary set out at the start of the debate the rationale behind the Bill and the role that it will play in our plan-a clear and credible plan-to reduce our budget deficit. Some Members have argued today that our plans move too fast, but our deficit is unprecedented and unsustainable so we must take action to tackle it. That action is supported across the world. Only today, Standard and Poor's, the credit rating agency, stated that the coalition parties
"have shown a high degree of cohesion in putting the U.K.'s public finances onto what we view to be a more sustainable footing".
It is simply untenable for Labour Members to spend yet another debate, yet another afternoon and yet more hours in refusenik mode arguing about what they do not like, while setting out no plans for what they would do instead.
We are spending £43 billion this year-£120 million a day-on the debt that the Government have inherited. The Labour party wants to airbrush that amount out of our financial worries, but that is simply not possible. Failing to act now would risk higher interest rates, higher mortgage rates, higher rates of business failure and higher unemployment. The Labour party knows all about higher unemployment, having again left unemployment higher when it left office than when it came in.
Toby Perkins: The Minister just said that higher employment is something that the Labour party knows all about. I do not know whether she is aware that unemployment was up near the 4 million mark under a Conservative Government. What does she consider to be a successful level of unemployment this time?
Justine Greening: The hon. Member for Edinburgh East (Sheila Gilmore) talked about judging Governments based on what they do. The previous Labour Government left unemployment around 400,000 higher when they left office than when they came in. I do not know what the hon. Member for Chesterfield (Toby Perkins) has to say to those people who were unemployed when the previous Government left office, but those people must be very pleased that the Labour Government are no longer in office taking bad decisions.
Today Labour Members have discussed fairness, but there is nothing fair about failing to tackle the deficit. They have discussed it being unfair to end eligibility for the child trust fund, but there is nothing fair about asking future generations to pay our debts, which is simply unacceptable. It was the ultimate irony to spend the afternoon listening to Labour Members discussing the value of saving, when the Labour Government left office with our savings ratio at an all-time low, as we have heard. A savings culture was nowhere to be seen in the Labour Government. If they had demonstrated a little bit more of that culture themselves, the rest of the country might have followed suit.
Justine Greening: I am sure that it suits Labour Members to talk about the past, but we want to talk about sorting out the future. The hon. Lady has mentioned interest rates, but surely she accepts that the biggest risk to interest rates is not tackling our fiscal deficit, and this Bill is part of our plan to do that. The former Chief Secretary to the Treasury, the right hon. Member for Birmingham, Hodge Hill (Mr Byrne), said, "There's no money left." For once, he was right.
The changes that we are making to child trust funds, the decision not to introduce the saving gateway and the abolition of the health in pregnancy grant will save us £370 million in this financial year, around £700 million next year and around £800 million each year from then on. That money can be used to reduce the deficit or to
fund our country's priorities today. We could not afford to spend £500 million of that money on the child trust fund, where it would have been locked up for 18 years. We want to help disadvantaged children now, which is when they need our help, and it was simply wrong to defer that help for 18 years.
We could not afford to introduce the saving gateway in July this year, at the point when we needed to start reducing the deficit, and we could not afford to continue spending £150 million on the health in pregnancy grant to every pregnant woman, whatever their income, whatever their need and however they wanted to spend it. Those policies were simply unaffordable given the fiscal challenge that we face, so we needed to take action.
I want to address some of the issues that hon. Members have raised, but let me first touch on child trust funds. A number of Opposition Members seem to be under the impression that people will no longer be able to pay into their children's trust funds, but that is not correct: people will be able to continue saving on behalf of their children. As my hon. Friend the Financial Secretary said earlier, we will introduce a new account allowing parents a clear and simple option to save for their children, while saving more than half a billion pounds from child trust funds. In the same way, we will not continue to pay the untargeted, unfocused health in pregnancy grant, but we will continue the Healthy Start scheme, which is targeted at those who need it most and which ensures that people spend their vouchers on milk, fresh fruit, vegetables and vitamins.
Let me briefly cover some of the points that have been made. The hon. Member for Walthamstow (Stella Creasy) talked about the need to maintain policies to ensure that parents can still save on behalf of their children and pass an asset to them when they reach the age of 18. First, child trust funds that are already open will still be a vehicle that parents can use to save. Only today, my hon. Friend the Financial Secretary launched details of a new tax-free savings account for children. The hon. Lady mentioned the Children's Mutual society, which very much welcomes the announcement that we have made today. It says:
"we absolutely welcome any product that promotes"
the idea of saving efficiently on behalf of children. I hope that she will welcome what it says about our plans. So we will continue to help parents and children to save and I simply do not accept the accusation that the new accounts will be of no use to people on lower incomes. The aim of the accounts is to provide people with a clear, simple way of saving for their children and we want to ensure that they will be accessible to people on lower incomes. The accounts will also allow savings to be locked up until children reach adulthood, so this is not about giving wealthy families a tax break.
The important issue of looked-after children has been raised. The details of any new tax-free account that is launched have yet to be agreed, and, as I said in the Westminster Hall debate last week, I am open to suggestions from hon. Members and others about how we can ensure that local authorities with parental responsibilities for looked-after children play their role in contributing in this area.
I congratulate the hon. Member for Erith and Thamesmead (Teresa Pearce) on her imminent grandchild and I assure her that a child born today will still be
eligible for the child trust fund. Her daughter will have got the health in pregnancy grant and if this is her first child she will be eligible for something that has not been mentioned today-the Sure Start maternity grant.
I hope that I have dealt with the specific points that have been raised and I conclude by returning to the wider point of the Bill. If we had carried on with these policies, our plans for reducing the deficit would have meant finding £3 billion of extra spending cuts elsewhere. Instead, these actions, alongside other difficult decisions, enable us to protect critical areas such as health, spending on schools, tackling the welfare state that currently traps people in poverty, laying the foundations for growth in our economy and creating more of the jobs that will ultimately help us to get the economy back on track. I commend the Bill to the House.
That the following provisions shall apply to the Savings Accounts and Health in Pregnancy Grant Bill:
1. The Bill shall be committed to a Public Bill Committee.
Proceedings in Public Bill Committee
2. Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 11 November 2010.
3. The Public Bill Committee shall have leave to sit twice on the first day on which it meets.
Consideration and Third Reading
4. Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
5. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
6. Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading.
7. Any other proceedings on the Bill (including any proceedings on consideration of Lords Amendments or on any further messages from the Lords) may be programmed. -(Mr Newmark.)
That, at this day's sitting, Standing Order No. 41A (Deferred divisions) shall not apply to the Motion in the name of Justine Greening relating to Excise. -(Mr Newmark.)
That the Alcoholic Liquor Duties (Definition of Cider) Order 2010 (S.I., 2010, No. 1914), dated 27 July 2010, a copy of which was laid before this House on 27 July, be approved. -(Mr Newmark.)
Mr Speaker: Just before I call Mr David Amess, can I please appeal plentifully and strenuously to right hon. and hon. Members who are leaving the Chamber to do so quickly and quietly, so that we can hear the hon. Gentleman?
Mr David Amess (Southend West) (Con): When I applied for this Adjournment debate, I did not anticipate quite the level of interest that there appears to be from colleagues, because I did not want to talk about specific constituency matters; I wanted just to draw to the House's attention to one or two general midwifery matters. So all I would say, Mr Speaker, is that I hope that colleagues will be fortunate enough to catch your eye.
There can be no more personal, emotional or exhilarating experience than watching a baby being successfully delivered. I had the privilege of watching each of my five children being brought into this world, and the sense of wonder and excitement is very personal and unique to everyone, but I am much more comfortable observing babies being born than having to deliver one. It is extraordinary how some members of the animal world seem to have babies so much more easily than human beings do.
However, the point that I really want to make is that from a woman's perspective, there can be nothing more personal than the relationship that a lady having a baby has with the midwife. Indeed, when our five children were born, I represented Basildon, and so strong was our relationship with the midwife, a wonderful lady called Ladze, that she ended up being godmother to all our children.
Despite some improvements in the national health service's maternity provision in recent years, much more must be done to ensure that women throughout the United Kingdom receive the best care possible. For those and many other reasons, I want the House tonight to consider how best we can value and support the work of our wonderful midwives.
Let me say immediately that Southend's maternity services are absolutely splendid. Indeed, their quality was recognised in the Healthcare Commission's report into maternity services in the UK, in which Southend University hospital was rated one of the very best in the country. Indeed, I have just heard that I have become a member of the Royal College of Midwives parliamentary panel. It is unpaid and voluntary, but I declare it as an interest. As I am sure that all colleagues will agree, midwives throughout the country provide an absolutely invaluable service.
Recently, when I was privileged enough to undertake voluntary service overseas in the Philippines in order to support Filipino nurses, I went to a village in Ifugao, and there at first hand I witnessed just how difficult it is for some ladies to deliver babies. Our services in the UK are somewhat better than those in the Philippines, bearing in mind the challenges that are faced there, but we could still do much better.
Relations between midwives and consultants must be strengthened, and I say to my hon. Friend the Minister that more training should be available to midwives. Although the previous Government claimed some success in introducing consultant midwives in 1999, by 2009 there were only 59 throughout the United Kingdom-just not enough.
Midwives throughout the country are anxious about the outcome of the review of their pensions. The NHS pension scheme hands billions of pounds over to the taxpayer. Indeed, more is paid into the fund than is paid out to pensioners. In the past five financial years, the scheme has handed over £11.3 billion in surplus to the taxpayer, thereby helping, not hurting, public funds.
I congratulate my hon. Friend Baroness Cumberlege on the work that she did when she was a Health Minister in 1993. The report that she produced, "Changing Childbirth", is as relevant today as it was back then. Furthermore, the work of the Royal College of Midwives, under its very capable general secretary, Cathy Warwick, must be acknowledged. This organisation, which represents 95% of all practising midwives in the UK, does wonderful work that helps women and newborns across the country. The NCT has also given me an excellent briefing on this subject and I know that it supports the points that I wish to raise this evening.
There has been a decade-long baby boom, with 100,000 more babies born last year than in 2001. Rises in the number of midwives have gone some of the way towards catching up with this extra demand. Indeed, there has been an increase of 2,000 in the number of midwives in the last three years and more than 600 more places for student midwives than there were four years ago. However, those extra midwives have largely been swallowed up by the need to provide valuable one-to-one care in labour. This means post-natal care remains woefully inadequate. Extra demand has also come from growing complexity. Mothers are increasingly younger or older than before, and some mothers have serious weight problems. The conception rate for women aged 40 to 44 has doubled since 1991, while the teenage pregnancy rate in the UK remains the highest in western Europe. There have also been significant increases in multiple pregnancies and pregnancies to women with medical conditions that would previously have precluded childbirth. The caesarean section rate is also at a historically high level-just shy of one in every four births. More midwives would help to provide women with the level of antenatal care that would prepare them properly for labour and birth.
Currently we are almost 4,800 full-time equivalent midwives short, based on calculations using established midwifery work force planning tools. For too long, maternity services were not a priority within the NHS: spending on maternity care as a proportion of the NHS budget fell from more than 3% in 1997 to below 2% in 2006, and the share of the NHS work force made up of midwives fell throughout the Labour years. Indeed, while in 1997 there were more midwives in the NHS than there were managers, after 12 years of a Labour Government, by 2009 there were 18,000 more managers than there were midwives-a ridiculous situation. The contrast in what has happened to the two work force groups illustrates how focus may have slipped away from clinical care on to performance monitoring and the dreaded targets. It is the task of the new Government to ensure that midwives do not continue to be sidelined, that their work is valued and that focus returns to good quality patient care.
Aside from resources, however, is the question of policy. The recent White Paper promises that the Government will extend maternity choice but there are questions about how it will be achieved. Although the
Labour Government often said the right things and made many promises in relation to choice, they failed to deliver. Progress in implementing choice for women throughout pregnancy, childbirth and the post-natal period was impeded by a lack of sustained investment in maternity services; insufficient recruitment of midwives; and a lack of prioritisation on the part of many commissioners and providers of maternity services. It is easy to assume that it saves money to consolidate, but I do not believe that in the medium to long term that is true.
The main issue with choice is location-the options being birth in a consultant-led unit in a hospital; birth in a midwife-led unit, which may or may not be on a hospital site; and birth at home. A midwife can handle more births in a year in a midwife-led unit or at home than in a hospital, so it is an issue of efficiency as well as choice. Capital investment to provide more midwife-led units is vital, but sadly the total number of such units has dropped significantly in the last two years.
The price of getting maternity care wrong is extremely high, as the cost of litigation shows, and in a time of austerity these are costs that the country simply cannot afford. Of the 100 biggest damages payouts made under the clinical negligence scheme for trusts, 79 derived from obstetric care, and of the total £3 billion paid out in damages under the CNST, almost £1.4 billion was down to claims deriving from obstetrics. Cutting corners in maternity care carries a heavy human and financial cost.
In conclusion, the Prime Minister has admitted that the profession is "stretched to breaking point", "overworked" and "demoralised". During the election, all three parties agreed that more midwives were needed to cope with the continuing shortfall. Rightly, the NHS was shielded from cuts in the comprehensive spending review, and this protection should mean that the Government can provide enough midwives to deliver the level of maternity care that women and newborns expect and thoroughly deserve.
Caroline Dinenage (Gosport) (Con): I will be brief, Mr Speaker. I just wanted to reiterate what my hon. Friend the Member for Southend West (Mr Amess) said. My constituency has a midwife-led maternity unit, Blake ward, at Gosport war memorial hospital, but it has been shut down temporarily on the basis that there are not enough midwives to cover the area. They have all been put into the Queen Alexandra hospital in Portsmouth. I am concerned about that because Gosport is a peninsula serviced by the A32, which is an unbelievably difficult road at the best of times, and I am worried that babies will be born somewhere along the road or on a roundabout.
I desperately wanted to bring that to everyone's attention, particularly the Minister's. The ward has only been shut until January, but this follows an incident earlier in the
year when the birthing pool was shut down. Now the ward has been shut down temporarily because of a baby boom caused by the snow earlier in the year. I sometimes feel that these are closures by stealth and that eventually the ward will be shut permanently. It is important that everyone understands the huge importance of these wards, particular the midwife-led maternity units, and especially in areas such as Gosport, which has high levels of social deprivation.
Jason McCartney (Colne Valley) (Con): I congratulate my hon. Friend the Member for Southend West (Mr Amess) on securing this Adjournment debate. Maternity services are an emotional and controversial topic in my constituency, because Huddersfield royal infirmary consultant-led maternity services closed in August 2008. Mums now have to be transferred to Calderdale hospital if there are complications during birth. Many mums are opting for Halifax just to be safe. There is a new midwife-led unit at Huddersfield royal infirmary, but mums want specialist and emergency care available there too. In an emergency, the time it takes to travel to Halifax can be the difference between life and death for mother and baby. Many Departments of the coalition Government are championing localism, and rightly so. I therefore plead with the Minister to reconsider restoring full maternity care close to where mums need it most.
Mrs Helen Grant (Maidstone and The Weald) (Con): In a few months, if the current plans proceed, there will be no consultancy-led maternity service at Maidstone hospital in my constituency, which means that every year, 2,000 mothers will be put at greater risk, and lethal consequences could follow. Maidstone is the county town of Kent, and is a growth point area. There are many areas of multiple deprivation, and we have high rates of teenage pregnancy, so we need a full maternity service. Our community has spoken out loud and clear against the reconfiguration plan. Thousands have signed petitions saying no. Our borough and county councillors have said no. The business community has said no. As a local resident and mother of two, I have said no, and in a survey with a 77% response rate, 97% of our GPs also said no.
We are not people who are resistant to change. We are not asking for anything new; we do not want anything extra. We simply want to retain our existing services, and make safe and genuine choices for our people. Choice, we are told by the trust, will be available to Maidstone mothers for the first time, but the choice is between a midwifery-led birthing unit with six beds for the county town of Kent, serving 250,000 people, or travelling to Pembury, Medway, Ashford or Dartford. However, mums with complications will have no local choice, and neither will mums needing an epidural, mums needing a caesarean section or mums who just want to know that they will have the best expertise and equipment available to them when their baby decides to come. The trust says that patients will vote with their feet, but it does not tell people that, if they want to remain in Maidstone, they cannot do so.
I have with me a bundle of letters to the Secretary of State for Health signed by more than 100 GPs in the Maidstone area. They say that the new journey times, over bad rural roads, are unacceptable. They say that the extra risk and stress to mothers in labour is unacceptable. Those GPs also say-this is really worrying-that it is a near certainty that some babies born in Maidstone may die or suffer brain damage while en route to Pembury or elsewhere. They are our GPs: they know exactly what they are talking about. They have voted. They have put their names down and they are saying no. They are talking about our mothers, our children and our babies. The campaign has been going for about two and a half to three years while I have been involved. It is about community, choice and safety. The evidence against downgrading is powerful and profound. The reconfiguration plan is very wrong and dangerous, and it will lead to fatalities. I urge the Secretary of State to reject the reconfiguration plan when he considers the matter imminently.
The Parliamentary Under-Secretary of State for Health (Anne Milton): I will come to the speeches by other hon. Members when I have dealt with-that sounds awful, -my hon. Friend the Member for Southend West (Mr Amess).
I am aware that my hon. Friend has maintained an active interest in this issue for many years, and I congratulate him on securing the debate. I should like to start by agreeing with him that there is nothing in the world more wonderful than a baby being born. I have given birth to four children, at four different hospitals. As is the case for many parents, having a baby was the most amazing thing that has ever happened to me. Getting elected to this House was a close second, but nothing compares to giving birth.
Maternity care is so much more than a new arrival in the family. Pregnancy is a vital time for health promotion, and a time when parents are receptive to information and advice, and motivated to do the best for their children. For some of the more hard-to-reach people in our communities, pregnancy is one of the first opportunities that health service professionals have to talk to them about bringing up children, as well as about their own health and well-being. The impact that midwives can have is significant. Midwives and our maternity services can help us to tackle issues such as nutrition, physical activity and health inequalities, which are some of the biggest public health issues that we face. Later this year, the Government will publish a public health White Paper setting out more detail, but there is no doubt that pregnancy and childbirth are golden opportunities.
The Government set out their long-term vision for the future of the NHS in the "Equity and excellence: Liberating the NHS" White Paper. We are committed to extending choice in maternity, to enable women and their families to make safe, informed choices throughout pregnancy and about childbirth. Maternity networks will help to make this a reality. They will extend choice by encouraging providers to work together to offer expectant mothers and their families a broader choice of maternity services and to facilitate a woman's movement between the different maternity services that she might want or need. Networks will also need to work closely
with health visitors to ensure the very best support for families at this vital early stage in their child's life. The extra 4,200 new health visitors that we plan over the lifetime of this Parliament will complement the work of maternity services to improve support for all new families and help to ensure extra support for those who need it most. The White Paper consultation period closed earlier this month and we are now considering the responses from the various royal colleges, stakeholders and the public.
I should like to join my hon. Friend the Member for Southend West in commending the work of the Royal College of Midwives, of Cathy Warwick and of all those who have gone before us. He mentioned the noble Baroness Cumberlege's work on the "Changing Childbirth" report. That document has stood the test of time, with its insight into what is needed during this special time for families. I should also like to join the praise for the National Childbirth Trust. I am proud to say that I was chairman of its Hackney and Islington branch many years ago, when my first child was born. I certainly know only too well the contribution that it makes to many families.
Women and families who are well informed about the maternity care options available to them are more likely to receive the care that meets their particular needs, to feel more satisfied with their care and to feel confident about the transition to parenthood. In recent years, maternity services have faced increased challenges, including a rising birth rate and an increase in complexity in pregnancies. Demographic changes in childbearing, such as more women giving birth at a later age, increased rates of heart disease and obesity, and more births to mothers born outside the UK have resulted in a greater number of higher-risk births. We welcomed the recent guidelines produced by the National Institute for Health and Clinical Excellence on pregnancy and complex social factors.
Stephen Lloyd (Eastbourne) (LD): Will the Minister confirm that the organisations that she has mentioned, including the National Childbirth Trust, all emphasise, as my hon. Friends have done this evening, that a key part of pregnancy and maternity services is that they should be close to the mothers-to-be? I believe that that is a clear objective of the White Paper, as well as of many of the organisations and groups that have been mentioned. Will she confirm that that will be a thread running through the findings of the White Paper when they finally come before the House in the form of a Bill?
I should like to mention the Marmott review, "Fair Society, Healthy Lives", which highlighted the strong associations between the health of mothers and the health of their babies. It also pointed to equally strong associations between the health of mothers and their socio-economic circumstances. This means that pre-conception care and early intervention before birth are as important as support during and after the birth. We need women to access maternity care early and for that to continue, exactly along the lines that the hon. Member for Eastbourne (Stephen Lloyd) suggests.
Family nurse partnerships will be extended so that we can provide the highly targeted, highly specialised support through pregnancy and the first years of life that the most vulnerable young families need. Our vision is for all women to have choice and equity of service standards and quality of care, wherever in England they are receiving care. However, we know that, in practice, not all women are offered a choice. "No decision about me without me" is what this is all about. It is about giving people the opportunity and support to make the choices that will make a difference to them, their babies and their families. It is also about giving them the information they need to exercise control, and of course the confidence to use it. Not all families find that easy.
The new outcomes framework proposes five national outcome domains covering all treatment activity across effectiveness, patient experience and safety. A number of indicators for maternity and children were proposed, including maternal death, infant mortality and the unexpected or unplanned admission of term babies to neonatal care. The consultation period has now closed and we are considering the responses. I hope that that will deal with many of the issues that have been raised this evening.
Midwives and the maternity team use their skill and compassion to help parents-to-be along their journey-a vital journey-to parenthood. We will make sure that any changes in services are led by local clinicians, patients and service users. The NHS White Paper is all about giving control of health services to the clinical staff who deliver them. My hon. Friend the Member for Maidstone and The Weald (Mrs Grant) spoke passionately about that this evening.
Effective skill mix in the maternity work force will be important. The NHS is focusing increasingly on utilising the whole maternity team and helping to use innovation and new technology to drive up the quality of care and deliver value for money.
In the next few months, we will receive information about women's experience of maternity services from surveys conducted by the National Perinatal Epidemiology Unit and the Care Quality Commission. These survey results will give us a clear and up-to-date picture of what women think about the maternity services they receive and what more needs to be done.
My hon. Friend the Member for Gosport (Caroline Dinenage) raised local concerns about the closure of the Blake. Although I am assured that it is due to open again in January next year, I know how very unsettling it is to have local services closed. It causes a loss of confidence among local people.
My hon. Friend the Member for Colne Valley (Jason McCartney) raised the closure of services in his area. I am sorry, but sadly we cannot always turn back the clock. I am delighted to hear that a new midwife-led unit has opened and I hope it will be possible to provide people with the services they need.
As I have already said, my hon. Friend the Member for Maidstone and The Weald also raised some constituency issues. Nobody but nobody could have done more or have campaigned harder on those issues. I know that the Secretary of State asked the strategic health authority to report to him at the end of September, and he now has that report. I am sure that my hon. Friend will agree that the Secretary of State must be allowed some time to consider the report's content.
I thank my hon. Friend the Member for Southend West for calling this debate. He has raised a number of important points about maternity care and the provision of maternity services. Our White Paper gives us the chance to refocus the NHS on what is important to its users and staff, providing those services so that we achieve the results that are important to them-ensuring
that all women and their families have access to the best possible care at this crucial time in their and their family's lives.