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Put simply, the Government have not got to grips with child care costs, partly because they have failed so miserably to resolve the issues of availability of care, to which I will turn in just a moment. That failure has guaranteed that child care is one of the driving forces behind the feeling of so many families that they are not getting the benefits of economic recovery. If there is growth, too many people are just not feeling its benefits. Many parents find that going back to work, or going back to work for their preferred number of hours, is simply not financially viable. The policy reduces employment—it is why Britain has one of the lowest maternal employment rates in the OECD—and contributes to the gender pay gap. However, this is by no means a women-only issue; dads are hit by unaffordable child care too. By hitting family budgets and cutting the ability to earn, high child care costs contribute far too often to child poverty.

After more than a million children were lifted out of poverty under the previous Labour Government, progress has now ground to a halt. The Social Mobility and Child Poverty Commission says that if the Government continue on the current track, they are doomed to miss the 2020 target to eradicate child poverty. We will not meet that noble aim, established by the previous Government, without a serious policy on affordable child care.

Any steps to increase the support available to families are welcome. Labour’s Front-Bench team have made it clear at every stage that we do not oppose the Bill and that we support its aims. In some respects, it builds on the scheme introduced by my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown) in 2004, which allowed for £50 of tax-free child care each week. The tax system is a valuable mechanism in securing more affordable child care, but there are limitations to its effectiveness.

As my hon. Friend the Member for Newcastle upon Tyne North has already said in relation to new clause 1, there are real risks from adopting a demand-side-only approach to this issue. There is little in the Bill that seeks to address the underlying inflation of child care costs. Indeed, there is serious concern in many quarters that it could simply end up exacerbating those pressures. The Committee heard evidence from Australia that, following the introduction of a 30% child care rebate, the following decade saw child care costs rise by 100%, compared with an inflation rate of just 27%. There are similar such examples in the Netherlands.

We should be frank that the introduction of the UK tax credit system, immensely valuable as it was, was followed by a period when child care cost inflation was higher. We want the Government to learn properly from that experience. The simple fact is that many child care providers are close to breaking point. Their operating costs have risen significantly. Some held down price increases during the worst years of the downturn so as to retain customers and are now under even more strain. Some have gone under. This is not a market with lots of spare cash floating around, either from provider or consumer.

In the Bill, the Government propose to put a significant sum into the market, and that will be a welcome boost. However, it is only logical and understandable that businesses that face rising costs, and which may have attempted to restrain price increases in the worst years, should see the moment when consumer spending power

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increases overnight as an appropriate time to increase their fees. The National Day Nurseries Association told the Committee that its members needed to “play catch-up” with regard to prices. In written evidence, the Family and Childcare Trust said that

“there is little incentive for these providers not to increase prices to take advantage of the extra subsidy.”

The Institute for Public Policy Research has gone so far as to estimate that the inflationary pressures unleashed by the extra cash could negate the positive impact of the subsidy to families within a matter of just a few years. That is a crucial point of which the Government should be aware. If they really want each and every family in our country to see the benefit of growth, they must be aware of the risks that they face. Such an outcome would obviously be bad for parents, who would be paying as much as they do now for the same thing, but it would also mean that the Government had secured appalling value for money for their child care policy. We all have an interest, across the House, in ensuring that that does not happen. It is also why Labour is deeply sceptical about the wisdom of a demand-side-only approach.

Hywel Williams (Arfon) (PC): Does the hon. Lady accept that there are particular stresses on parents in rural areas, as the cost of travel has to be added to the cost of child care itself? The money could be better deployed in such areas in increasing the provision rather than the amount that child care providers get.

Alison McGovern: It is important for all of us to recognise the extra pressures on families in rural areas. People’s circumstances are different. We want to increase employment in rural areas as well as in suburban and urban areas. The hon. Gentleman makes an important point.

Alex Cunningham: My hon. Friend helps me to talk about the needs of parents with disabled children. When inflation and prices go up, the increase is felt particularly acutely by those families. Does she agree that the Government really need to think again about that particular element?

Alison McGovern: Again, I support the views of my hon. Friend. Too often, parents of children with disabilities are forgotten in our debates. They have the most important responsibility. Children with disabilities deserve all our care and attention. I hope that, by raising this matter, we can remind ourselves that their parents might not have the time to make these points, so it is important that we all remember the extra costs and the circumstances that those parents face. We all have an interest in this matter. It is why Labour is sceptical about the wisdom of a demand-side-only approach.

In general, better value for money and better outcomes could be achieved through a radical expansion of the free child care entitlement to three and four-year-olds, from 15 hours a week to 25, paid for by an extension of the bank levy. There is no better week than this to be making the argument about extending the bank levy, as once again we are seeing banks being taken to task for their poor behaviour. I make no apology for reminding Members about the importance of that bank levy, especially as it could pay for something as vital as child care.

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As we saw from the debate on new clause 1, the Government are not about to accept the policy—more fool them—but we want to ensure that Ministers are required to keep track of the inflationary impacts. New clause 2 requires that within three months of the Bill’s becoming an Act and every three years subsequently, the Chancellor will have to review the impact of the subsidy on making child care more affordable, on what the average cost of child care for parents in work is and on whether supply-led measures could be more effective. That is not a massively onerous burden on the immense capabilities of the Treasury, but a very valuable canary in the coal mine regarding child care inflation.

In Committee, the Minister was consistently against any suggestion of hourly rate capping or other means of placing a brake on any inflationary pressures arising from the policy. A regular review might demonstrate whether the post hoc implementation of such provisions might in fact be necessary if the subsidy is to be anything more than a damp squib.

The Bill is a blunt instrument that fails to target Government funding and gives the most financial support to the best-off families. It will possibly provide some short-term relief for parents, but does little to deal with the underlying problems of inflation, supply and quality in the child care system. There are 40,000 fewer child care places in England than there were when the Government came to power and almost 4,000 fewer suppliers. Childminder numbers are down by 13%. For tens and likely hundreds of thousands of families across the country, the proposals in the Bill will mean little or nothing because they simply cannot find a child care place or access one that will offer the flexibility in hours to fit around work. We need radical reform of the broken child care market. This Bill does not provide it, but by supporting new clause 2 today Members can at least take a step that will help guard against its being a worse than a useless creator of child care cost inflation.

Alex Cunningham: My hon. Friend the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) has already talked about the complexity of the Government’s scheme. Amendments 12, 13 and 3 to 11 are all aimed at simplifying the relationship and interaction between the tax-free child care scheme and other sources of support, particularly tax credits and universal credit.

Members might be aware that I tabled amendments 3 to 11 in Committee with the intention of broadening the provisions of the Bill and allowing those households in receipt of tax credits that do not receive any support for their child care costs in their tax credit award to receive support from the tax-free child care scheme. My hon. Friend the Member for Wirral South (Alison McGovern) has already outlined that the working poor have been hit most by the policies of this Government and I would like that not to apply to child care.

Giving those people help will entail several minor changes being made to the clauses dealing with the special rules affecting tax credits and universal credit claimants: specifically clauses 30, 32, 35 and 36. In Committee, the Minister was very clear about the need to deliver a welfare system that is

“designed to encourage progression into work”.––[Official Report, Childcare Payments Public Bill Committee, 23 October 2014; c. 223.]

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However, that is not what will result from the Bill in its current form.

Let us take as an example a parent who is offered 15 hours of work a week on a low rate of pay. Most, if not all, of any gains from this employment could be totally lost in child care costs. They would not get any support from the Government to meet those costs and might therefore not be able to afford to take the work in the first place, and I for one would not be surprised if they chose to spend the time with their children instead. These amendments, however, would create a much greater financial incentive for people to start working part time.

It is important to be clear from the outset that the purpose of the tax-free child care scheme is to provide support for child care costs for those who are not eligible for help from elsewhere. As I mentioned when I raised the matter in Committee, there is an anomaly in the Bill if we are serious about encouraging people to go back into work or to stay in work—particularly those who are on the lowest earned incomes in our society.

The Bill as it stands says that the Minister recognises that there are some who do not get any help through tax credits but that the Government will do nothing to help. I am sure that that is not what she intends. Indeed, in Committee, she specified that the new scheme should not interfere with financial incentives for people to work more hours, let alone create perverse incentives, but that is precisely what the Bill will do.

Many parents who claim tax credits are both working and incurring child care costs, but they are not entitled to claim the child care element because, for instance, they do not meet the minimum number of working hours per week to qualify. Clause 30, however, makes it clear that any tax credit award will be terminated when a valid claim for the tax-free child care scheme is made, regardless of whether the child care element of working tax credit is received. Put into context, that means that households in which one parent is working full-time while the other works 12 hours a week will not be entitled to receive the child care element of tax credits to support them in the payment of child care costs. Similarly, single parents working 15 hours or fewer per week on average will also not be entitled to the child care element of working tax credit. Both would have to pay for their child care out of their own, potentially low, earnings.

7.15 pm

There can be no doubt that that would be all the harder to swallow if such parents knew that their next door neighbour, who worked the additional hour to hit 16 hours a week at minimum wage, would get up to 70% of their child care costs paid through tax credits, or that their neighbour on the other side who earned too much to receive any tax credits would get support of up to £2,000 per child through each of their tax-free child care accounts.

We all know that many part-time workers have very little control over whether they can work more than 16 hours. Shift workers often have to work the hours that are available to them. It can be a big disincentive to work if people cannot guarantee that they will be able to secure 16 hours of work and qualify for the support that would mean that they would be able to cover the costs of child care. These amendments would give working

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families that security, allowing them to go to work safe in the knowledge that however many hours they work, they will have enough support to pay for their child care.

In Committee, the Minister highlighted the fact that as earnings increase tax credit payments are gradually reduced. That includes any child care element. However, that should not result in any additional complexity, because what matters under the amendment is a parent’s initial entitlement, not whether their final payment has been tapering off. At the same time, the amendment would also conveniently address another matter. As I said in Committee, many parents will be very aware that they do not receive help with child care costs from tax credits. Some are therefore likely to be confused by the message that the tax-free child care scheme is to provide support for child care costs to those who are not eligible for help from other sources that are state funded. Indeed, I for one would not consider it unreasonable or unforeseeable for parents in such circumstances to expect that they can claim tax-free child care in addition to tax credits. However, if they claim tax-free child care, their claim for tax credits will be stopped.

I hope that the Minister will examine very carefully what she could achieve by accepting this group of amendments. She could provide some very limited support to those who need it most and at relatively little cost. Once again, I ask her to consent to paying a 20% top-up on small contributions to child care made by some of our poorest working people who are otherwise at risk of slipping through the safety net.

Amendments 12 and 13 would similarly make provision to close potential holes in the safety net. They would allow the current scheme to go forward as designed, but, if it were deemed desirable following the necessary further consultation, they would create provision for tax-free child care and/or child care accounts to be expanded to households in receipt of universal credit or tax credits without the need for additional primary legislation. In Committee, the Minister argued that families in receipt of universal credit will

“already receive good, generous support for their child care costs”.––[Official Report, Childcare Payments Public Bill Committee, 21 October 2014; c. 176.]

However, she also pointed out that, as we all know, the roll-out of universal credit is ongoing and quite slow. Although I do not doubt that much work is going in to getting it right, that is not a guarantee that the right formula will be achieved straight away.

I was concerned, to say the least, that the Minister was unable to offer a definition of “changing circumstances” as that was deemed still to be a work in progress, and I feel it would be premature to rule out the possibility of extending the tax-free child care scheme and child care accounts without further primary legislation at this point. In essence, clause 11 specifies that neither a person receiving child care support under the tax-free scheme nor their partner can be in receipt of universal credit at the time of making a declaration of eligibility. Clause 15, on the other hand, deals with the rules that apply to child care accounts and sets out details such as who can hold an account and who can provide one. I will come to that in a few moments.

The Committee discussed in some detail the complexity of the interaction between the various sources of support for child care costs, whether through the tax-free child care scheme, tax credits or universal credit. There can

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be no doubt that there is potential for great confusion among parents. Indeed, I suggest that those interactions have still not been adequately considered. The Minister claimed in Committee that it was the Government’s

“objective and my mission to ensure that the scheme is easy for parents to use”––[Official Report, Childcare Payments Public Bill Committee, 21 October 2014; c. 176.]

I urge her to look again at these amendments.

The extreme complexity of the competing options is likely to lead to confusion for claimants, and to result in them having considerable difficulty making sensible and informed financial decisions. Take, for instance, the tax-free child care scheme in the Bill. The amount payable under the scheme is not means-tested, yet universal credit, tax credits and housing benefit are all means-tested, so the amounts payable will vary with income and circumstances. The upshot is that the system that is financially right for an individual will depend on a number of interconnected factors and will not always be immediately clear. It will, in short, become nigh on impossible for some to calculate.

For those who are on the threshold between different systems, the complexity will be greater still. For many, particularly those with fluctuating incomes such as the self- employed, or those likely to have a change in circumstances later in the year, the complexity will be so great that it is likely to be impossible to provide a better off calculator that can cover many of the situations in which claimants find themselves.

Hywel Williams: I very much agree with the thrust of the hon. Gentleman’s argument. His point applies particularly to people in seasonal industries such as agriculture or, as in my constituency, tourism. I am sure that he agrees that there is a particular problem for those sorts of workers.

Alex Cunningham: Yes. I am grateful to the hon. Gentleman for that intervention. I most certainly do agree with him. Pieceworkers and others can have hours and wages that fluctuate over a long period; they will most certainly be affected. I feel that the

“easy-to-use online tool”––[Official Report, Childcare Payments Public Bill Committee, 23 October 2014; c. 222.]

promised by the Minister in Committee will prove elusive.

On top of the sizeable potential for confusion, the different mechanisms by which child care costs are to be paid under the tax-free child care scheme and universal credit are also worrying. As we are aware, under the tax-free scheme, payments will be made through child care accounts. That will provide families who are in receipt of tax-free child care with an important budgeting tool to help them manage their finances; that is particularly important as payments will be made through child care account top-ups before costs are paid by the parent. However, child care support received through tax credits and universal credit cannot be provided through child care accounts. That means that child care payments are not aligned, which gives rise to the potential for further confusion and complexity for parents, and it means that an important budgeting tool for households in receipt of tax-free child care is not available to those receiving child care support through universal credit.

It is worth highlighting that the Children’s Society report “The Debt Trap” found households in poverty containing dependent children to be twice as likely to be in some form of arrears as families on higher incomes.

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It is precisely these families who are most likely to need help with budgeting, but who will be given the least support. Moreover, universal credit payments of child care costs will be made in arrears. As Members will be aware, parents are usually required to pay child care providers one month in advance, but families on low incomes claiming universal credit are likely to have the lowest savings, if any at all; this will inevitably result in many being forced to borrow money to pay for their child care up front. We should be under no illusion: that could be a hefty sum, and if child care costs are higher during school holidays, further loans may be required to meet those costs. This runs the obvious risk of forging a cycle of dependence. Reporting requirements for universal credit are significantly greater than those for either tax credits or tax-free child care, and any failure to report in time will lead to the loss of all payments for that assessment period.

Mark Durkan (Foyle) (SDLP): Does the hon. Gentleman not think it strange that in this time of austerity and everything else that we hear about, the Government have come forward, under this Bill, with a child care payment scheme that gives more, including more flexibility, to those who have more? I am thinking of the bankable allowances and so on. Compare that with what the Government are providing, in terms of child care, under the universal credit rules. It really is one scheme for the better-off, and another, much worse scheme for the less well-off.

Alex Cunningham: I most certainly do agree with my hon. Friend. It is a peculiar world—I would use the word “bonkers”—when someone earning £100,000 can benefit more from a new Government scheme than somebody on perhaps £20,000. It is important that the Government think again on some of these points.

Let us not forget that families on higher incomes will get their child care accounts topped up by the Government before they have to pay their provider, so the rich get paid up front, while the poor do not get any payment at all. One possible solution that could be explored further is the provision of child care accounts and tax-free child care to families in receipt of child care support through tax credits or universal credit. Allowing these claimants to use child care accounts to receive their payments of child care costs would allow receipt in advance of payment, but without the risk of any overpayments being lost within wider family budgets. However, as things stand, the Bill would not permit that without additional primary legislation. These minor amendments to clauses 11 and 15 would allow the tax-free child care scheme to go forward as designed, while allowing us the time to consult and to assess these issues fully. We would have the flexibility to make changes by regulation, rather than through additional primary legislation.

Universal credit is still in its infancy and is being gradually rolled out. It seems to make little sense to limit how it may evolve by putting barriers, in the form of primary legislation, in the way of what may be sensible reforms. I would like to hear from the Minister what further considerations she has given to extending the tax-free child care scheme in this way, and expanding child care accounts beyond the scheme. I hope that she

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will support these minor amendments, which would allow for the potential benefits that those changes could deliver, particularly for some of the poorest people in our society.

Priti Patel: I welcome the hon. Member for Wirral South (Alison McGovern) to her position and post. It is good to hear from her. Obviously, she did not have the full benefit of participating in the Committee, so it is good to hear her views today.

New clause 2 is about the Bill’s impact on child care costs, an issue that we discussed at some length in Committee. The new clause would require the Government to publish a review of the Bill’s impact on the cost of child care three months after it passed into law, and every three years thereafter. The review would have a particular focus on the effectiveness of the Act in making child care more affordable, the average cost of child care for working parents, and the impact of supply-led measures on costs.

As I have said many times in debates on this Bill, the Government have made a clear commitment to review the impact of the scheme two years after full implementation. That was set out in the impact assessment published alongside the Bill. The Government feel that a two-year assessment period is reasonable and will allow sufficient time for the scheme to become bedded in, so that the full impacts can be assessed and properly evaluated in the context of wider Government policy. We do not think that there is anything to be gained from adding a further review after only three months.

I think that all hon. and right hon. Members are rightly concerned about the impact that high child care costs have on working parents. We understand the cost of child care, and the Government are committed to supporting parents to meet that cost; that is the purpose of the Bill.

Bob Stewart (Beckenham) (Con): I assume that the Minister and her team will watch this very closely from the start. She may not need a review: if she saw something going wrong, she would take immediate action to correct it, before the two-year point.

Priti Patel: I thank my hon. Friend for his comment. Naturally, we want to get this right, so there is oversight at every level. Later in my remarks, I shall touch on areas where his remarks are valid and pertinent.

We know that child care is an expensive outgoing for many families across the country. This Government understand the need for both demand and supply-led measures to ensure that the costs of child care do not spiral out of control. We have been taking steps to ensure that both sides of the problem are properly considered. The Government believe that increasing supply is an effective way of limiting further price rises, and are therefore making significant reforms to support the child care sector in increasing the supply of places.

The Government are taking actions beyond the scope of the Bill to improve the quality and supply of child care provision. These reforms are designed to ensure that any increase in demand for child care arising from the new scheme will be matched by increased supply and not by increased costs. The latest figures show that there are about 100,000 more child care places than in 2009, and the Government are taking action to grow

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the supply of child care still further, which will improve choice and affordability for parents. For example, we are making start-up grants of up to £2 million available to help people set up new child care businesses. We are also enabling good and outstanding childminders to access funding for early education places. Only 4,000 do so currently, but as a result of our reforms, up to 32,000 will be automatically eligible. We are making it simpler and easier for schools and child care providers to work together to increase the amount of child care available on school sites, and only this year we have introduced childminder agencies, which are designed to improve the support available for both childminders and parents, and to simplify existing regulatory frameworks to allow nurseries to expand more easily.

We recognise that child care costs place a significant financial burden on many families, but research shows that after 12 years of consistently rising prices, the costs of child care in England have stabilised for the first time. There is encouraging evidence that costs of some of the most popular types of child care are falling in England. For example, the Family and Childcare Trust reported in March that the cost of nurseries in 2014 was 2% lower than in the previous year in real terms. Similarly, the cost of after-school clubs reduced by 5% in real terms during the same period. Once inflation is taken into account, costs for the majority of parents have fallen. This means that more parents are able to access affordable child care and support their families, and shows that the Government’s reforms are making a difference. We should compare that with the situation under Labour, when costs rose nearly 50% between 2002 and 2010, and the average cost of child care rose faster than inflation.

Alongside these measures to increase the provision of good quality, affordable child care, the Government have taken significant steps to support families in meeting their child care costs.

Alex Cunningham: I welcome the fact that more families may well be able to access child care because of falling costs, but the costs are still high and they are paid by the poor as well as the rich. Will the Minister please outline what she will do for the working poor who do not qualify for anything under any of her schemes?

Priti Patel: I will come on to the hon. Gentleman’s amendments and refer specifically to the points he makes.

For low earners, the Government will continue to pay up to 70% of child care costs through working tax credit, and under universal credit this support will be extended to up to 85% of costs when both parents are working, as all hon. Members heard in Committee. In addition, as we have touched on, the Government fund an early years entitlement of £15 a week.

The Government are making good progress in tackling the root causes of child poverty, to which the hon. Member for Wirral South referred. All Governments are committed to ending child poverty once and for all, but I reiterate that work remains the best route out of poverty. We discussed this at length in Committee, including the interactions between universal credit, making work pay, and interdepartmental measures on child poverty.

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Alison McGovern: The Minister mentions universal credit and making work pay—for too many families I only wish it did. Will she comment on the role of universal credit in discouraging dual earners? In the context of this child care debate, does she think the Government should look again at its operation?

Priti Patel: We had much debate in Committee on universal credit and the way in which the scheme interacts with it. The hon. Member for Manchester Central (Lucy Powell) made some strong and valid contributions in this regard.

Amendment 12, tabled by the hon. Member for Stockton North (Alex Cunningham), would allow regulations in future to permit parents to receive support under the new scheme and universal credit at the same time. As I have said, we must not forget that families in receipt of universal credit already rightly receive generous support with their child care costs. Child care support is offered to parents on universal credit as part of a welfare system designed to make sure that work pays and that those who need the support get it. Up to 300,000 more people are likely to be in work as a result of universal credit, and we expect a significant proportion of those to be households with children. But it is not right for a parent to receive support under the new scheme in addition to universal credit, when parents will receive 85% of their child care costs from April 2016. It will be easy for parents to access support that best suits their circumstances, so I reassure the hon. Gentleman that parents who are eligible for universal credit will be able to opt out and claim support under the new scheme should they wish to do so. We shall be supporting parents in making those decisions.

As we said in Committee—hon. Members have touched on it again today—we shall be launching the online support tools, the calculator and clear guidance. Draft guidance has been published well ahead of the launch of the scheme and shows our commitment to work in close collaboration with parents, child care providers and employers, and their feedback will ensure that guidance is tailored to meet their needs.

This is about ensuring that support remains focused on those on lower incomes, and the introduction of the scheme gives parents confidence that as they increase their income and move off universal credit, they will continue to receive Government support with their child care costs, which is vital.

Alex Cunningham: I do not want to go over the top on this, but will the Minister please outline what help she proposes for families who do not qualify for anything at the moment but who are still the working poor?

Priti Patel: There is support that remains focused on those on lower incomes. As I said at length in Committee, the Government’s overall child care system is very much focused on those on lower incomes, and it is wrong to suggest that that is not the case. Families in receipt of tax credits receive more generous support with child care costs. We have already discussed universal credit, which is being extended to cover up to 85% of the costs of child care. All the analysis shows that the benefits of the scheme are focused on households on lower incomes. The new scheme ensures that for the first time parents can be certain that support will be available for them;

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yes, obviously, at the lower end, but importantly, as they move into work and increase their incomes too. The scheme is much more fairly targeted than the existing scheme of employer-supported child care. It supports working families, getting households and families back into work. It was debated at length in Committee, and I reassure the hon. Gentleman that that is the case.

Today’s debate has shown that the Government are taking a broad range of actions to support families with the costs of child care, not just through this scheme, but through improvements in the welfare scheme—

Mark Durkan: In considering how the Government can best take this forward, will the Minister take account of the fact that whenever the Northern Ireland Assembly debated the legislative consent motion, there was much confusion, even on the part of the junior Minister, about its impact on child care in Northern Ireland? Child care provision in Northern Ireland has a different profile from here, and it seems that the Government’s scheme will lead to degrees of confusion and uncertainty, particularly for existing schemes that are well favoured.

Priti Patel: I take this opportunity to re-emphasise that the scheme in no way creates confusion. In Committee we touched briefly on the situation in Northern Ireland and provided information and guidance in that regard. This is about working with all the players—parents, employers, and other stakeholders. It is about making the system abundantly clear and simple, not about complexity. Guidance has been drafted. We are working with third parties. We are designing a calculator tool, as we have discussed before. This is all about giving guidance and providing clarity.

I shall briefly cover amendments 3 to 11 on families in receipt of tax credits. The child care element of tax credits is just one component of the package of support designed to help lower-income households. I emphasise that there is support for those on low incomes, in particular. We should reflect on the fact that under the new scheme more working families than ever before will be eligible for support with child care costs. The scheme will be an important component of the overall offer to working families. It will sit alongside existing schemes to ensure that support is available to those increasing their incomes as they move off benefits.

Alex Cunningham: Does the Minister not see any advantage in leaving the door open by amending the Bill to allow for the scheme to be extended at a later stage? As I said in my speech, it will take primary legislation to extend the scheme any further, whereas she could accept an amendment that would mean that the door was open to simple, straightforward regulation instead.

Priti Patel: I commend the hon. Gentleman for his tenacity in making that point again, as is absolutely right and proper. I reiterate that the Government are committed to reviewing the scheme, as I have outlined previously in Committee and during today’s debates on new clauses 1 and 2. It has to be right and proper to have that review. Once the scheme has bedded down

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and we have had the full assessment and evaluation, we will look at all its aspects. I hope that I have given the hon. Gentleman sufficient reassurance. I ask him to withdraw his amendment and Labour Front Benchers to withdraw their new clause.

Question put, That the clause be read a Second time:—

The House divided:

Ayes 208, Noes 272.

Division No. 81]


7.43 pm


Abbott, Ms Diane

Abrahams, Debbie

Ainsworth, rh Mr Bob

Alexander, Heidi

Ali, Rushanara

Allen, Mr Graham

Ashworth, Jonathan

Austin, Ian

Bailey, Mr Adrian

Bain, Mr William

Banks, Gordon

Barron, rh Kevin

Bayley, Hugh

Beckett, rh Margaret

Begg, Dame Anne

Berger, Luciana

Betts, Mr Clive

Blackman-Woods, Roberta

Blears, rh Hazel

Blenkinsop, Tom

Blomfield, Paul

Blunkett, rh Mr David

Bradshaw, rh Mr Ben

Brown, Lyn

Brown, rh Mr Nicholas

Brown, Mr Russell

Buck, Ms Karen

Byrne, rh Mr Liam

Campbell, rh Mr Alan

Campbell, Mr Ronnie

Champion, Sarah

Chapman, Jenny

Clarke, rh Mr Tom

Clwyd, rh Ann

Coaker, Vernon

Connarty, Michael

Cooper, Rosie

Crausby, Mr David

Creagh, Mary

Creasy, Stella

Cryer, John

Cunningham, Alex

Cunningham, Mr Jim

Cunningham, Sir Tony

Curran, Margaret

Dakin, Nic

Danczuk, Simon

David, Wayne

Davies, Geraint

De Piero, Gloria

Dobson, rh Frank

Docherty, Thomas

Donohoe, Mr Brian H.

Doran, Mr Frank

Doughty, Stephen

Doyle, Gemma

Dromey, Jack

Durkan, Mark

Eagle, Maria

Esterson, Bill

Evans, Chris

Farrelly, Paul

Field, rh Mr Frank

Fitzpatrick, Jim

Flint, rh Caroline

Flynn, Paul

Fovargue, Yvonne

Francis, Dr Hywel

Galloway, George

Gapes, Mike

Gilmore, Sheila

Glindon, Mrs Mary

Godsiff, Mr Roger

Goodman, Helen

Greatrex, Tom

Greenwood, Lilian

Griffith, Nia

Gwynne, Andrew

Hain, rh Mr Peter

Hamilton, Mr David

Hamilton, Fabian

Hanson, rh Mr David

Harris, Mr Tom

Havard, Mr Dai

Healey, rh John

Hepburn, Mr Stephen

Hermon, Lady

Heyes, David

Hillier, Meg

Hodgson, Mrs Sharon

Hoey, Kate

Hood, Mr Jim

Hosie, Stewart

Howarth, rh Mr George

Irranca-Davies, Huw

James, Mrs Siân C.

Jamieson, Cathy

Jarvis, Dan

Johnson, rh Alan

Johnson, Diana

Jones, Helen

Jones, Susan Elan

Kane, Mike

Kaufman, rh Sir Gerald

Keeley, Barbara

Kendall, Liz

Lammy, rh Mr David

Lavery, Ian

Lazarowicz, Mark

Leslie, Chris

Lewell-Buck, Mrs Emma

Llwyd, rh Mr Elfyn

Love, Mr Andrew

Lucas, Ian

MacNeil, Mr Angus Brendan

Mactaggart, Fiona

Mahmood, Mr Khalid

Mahmood, Shabana

Malhotra, Seema

Mann, John

Marsden, Mr Gordon

McCabe, Steve

McCann, Mr Michael

McCarthy, Kerry

McDonagh, Siobhain

McDonald, Andy

McDonnell, John

McGovern, Alison

McGovern, Jim

McGuire, rh Mrs Anne

McInnes, Liz

McKechin, Ann

McKenzie, Mr Iain

McKinnell, Catherine

Meale, Sir Alan

Miller, Andrew

Mitchell, Austin

Moon, Mrs Madeleine

Morden, Jessica

Morrice, Graeme


Morris, Grahame M.


Mudie, Mr George

Munn, Meg

Murphy, rh Mr Jim

Murphy, rh Paul

Murray, Ian

Nandy, Lisa

Nash, Pamela

O'Donnell, Fiona

Osborne, Sandra

Owen, Albert

Pearce, Teresa

Perkins, Toby

Phillipson, Bridget

Pound, Stephen

Powell, Lucy

Qureshi, Yasmin

Raynsford, rh Mr Nick

Reed, Mr Jamie

Reed, Mr Steve

Reeves, Rachel

Reynolds, Emma

Reynolds, Jonathan

Riordan, Mrs Linda

Ritchie, Ms Margaret

Robertson, Angus

Robertson, John

Robinson, Mr Geoffrey

Rotheram, Steve

Roy, Mr Frank

Ruane, Chris

Sarwar, Anas

Sawford, Andy

Seabeck, Alison

Sharma, Mr Virendra

Sheerman, Mr Barry

Shuker, Gavin

Skinner, Mr Dennis

Slaughter, Mr Andy

Smith, Angela

Smith, Owen

Spellar, rh Mr John

Straw, rh Mr Jack

Stuart, Ms Gisela

Sutcliffe, Mr Gerry

Tami, Mark

Thomas, Mr Gareth

Timms, rh Stephen

Trickett, Jon

Turner, Karl

Twigg, Derek

Twigg, Stephen

Vaz, rh Keith

Vaz, Valerie

Watson, Mr Tom

Watts, Mr Dave

Weir, Mr Mike

Whitehead, Dr Alan

Williams, Hywel

Williamson, Chris

Winnick, Mr David

Winterton, rh Ms Rosie

Wishart, Pete

Wood, Mike

Woodcock, John

Woodward, rh Mr Shaun

Wright, David

Wright, Mr Iain

Tellers for the Ayes:

Graham Jones


Phil Wilson


Afriyie, Adam

Aldous, Peter

Amess, Mr David

Andrew, Stuart

Arbuthnot, rh Mr James

Bacon, Mr Richard

Baker, Steve

Baldwin, Harriett

Barclay, Stephen

Barker, rh Gregory

Bebb, Guto

Beith, rh Sir Alan

Benyon, Richard

Beresford, Sir Paul

Berry, Jake

Bingham, Andrew

Binley, Mr Brian

Birtwistle, Gordon

Blackman, Bob

Blackwood, Nicola

Bone, Mr Peter

Bottomley, Sir Peter

Bradley, Karen

Brady, Mr Graham

Bray, Angie

Bridgen, Andrew

Brine, Steve

Brokenshire, James

Brooke, rh Annette

Browne, Mr Jeremy

Bruce, Fiona

Bruce, rh Sir Malcolm

Buckland, Mr Robert

Burns, Conor

Burns, rh Mr Simon

Burt, rh Alistair

Burt, Lorely

Cairns, Alun

Campbell, rh Sir Menzies

Carmichael, rh Mr Alistair

Carmichael, Neil

Chishti, Rehman

Clark, rh Greg

Coffey, Dr Thérèse

Collins, Damian

Colvile, Oliver

Crockart, Mike

Davey, rh Mr Edward

Davies, David T. C.


Davies, Glyn

Davies, Philip

Davis, rh Mr David

de Bois, Nick

Dinenage, Caroline

Djanogly, Mr Jonathan

Doyle-Price, Jackie

Drax, Richard

Duncan, rh Sir Alan

Duncan Smith, rh Mr Iain

Dunne, Mr Philip

Ellis, Michael

Ellison, Jane

Ellwood, Mr Tobias

Eustice, George

Evans, Graham

Evans, Jonathan

Evennett, Mr David

Fabricant, Michael

Fallon, rh Michael

Featherstone, rh Lynne

Field, Mark

Foster, rh Mr Don

Francois, rh Mr Mark

Freeman, George

Freer, Mike

Fullbrook, Lorraine

Fuller, Richard

Gale, Sir Roger

Garnier, Sir Edward

Garnier, Mark

Gibb, Mr Nick

Gilbert, Stephen

Glen, John

Goldsmith, Zac

Goodwill, Mr Robert

Gove, rh Michael

Graham, Richard

Grant, Mrs Helen

Gray, Mr James

Grayling, rh Chris

Green, rh Damian

Greening, rh Justine

Grieve, rh Mr Dominic

Griffiths, Andrew

Gummer, Ben

Gyimah, Mr Sam

Hague, rh Mr William

Halfon, Robert

Hames, Duncan

Hammond, Stephen

Hancock, Mr Mike

Hands, rh Greg

Harper, Mr Mark

Harris, Rebecca

Hart, Simon

Harvey, Sir Nick

Haselhurst, rh Sir Alan

Hayes, rh Mr John

Heald, Sir Oliver

Heath, Mr David

Heaton-Harris, Chris

Hemming, John

Henderson, Gordon

Hendry, Charles

Herbert, rh Nick

Hinds, Damian

Hoban, Mr Mark

Hollobone, Mr Philip

Hopkins, Kris

Horwood, Martin

Howarth, Sir Gerald

Howell, John

Hughes, rh Simon

Hunt, rh Mr Jeremy

Hunter, Mark

Huppert, Dr Julian

Hurd, Mr Nick

Jackson, Mr Stewart

James, Margot

Jenrick, Robert

Johnson, Joseph

Jones, Andrew

Jones, rh Mr David

Jones, Mr Marcus

Kelly, Chris

Kirby, Simon

Knight, rh Sir Greg

Kwarteng, Kwasi

Lamb, rh Norman

Lancaster, Mark

Latham, Pauline

Leadsom, Andrea

Lee, Jessica

Lefroy, Jeremy

Leslie, Charlotte

Letwin, rh Mr Oliver

Lewis, Brandon

Lewis, Dr Julian

Lidington, rh Mr David

Lilley, rh Mr Peter

Lloyd, Stephen

Lopresti, Jack

Luff, Sir Peter

Maude, rh Mr Francis

Maynard, Paul

McCartney, Jason

McCartney, Karl

McIntosh, Miss Anne

McVey, rh Esther

Menzies, Mark

Metcalfe, Stephen

Miller, rh Maria

Mills, Nigel

Milton, Anne

Moore, rh Michael

Mordaunt, Penny

Morris, Anne Marie

Morris, David

Morris, James

Mowat, David

Mulholland, Greg

Mundell, rh David

Munt, Tessa

Murray, Sheryll

Newmark, Mr Brooks

Newton, Sarah

Nokes, Caroline

Norman, Jesse

Nuttall, Mr David

O'Brien, rh Mr Stephen

Offord, Dr Matthew

Ollerenshaw, Eric

Opperman, Guy

Paice, rh Sir James

Parish, Neil

Patel, Priti

Paterson, rh Mr Owen

Pawsey, Mark

Penrose, John

Percy, Andrew

Perry, Claire

Phillips, Stephen

Pincher, Christopher

Poulter, Dr Daniel

Pugh, John

Raab, Mr Dominic

Randall, rh Sir John

Redwood, rh Mr John

Rees-Mogg, Jacob

Reid, Mr Alan

Rifkind, rh Sir Malcolm

Robathan, rh Mr Andrew

Robertson, rh Sir Hugh

Robertson, Mr Laurence

Rogerson, Dan

Rosindell, Andrew

Rudd, Amber

Ruffley, Mr David

Russell, Sir Bob

Rutley, David

Sanders, Mr Adrian

Sandys, Laura

Scott, Mr Lee

Selous, Andrew

Shapps, rh Grant

Sharma, Alok

Simmonds, Mark

Simpson, Mr Keith

Skidmore, Chris

Smith, Chloe

Smith, Henry

Smith, Julian

Soames, rh Sir Nicholas

Soubry, Anna

Spelman, rh Mrs Caroline

Stanley, rh Sir John

Stephenson, Andrew

Stewart, Bob

Stewart, Iain

Streeter, Mr Gary

Stride, Mel

Stuart, Mr Graham

Stunell, rh Sir Andrew

Sturdy, Julian

Swales, Ian

Swayne, rh Mr Desmond

Swire, rh Mr Hugo

Syms, Mr Robert

Thornton, Mike

Timpson, Mr Edward

Tomlinson, Justin

Tredinnick, David

Truss, rh Elizabeth

Turner, Mr Andrew

Tyrie, Mr Andrew

Uppal, Paul

Vaizey, Mr Edward

Vara, Mr Shailesh

Vickers, Martin

Villiers, rh Mrs Theresa

Walker, Mr Robin

Wallace, Mr Ben

Watkinson, Dame Angela

Webb, rh Steve

Wharton, James

Wheeler, Heather

White, Chris

Whittaker, Craig

Whittingdale, Mr John

Willetts, rh Mr David

Williams, Roger

Williams, Stephen

Williamson, Gavin

Willott, Jenny

Wilson, Mr Rob

Wollaston, Dr Sarah

Wright, rh Jeremy

Wright, Simon

Yeo, Mr Tim

Young, rh Sir George

Zahawi, Nadhim

Tellers for the Noes:

Tom Brake


Gavin Barwell

Question accordingly negatived.

17 Nov 2014 : Column 97

17 Nov 2014 : Column 98

17 Nov 2014 : Column 99

Third Reading

7.55 pm

Priti Patel: I beg to move, That the Bill be now read the Third time.

The Bill has been many months in development through consultation, drafting and detailed discussion in Parliament, and I am sure the House will agree that it will leave the Commons in good shape.

Before I proceed, I would like to pay tribute to my right hon. Friend the Secretary of State for Education who, as Financial Secretary, was responsible for some of the key features of the scheme and introduced the Bill in the House of Commons in June. I spoke on Second Reading as a Back Bencher, and it is an honour for me to appear today as the Minister responsible for the Bill.

I welcome this further opportunity to speak on the Bill and to reflect on the important role it will play in the Government’s broader strategy to get people into work. One of our fundamental principles has been that every person who can stand on their own two feet

17 Nov 2014 : Column 100

should do so. That means being in work, making their contribution and taking responsibility. We want to empower people in their choices. As a mother myself, I strongly believe that child care costs should not be a barrier to work. Since 2010 we have introduced a comprehensive package of measures to help working families cover nursery costs for their children. The new child care scheme will greatly expand the support we provide to working families towards their child care costs.

Even before the financial crisis, there were around 5 million people in the United Kingdom of working age on out-of-work benefits, some 1.4 million of whom have spent the past decade unemployed. The number of households where no one had ever worked almost doubled between 1997 and 2010, so when we took office in 2010 we made getting people back into work one of our key priorities. We can be proud of some major successes. Figures from the Office for National Statistics have shown that unemployment fell by 154,000 to below 1.97 million in the three months to the end of August, the first time it has been below 2 million since 2008. Since 2010, the UK has created over 2 million more jobs for people to go to—the fastest rate of job creation of any major economy, or, as the Financial Times put it in September, more jobs than the rest of the European Union combined. Female participation in the work force is at an all-time high, and we should welcome that.

As ever, there is more that can be done. If we had the same levels of men and women participating in the labour market, the OECD says that could lead to an increase in GDP of around 10% by 2030. Survey data from the Department for Education suggest that more than half of mothers would prefer to be in paid employment if they could arrange reliable, convenient, affordable, good quality child care. The Government are therefore taking action to ensure that high-quality child care is available and affordable. We recognise that child care costs are a major part of most working families’ budgets so we are putting in place measures to help every working family in the UK with their child care costs.

We have almost doubled the amount of child care support available to most middle earners, and we are doing even more for those on low pay. We are already funding 15 hours a week of free child care for every three and four-year-old, funding 15 hours a week of free child care for 40% of two-year-olds, and increasing the child care support for low income families to 85% under universal credit. Now, this scheme will significantly broaden access to child care support. Hundreds of thousands of families who are excluded from the current employer-supported child care scheme will be able to benefit from the scheme, and up to 200,000 self-employed parents will have access to child care support.

We have paid particular attention to designing the scheme so that it suits the needs of part-time workers. Parents earning as little as £52 per week—averaged over a quarterly entitlement period, or over a tax year for self-employed parents—will qualify for support.

We do not believe, however, that providing direct support to parents is the only way to address the high cost of child care. That is best achieved by supporting the child care sector to increase supply, which will ensure that any increase in demand for child care will be matched by increased supply measures, rather than just increased costs.

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The latest figures show there are now 100,000 more child care places than there were in 2009. We are making start-up grants available to help people set up new child care businesses. We have made up to 32,000 good and outstanding childminders automatically eligible for early education funding. We are making it simpler and easier for schools and child care providers to work together to increase the amount of child care available on school sites before and after school. Only this year, we have created childminder agencies, which will improve the support available both for childminders and for parents, and simplified existing regulatory frameworks to allow nurseries to expand more easily.

The evidence shows that our reforms are having an effect. After 12 years of consistently rising prices, the costs of child care in England have stabilised for the first time. Indeed, the costs of some of the most popular types of child care in England are now falling. Once inflation is taken into account, costs for the majority of parents have actually fallen, which means that more parents are able to access affordable child care and support their families. By contrast, the costs of some types of care have risen in Scotland and Wales, where these reforms do not apply.

As we have discussed in previous debates on the Bill, child care costs are not the only pressure on family budgets. We can never forget the impact of the 2008 recession and its effect on incomes for every household.

Alex Cunningham: I welcome the fact that prices are coming down and that more places are available, but the vast majority of the new jobs to which the Exchequer Secretary has referred are low-paid, part-time, insecure and involve zero-hours contracts and similar, which do not make anybody’s life easier as they consider care for their children. Perhaps that is why we are seeing an overspend of many billions of pounds in the Government’s social security budget.

Priti Patel: I re-emphasise a point I have made consistently throughout the passage of the Bill: the Government’s overall system of child care remains focused on those who are on lower incomes. We are concentrating on supporting families getting into work and ensuring, as we have touched on in previous debates, not only that work pays, but that child care support remains focused on those on lower incomes.

Living standards—the cash in people’s pockets and what they can buy with it—are perhaps the biggest issue facing British families. The tough decisions we have taken as a Government have a very clear end in mind, which is to help create prosperity and boost living standards. Alongside that, we want to make sure that the Government have the right measures to support working families and households and to ensure that work pays.

Since coming to power, this Government have taken decisive action to ease the pressure on households and families. We are providing free school meals for all infant school pupils in reception year and in years 1 and 2. We have increased the personal allowance to £10,000 and in April 2015 it will increase to £10,500. During the course of this Parliament, we have cut the income tax of the typical taxpayer by £805, taking more than 3.2 million individuals out of income tax by 2015-16 and boosting the take-home pay of 25 million people.

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Additional measures on living standards include freezing council tax in real terms and cutting the cost of driving by freezing fuel duty until the end of this Parliament, saving a typical motorist £680. We recently announced that the cost of driving licences will also be cut. Ultimately, however, as every family knows, the best way to raise living standards is by being in work, and we are pulling out all the stops to help those who want to work get into work by making work pay and introducing this Bill, which provides important financial measures to support child care.

I thank all Members for the opportunity to debate all the issues associated with child poverty as the Bill has passed through the House. Child poverty is an extremely important issue and this Government are fully committed to the goal of ending child poverty in the UK by the end of 2020.

Ms Margaret Ritchie (South Down) (SDLP): As my hon. Friend the Member for Foyle (Mark Durkan) said on Report, the Northern Ireland Assembly has already debated the legislative consent motion, which will enable enactment of the legislation in Northern Ireland. Does the Minister accept that there are fewer opportunities to access child care in Northern Ireland and fewer job opportunities? Will she consider allowing the other place to debate the extension of the child care voucher scheme so that it can remain in place while the measures are being implemented and both the scheme and the Bill can run concurrently?

Priti Patel: I will come on to Northern Ireland in a moment, because I want to finish addressing child poverty. Our child poverty strategy 2014-17, which was published in June, outlines our plans to tackle the root causes of child poverty, including parents being out of work, low earnings and educational failure. That approach reflects the reality of child poverty today and, importantly, reflects our determination to achieve lasting change to protect the poorest in our society.

The evidence is clear that work remains the best route out of poverty, and children are three times as likely to be in poverty if they live in a workless family. That is why we are taking decisive action to make work pay and reform the welfare system. We have touched on universal credit, the child care support we are providing and increasing the national minimum wage.

This is a complex, multifaceted problem, and it would be wrong to suggest that there is a silver bullet. We have made good progress, but there is more to do in tackling child poverty. The Bill will support this Government’s efforts to tackle the root causes of one of our greatest social ills.

I am grateful to all those who have participated in the debates on the Bill. I welcome the support from both sides of the House for this important new scheme, which marks such an improvement on the current support available to parents. I am particularly delighted that the Northern Ireland Assembly recently voted in favour of a legislative consent motion to enable the scheme to be available to families in Northern Ireland in the same way as it will be to families elsewhere in the UK. That was entirely a matter for the Assembly, which has given the scheme a positive vote of confidence.

I understand that the Offices of the First Minister and of the Deputy First Minister will consider the impact of the scheme and its interaction with other initiatives

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in the context of wider work on the development of their own child care strategy, so it would be inappropriate for me to make further comment on those devolved matters. Obviously, that is work in progress.

During all stages of the Bill, we have consulted widely on the design of the scheme over the past year. We have listened to feedback from parents, employers, the child care industry and all stakeholders.

Following those discussions, we are already making several changes. We are rolling the scheme out to families more quickly. Within a year of its introduction, all families will be able to apply for support, which is significantly faster than the previously announced timetable for the roll-out, of seven years. There is a more generous cap so that families can receive up to £2,000 of Government support per child. We are making the scheme available throughout periods of paid and unpaid parental leave, and we are making changes to the minimum income level to support those in self-employment. We are extending to 14 days the time during which parents can access the scheme before starting work. I have committed to looking at the cap with reference to the costs of caring for disabled children.

The scheme will not only deliver valued support to hard-working families, but it will do so in a way that works for parents. It will be a smooth, simple and secure scheme. From the outset, it has been designed to have parents at its heart. Rather than requiring parents to report changes of circumstances in real time, the scheme will be based on quarterly entitlement periods. That will give parents the certainty that they will continue to be eligible for support for three months at a time, regardless of any unexpected changes in their circumstances. For parents to reconfirm for the next quarter will simply take a few clicks through the system that we are designing and setting up. Those are just some of the ways in which we have engaged with stakeholders and, importantly, learned lessons from the experience of tax credits. Our ambition is for the new scheme to represent a real step change in user experience.

The scheme will be a vast improvement on the current employer-supported child care scheme, which provides support to a limited number of employees. As well as being available much more widely, it will be better targeted, make payments on a fairer basis—on the number of children, rather than the number of adults—and will be much more efficient. That is why we will close the current scheme to new entrants when the scheme is introduced, although those who already receive support under it can stay in it, if they so choose, for as long as they wish.

As a result of the Bill, more working families than ever will be eligible for Government support with their child care costs. Our proposals have been welcomed by families and child care providers around the country. The Bill represents an important part of the Government’s strategy to get people into work, and I commend it to the House.

8.12 pm

Catherine McKinnell: Any new investment in child care—particularly support for struggling families up and down the country who are battling to juggle their

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work and family lives—is clearly welcome. The Bill is therefore important, but it is long overdue for thousands of parents.

Fundamentally, we remain concerned that the Bill will simply not address the situation in which too many parents have been left. The evidence is now overwhelming. The cumulative changes to tax and benefits over the Government’s time in office have hit families hardest, as is clearly shown by new research published today. From our analysis of official statistics, we know that some families in which both parents are in work will be £2,000 a year worse off on average by the next election as a direct result of the Government’s tax and benefits choices. Researchers from the London School of Economics and the university of Essex have released findings showing that the clear losers under the Government are lone-parent families, large families and children.

This summer, the Prime Minister announced that all Government policies have to pass a families test. It is interesting that that is his aspiration only now, because it is abundantly clear that the Government have completely failed the families test to date. We share the widely expressed concern that the Bill will not go anywhere like far enough to make up the shortfall that families face, partly because of the tax and benefits changes, but also because of soaring child care costs.

Aside from that central issue, we have several other concerns. We are worried that parents will be left exposed to inflated child care prices, as my hon. Friend the Member for Wirral South (Alison McGovern) clearly set out in her speech on new clause 2. The Government have only one chance to get the hugely important IT infrastructure right, but crucially there is huge concern that parents might face a nightmare of complexity and confusion if the Government fail to provide adequate support and information to help them to make informed choices and to navigate between the schemes for universal credit and for the top-up payments.

Welcome though the support is, for far too many parents it will be far too little, far too late. I hope that the Minister has taken on board the concerns we raised throughout the proceedings in Committee and on Report, whether on some of the more technical aspects of the Bill’s operation or on the more fundamental issues.

Ms Ritchie: My hon. Friend is making some compelling points. Is she aware of research by the Resolution Foundation that found that 80% of the families who will benefit from the top-up payments available through the tax-free child care scheme are in the top 40% of the income distribution scale, and that the remaining 20% will go to families in the middle of it? How will the scheme help those on low incomes, lone parents and those with large families?

Catherine McKinnell: My hon. Friend has herself made the point very powerfully. I was concerned when the Minister spoke at length about child poverty because the Bill will do very little to deal with such issues, and we know that such figures will only increase. Levels of child poverty have increased significantly under this Government, as the facts and evidence prove.

Although we should focus on what the Bill will achieve—it will provide support in meeting demand for some payments for child care—my hon. Friend clearly sets out which parents will benefit most from the support.

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However, even those parents are concerned that the scheme might unduly complicate their lives. It might be burdensome for parents to navigate it, particularly those at the lower end of the income scale who have to navigate between a reduction in universal credit support and a movement into the top-up payments scheme, where potentially disastrous child care support pitfalls await them. We discussed that at length in Committee and we have put our concerns on the record. Other Opposition Members and I very much hope that the Minister has taken all such concerns on board and can deliver on the reassurances that she has given.

Let me take this last opportunity to urge the Government to recognise the value to parents not only of this support with child care costs, but of the extension of the free entitlement to three and four-year-olds. Quite simply, that would ensure that working parents are better off. It would help more parents to get back into work or to work more hours, and it would help to bring home more pay for the hours they work. We know that so many parents are desperate for such support. It would be simple and effective, and it would not place any more burdens on parents than those they already face. It would not add any more complexity to a child care market that is already hugely complicated.

Parents have struggled for four years under this Government with a child care crunch of rising prices alongside stagnant wages. Although we will support the Bill tonight, I urge the Minister to ensure that she, her officials and her partners who deliver the scheme fulfil the promises that have been made during its passage in Committee so that parents can receive this much-needed support.

I look forward to the arrival, in 2015, of a Labour Government who will ensure that parents receive not only the support provided in the Bill, but an additional 10 hours of free child care for three and four-year-olds. That will deal with many of the supply-side and price inflation concerns, and it will also provide child care support for the parents who will not benefit at all from the scheme.

8.19 pm

Maria Miller: It has been a privilege to have served on the Bill Committee, and I pay tribute to the two hon. Ladies who have led the debate. My hon. Friend the Minister has navigated us through the Bill with incredible style. She has listened to the arguments, acted on what she has heard and understood the importance of flexibility for parents in this scheme.

The Minister also listened closely to the hon. Member for Stockton North (Alex Cunningham) and his powerful

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arguments, both today and in Committee, about the particular needs of disabled children. None of us could have anything but admiration for the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), who obviously has her own interest in child care issues. She has led from the Opposition Benches incredibly well.

My hon. Friend the Minister is right to say that child care costs should not be a barrier to work for parents, and the Bill goes further than ever before to help achieve what we all want—for parents to have the opportunity to go back to work after they have had children, or to continue in employment when they have children of a young age. I am glad that the Opposition will support this important Bill tonight, because child care costs are not a problem only for those on very low wages; they are a problem for almost all the parents I have talked to, and it is right for the Government to consider how to address it.

Under this Government, more women are in work than ever before and, interestingly, the cost of child care for parents is falling—perhaps those two issues are not entirely separate. The Government have set the standard when it comes to enhancements to child care, not only by taking on what the Labour Government put in place, but frankly by going a great deal further: free entitlement to 15 hours a week of early-years care for four and five-year-olds and 40% of two-year-olds; new support under universal credit; and tax-free child care, which will mean that for the first time ever, people who are self-employed can get access to important child care help and support when running their own businesses.

I disagree with comments made by the hon. Member for Newcastle upon Tyne North about the Prime Minister and the families test, because I think the Bill passes that test with flying colours. It shows that we have been listening to parents and families, and that the Government have acted.

Parents want choice on child care—the Minister knows that, as do the Government. We all want child care that will fit around our children’s lives and needs and our family life. I believe that the Bill takes us one step further towards giving freedom to parents to choose the child care they want and need for their children. That will provide an enduring framework for changes to child care in the future. I hope the Minister will come back to the Dispatch Box when the Bill becomes an Act, and say how we can use it as a framework to provide further support in the future. I am sure she will.

Question put and agreed to.

Bill accordingly read the Third time and passed.

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Business without Debate

delegated legislation

Mr Deputy Speaker (Mr Lindsay Hoyle): With the leave of the House, we shall take motions 2 to 7 together.

Motion made, and Question put forthwith (Standing Order No. 118(6),

Terms and Conditions of Employment

That the draft Shared Parental Leave and Paternity and Adoption Leave (Adoptions from Overseas) Regulations 2014, which were laid before this House on 13 October, be approved.

That the draft Paternity, Adoption and Shared Parental Leave (Parental Order Cases) Regulations 2014, which were laid before this House on 13 October, be approved.

That the draft Employment Rights Act 1996 (Application of Sections 75G and 75H to Adoptions from Overseas) Regulations 2014, which were laid before this House on 13 October, be approved.

That the draft Statutory Shared Parental Pay (Parental Order Cases) Regulations 2014, which were laid before this House on 13 October, be approved.

That the draft Employment Rights Act 1996 (Application of Sections 75A, 75B, 75G, 75H, 80A and 80B to Parental Order Cases) Regulations 2014, which were laid before this House on 13 October, be approved.

That the draft Statutory Shared Parental Pay (Adoption from Overseas) Regulations 2014, which were laid before this House on 13 October, be approved.—(Dr Thérèse Coffey.)

Question agreed to.

Business of the House


That at the sitting on Wednesday 19 November paragraph (2) of Standing Order No. 31 (Questions on amendments) shall apply to the Motion in the name of Edward Miliband as if the day were an Opposition Day; proceedings on the Motion may continue, though opposed, for three hours and shall then lapse if not previously disposed of; and Standing Order No. 41A (Deferred divisions) shall not apply.—(Dr Thérèse Coffey.)

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Christina Edkins

Motion made, and Question proposed, That this House do now adjourn.—(Dr Thérèse Coffey.)

8.24 pm

James Morris (Halesowen and Rowley Regis) (Con): The murder of Christina Edkins on 7 March 2013 in a random knife attack on the No. 9 bus, while travelling from Birmingham to school in my constituency, was a devastating blow to her family, friends and the community where she lived in Birmingham, and where she went to school in Halesowen. Nobody could imagine the depth of pain and anguish that the Edkins family have had to suffer, and I will read an extract from their victim impact statement:

“The school have been wonderful and so have all of Christina’s friends, who have also been affected by her death. They wanted us to come to the Prom for Christina, but we couldn’t do it, it would have been too difficult…Some months after her death, we had a parcel delivered—it was Christina’s exam results, she had done really well. Also enclosed was the school year book, where Christina was included, and at the back they had done a tribute page to her. There was a poem and lots of photographs of her and a quote by her headmaster ‘if a school could choose its pupils, it would be full of Christinas’…Our family are so devastated I don’t know how we will get over what has happened. We are a big family and no one has been left untouched. Christina loved her family and her cousins—they all called her CJ. Our lives have been changed beyond all belief by that knock on the door on 7 March 2013. Our lives will never be the same and I don’t know what we will do without our precious daughter Christina.”

At first, the focus following this act was on the use of a knife in the attack by Phillip Simelane. Immediately after the incident I called on the Prime Minister in Prime Minister’s questions to tighten knife laws, and I supported an amendment to the Criminal Courts and Justice Bill, which has significantly strengthened our knife laws.

It became clear when matters were brought to court that Phillip Simelane was unable to make a plea because he was considered too mentally ill to do so. In September 2013 he appeared in court, and in October 2013 he was convicted of manslaughter on the grounds of diminished responsibility and detained in a psychiatric hospital. During court proceedings, the judge at Birmingham Crown court raised a number of issues and questions about the mental health of Simelane. Why had he not been admitted to a psychiatric hospital? Why had he been discharged from HMP Birmingham without any follow-up? Why did the services he was involved with prior to being admitted to HMP Hewell not deem him to require treatment.

As a result of questions raised by the trial judge, Birmingham and Solihull Mental Health NHS Foundation Trust initiated a serious incident review. Culminating in the report chaired by Dr Alison Reed, the review revealed more than a decade of contact by services with Phillip Simelane, including Birmingham and Solihull mental health trust, the Black Country Partnership mental health trust, Sandwell social services, Worcestershire Health and Care NHS Trust, Phillip Simelane’s GP, the West Midlands police, Sandwell Women’s Aid, HMP Hewell in Birmingham, the Crown Prosecution Service, and Her Majesty’s Courts and Tribunals Service. The report revealed a litany of service and system failures that led it to conclude:

“The homicide of Christina by P was directly related to his mental illness and could have been prevented if his mental health needs had been identified and met.”

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The report revealed a lack of co-ordination between services over a long period, from the time that problems with Simelane were raised in school, through to his discharge from HMP Birmingham almost a decade later. It identified the complete breakdown of communication between different services that came into contact with Simelane over a 10-year period. It identified the unrealistic responsibility that was placed on Simelane and his mother—to whom he had made several violent threats and actions—to initiate and engage with health care services, including his GP, child and adolescent mental health services, and the Prison Service, when it became increasingly clear that Simelane was not in a position to judge his own mental health needs.

Paragraph 64 of the report illustrates one of the issues. On 26 March 2009, Phillip Simelane’s GP called his mother on the telephone. The report says:

“There was a further discussion about whether P was involved with drugs, but she had not discovered any illicit substances. It was reported to the GP that P had admitted to using alcohol/cannabis in the past. The GP recorded that the plan was to refer P to the BCPFT Community Mental Health Team and ask them to assess P soon. The BCPFT Oldbury & Smethwick Community Mental Health Team sent an ‘opt in’ letter to P on 1 April 2009 asking him to contact them to make a ‘mutually convenient appointment’ within the next 14 days. The letter also stated, ‘If we do not hear from you within two weeks, we will assume you do not need our service’. On the 20th April 2009 the team wrote back to the GP saying they had not had any response from P and were therefore discharging him back to the GP’s care. The case was closed. P did not receive any written confirmation that his case had been closed. On interview, the GP stated that if a GP expressed concerns to a mental health specialist about a patient, then at the very least the patient should be seen.”

My intention is to raise the serious problems with the idea that people should “opt in” to mental health care.

The next issue is the repeated failures of professionals across the agencies to determine Simelane’s future risk to himself, his family and the public, with often contradictory assessments of his mental health state over a 10-year period. Another issue is the lack of basic information sharing between agencies and within the prison and courts system, leading to bad or confused decision making about the care—or lack of care—of Phillip Simelane. As an example, attempts were made in 2012, some six months before the incident took place, by the Black Country Partnership mental health trust crisis team to raise their concerns about Phillip Simelane with HMP Hewell, but these were not followed up.

One of the most devastating indictments in the report is that in October 2012 Simelane was released from HMP Hewell on licence, with no notification to his GP of prescribed medication and no mental health follow-up. He was also discharged with only three days of anti-psychotic medication. After he had reoffended while on licence, he was released from HMP Birmingham having been rendered homeless. An injunction was at his mother’s address. Again, there was no notification to his GP from the Prison Service and no mental health follow-up.

The failures identified in the report have a depressing familiarity. The truth is that they are failings that have been identified many times in previous reviews. We now have a duty to the memory of Christina Edkins and the anguish suffered by her family to act, and to do everything that we can to stop a repeat of this tragedy.

I ask the Minister to take specific actions to address the concerns and failings highlighted in the report. First, we need to address the consistent failure of all

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agencies involved to share crucial information about Phillip Simelane. How do we ensure that we implement a radical culture change so that there is a presumption that relevant information will be shared across agencies? Will the Minister consider a potential role for the Care Quality Commission, as part of its inspection responsibilities, to ensure that that happens? How do we move to a more systematic and standardised assessment of risk that properly pulls together different perspectives and evaluations of individuals such as Phillip Simelane?

The interaction of Simelane with the child and adolescent mental health services reveals some well-known limitations of, and issues with, those services. How do we approach the treatment of people who, at one stage in their life, are deemed to be below the threshold? How do we overcome poor communication and lack of information sharing between GPs, schools, services and the voluntary sector? Will the Minister commit to a review of CAMHS, building on the recent Health Committee report on their functioning to take into account the particular examples in the report on Simelane?

The report reveals significant failings in HMP Hewell and HMP Birmingham while Simelane was in prison. Again, there was a lack of information sharing, of care plans, of co-ordination and of communication, including—incredibly—no notification of Simelane’s release from prison to his GP. Can the Minister commit to working with colleagues in the Ministry of Justice to address the issue of mental health in prisons and to ensure that appropriate care plans are in place on release? Will the Minister also reflect on the status of this report? It was commissioned by the Birmingham and Solihull Mental Health NHS Foundation Trust and co-ordinated by the cross-Birmingham clinical commissioning group. It was commissioned locally but has wide national applicability. How can we ensure that the lessons of this report and its recommendations are implemented nationally?

The family of Christina Edkins has written to NHS England to raise concerns and to ask whether a further independent inquiry is needed. Will the Minister commit tonight to discuss immediately with NHS England its views on the need for a further independent inquiry as a matter of urgency? In the end, nothing will diminish the pain and anguish suffered by the family of Christina Edkins, but those in positions of public responsibility should now do everything they can to ensure that the tragic circumstances of this case are not repeated.

8.37 pm

The Minister of State, Department of Health (Norman Lamb): I congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) on securing this debate on this incredibly important and difficult issue. He asked some specific questions. First, he talked about the failure of organisations to share information, and I will develop my thoughts on that in due course. He made a particular point about the role of the Care Quality Commission. Under the new inspection regime, the CQC will undertake much more detailed inspections of providers than has been the case in the past, and it will be able to take into account issues such as the importance of sharing information to ensure good care. I will make sure it receives the Hansard report of this debate, so it can take on board the specific points he makes.

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My hon. Friend talked about the importance of a more systematic and standardised assessment of risk. That is one of the points the Government need to respond to in terms of the report. At the end of his speech he asked about the status of the report. It is clear that the report raises issues of both local and national significance. It is incredibly important that the Government recognise that and seek to address and respond to the concerns identified. I am happy to write to him to pursue that further, but I am intent on ensuring that we respond as soon as possible where it is clear that there are national lessons to be learned. This tragic case raises issues that have been raised before—they are not new. It is imperative for all of us to seek to address the issues identified in the report.

My hon. Friend raised a concern about individuals who do not hit the threshold for admission to secondary care. He also asked whether I would be prepared to review child and adolescent mental health services. I am pleased to say that in the summer I announced a taskforce to review the way in which CAMHS operate. I do not think that the way we commission or organise CAMHS is fit for purpose. There is a need for a fundamental review of how the services are organised and commissioned. The findings of the report can absolutely feed into that taskforce.

I would just like to dwell on some of the issues we need to look at in the taskforce process. At the moment, four organisations are involved in the commissioning of services for children and young people: local authorities, schools, clinical commissioning groups and NHS England. The fragmented arrangement for commissioning care does not lead to the best chance of joined-up services and that fundamentally needs to change. We recognise that it is very clear that only a minority of youngsters who have mental health problems receive access to any service at all. That has been the case for a very long time, but it does not make it right.

It is clear that many interventions deployed with youngsters have a very strong evidence base. For example, early intervention in psychosis—after the first episode of psychosis—can stop deterioration occurring. However, around the country the position is variable. In some areas there is access to good services, but in other areas there is either no service at all or people have to wait a very long time. I am therefore very pleased that the Prime Minister announced in October the introduction, for the first time, of an access waiting time standard of two weeks for early intervention in psychosis. We start with 50% of everyone who experiences an episode of psychosis. In future years, the aim would be to raise that percentage so that as many people as possible have access to support as fast as possible, and access to a service that is evidence-based, NICE-based and approved.

That is a breakthrough and a watershed moment for mental health services, but another area that the CAMHS taskforce wants to look at is how to improve access more generally. In Australia there is something called Headspace, which involves non-stigmatised access to services often provided by third sector consortia. There are local Headspace centres around the country, and a telephone service and an online service. That means that far more youngsters can receive access to some support at a much earlier stage than is the case in this country—and was the case in Australia before it introduced

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Headspace. We can learn lessons from the way services are commissioned and provided, and there is a lot we can do to improve access to support in those earlier years.

Moving on from the specific points my hon. Friend raised, I should put on the record my horror at Christina’s murder. I share his sentiments and wish to extend my personal sympathies to the family. What they must have been through is unimaginable, and my heart goes out to them. Christina Edkins was a happy, well-loved teenager with a bright future ahead of her. She was doing well academically, she played netball for the school team and enjoyed writing. She had ambitions to become a midwife and was already working with young children in a nursery school. Her death was tragic. We should all be able to go about our daily lives without fear of violence.

As Dr Reed’s report says, the attack was random and unprovoked. The question is whether it was preventable. As my hon. Friend made clear, Phillip Simelane’s mother tried for many years to get him the help she knew he needed. The system has let down that family as well as the victim’s family, and one’s heart goes out to his mother for what she must have gone through, having tried so hard to get help over many years. She herself suffered a number of attacks by Phillip, and she knew that his mental state was deteriorating and tried to get help. We cannot say what would have happened had she been successful, but it could hardly have been worse than what took place in March 2013. I am sure I speak for everyone here when I say that my heartfelt sympathies go out to the families of both Christina Edkins and Phillip Simelane.

Nothing we can do can return Christina to her family, but as my hon. Friend said, we can ensure that lessons are learned and that appropriate action is taken to prevent, as far as is humanly possible, any similar event from happening again. This afternoon, I met Dr Reed, who wrote the homicide report into Christina’s death, and discussed with her at length both her report and the importance of responding to the recommendations raised in it. Lessons can be learned from this tragic incident, both locally and nationally, and we are considering the national recommendations in the report. As well as explaining some of the actions today, I would be happy to write to my hon. Friend setting out in more detail what action the Government are taking to address the recommendations. I want us to be clear about the time scale for responding more fully and about what actions might follow a formal written response.

Before I turn to the specifics of the report, I would first like to touch on the importance of parity of esteem for mental health, which has long been a personal priority of mine and of my hon. Friend. The Government are clear that mental health care is as important as physical health care. It is unacceptable that in this time of modern medicine three out of four people with common mental health problems receive no treatment. If three out of four people with diabetes, for example, received no treatment, we would all be completely outraged. Mental health problems can have a huge impact on the quality of life of individuals and their families and friends and should be taken as seriously as physical health problems. I think that this simple principle of equality is starting to be accepted, but there remains a

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big and frustrating time lag when it comes to translating it into practice in terms of the responsiveness of services on the ground.

It is clear from the homicide investigation report that Phillip Simelane did not receive the treatment he needed for his mental health conditions. His mother repeatedly attempted to get appropriate treatment for her son from the time he was 14. The report found that there were multiple opportunities for Mr Simelane to be given access to mental health interventions or treatment, but many opportunities were missed. In some cases, Mr Simelane did not meet the provider’s criteria for specific services—a point made by my hon. Friend—such as admission to a psychiatric intensive care unit. In others, he was not able or willing to engage with services. During this time, his behaviour deteriorated and his mother became increasingly concerned and at risk. One can only begin to imagine how hard it must have been for her to see the deterioration happening before her eyes, to be at risk herself yet to have no proper response from the authorities, who ought to have been safeguarding her and ensuring that others were safeguarded from the actions of someone whose condition was deteriorating.

In total, Mr Simelane was reviewed or formally assessed for mental health conditions 17 times by four different organisations between April 2009 and December 2012. Quite a lot of effort and time were put into assessing him, but there was precious little action or support. None of this resulted in him getting the help he actually needed.

The 2014-15 mandate to the NHS sets out an explicit target for NHS England to make measurable progress to ensure that

“everyone who needs it has timely access to evidence-based services”,

whether it be for mental health or physical health. We have identified £40 million of additional spending to kick-start change in mental health services in the current year, and a further £80 million for 2015-16. As I said, this will for the first time enable the setting of access and waiting time standards in mental health services. This will include 75% of people referred to the improving access to psychological therapies programme being treated within six weeks of referral, and 95% being treated within 18 weeks of referral as a backstop. At last, people with a mental health condition—depression, anxiety or a condition such as obsessive-compulsive disorder—will have an entitlement, just like those with a physical health problem, to access treatment on a timely basis. Furthermore, at least 50% of patients experiencing a first episode of psychosis will be treated with a NICE-approved care package within two weeks of referral, while £30 million-worth of targeted investment from within the total £80 million envelope will be spent on effective models of liaison psychiatry in more acute hospitals.

Crisis care is one area where the gap between the experience of those with physical and mental health problems is at its greatest. If someone suffers a physical health crisis, they will know what will happen—an ambulance will arrive and they will be taken to A and E. The system may be under pressure, but access will be granted to a specialist who can help with the particular condition. If someone suffers a mental health crisis, however, God knows what will happen. They may have

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a good service, but too often it falls short. Too often still, people end up in police cells when they are in the middle of a mental health crisis.

James Morris: One crucial aspect of this particular report is the interaction between crisis care services and the Prison Service. One of the big gaps revealed by the report relates to what happens when someone is released from prison with known mental health problems. In this case, nothing happened and the individual was lost to services. Will the Minister reflect a little on how we might be able to join the Prison Service and health services more closely?

Norman Lamb: I completely agree with my hon. Friend on that point. The first incredibly positive thing to say is that we have embarked on the national roll-out of a liaison and diversion service, the purpose of which is to ensure that when a person first appears in the criminal justice system—whether at a court or a police station—someone will be able to assess their mental health. If they have an identifiable mental health problem, they will be referred straight away for treatment and support. They may still go through the criminal justice system and may still end up in prison, but their condition will have been identified and they will have been referred for the treatment that may help them to address their offending behaviour.

So far we have spent £25 million in the current financial year. We have covered about 25% of the country, and next year we will cover more than 50%. Our aim is a national roll-out by 2017, subject to the making of a business case to the Treasury, and that in itself will make a dramatic difference. No other country in the world is pursuing this on such an industrial scale. Moreover, what we are doing is evidence-based, and as we build on the programme, we will develop the evidence and ensure that we apply it. There is also the issue of what happens to someone who is in the system and what happens when the person leaves prison, and I shall deal with that in a moment.

The Department has funded nine street triage pilots this year, in which police and mental health professionals have worked together to support people who are experiencing mental health crises. Perhaps most relevant to cases such as that of Mr Simelane is the £25 million to which I referred earlier, which constitutes the first stage of the roll-out of a national liaison and diversion service.

Before my hon. Friend intervened, I was talking about the unacceptable practice of allowing people who are in the middle of mental health crises to end up in police cells. It is good news that between the 2012-13 and 2013-14 financial years there was a 24% reduction in the use of police cells, and evidence suggests that that trend is continuing in the current year. Earlier this year we published the mental health crisis care concordat, in which more than 20 national organisations committed themselves to standards of care in mental health crisis for the first time. Our objectives were a 50% reduction in the use of police cells in the current financial year compared with two years ago, and a complete ending of the use of police cells for children. My right hon. Friend the Minister for Policing, Criminal Justice and Victims and I are currently writing to local authorities asking them to take seriously their responsibility to end that

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unacceptable practice. I think everyone would agree that the practice of allowing a child under the age of 18 to end up behind bars in a police station must be brought to an end.

A key finding of the homicide report was that information sharing within and between organisations involved in Mr Simelane’s case was not effective. The sharing of information between organisations that are responsible for the care of vulnerable people has many benefits, and all organisations of that kind should strive to communicate and share information effectively. Indeed, I believe that they have a duty to do so. At the heart of most of the scandals over the years when something dreadful has happened has been a failure to share information effectively, and that certainly includes the case of Mr Simelane.

I realise that, in practice, such information sharing is difficult to achieve, but it must be an absolute priority, and the organisations involved must actively seek solutions. We recently issued a simple one-page guide for practitioners working in the health system, which emphasised the importance of sharing information. We are right to focus on the importance of confidentiality, but, in doing so, we sometimes forget that need to share information to ensure that good care is provided.

Electronic patient records are becoming more prevalent and are making information sharing easier, but they are not foolproof, and there are still security and confidentiality issues that limit the sharing of some information. For the time being, such systems should be seen as adding an additional layer of patient safety, and it is important for all clinicians receiving a referred patient to satisfy themselves that they have a thorough understanding of the patient’s history. Clinicians also have the ability to request additional information from other clinicians or relevant professionals if they feel that such information would be beneficial in making an accurate assessment of the patient.

The Ministry of Justice is responsible for the management of offenders in the community. Care and supervision may be delivered by a number of agencies working together to share information, including health, social care, probation and other authorities. This enables appropriate action to be taken if an offender’s behaviour escalates to present a risk to the public, and that may include intervention by professionals or even recall to prison or to another appropriate facility.

We come back to the need for appropriate sharing of information among organisations. As I have said, this can in practice be complex and difficult to implement. However, organisations with a responsibility to care for vulnerable people and to protect the public must be able to work effectively together. Dr Reed’s report was only published in September and there will be no quick fixes for the organisations involved in this case. We expect NHS England to work with all the NHS providers involved to ensure that they address the recommendations in the report. This will require NHS providers to work with non-NHS organisations, including the Prison Service, to ensure that the lessons that need to be learned from this report are implemented across the board.

The issues identified in the report as essentially local will probably be common to many other organisations around the country, and we owe it to the families who

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have been devastated by this tragedy to ensure that those local lessons with wider applications and the issues identified as of national importance are all properly addressed, and I am happy to work with my hon. Friend to try to achieve that.

James Morris: On the specific point about the status of this report, I know that the Edkins family have written to NHS England expressing concerns about some of the findings in the report and asking whether there needs to be a further independent review. I think NHS England has promised to get back to them. Could the Minister use his good offices to communicate with NHS England to get back to the family?

Norman Lamb: I absolutely will communicate with NHS England and seek to ensure that the family get a response to that request.

As I said earlier, I shall write to my hon. Friend on all the issues that emanate from the report, and in doing so I will summarise the work being undertaken by the Government in response to this report. Work on this has already begun. The health care providers at HMP Hewell and HMP Birmingham have developed action plans in response to the recommendations in the report. NHS England’s Shropshire and Staffordshire area team is monitoring progress closely to make sure that all recommendations are met. The report also contained national recommendations for NHS England, and the Department of Health and the Ministry of Justice will work with partner organisation to address these recommendations.

Black Country Partnership NHS Foundation Trust has already implemented some changes in response to Christina’s death. It has phased out the use of “opt-in” letters, which my hon. Friend specifically referred to. Their use was an extraordinary practice when one thinks about it, given the nature of the condition that individuals such as Mr Simelane suffer from. Opt-in letters were previously used to invite patients to make an appointment, but they allowed someone to be discharged from secondary care if they did not respond. This practice has to end. The trust now proactively assesses all patients referred to it. That issue has wide application across the country.

The trust is working to improve the way its services join up with others, particularly those provided by external agencies, in the care of someone with severe mental illness. The trust will shortly be introducing electronic patient records which will enable teams across different parts of the service to access relevant patient information more quickly.

Birmingham and Solihull Mental Health NHS Foundation Trust has also implemented changes, including putting in place a robust escalation process for all cases in which disputes or concerns are raised about the outcome of a prison assessment, and ensuring that a full check is made on the HMP health care patient information recording system to identify any previous significant physical and/or mental health history.

The trust also has work under way. This includes changing psychiatric intensive care unit induction and training for doctors and nurses to include training on how to undertake prison assessments; introducing a review of all new prisoners by a nurse specialist within 24 hours when mental health concerns have been raised and, if recommended, by a psychiatrist within a maximum of five working days; and including in health screening

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on discharge cross-checking and reference between the health and prison records systems. The trust aims to have these and other changes in place by March 2015.

The investigation makes national recommendations, including the implementation of new supervision requirements for offenders who have served sentences of under 12 months, as was the case for Mr Simelane at the time of the incident. As part of the Transforming Rehabilitation programme, the National Offender Management Service is working with the NHS on through-the-prison-gate support for offenders serving sentences of under 12 months, including those offenders who are known to have mental health problems.

The Ministry of Justice is putting in place an unprecedented nationwide resettlement service, which will mean that most offenders are given continuous support by one provider from custody into the community. The Ministry will ensure that most offenders are held in a prison designated to their area for at least three months before release. This will mean better continuity of supervision and rehabilitation services, as well as better family links for those offenders and a network of prisons more specifically catering for the needs of short-term

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offenders. As my hon. Friend has pointed out, continuity of care and support when an individual leaves prison is of fundamental importance.

None of the changes made in response to Dr Reed’s report can bring Christina Edkins back, but we can all do our very best to ensure that no other family suffers in the way that Christina’s has done. None of the recommendations in the report is unachievable. They will require hard work on the part of many organisations, but the result will be better care, supervision and support for some of our society’s most vulnerable people.

I close by once again offering my heartfelt condolences to Christina’s family and assuring them that we will ensure that everything that can be done to prevent similar tragic events in future will be done. I shall be happy to work with my hon. Friend and to continue a dialogue with him to ensure that we maintain momentum in addressing the recommendations in the report and the concerns of the family.

Question put and agreed to.

9.7 pm

House adjourned.