Westminster Hall Sitting of 29 October 2003

Preamble
[MR. FRANK COOK in the Chair]

Breast Cancer
Motion made, and Question proposed, That the sitting be now adjourned.—[Vernon Coaker.]
9.30 am
Mrs. Marion Roe: I am sure that I am correct in saying that everyone in the Chamber will know someone, woman or man, who has been diagnosed with breast cancer, and will therefore know the challenges that they, their family and their friends face in dealing with the disease. That is why I appreciate the opportunity to have this debate during breast cancer awareness month 2003, on the 10th anniversary of one of the key health awareness campaigns in the United Kingdom. I am delighted to see that the Minister and many other hon. Members are wearing pink ribbons as a symbol of support for the campaign.
I pay tribute to the breast cancer and other cancer charities that have been working in partnership this month to raise awareness of the disease, which also work hard all year round. I shall mention some of them by name. Breakthrough Breast Cancer is a research and awareness charity, which established the Breakthrough Toby Robins Breast Cancer Research Centre. It is the first centre in the UK dedicated solely to breast cancer research. Breakthrough Breast Cancer also provides much-needed administrative support for the all-party group on breast cancer, of which I am one of the joint chairmen. We are extremely grateful to Breakthrough Breast Cancer for all its help.
The UK Breast Cancer Coalition successfully involves hundreds of patients with direct experience of breast cancer in its advocacy work. I congratulate it on the success of its Westminster Fly-in, which took place earlier this week. Breast Cancer Care is the leading provider of vital information and support for everyone affected by breast cancer. Breast Cancer Campaign is a charity specialising in funding independent breast cancer research, and also supports individual research projects.
I am delighted to announce to hon. Members the news of the impending merger between Breakthrough Breast Cancer and the UK Breast Cancer Coalition, which will create the country's largest charity dedicated to breast cancer research, campaigning and advocacy. It will be known as Breakthrough Breast Cancer.
We should not forget the other cancer charities that work tirelessly, carrying out research and providing support to people affected by breast cancer: charities such as Macmillan Cancer Relief, Cancer Research UK, Marie Curie Cancer Care, CancerBACUP and the Institute of Cancer Research. I also take this opportunity to pay tribute to the countless companies that go out of their way to support breast cancer awareness month, in particular Avon Cosmetics, which announced earlier this month that it had raised more than £10 million for cancer charities through the Avon breast cancer crusade.
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I know that a number of hon. Members wish to contribute to the debate, so I shall try to be brief. Perhaps it would be helpful if I began with a few facts about breast cancer. It is the most common form of cancer in the United Kingdom, with more than 40,000 women and about 300 men diagnosed with the disease every year. Over the course of her lifetime, a woman's risk of developing breast cancer is one in nine. Tragically, about 1,000 women lose their lives every month as a result of the disease, a sure sign that there is still much to do to improve treatment in the United Kingdom.
This debate gives us the opportunity to raise awareness of the improvements in breast cancer services that have taken place over the last few years, but also to highlight key concerns about breast cancer research, service delivery and patients' access to treatment. Let us focus first on one of the key targets, the two-week wait from the urgent referral of a suspected breast cancer patient to an appointment with a specialist. According to the statistics for the first quarter of 2003–04, the target has been effectively reached, with a 98 per cent. success rate for England. However, the all-party parliamentary group on breast cancer estimates that approximately 10,000 women in England are diagnosed with breast cancer through the routine referral route.
In a recent report entitled "Left in the Dark", Breakthrough Breast Cancer highlighted the horrific reality that some of those women could have waited up to 17 weeks—a third of a year for—an appointment wit a specialist. The report states:
"Many women referred routinely are living in fear and literally putting their lives on hold while they endure long routine waits. They are left in the dark, anxious to know if they have breast cancer. This is unacceptable—women deserve better and they deserve a more mature higher quality debate on the subject."
Researchers found that 90 per cent. of women who were interviewed for the report said that they would want an appointment within two weeks of visiting their GP, regardless of whether their case was deemed urgent or non-urgent. Furthermore, we know that the wait between referral and diagnosis is an extremely distressing time. The views of those women, and of patients in general, must be taken on board if a patient-centred NHS is to become a reality.
I want to share with the Minister and other hon. Members further statistics on the process of breast cancer referrals, all of which paint a worrying reality for patients and health professionals alike. For instance, 42 per cent. of GPs felt that it was difficult to distinguish between urgent and routine referrals, 35 per cent. of them admit to not using any form of guideline on whether to refer, and 42 per cent. never receive feedback from consultants on the accuracy of their referral decisions.
I am sure that the Minister shares my concern about the findings of that report. Perhaps she will comment on the unacceptable wait faced by many of those women. I should also like to know how the Government plan to reduce those waiting times and improve the accuracy of the referral system by improving communication between GPs and consultants, and how health professionals can be encouraged to work towards continuous improvement.
I draw the Minister's attention to one of the key concerns of those involved in the health sector—that is, the implementation and monitoring of the National

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Institute of Clinical Excellence guidance. About a year ago, NICE issued guidance on Herceptin, a drug known to extend and improve the quality of life of women with terminal breast cancer. If the drug were to be made available to all who could benefit from it, it would be an extremely important step in bringing an end to the so-called postcode lottery for treatment.
However, recent research by Roche, the makers of the drug, unveiled the fact that there are still serious inequities in access to Herceptin. In some parts of the country only one in 30 of the patients eligible for Herceptin receives it; I am sure that the Minister will agree that that statistic is shocking. Sadly, it is not just Herceptin—or, indeed, cancer drugs in general—that seems to be affected; there is a problem with NICE implementation across the board in health care, as has been demonstrated in recent reports by the Arthritis and Musculoskeletal Alliance, Breakthrough Breast Cancer, Breast Cancer Care, CancerBACUP and the UK Breast Cancer Coalition. The problem is to ensure that not only is NICE guidance implemented, but the implementation is effectively monitored.
The Minister acknowledged the problems with NICE implementation as recently as last week, at the all-party group on cancer's Britain Against Cancer conference. I ask her to outline today how the Government plan to ensure that primary care trusts have adequate support to implement guidance, and what methods they will use to monitor national implementation systematically.
Although we have come a long way in improving services and treatments for breast cancer patients, we must acknowledge that we have much further to go. I urge the Government to ensure that breast cancer, and cancer in general, remains a top priority. For the sake of the women and men directly affected by the disease every day, we cannot afford to be complacent.
Several hon. Members rose—
Mr. Deputy Speaker (Frank Cook): Order. Two hon. Members have written seeking to make contributions, and since my arrival a further two have indicated that they would like to catch my eye. I remind the Chamber that it is customary to begin the first of the three winding-up speeches at least 30 minutes before the conclusion of the debate. There is ample time today, provided that hon. Members take account of that time limit in making their contributions, in accepting interventions and in responding to them.
9.42 am
Mrs. Anne Campbell: I am pleased to be able to speak in the debate, and I congratulate the hon. Member for Broxbourne (Mrs. Roe) on having secured it at this important time for breast cancer treatment.
Three years ago, the new Labour Government identified cancer as a top priority. I was especially pleased about that, because my local cancer specialists at Addenbrooke's hospital had recently summoned me, and neighbouring Members of Parliament, to a cancer summit. They were concerned about the fact that treatment in the UK was not as effective as that in the United States, that more people were dying after
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diagnosis, and that equipment was extremely outdated. I am pleased that since that time we have made progress: the figures for the periods 1995 to 1997 and 2000 to 2002 show a 10.3 per cent. reduction in the death rate from cancer among people under 75. None the less, I would be the first to say that there is much more to be done.
National statistics indicate that more than 96 per cent. of women with breast cancer now receive their first treatment within one month of diagnosis. During the 1997 general election campaign, I spoke to two women who had recently discovered symptoms of breast cancer and were highly anxious. They had to wait 15 weeks for their first hospital appointment. That is totally unacceptable, as the hon. Lady said. The situation is now much improved.
I realise that I am extremely fortunate that Addenbrooke's is my local hospital. I am even more fortunate that it has the Cambridge breast unit, which Cherie Blair, the Prime Minister's wife, opened in 2001. That allowed the hospital to bring together in one centre all the breast cancer treatments that were provided in different parts of the hospital. The centre is staffed by a group of professionals from different disciplines, whose primary goal is to ensure that high-quality care is given to all women with benign and malignant breast cancer and breast disease. Work at the centre is led Dr. Purushotham and his team, and I pay tribute to their pioneering work.
Each year, some 3,000 new patients are referred to the unit. The Cambridgeshire and Huntingdonshire breast-screening service also refers patients to the unit, which is constantly flagged up as a model for the development of other tumour treatment sites in Addenbrooke's. Other cancer specialists are learning from the work done by the breast unit and in the West Anglia cancer network—a highly effective network developed in the past few years through which local hospitals may share good practice. It has made quite a lot of progress: it has consistently delivered against all Department of Health targets, despite the pressures of an enormous work load. It has succeeded because of the high level of commitment shown by all its members.
The target wait for a patient whose GP has referred her to the unit is now two weeks, and 100 per cent. of patients see a specialist at the unit within that period. That represents a huge improvement since 1997, when the patients with whom I spoke had had to wait much longer. A woman experiences great anxiety when she finds a lump in her breast. That results in pressure on GPs to refer patients even though they may not believe that it is breast cancer, and leads to a heavy demand on the service. Providing a better service therefore creates greater demand, so it is not always sustainable and may break down.
In response, the unit has issued GPs with detailed guidelines on the referral process, which is available on its website and in hard copy on each GP's desk. The guidelines contain detailed patient information sheets, which GPs may hand out to patients to reassure the worried well and to provide information for patients referred to the unit. There are regular GP education meetings, and frequent discussions with members of the GP liaison committee.
There have, however, been problems, one of which is the reduction in junior doctors' hours, which has led to a reduction in the time available to the specialist

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registrar and the senior house officer to contribute to the unit's service delivery. Addenbrooke's has considered the unit's service delivery as the model for its own service delivery, which has led to two significant developments that could be copied elsewhere.
First, Dr. Liz Cox, a GP specialist, underwent rigorous and updated training in the breast clinic with a view to functioning as an independent practitioner in the new patient clinic. She now runs a new patient clinic and follow-up clinic with the clinical nurse practitioner. The clinical nurse practitioner is also a new role, which has been developed following two years of intensive training supervised entirely by the consultant at Addenbrooke's. For the past two years Sister Dawn Chapman has been an independent nurse practitioner in both the follow-up and the new patient clinics. That is a unique role in the United Kingdom and is attracting considerable interest from other units.
It is rewarding that the Cambridge breast unit is regarded nationally as an excellent place to train. The unit has been rewarded with an appointment from the Department of Health of an oncoplastic surgeon, following a competitive bid for 10 such new posts that have been created in England over the last 18 months.
It is good too that the hospital recognises the importance of breast cancer. High priority is given to patients with breast cancer and a concerted effort by all hospital staff has ensured no cancellations of operations on the day. I cannot imagine what it must feel like to go into hospital thinking that one is going to have an operation for breast cancer only to find that the operation has been cancelled, so I am sure that the elimination of that problem at Addenbrooke's has been a huge relief to many.
Addenbrooke's is also reducing the length of in-patient stay for patients treated for breast cancer, from seven days to a mean of three days. The hospital has done that by training district nurses in the area to manage the drains that drain the fluid after the operation. Patients are therefore discharged within 48 hours post-surgery with their wound drains in situ. That is the result of efforts made by Sister Dawn Chapman, which resulted in her receiving the nursing standards award for surgical nurse of the year 2001.
The Cambridge breast unit is evaluating a new surgical technique in the context of a randomised control trial called sentinel node biopsy. Patients undergoing the procedure are discharged within 24 hours after surgery, and the process leads to far less trauma and surgery than normal breast cancer surgery does. It is predicted that the technique will revolutionise the management of early breast cancer, and it is also envisaged that within three years it will be possible for more than 50 per cent. of all women with breast cancer—approximately 150 patients a year—to be treated in the day surgery unit. I hope that that shows that every constituent of mine is fortunate to live in the catchment area of Addenbrooke's hospital.
I should like to talk about genetics and hereditary breast cancer. Since the publication of the White Paper on genetics this year, which promised £50 million over the next three years to help to realise the benefits of genetics in health care, there has been a great deal of publicity about genetics and hereditary breast cancer.
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The Breakthrough Breast Cancer genetics reference group is a national network of approximately 100 people who, as a consequence of their family histories, have a strong interest in breast cancer genetics and genetic services. Through the group's work, several areas of concern that need to be addressed if genetic services are to be designed round the needs of the patients have been highlighted to women.
To put the matter in context, it is important to remember that only 5 to 10 per cent. of the 40,000 women and 300 men who are diagnosed with breast cancer every year in the UK develop the disease as a result of a strong genetic risk. That roughly equates to between three and six people in each constituency developing breast cancer as a result of their genetic predisposition.
At present, there are very few ways of treating those who are known to carry genes linked to breast cancer. Therapies currently offered include prophylactic surgery to move the breasts and drug treatments that have unclear outcomes. Furthermore, approximately 20 per cent. of breast cancer cases occur in woman who are classed as having a moderately increased risk of developing the disease and are not eligible for genetic testing, as the genes involved in their breast cancers have not yet been identified. To aid early detection, access to screening and surveillance programmes is a priority for those women.
As most people here will be aware, the NHS breast-screening programme invites women between the ages of 50 and 64 for a mammogram every three years. By 2004 that programme will be extended to women aged up to 70. However, hereditary breast cancer is more likely to occur at a younger age. Will the Minister tell us what provision the Government are making to screen or to keep regular surveillance of women under 50 who have a moderately increased or high risk of developing hereditary breast cancer?
Dr. Ian Gibson: It has been enjoyable hearing about the work at Addenbrooke's, which is a paradigm for work that could go on across the country. It is wonderful that the debate has been secured.
My hon. Friend is really talking about prevention. I wonder if there are any other preventive measures that we might adopt. Although much research has been done, it is not quite enough. I wonder if anyone is as confused as I am about what the other causes of breast cancer might be. Do they include obesity or diet? How do we address such issues and give advice beyond genetics about how to prevent breast cancer from developing at any age?
Mrs. Campbell: My hon. Friend should consider joining the all-party group on breast cancer. He would then be able to attend some of our excellent presentations, such as the revealing one last week on the connection between hormone replacement therapy and breast cancer incidence in the UK. Knowing the risks about the increased incidence of breast cancer made many of us think quite hard about whether one should use HRT. That is an example of the excellent work that the all-party group does. I invite my hon. Friend to join.

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Many women wait up to 18 months for referral to a family history clinic for genetic services. Even after referral, the women who take a genetic test for gene mutations face long delays; many wait more than a year for the results. Some women who were tested in the late 1990s are still waiting for their results. They have received little, if any, explanation of the delay. Despite evidence that mutations occur throughout the gene, it is accepted practice to examine only two thirds of either gene, which is thought to detect approximately 60 to 80 per cent. of mutations. That results in the possibility of mutations being missed or occurring in another gene. Therefore, women wait more than a year for a partial test result, after which some are still left in the dark about their risk of developing breast cancer.
There are also indications that the diagnostic testing of the BRCA genes patented by Myriad Genetics, Inc. has seriously hindered the availability and adequacy of genetic tests for breast cancer in the NHS. Will the Minister comment on the position regarding the Myriad patent on the BRCA genes and commit to ensuring that the NHS provides the best-quality genetic testing available to those at risk from hereditary breast cancer, in order to provide accurate, meaningful and prompt results?
9.58 am
Mr. Iain Luke: I, too, begin by congratulating the hon. Member for Broxbourne (Mrs. Roe) on securing the debate. I admire the way in which she introduced the topic, which is highly charged and highly significant to many. I know that she speaks from a deep-seated concern and has a personal awareness of the anguish and distress that that form of cancer can cause.
As the hon. Lady said, this is a highly significant time to hold the debate, as it is national breast cancer awareness month. I must say that if the debate had been held this time last year, I probably would not have attended—but now I am very aware of the impact that breast cancer has. For me, until last year, cancer was a taboo subject to some extent: an acknowledged scourge, but something that happened to others, a wolf that was best kept at the door. I would certainly have sympathised with the sentiments of care and concern that would have been expressed in such a debate—but at a distance. However, the chance discovery of a small lump in my wife's breast on 13 November last year changed all that. Life for us all—my wife, myself and our family—was turned upside down, and my wife was set on a course of treatment which is, I am thankful to say, coming to an end this Friday after almost 12 months.
The year has passed quickly, if painfully; it began with two sessions of surgery, interspersed with frequent meetings with consultants and Macmillan nurses, moving through eight sessions of chemotherapy, lasting six months, and culminating in six weeks of radiotherapy, involving daily visits to hospital. My wife has made a significant contribution to the drafting and phrasing of my speech today, and much of the pain that we have felt has gone into it.
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The impact on family life of such intensive and debilitating treatment cannot be overstated, but the kindness and professionalism of the staff at our local hospital, Ninewells, with whom we have come into regular contact, have certainly made the past year's journey easier. The dedication of NHS cancer staff is something that we can be proud of, and my wife certainly appreciates it.
The first real impact of the breast cancer diagnosis on us as a couple was the strange feeling of being alone and in isolation—a feeling that within the hustle and bustle of a busy world we were set to one side. We found it difficult, initially, to talk to our immediate family and friends, as breast cancer was not a subject that people talked about. However, it is a subject that people should talk about, and that is why I am here today. Only by talking about cancer can we rid ourselves of the fear associated with it, and only by talking about breast cancer can we learn that it is no longer synonymous with an early death—far from it.
A year ago, my wife and I knew that breast cancer was not an uncommon phenomenon. We were well aware of the illness, given its media coverage, but it was from talking to friends, family, colleagues and acquaintances that we began to realise how many people we knew, both in Dundee and in London, were also coming to grips with that cancer, struggling, like us, through their treatments and the day-to-day reality of coping with whatever might hit them next. That revelation, coupled with our very frequent visits to Ninewells hospital, impressed upon us the enormity of the impact of breast cancer—the second most frequent cancer among women—on people's lives.
I appreciate the improvements that have been made in treatments, and the greatly improved survival rates that have resulted from those advances, so that nearly four out of five women survive for five years or more. There has been a 21 per cent. reduction in fatalities in the past 10 years. Encouraging as those survival rates are, I believe, and I am sure that everyone present would agree, that they need to be better. Breast cancer is still the second most common cause of cancer deaths for women in the UK, after lung cancer. There is no doubt that progress has been made and continues to be made, thanks to patient support for clinical trials—my wife was involved in a clinical trial at Ninewells hospital—research institutes, medical staff and drug companies, but the need to do more is constantly at the forefront of one's thinking.
It is encouraging that the current national screening programme will be extended to women of 70 by 2004. However, given that 8,000 pre-menopausal women are diagnosed each year, and that the earlier breast cancer is detected the better the chances of survival, should we not be looking into the possibility of extending the screening programme to younger women on a more regular basis?
Examination of the figures reveals the need for greater equality of access to fast-track treatment throughout the country. We have already heard about Addenbrooke's hospital. I live in Dundee, and my wife and others like her are lucky to live near Ninewells teaching hospital—part of an academic community linked to the Wellcome Trust institute, which is playing a major part in seeking the elusive comprehensive cure for cancer. Even in that centre of excellence, the lack

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of money threatens the Government's target of 80 per cent. of patients being seen at a symptomatic clinic within two weeks of their being referred to one by their GP.
Waiting times for urgent referrals at Ninewells are as long as six weeks, because of the lack of resources to fund additional sessions at the breast clinic to tackle the backlog of patients, which has built up because radiologists have been absent through ill health. Obviously, the situation is exaggerated by the national shortage of radiologists. Last year, my wife was seen in six days after a referral from her GP.
A six-week wait for an urgent mammogram has knock-on effects, which can delay surgery. Any delay increases the risk to the patient and can result in a more extensive and drastic form of surgery being required. The provisional resources to allow prompt diagnoses are surely the best way to take cost-effective action.
As a male contributor to a debate on an illness that predominantly affects women, I must admit that there have been moments over the past year in which I have been found wanting in the face of the demands placed on me. However, I am determined to do all that I can to assist in making the best possible package of care available to those who need it, whatever their postcodes may be.
In the fight against breast cancer, we must do all that we can not only to encourage direct medical care to alleviate by medicine and drugs the physical impact of cancer on patients, but to promote projects such as Maggie's centres, which offer support in the form of drop-in centres for cancer sufferers, carers and anyone whose life has been touched by cancer. In such centres, people can find support and information to help them come to terms with the initial diagnosis and to make treatment choices in peaceful and tranquil surroundings.
A Maggie's centre designed by the world-renowned architect Frank Gehry has recently been built in Dundee, and that is a place where people can make such choices. It is situated on the brow of a hill within the grounds of Ninewells hospital. There is a beautiful vista up the Tay valley estuary as it winds its way westwards up the Carse of Gowrie to Perth. Bob Geldof and Frank Gehry jointly opened the centre last month. It offers quiet and restorative contemplation, and the chances of a spiritual uplift and renewal to combat the invasive nature of one of the worst medical conditions known to women, and men. People who do not know the area will find it hard to picture the scene, but it is the most tranquil setting for a medical building that I have ever seen.
Many more such centres are urgently needed, and I hope that they will be built in the years to come, to benefit all those who suffer from cancer. Outside that form of supportive retreat, we must give the treatment of and cure for that scourge our fullest attention. We must renew, reinvigorate and resource our efforts to reduce the number of women and their families who are sentenced to experience the agony, distress and suffering currently associated with the disease.
Perhaps I should have said this at the beginning of my speech, but I welcome the initiative taken by the hon. Member for Broxbourne in securing today's
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debate, which allows us to focus on what can be done to reduce the suffering that future patients and their families endure from that type of cancer.
10.8 am
Mrs. Ann Cryer: I start by putting on record my genuine appreciation of the work of the all-party parliamentary group on breast cancer. It was the first all-party group that I joined in 1997, when I was elected to Parliament. The all-party group has three joint chairs, and I particularly want to mention my hon. Friend the Member for Halifax (Mrs. Mahon), who has dedicated a great deal of time and energy to the group over many years. I am sorry to say that she will be standing down shortly—but I am sure that she will stay with us and attend meetings, as always.
I shall also mention the enormous help provided by Breakthrough Breast Cancer, whose clarion call is:
"Our vision is a future free from the fear of breast cancer",
which we can all endorse. The group's aims are set out in its current bulletin, which highlights breast cancer awareness month. They are that it:
"Raises issues of concern with Government and other policy makers.
Provides a forum for MPs and Peers of all political parties to discuss breast cancer related issues.
Takes action on behalf of people with breast cancer".
The unsung heroes of this place, who are not often mentioned, are the ever-helpful research assistants in the Library. They now complete an appropriate Library debate pack for all 90-minute Adjournment debates. I called into the Oriel Room last night to collect the pack on breast cancer. All copies had gone, so the assistants made me a reprint—but I shall not rely too heavily on those notes, in case we all seem to be singing too much from the same hymn sheet.
I shall quote just some of the information provided by Cancer Research UK, but shall not go into enormous detail because I want to allow time for others to speak. It says:
"Over 39,500 women are diagnosed with breast cancer every year in the UK. It is now the most common cancer in the UK and by far the most common cancer amongst women. For women, the lifetime risk of developing breast cancer is now 1 in 9",
as the hon. Member for Broxbourne (Mrs. Roe), said. The document continues:
"Most of the women who get breast cancer are past their menopause, but over 8,000 are under 50 years old. About 300 men are also diagnosed with breast cancer every year.
Various factors are thought to increase the risk of breast cancer. These include:
A close relative with a history of breast cancer. About 10 per cent. of cases are thought to have a genetic basis.
Early start to menstruation (before the age of I1) and late menopause (after age 54).
Having a first child late.
Exposure to radiation (other than normal background radiation).
High fat intake in the diet.
Being overweight.
Moderate to heavy drinking of alcohol.
Oral contraceptives and hormone replacement therapy (HRT) may very slightly increase the risk of breast cancer.

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Those with a strong family history of breast cancer carry one of a number of faulty genes which increase the risk of breast cancer. At the moment it is possible to test for two of them, BRCA1 and BRCA2. Up to 85 women out of every 100 that carry a faulty breast cancer gene will have developed breast cancer by the time they are 55."
I asked my local Airedale primary care trust to give me some information on what is happening in my constituency. I should mention that Airedale general hospital does not compare that well with Addenbrooke's, but it is a very good local general hospital, and the biggest employer in my constituency. Lyn Wilkinson, director of community and nursing services, has provided me with one or two points. She says:
"Airedale has a fully accredited Breast Cancer service with the Richardson Clinic providing women with access to Specialist Breast Cancer nurses and surgeon Mr Nejin who specialises in Breast surgery including reconstruction breast surgery (a recent development).
Airedale has a prosthetic service and a lymphoedema service, led by a Macmillan funded lymphoedema nurse."
She also says that the oncology and haematology day unit enables women to have chemotherapy locally in Airedale general hospital. However, women must still travel to Leeds for radiotherapy. The outcomes for women are good, as is referred to in a survey provided by Dr. Foster.
I went to the opening of the comparatively new haematology and oncology unit, and was delighted by it. It is a cheerful large room, well furnished and comfortable. At a time when they are pretty depressed and unsure of their future, it must help women a great deal to be able to go into such a room for chemotherapy.
Because of certain events that are to take place this afternoon, our debate may not grab the headlines. To paraphrase: it is a good day to bury reasonably good news. That is a pity.
10.14 am
Mrs. Alice Mahon: My hon. Friend the Member for Dundee, East (Mr. Luke) made a valuable contribution. I am always delighted when men stand up and move the case forward, and do so as movingly and as well as my hon. Friend did. He was also rather optimistic, which was good for us all. I echo the sentiments of my fellow officers of the all-party group on breast cancer in saying how delighted I am that we have this opportunity to highlight the importance of breast cancer awareness month.
I want to pay tribute to one or two people, including the joint chair, the hon. Member for Broxbourne (Mrs. Roe), who, way back in the mists of time, as Chair of the Select Committee on Health, oversaw the production of a useful report on breast cancer. We have seen a lot of progress since then. I also pay tribute to my other hard-working colleagues. I am going to stand down from the chair and hand over to my hon. Friend the Member for Keighley (Mrs. Cryer), because of pressure of work and because I am standing down at the next election. The group works really well. It is a cross-party group, but parties never come into it. We just consider the disease
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and the foot soldiers—the women—and we see how we can progress matters and help deal with this dreadful disease.
I want to focus on some issues relating to screening. I congratulate the NHS breast screening programme on its 15th anniversary. The programme has been remarkably successful in detecting breast cancers in British women. More than 15 million mammograms have been taken, and more than 90,000 cancers detected. Will the Minister confirm the number of cancers detected through the programme in 2001–02, including the number of cancers smaller than 15 mm, which are usually impossible to detect by self-examination?
As I am sure the Minister knows, the World Health Organisation's International Agency for Research on Cancer recently determined that there has been a 35 per cent. reduction in mortality from breast cancer among screened women aged 50 to 69, which may go some way towards explaining the dramatic 22 per cent. fall in breast cancer mortality rates in the UK over the past 10 years. That is good news for women, and I declare an interest here.
Bearing in mind the importance of the screening programme, we should be extremely concerned that not all women who are invited to take up the opportunity to be screened do so. That is a worry when one considers that 80 per cent. of breast cancers occur in post-menopausal women, and that early detection and diagnosis are vital in improving women's chances of surviving the disease.
The problem is of particular concern in London, where the minimum standard of 70 per cent. has not been met across the board. In the most extreme case—in central and east London—only 51 per cent. of women took up their invitation for screening. There is clearly a job to be done there. I am pleased to say that in my constituency, Halifax, we are way above the minimum standard, and we also have a beautiful facility with dedicated staff. I pay tribute to every one of them.
As joint chair of the all-party group on breast cancer over the years, I have put questions to various Ministers. Will the Minister comment on how the Government are encouraging women to take up their invitations? I know that there is an ongoing programme. Will she, in particular, investigate the low uptake in black spots such as east London? Perhaps the screening programme could be directed to conduct a survey into why that is happening. I accept that there are problems in certain inner-city areas, but the statistics are poor, and we should be finding out why those women are not attending. I have highlighted London today, but our main aim should always be to ensure that all women entitled to screening take up their invitations, because not doing so can have effects on their future health.
The programme also appears to be struggling with the numbers of women being screened, because of the increase. In 2001–02, the number of invitations sent out fell by more than 60,000 to 1.7 million, compared with 1.8 million during the previous year. We should consider and concentrate on that statistic. I know that it has been partly blamed on the pressure on the service due to staff shortages and recruitment problems, but getting the companies and charities that support us to publicise the issue through some sort of advertising campaign might help.

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I am not criticising the service. It has been brilliant, and it has saved lives, but I would like to see an improvement in that brilliant service. I am not making a criticism of anyone working in it, or the Government—or the last Conservative Government, who introduced it. However, there are numerous examples involving the interval between screenings. The agreed three-year period is now being stretched to four years in London in other areas. Some organisers are adding several months on to the three-year recall interval. That is a worrying trend, because a delay means that some women will miss the chance of having breast cancer spotted at the earliest opportunity.
Breakthrough Breast Cancer has evidence that many women have to chase up the results of their mammograms, or have to wait for more than two months for any result to be received. That is a worrying time, and we could improve that situation. The pressure on the existing system will no doubt be further compounded by the increased capacity when the programme is extended to women aged up to 65 and 70 next year. I declare an interest: I am very pleased about that, because I am in that age group.
Will the Minister comment on those situations and outline what initiatives are currently in place or being planned to ensure that all women who should be screened are given the opportunity to attend? It is important that they receive adequate information promptly and get accurate results from the programme. That goes without saying.
Finally, I want to draw attention to the information provided for women attending screening appointments. The information women receive when invited to routine screening as part of the NHS screening programme is different from what women and men receive if they are referred with symptoms. I am concerned that people who are referred with symptoms are not getting enough information about their situation. The standards of information differ throughout the country. I shall be interested to hear the Minister's response to that problem. This has been an excellent debate, and I congratulate the hon. Member for Broxbourne on securing it.
10.23 am
Mrs. Patsy Calton: I add my congratulations to the hon. Member for Broxbourne (Mrs. Roe) on securing this important debate. It touches on all our lives, and none of us is in the happy position of knowing nobody with this particular disease. I would like to associate myself with the hon. Lady's remarks regarding the huge range of breast cancer charities that she mentioned. All of them have played an enormous part in the work that needs to be done on the issue.
I add my own personal thank you to the all-party group, which I joined on becoming a Member of Parliament in 2001. I was made aware of it by my hon. Friend the Member for Hazel Grove (Mr. Stunell), who passed me the documents produced by the all-party group after its 1997 resurrection. I was aware of the work being done by several hon. Members to raise the profile of the issue and point out the importance of getting more than adequate treatment. That group, alongside the secretariat provided by Breakthrough Breast Cancer, has made a real difference. Its calls for better treatment and care have not fallen on deaf ears.
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I also wish to mention the work of the hon. Member for Lewisham, Deptford (Joan Ruddock) who made such a valuable contribution to the group, but, sadly, as is the way with these things, had to move on to other responsibilities—and also that of my hon. Friend the Member for Richmond Park (Dr. Tonge), who as my predecessor was very involved with the group, and of the hon. Members for Halifax (Mrs. Mahon) and for Broxbourne.
The calls for better breast cancer treatment have shown that a multidisciplinary approach, which we have in various excellent centres—we have heard about the centre in Cambridge, and I can also point to the Christie hospital and the Nightingale centre in Greater Manchester—competes with the most advanced treatments in the world. It is a model for treatment of other cancers and for other illnesses. There has been progress, but there is a great deal more to do. Sadly, too often the multidisciplinary specialist approach is still not available, and women and men face a difficult journey on a system that is like the London underground, with parts out of action, parts delayed, and not enough signposting—I owe thanks to a speaker at last week's cancer conference for this analogy.
I pay tribute to the screening service, but there is a shortage of radiographers. The Nightingale centre in my area of Greater Manchester deals with that shortage by training others from related professions to do some of the work. I am sure that acknowledging the numbers problem and ensuring that people are retrained to perform parts of that valuable work are the right things to do.
As we have heard, breast cancer is the most common form of cancer, with around 40,000 cases diagnosed every year. In 2001 there were 13,000 deaths from breast cancer, and about 300 men every year are diagnosed with it as well.
We have heard from the hon. Member for Keighley (Mrs. Cryer) about the number of risk factors that are known because of the valuable work of Cancer Research UK and others. Early puberty and excessive weight gain are two not unconnected factors. Early pregnancy, more pregnancies and breast-feeding all lessen the risk. The point has been made that although we sometimes discourage women from early pregnancy, it seems that early pregnancy is what nature intended.
Between 5 and 10 per cent. of cases of breast cancer are connected with the BRCA1 and 2 genes, and it is appalling and offensive that Meridian has the patent for those genes and has therefore put an obstacle in the way of research across the world. I hope that the Minister will tell us of the progress that has been made in dealing with a company such as Meridian, which feels it has the right to make money out of people's genes.
Excessive alcohol, excessive post-menopausal weight gain, too little exercise and dietary factors all appear to be implicated in an increased risk of breast cancer. I am grateful to Cancer Research UK for its support of this debate. Its "million woman study" has found a clear link between HRT and increased rates of breast cancer, and it is investigating other factors such as diet, childbirth, breast-feeding, vitamin and mineral supplements, oral contraceptives and family history. I hope that it will soon be able to give a clear indication of the increased risks associated with each factor.

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Our main aim must be to reduce the number of breast cancer cases. More research is needed into how to reduce risk factors, and as important is the need to provide information about risk to ensure that parents, young and older women, and men, can make informed choices about reducing their risk.
The Government have promised to match pound for pound the money raised by charities for research by 2003. Will the Minister confirm that commitment? What will be the total sum devoted to cancer research? We heard at the Europa Donna lecture last year that treatments can be more tailored to particular types of breast cancer, thereby in some cases avoiding the need for the entire bundle of available treatments such as surgery, chemotherapy, hormonal treatment and radiotherapy. At the Europa Donna lecture this year, we heard that radical surgery is not always necessary and that outcomes can be as good with lumpectomy, which is becoming a more common practice. As the hon. Member for Cambridge (Mrs. Campbell) said earlier, all lymph nodes do not have to be removed.
Women with breast cancer, and their families, need patient-centred care with speedy and co-ordinated diagnostic investigations—I emphasise the co-ordinated element—followed by clear signposts to treatment and complementary therapy options. I never got a wig, because I was never at the hospital on the right day. I suspect that such things still happen in some places.
The Nightingale centre, which I attended, and the Christie hospital in Manchester have launched an appeal for a purpose-built centre like the Cambridge centre. It will have all the facilities on site so that women and men are not passed around or made to find their own way along a difficult path at an emotionally charged time, when finding their own way is very hard for them, and for their families.
We all want to know how to reduce our risk, and our daughters' risk, of breast cancer. Some factors are outside our control, but some are not, such as those associated with the other major health problems of heart disease, stroke, other cancers and diabetes: lack of exercise, excessive weight gain, excessive alcohol intake, smoking and dietary factors. The Government have acknowledged those factors in their public health programme, but it is important that their role in cancers, particularly breast cancer, is also played up. Women want to believe not only that first-class treatment will be available to their daughters, but that research to confirm the avoidable risk factors will be financed.
10.32 am
Mr. John Baron: I, too, congratulate my hon. Friend the Member for Broxbourne (Mrs. Roe) on securing this important debate, and I take this opportunity to congratulate all hon. Members on their contributions. This highly emotionally charged subject deserves to be handled sensitively.
This is an important debate. One in nine women in the UK will develop breast cancer during her lifetime. The disease accounts for almost one in three of all cancer cases in women and, as we have heard, it is the most common cancer for women in the UK. Last year, some 40,000 women were diagnosed with breast cancer, and
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unfortunately, some 12,990 died because of it. The UK survival rates for breast cancer are lower than those for the EU as a whole, and that must be corrected. There is no doubt that the Government are attempting to address the problem, but in the next 10 minutes I shall raise several questions about their well intentioned targets, and ask whether they are having the desired effect.
I begin with the two-week referral target, which my hon. Friend discussed. A two-week target was set—in April 1999, I believe—to ensure that all women with suspected breast cancer who were urgently referred by their GP should see a hospital consultant within a fortnight. The target has largely—98 per cent.—been achieved, which is creditable. However, research by the Thames Cancer Registry has found that although that target has been met and the proportion of women who are seen within that time has risen, waiting times for subsequent treatment have gone up, and overall waiting times have not changed at all.
The research found that the introduction of the target had meant that non-urgent referrals could easily wait for up to 12 weeks for an appointment; indeed, we have heard examples of 17-week waits. That is a major area of concern. Long delays can impact on treatment outcomes. As Dr. David Robinson, who was party to the research, put it:
"The problem with arbitrary targets is that they just seem to push patients from one queue to another."
He went on,
"Our study suggests that the Government's two week target has changed little for women undergoing Breast Cancer treatment."
Indeed, the study found that women who went to their doctors with symptoms of breast cancer generally waited longer for appointments than those diagnosed through screening, even though their cases might have been more urgent. Some 86 per cent. of women whose cancers were detected by the screening programme saw a consultant within two weeks, compared with 68 per cent. who went to their doctors with symptoms of cancer. That brings us back to the points raised by a number of speakers. As Dr. Robinson put it:
"The effects we have observed reflect the risks inherent in a policy of targeting one element of the patient pathway in isolation."
Will the Government now make a detailed assessment of the effects that the two-week target is having on non-urgent referrals? There is concern that many women who need to be urgently referred are waiting too long to see specialists, and their treatment is subsequently delayed.
Another target that I would like to bring to the Minister's attention is the one-month wait from diagnosis to treatment. It is generally recognised that many trusts—almost 97 per cent., according to the latest figures—hit that target. That is laudable. However, the cancer plan's target refers only to the wait from diagnosis to the start of the first treatment. Concerns have been raised, particularly by Breakthrough Breast Cancer, about the time that patients have to wait between diagnosis and all the stages of treatment. Many patients receive the first stage of the treatment—often surgery via a lumpectomy or mastectomy—relatively quickly, but they then face significant delays before further treatment, particularly radiotherapy.

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Only last week the Royal College of Radiologists reported that the service is still short of the target set by the NHS cancer plan five years ago and, as the Minister will be well aware, the situation is getting worse. The president of the Royal College, Dr. Dan Ash, went as far as to say:
"There is no doubt that patients are dying unnecessarily."
According to the report, many patients have to wait longer for treatment. When responding to the survey, the Government dismissed it on the basis that the figures were out of date. Will the Government now provide up-to-date figures? Furthermore, will the Minister outline other ways in which the Government are tackling the unacceptable wait for radiotherapy treatment?
In a debate such as this, it is important to pay tribute to all the staff within the NHS who deal with cancer in general and breast cancer in particular, for carrying out their work, often under difficult conditions. I add my tributes to those that have already been made to the many charities that have been active in raising awareness of the issue. I wish the merger of Breakthrough Breast Cancer and the UK Breast Cancer Coalition well.
The centre of our focus must always be the patient—today that means the breast cancer patient in particular. We often talk about patient priorities and the level of service and treatment that patients require, without finding out from patients what they really want. For example, many women affected by breast cancer feel that they still do not receive the written information about the condition, or about available support services, that they rightly feel they deserve. The Department of Health's own survey of cancer patients in 2000 revealed that only 51 per cent. of breast cancer patients were given information at the time of diagnosis. I hope that the Government will address that issue; I believe that they are trying to.
A recent survey of 50 cancer experts conducted by Breast Cancer Care, called "Breast Cancer in the UK: What's the prognosis?"—evidence that cannot be lightly dismissed—found that 80 per cent. of patients did not think that the NHS met the information and support needs of patients satisfactorily. Furthermore, 92 per cent. felt that patients needed more time and support from health professionals to help them make decisions about treatment.
There was also a concern about public misconceptions concerning the age-related risk of breast cancer. We know that 80 per cent. of breast cancer cases occur in women who are over 50—that statistic has been referred to on several occasions. That figure was confirmed in a survey commissioned in July 2000 by Breast Cancer Care in association with Boots. It found that many older women were unaware that the risk of breast cancer increases with age.
What initiatives will the Department of Health instigate to review its breast cancer education strategy in order to ensure that the right messages are getting to the right people at the right time? What efforts will be made to improve awareness generally and to inform decision making? We all know of the cancer risks created by smoking, obesity and diet, but it is felt that the message is not being put across aggressively enough.
I would also like to use this opportunity to bring attention to a group that has campaigned for 12 years to seek justice for its members, who have suffered from the
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effects of an overdose of radiation in the brachila plexus region. The group is called the Radiotherapy Action Group Exposure—RAGE for short. Its campaign started after the published case of Lady Audrey Ironside's failed court action against a consultant at the Royal Marsden hospital. During her case it was discovered that a large group of women had been injured accidentally at certain cancer centres between 1980 and 1985.
I ask the Minister to give the Government's position with regard to RAGE. In particular, will she urge the Secretary of State for Health to answer my letter dated 15 September 2003, which sets out the case for compensation for those affected by radiation exposure? It asks whether, as the Department of Health is set to make awards to those who have contracted the hepatitis C virus, it will now reconsider the case of the 250 or so women who are represented by RAGE.
I ask the Minister to address the following key issues that I have raised. The Government's two-week target is failing to bring down waiting times for breast cancer treatment, and may indeed in certain cases be leading to urgent cases being put on the non-urgent referral list. The one-month first treatment target may actually be causing significant delay in breast cancer patients receiving subsequent treatments, particularly radiotherapy. Most breast cancer patients believe that the NHS fails to meet their information and support needs. The Government have not responded to my request for a review of the RAGE campaign. I look forward to hearing from the Minister, in the hope that she will answer those specific questions.
10.44 am
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): It is with great pleasure that I rise to respond to this excellent debate. I congratulate, as others have done, the hon. Member for Broxbourne (Mrs. Roe) on giving us this opportunity. I think that we have all seen it as a fantastic chance to be able to talk about a subject very dear to our hearts and close to the concerns of many people across the country. It is always a pleasure to rise as a Minister, knowing that one is responding to a debate of quality and interest such as that demonstrated by hon. Members' contributions this morning.
I shall endeavour to respond to as many points as possible, but in the time left I may have difficulty in responding to all the many useful points that the numerous experts around me have raised. First, I shall mention the successes that we have had in working with breast cancer charities, whose contribution I welcome. The hon. Lady set out a long list of breast cancer charities, so I shall not risk rehearsing all of them, for fear of leaving one off the list. Their work with patients, their research work, their work on user involvement and the many campaigning and other activities in which they are involved form an excellent addition to the work of the national health service on breast cancer. They have a very important role in making women aware of breast cancer, and of symptoms, treatment and support. That is all to be warmly welcomed.
This debate gives us the chance to look at a wide range of issues. I shall say a few words on prevention, which a number of hon. Members touched on. We know that

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obesity contributes to the risk of breast cancer, and it is important that that message become more widely understood. There is a particular relationship between fat intake, including saturated fat, and the development of breast cancer. Only yesterday, Cancer Research UK published research detailing an association between high meat consumption and breast cancer. Improving diet, as we are advocating in general, by increasing fruit and vegetable consumption is considered the second most effective strategy in reducing the risk of cancer, after giving up smoking. We are therefore leading the development of a comprehensive food and health action plan, which will bring together current initiatives on diet and nutrition and focus more strongly on achieving a healthier diet for people in England.
We are also trying to do more to increase women's awareness of breast cancer. That is very important because 90 per cent. of breast cancers will be found by women themselves. There is a five-point code in that regard: women knowing what is normal for them, knowing the look and feel of their breasts, knowing what changes to look for, reporting any changes without delay, and attending for breast screening if aged 50 or over.
On screening, I join other hon. Members in congratulating my hon. Friend the Member for Halifax (Mrs. Mahon) on her contribution and her work with the all-party group on breast cancer in the past few years; hers was one of several contributions that mentioned screening. Of course, we cannot prevent all cancers, although it would be highly desirable to do so. Even if people took all the useful precautions that they could take, we would be a considerable way from achieving that. The fact that 8,500 cancers were detected through the breast cancer screening programme in 2001–02 speaks for itself. In many cases, screening finds cancers before they turn into detectable lumps. Many of those detected were small cancers that would not have been found by self-examination or by general practitioners. Early detection and treatment means that women have a far greater chance of survival than they would otherwise have.
As my hon. Friend the Member for Halifax mentioned, we are in the process of extending the breast screening programme to women aged 65 to 70 by 2004. That has been rolled out in a number of areas, and an additional 200,000 women have already been invited for breast screening since we began the extension in April 2001. By the time that the extension is completed next year, 400,000 more women each year will be invited, when the scheme is fully implemented. In addition, we are upgrading current services by offering two-view mammography at all screening rounds by 2003, which will lead to an estimated 43 per cent. improvement in the detection of small cancers.
We are aware that some women who are invited for screening do not take up the offer, and the point about the difficulties in London was well made. We cannot force women to attend, however, and problems can arise when they change address. What we can do is to make women aware of the importance of attending. The cancer charities have a major role to play in making women aware of the benefits, limitations and risks of
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screening, and in helping them to make informed choices. Hopefully, women will attend, but it is a matter for them.
I shall provide more information about our achievements through the screening programme, because it is important to realise how effective much of the work has been. In 2001–02, 1.3 million women in England were screened and more than 8,000 cancers were detected. Some 93.8 per cent. of women who had invasive breast cancer detected by screening are alive five years later, which is an impressive statistic. In cases of non-invasive cancer, 98.6 per cent. of women were alive five years later.
Early screening has reduced mastectomy rates, which have fallen by half since the introduction of screening. That is because women can often be treated with minor surgery, which conserves the breast, rather than with the radical surgery that results in mastectomy. The mortality rate fell by more than 21 per cent. between 1990 and 1998. One third of that fall is attributed to screening, which plays an important role in tackling breast cancer and its incidence.
On waiting times, as the hon. Member for Broxbourne said, the two-week wait has been a huge success. Some 98 per cent. of women wait two weeks from urgent referral to being seen at a clinic, which is welcome. In the last quarter of 1999, 28,000 women were seen within two weeks; in fact, the figure may be more recent, but my notes are not entirely clear. The two-week out-patient standard was introduced in 1999.
Patients must be confident that, if they have symptoms of what could be cancer, they can discuss them with their GP and be referred quickly and appropriately if necessary. A GP with a list of 2,000 patients, which is typical, can expect to see one new breast cancer patient per year, but they will also see a considerably larger number of women with benign breast problems.
The need for GPs to pick up and refer people appropriately has already been mentioned. Their task is to differentiate between patients whose symptoms may be cancer and the very much larger group of patients who have similar symptoms arising from other causes. We have developed cancer referral guidelines for primary health care teams to help them to identify those patients who are most likely to have cancer, and who require urgent specialist investigation. The National Institute for Clinical Excellence is currently reviewing those guidelines.
As was mentioned, the referral guidelines recommend a local audit of referrals and feedback to GPs, and we are looking systematically at the review across the local audits. Indeed, we have primary care clinical leads appointed in more than 300 primary care trusts, which is almost all of the trusts in England. As I said, the referral guidelines are being reviewed.
Mr. Baron: I hear what the Minister says, but will she accept that an increasing body of evidence suggests that the Government's two-week target is failing to bring down waiting times for breast cancer treatment and may, in certain cases, lead to urgent cases being put on the non-urgent referral list?
Miss Johnson: I think that the hon. Gentleman is exaggerating what may be a difficulty. We need to check,

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and I shall be happy to investigate whether there is a difficulty. Unfortunately, much of the available information on cancer tends to lag behind what is currently happening. The vast majority of women are served nothing other than extremely well by the target, and by its having been met by 98 per cent.
Another target, which also serves women well, requires that when breast cancer has been diagnosed, women should receive prompt treatment. They should receive treatment within a month of diagnosis, and during the most recent quarter for which we have information, the one-month diagnosis to treatment target was achieved in almost 97 per cent. of cases. I undertake to see whether we can do anything more, outside of reviewing the guidelines, about the time that it takes for some women who are not urgently referred to be seen.
As several hon. Members said, in general death rates are showing a marked improvement. The 21 per cent. reduction in breast cancer, and the 10 per cent. overall drop in cancer death rates over the five years, from the mid-1990s average to the 2000–01 average, indicate that we are making substantial progress on breast cancer and on other cancers. That is an illustration of earlier treatment and diagnosis, better treatment and better follow-up across the piece.
As I am short of time, I will turn to the question of a postcode lottery for prescriptions, and, as was mentioned, for Herceptin in particular. We were concerned by the recent evidence, produced by Roche and Breakthrough Breast Cancer, on Herceptin. As a result of that information, we asked Mike Richards, the so-called cancer tsar and the national director for cancer, to investigate the causes of the apparent differences in the prescription of Herceptin around the country. He has been asked to report to the Secretary of State within three months, and we will consider his findings. I assure hon. Members that we do not believe that funding should be the cause of any such postcode prescribing, and we are committed to ensuring that the drugs are available to patients in line with NICE guidelines.
Government matching of voluntary funding has also been mentioned. The latest analysis, covering the year 2000–01, shows that the Government matched voluntary funding—the figure was, I think, about £180 million per annum—and we continue to do so.
Macmillan Cancer Relief and the Department of Health are working with service users and leading experts in cancer and genetics to develop a model approach for people at risk. Plans are currently being drawn up, in partnership with Macmillan Cancer Relief, to pilot the model from 2004 in some six sites throughout England. In addition, NICE is producing guidelines for women who are worried about familial breast cancer, and they are due to be published early next year. As announced in the genetics White Paper, some of the £50 million investment will he used to upgrade genetics laboratories.
I have not had time to do justice to the many points that have been raised. However, I have had breast cancer and I understand exactly what this means for women. So I can assure hon. Members, whose enthusiasm and interest I welcome, that we are very committed to achieving huge improvements.

Disabled Children
11 am
Mr. David Cameron: I am grateful for the opportunity to debate this important issue, and I am pleased that a Health Minister will respond.
In the early years, the national health service and social services are the vital support services for families with disabled children, especially for people with very severely disabled children—the group on which I want to focus. My interest in the subject was first aroused by a very brave woman, Tussie Myerson, who lives in a neighbouring village in my constituency. She has a severely disabled 12-year-old daughter, Emmy, who is quadriplegic and has intractable epilepsy, asthma, severe learning difficulties, and recurrent infections that often require hospitalisation.
Tussie has fought hard to get the support that she needs to care for her child and to try to maintain some sort of normal family life. While trying to help her, I suddenly found myself perhaps not in the same boat, but at least trying to navigate the same sea. My wife and I have a son, Ivan, who is now 18 months old. He has chronic epilepsy, cerebral palsy, and severe developmental delay. One never knows about the future, but he is unlikely ever to be able to walk or talk. He is a magical child, with a smile that can make me feel like the happiest father in the world, but anyone who has experienced the elation of having a child and then the agony of watching them suffer and finding out about their disability will say that there is also a huge amount of pain.
It is very dangerous for a politician to say that one must experience something in order to understand it. By and large, I do not believe that, but there is something about being thrown into a situation that is so totally unexpected and having to face all the difficulties of coping, all the worry about the suffering of one's child, all the hospital visits, the different treatments, the hopes raised and then dashed, and everything else one experiences that makes one think about the issue with great intensity. Many other parents of disabled children have come to my surgery, both before Ivan was born, and especially since then. I am still a beginner in getting to grips with the wider issues—there are many in this place who are more expert than I but—much of what I have heard and read of others' experience jumps off the page because it fits so closely with what I have found and how I have felt.
Let me be clear; I am saying neither that the way in which we handle disability in this country is a disaster, nor that the Government are getting it all wrong. The care that my family have received through the NHS has, by and large, been superb, and many others would say the same. The help provided by social services can be much more variable, but the staff are good people struggling to do their best and to help. However, much more needs to be done, which is why I requested this short debate today.
As the Minister will know, there is a growing number of severely disabled children in this country. According to Mencap, there are 210,000 children and adults with severe or profound learning disabilities in England, of whom nine in 10 children and six in 10 adults live at home with their family. Those last two figures should be

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stencilled on the Minister's desk, because the vast majority of their care is provided not through the NHS or social services, but through families and carers. I am not talking about my own family: I can afford to get a great deal of help, and we get it. However, others cannot afford it, and they are, quite frankly, heroes and heroines who are doing an often impossible job. The disabled children about whom I am speaking are probably the most vulnerable people in our society. Many need support 24 hours a day, seven days a week, 52 weeks a year.
There are two fundamental points to make in this debate. The first is that support for families, especially that provided by social services, needs to keep up to date with advances in medical practice. More disabled children are surviving birth and more are living longer—a fact that all Departments need to register. The ACE—aiding communication in education—centre in Oxford, which I visited recently, does amazing work in developing new equipment and technology to help the disabled, but it receives pretty much the same funding today that it did eight years ago. Most children's hospices get very little support from Government funds. Helen house—also in Oxford and visited recently by me—gets none, yet it has never been so busy. It is building a new home, Douglas house, for those with life-ending disabilities or conditions who survive into their teens and beyond. The number of such people has grown remarkably, and policy needs to reflect that fact.
The second starting point is that because families bear the brunt of the work, there is an essential unfairness in the system. Often those who do the most receive the least help. The family of a child with cerebral palsy came to my surgery: they were receiving only one hour of support a week, because they were a magnificent family coping as best they could. As the truly excellent Audit Commission report puts it,
"The services that disabled children, young people and their families are offered depend largely on where they live and on how hard parents are able to push."
That cannot be right. Some parents who cannot cope inevitably throw in the towel, and the state is then left with more children in care and a huge bill. The cost of looking after a severely disabled child in residential care is often more than £100,000 a year, yet a fraction of that money, if delivered in the right way, could help a family to cope at home.
What needs to be done? Here comes the shopping list, I am afraid. More priority needs to be given to helping families with disabled children. As the Audit Commission puts it:
"Services for disabled children are still Cinderella services. Their level of priority remains low, with other priorities experienced as more pressing."
That means money. I come back to my point about advances in medical science. Investment in the NHS over decades means that more of the children in question survive, and that they live longer—but has there been a corresponding increase in support? Of course not. If we are going to give those children life, we must also give them and their families decent lives.
I am not a fan of ring-fenced funding, because I believe in local democracy and local discretion. However, we have a problem. Not unnaturally, social
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services departments are—rightly—most concerned about children at risk of abuse, but as a result disability services can become a Cinderella service within a Cinderella service. That is certainly not right. More planning and greater understanding of the numbers are essential in social services departments. If we do not know how many children we are trying to deal with, service provision will never match up.
I beg the Government to aim to achieve some simple goals. They have produced good documents, like the new Green Paper and the national service framework, which I am sure the Minister will mention, but a clear focus is needed on a few areas that would make a real difference. I suggest two. The first is ensuring that parents have clear rights and understand them. Trying to find the right services for a child is like trying to shop in the high street in a blizzard: people know that there are doors they are meant to open and places they are meant to go, but it is all desperately unclear. When events turn lives upside down, people need to know straight away what benefits and services are available and the level of service they should expect. Services should lock on to them like a laser-guided missile as soon as their child's needs and their own needs are assessed, yet six out of 10 families have never had a carer's assessment.
If the relevant rights were set out clearly, and were nationally available and well understood, the problem of the lack of ring-fenced funding would be much less serious. Instead of national rights, however, we have locally set eligibility criteria, and in recent years those criteria have often been tightened. It is hard to blame local social services departments for setting them, given that they are trying to provide services out of very tight budgets. In Oxfordshire, substantial cuts have recently been necessary because the standard spending assessment is so low. However, the lottery of provision that results is simply not good enough.
The second simple goal is respite. One thing agreed on by almost everyone I have spoken to who cares for a disabled child is that they desperately need a break. I think that Mencap's "Breaking Point" campaign is one of the most persuasive and well targeted campaigns that I have ever seen. Mencap has found that eight in 10 families caring for disabled relatives are at breaking point, yet six in 10 get no short break service at all, or one that is so minimal that it does not meet their needs, and three in 10 say that they had less in the way of breaks last year than the year before because of reductions in services. Different ways of delivering breaks suit different people. For some, respite consists of care in a residential centre; for others, it means a carer going to work in the home so that the parent or usual carer can get away for a bit. Whatever the method, breaks there must be.
Parents cannot but be struck by the difference between the amazing care within the NHS and the often rather sketchy care that they receive from social services once they are outside the NHS. One minute, their child is in hospital having magnetic resonance imaging scans, being cared for by nurses and visited by speech and language therapists and physiotherapists, and so on; the next minute, the family are back at home trying to cope, often alone. Better integration of health and social care is essential.

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The teamwork model, with a consultant leading one's case and all the other specialties attached, must be the right way forward. That is what I have experienced at St. Mary's hospital in Paddington, and I praise it. Not all hospitals can deliver that model of care, however, and they should be able to. Easy access to hospital is essential. My family are on our 14th hospital admission in less than a year, and doctors and nurses have told me of many other similar cases, so our experience is not untypical. All too often, however, parents with children who frequently need to be admitted to hospital wait for hours in accident and emergency, sometimes in the middle of the night. Can the Minister say what more can be done to give more automatic access to wards to such people?
A further issue is waiting times for social services. Everyone talks about the same things: the wait for an assessment, the wait for a decision, the wait to see if funding can be put in place, and the wait for equipment that often no longer fits by the time it arrives. The Audit Commission's study contains a powerful quotation from a mother, who says:
"Once you get a service it's usually quite good, but the problem is getting it. The first problem is knowing about it. The second problem is persuading someone you need it. And the third problem is finding someone who can deliver it".
I have one or two further suggestions, the first of which is about waiting times. When a family are close to breaking point, it is an emergency, but there does not seem to be anything like an emergency service. Almost anyone—a nurse, a carer, someone to help—would be better than nothing for some of the parents who have come to my surgery in west Oxfordshire. They ask, "Can't the assessments, the form filling and all the bureaucracy be short-circuited just to throw in someone who could actually help for a few nights, or even a few hours?" It is difficult to answer them, so we need to consider the issue closely.
Secondly, although I pay tribute to the Government for trying to move ahead with the idea of individual payments—giving families the money and letting them decide how it is spent on the services that they need to cope at home—I understand that the idea has not taken off as fast as they hoped it would, possibly because of the bureaucracy involved. I wonder whether the Minister has considered the idea of personal trusts, which MacIntyre Care, among others, is proposing. The concept is quite straightforward. Disabled people have around them a network of relatives, carers and friends who can be trusted to act on their behalf. Creating a personal trust involving those people would ensure that much of the state bureaucracy would not be needed, because the trust would have to provide a full account of the money raised and the money spent. Setting up a trust would make it possible to access extra support from the community and other organisations. I commend what MacIntyre Care has said and can give the Minister details if he wants to consider the idea, as I hope he will.
I apologise that, with my passion for the subject, I have thrown off ideas like sparks from a lathe, but I plead with the Minister to have one guiding principle—to make the lives of families who are struggling to cope with severely disabled children easier. When I spoke to our carer this morning, she gave me another idea. She said, "Why do we wait until severely disabled children are two years old before giving their parents disabled
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parking badges?" Most of those kids cannot have immunisations because of their illnesses and cannot go on public transport, but they have appointments all over the place for services that I am sure the Minister will tell us about. It may be a small thing and, as I have said, there is much to do, but the Minister is a sensitive soul and will want to start somewhere.
Before asking the Minister to reply to this debate, I ask him to recall the last time that we faced each other across this Chamber, when I asked about group B streptococcus infections. In answer to an intervention from me, he kindly said that he would entertain a delegation of parents who have lost children to such infections. He said that we could pick a suitable time to see him, and I hope that we shall be able to do that, either later this year or early in the new year, when he has more of the medical and other evidence that he said would be necessary to respond. I look forward to hearing what the Government intend to do to support families with disabled children.
11.14 am
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): It is a pleasure to answer a debate initiated by the hon. Member for Witney (Mr. Cameron). I congratulate him on raising such an important issue and on his continued interest in the health and care of children. He says that it is not necessary for anyone to have personal experience of something in order to speak authoritatively about it, and I entirely agree. However, it is important that we learn from those who have such experience, so I welcome the fact that he used his experiences as well as those of his constituents to illustrate his speech, and I look forward to further exchanges on the matter, both in the Chamber and in private.
I have not forgotten my commitment to meet parents and others involved in the group B streptococcus campaign. The timing mentioned by the hon. Gentleman—towards the end of this year or early next year—is what I had in mind. By then, we will have concluded or at least made progress in our review, and we will be able to have a more meaningful discussion than we could now. As soon as I have the information, I promise that a date will be entered in my diary.
For those interested in the machinery of government, if we had had this debate last year, my predecessor in this post, my right hon. Friend the Member for Redditch (Jacqui Smith), who is now the Minister for Industry and the Regions, would have been answering as the Minister responsible for children's health and for children's social care. We now have a Minister for Children at the Department for Education and Skills, but my right hon. Friend the Member for Barking (Margaret Hodge) is responsible only for children's social care; I, a Minister at the Department of Health, have responsibility for children's health.
The hon. Member for Witney mentioned the need for joined-up services, and my right hon. Friend the Minister for Children and I are trying to lead by example. We have joint meetings on the various issues that concern us both, and we make decisions and keep each other informed of progress on our respective responsibilities. On many issues, we work in tandem, so not only can I speak with confidence about children's

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health issues, but I can answer on behalf of my right hon. Friend about social care matters. She will at some point be answering questions or debates on children's social care, and I have no doubt that she will be equally happy to answer questions on children's health.
I shall deal later with the Green Paper and the national service framework for children. The hon. Member for Witney mentioned the Audit Commission's report and Mencap's "Breaking Point" report, which raise serious issues. I wholeheartedly agreed with much of what he said—indeed, I heard nothing that had not already crossed my mind and is not already on my agenda. We may dispute our priorities over the coming year, because I cannot work on everything at once, but I assure him that our minds are working along similar lines.
The Audit Commission found a lottery of provision in health and social care support. I acknowledge that the quality of service depends on where one lives and how well the local council is working. That is not acceptable. I want high-quality services to be available everywhere. I promise the hon. Gentleman that, far from slipping down the Government's agenda, children's social care and children's health—not only for children at risk, as dealt with in the Green Paper, but for those with disabilities and all other children—are at the top of our agenda. I am sure that he listened to me when I had Adjournment debates on the subject as chairman of the all-party group on autism, before I was promoted to my present post. He will have found common cause with me on the need for joined-up services.
The example that I always gave was what I called the bag ladies. Hon. Members will immediately recognise the bag ladies from their surgeries. They are the mums—occasionally dads, but usually mums—who into our surgeries carrying bags full of letters that they have had to write to get all the services that they need for their disabled children. We need to arrive at a system in which, as the hon. Gentleman identified, there is an early assessment of a child's disabilities and we immediately plug in all the services that that child needs, so that mum does not have to become a bag lady to get the required level of service. A good example of progress is the national initiative for autism: screening and assessment, which became the national autism plan for children. It identifies a process of early intervention for disability, which the Government are considering. Of course, the national service framework is intended to consider such issues and the way in which we join up all those services.
Over the past couple of years, the Government's quality protects programme has been the key vehicle for driving upward the quality of services. Disabled children have been a priority in the programme. Over three years, £60 million for the children's services special grant has been earmarked for services for disabled children and their families. We have had some success. The national overview report for quality protects shows that more family support services, particularly home-based respite care and sitting services, are being provided. The majority of councils have started developing proposals in collaboration with partners from other agencies and sectors, such as the NHS and the voluntary sector, and there are numerous examples of improved provision around the country. We need to
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build on that success and ensure that all disabled children have access to excellent services. That is why we have doubled the earmarked funding for disabled children from quality protects from £15 million to £30 million.
We are also increasing support through the carers grant. That is leading, in particular, to increases in the levels of provision of short-term breaks for carers, including parents of disabled children. Last year the total number of carers helped via children's services was 52,000. The carers grant is increasing annually, and by 2005–06 it will have nearly doubled to £185 million. I assure the hon. Gentleman that I was equally interested in the "Breaking Point" report. I am determined to do even more to support carers and am looking for further opportunities for the Government to be able to help them in future.
The hon. Gentleman mentioned direct payments and the views of MacIntyre Care about setting up disabled people's trusts. I have not seen that work and I would welcome details of it. I will certainly consider the idea. My immediate instinct is that I am not sure that it will be necessary to go down that route because the legislation is absolutely clear, although it is often misinterpreted. It says that councils have a duty, not to offer, but to make a direct payment. Councils should presume that they are going to deliver care through a direct payment; they should not presume that they are going to provide care directly. Direct care should be provided only when people—whether they are the parents of a disabled child, or older adults—have turned down the opportunity of a direct payment.
The legislation is equally clear in relation to judging whether somebody can manage a direct payment. It states:
"with such assistance as may be available to him".
That assistance is family, friends, carers and the local council itself. I have met people with severe learning disabilities who are managing a direct payment perfectly in order to provide themselves with an independent life. They are plugged into a network of assistance that helps them to manage that payment. I hear what the hon. Gentleman says, and I will certainly consider the idea of a personal trust, but the legislation makes it possible for us to deal with that in other ways. If that is not working, we need to find out why.
I intend to exert major pressure to move forward on direct payments. This week, I received an email from an old friend whom I have not seen for 15 years. About 10 years ago, he had an accident that left him severely disabled and in a wheelchair. He emailed me to say that direct payments have transformed his life. That is the experience of disabled people and parents of disabled children all over the country who have had access to direct payments. We need to push ahead on that agenda.
The hon. Gentleman raised the subject of the benefits of fostering compared with residential care. I know that he is concerned that residential care is occasionally not an option and that fostering always seems to be preferred. When a family cannot cope with a disabled child any longer and needs some extra help, we usually prefer the fostering environment because it keeps the child in a family setting, and the sort of family support that we believe a child needs continues to be provided.

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However, I accept that the option of residential care should sometimes be on the table and that it needs to be kept available.
On equipment and therapy services, we are taking specific action to improve services for disabled children. The Audit Commission said that many disabled children have had to wait long periods for equipment services. The NHS plan set out our commitment to modernise community equipment services and, backed by additional funding, we are working towards the development of integrated equipment services.
As the hon. Gentleman rightly said, therapy services are another key service for disabled children. In the NHS plan, we recognised that the shortage of human resources is the biggest constraint faced by the NHS today, and we set out our commitment to increase the work force. With the extra investment that we announced in the 2002 Budget, we will build on that target. By 2008, we expect the NHS to have had net increases of at least 30,000 allied health professionals and scientists over the September 2001 staff census. The plan also announced an increase in the number of training places for therapists and other health care professionals. It set a target of 4,450 extra training places for therapists and other key professional staff by 2004. I must add that recruitment will be our biggest challenge; I cannot turn on a tap and magically produce trained professionals. It takes time to attract people to that type of career, and to train and deploy them, but we have a strategy to bring them into the NHS as rapidly as possible.
The hon. Gentleman mentioned the Green Paper, "Every Child Matters", which I spoke of earlier. It is essential that we have a strategic framework to protect children and to ensure that they have all the services that they need. The Green Paper provides us with that framework. It specifically states that we will shift the balance of services towards early intervention,
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particularly in the early years. It also states that we will improve support to parents and provide targeted services, specifically mentioning the families of disabled children. We have set out proposals to integrate education, health and social care through children's trusts, extended schools and children's centres. They will be particularly important for disabled children, who often need the support of all of those agencies. Whether the starting point is health, education or social services, we expect coherence in the planning, commissioning and delivery of services.
The hon. Gentleman also mentioned the national service framework for children, which will be published next year. It will set national standards for health, education and social services and will help to tackle the problem that he mentioned: the postcode lottery of provision. It will also ensure better access and smoother progression in the provision of services for children. The leading external working group on such work has established seven task groups to address specific issues such as early diagnosis and intervention, family support, equipment, housing, therapy, transition, participation, and support for children with complex health care needs. They are all issues that the hon. Gentleman raised today. The framework will lead to disabled children having access to modern health and social care services designed to meet their needs—services that give choices to them and their families.
We recognise the agenda that the hon. Gentleman has set out today. That is my priority and a key priority of my right hon. Friend the Minister for Children. I give the hon. Gentleman an absolute commitment that we will work hard on every issue that he has raised. We may not be able to solve all the problems instantly, but I promise that we will endeavour to do so.
11.30 am
Sitting suspended until Two o'clock.

Housing
2 pm
Ms Sally Keeble: I am grateful for the opportunity to debate this important issue. Many Members have shown a great deal of interest in this Adjournment debate, including my hon. Friend the Member for Regent's Park and Kensington, North (Ms Buck) who first suggested calling it.
Overcrowding is the forgotten issue in housing policy. Because it is so difficult, perhaps it has not been so much forgotten as put on the back burner, where it has remained since 1935, when the standards were first introduced. The point of this Adjournment debate is to set out how disastrous the standards are and how they can be improved, and to press for their improvement as part of any housing legislation introduced in the near future.
The number of families in statutorily overcrowded conditions is not known, because the figures are not collected. London Housing states that 150,000 households are overcrowded, but its definition is not exactly the same as statutory overcrowding. In the introduction to his Housing (Overcrowding) Bill, my hon. Friend the Member for Edmonton (Mr. Love) referred to the survey of English housing, which states that 500,000 households nationally are overcrowded—but again, the definition is not necessarily the same as that for statutory overcrowding.
The actual number of statutorily overcrowded families is likely to be minimal, because the standards are so abysmally low that it is hard to breach them. My hon. Friend the Member for Bethnal Green and Bow (Ms King) and I have examined housing in her constituency. Although many of the families whom we met on that visit live in overcrowded conditions, when I counted up the people and the rooms, none of them was statutorily overcrowded. However, my hon. Friend knows of a number of cases of statutory overcrowding.
Many of us have been involved with housing over the years both as councillors and as MPs, and all the evidence, and the experience of those of us who have been involved with housing on a professional or a casework level, points to three things. First, overcrowded households include families with children. That may sound obvious, but it is worth emphasising that the issue concerns not only housing policy but policy for children. By and large, overcrowding does not affect single-person households. Secondly, the problem disproportionately affects people from ethnic minority communities. Some communities are affected more than others. In particular, the Bangladeshi community in Tower Hamlets, on which Shelter has produced an excellent report, is seriously affected by overcrowding. Thirdly, overcrowding is a problem for young families with one or two children who are trapped in one-bedroom flats in excruciating circumstances—something that I see a lot in my constituency.
Overcrowding is often seen as a big city problem, but that is not the case. In my middle England constituency, I come across the problem too often. For example, I know of a Bangladeshi woman with six children who lives in a little terraced house. She has created six bedrooms in her house by making haphazard subdivisions. She shares one small room with her baby,
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her 15-year-old daughter lives in another tiny room, her four other children sleep in a third room, another couple and one of their children share a fourth room, that couple's other three children, one of whom has special needs, sleep in another room, and a single man sleeps in an attic room.
Last weekend I visited a family who live in a one-bedroom first floor flat. The young woman, her husband and their two-year-old son share a bedroom. The daughter, who is about 10 years older, has serious special needs and sleeps in the sitting room. The sitting room is full of containers of clothes, baby items and toys. Both families have serious problems as a result of their overcrowded conditions, but neither is statutorily overcrowded. Neither has any hope of moving.
It is hard to overestimate the profound sense of injustice that overcrowded housing conditions can create in people. There is complete fury when people are told that they should relieve the pressure on the bedroom by putting a bed in the kitchen, or when they are told that they can meet the requirements for gender segregation if the wife sleeps in the same room as the daughter and the husband shares a room with the sons.
Mr. Geoffrey Clifton-Brown: We can all come up with terrible examples of overcrowding. Would not a really good outcome of the debate be for the Minister to give a direction under the Homelessness Act 2002 that when local authorities carry out their homelessness plan they should also inquire into the exact amount of overcrowding in their area?
Ms Keeble: I shall come to some ways forward at the end of my remarks. I said at the beginning that the problem is very difficult to solve. There must be careful thought about how we progress. One real difficulty with overcrowding is that in none of those cases are the families statutorily overcrowded. If a survey were done of statutory overcrowding, the horror stories that everyone could tell would not show up, because the families are not statutorily overcrowded according to the present rules.
We must review the standards and set new ones that would have been more appropriate even in 1935, let alone today. We must also consider how the Government work with local authorities to map out the extent of overcrowding and to determine how to catch the small but acutely disadvantaged group of people who live in unacceptable conditions.
One could argue that people who are overcrowded should simply be regarded as homeless. That would create a catch-all, but no clear framework for solving the problem. I shall come on to some solutions later. It is important that proposals are put forward in this debate that can be picked up and implemented by the Government to ensure that we end what has been a complete scandal for many years.
The sense of injustice felt by people who live in such circumstances is increased when they see homeless families get two or three-bedroom houses. Most local authorities use more generous space standards for housing allocations, but overcrowded families do not score highly on points systems for transfers.
Overcrowding is often a problem for growing families who become trapped because they cannot get transfers, or because adult children who cannot get housing

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remain with their parents and have children of their own. Two or three families may live in one house. One way out is for families to make themselves homeless, and some end up doing just that.
It is hard to overestimate the damage caused by overcrowding. It is an area on which the different aspects of Government policy are not joined up properly. Children cannot do their homework if the sitting room is a bedroom and there is no space to study. The consequences for health can also be dire. The British Medical Association's head of science and ethics has said that
"poor housing can cause psychological and physical health problems, and the best way to reduce health inequalities in this country is to improve living standards."
There are also risks to children's safety and well-being as the result of inappropriate sharing of bedrooms and the resulting lack of privacy.
The Government are making real progress in developing good children's policies and putting them into effect, but for some families, overcrowded housing is a barrier to child health, educational achievement and freedom from abuse.
There is nothing new about the criticisms of overcrowding standards. I invite Members to consider this statement:
"the right hon. Gentleman's standards as regards overcrowding are not standards which are tolerable in the twentieth century. He contemplates as a normal thing that living rooms should be used as bedrooms. I can never agree to that. I think it is wrong."—[Official Report, 20 May 1935; Vol. 302, c. 42.]
Here is another one:
"it would be much preferable to establish a standard which hon. Members can defend in the country, even if we give a time limit to local authorities, rather than hang around the necks of hon. Members and local authorities a standard of overcrowding of which this country will be ashamed within the next two years."—[Official Report, 29 May 1935; Vol. 302, c. 1191.]
Those criticisms of the overcrowding standards were made when the Housing Bill was on Report in 1935—the year that the standards were first introduced. It was expected that they would be upgraded in future years. It is interesting to note that those standards were introduced by a Health Minister, because of the link between housing standards and health.
The amendment tabled in 1935 was radical, because it proposed to disregard the living room in the calculation of standards. It was recognised that the standards were deliberately set low in order to prevent the building of a whole swathe of extra houses. That really is the rub. As the hon. Member for Cotswold (Mr. Clifton-Brown) pointed out, the question is not whether, but how, the standards should be changed,
My hon. Friend the Member for Edmonton set out a gold standard in his Bill, which has been very important, as has the report of the Select Committee on the Office of the Deputy Prime Minister: Housing Planning and Local Government, and the excellent work of Shelter.
Mr. Andrew Love: I thank my hon. Friend for her kind remarks. She will be aware that the standards in my Bill were based on those set in the English housing conditions survey, which is, by
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unanimous acclaim, a modest overcrowding standard. To have a gold standard, we would be considering something significantly better than the standard in my Bill.
Ms Keeble: I take my hon. Friend's point. I was just trying to say that if his standards were enshrined in legislation, we would be doing extraordinarily well.
Whatever happens, we must see some improvements on the present position. It is a scandal that the standards MPs said in 1935 that they would be ashamed of two years after their introduction are still in place almost 70 years later, and without the modest improvements that were proposed then, such as discounting the sitting room.
My hon. Friend's standards would have been contained in primary legislation, but they should not be introduced there because they should be open to wide discussion. They should also be open to simpler amendment than primary legislation allows. Secondary legislation would provide for greater flexibility and allow us to improve standards without the problems that we have seen with past housing Bills, in which it has been difficult to change standards. There is a reluctance to commit too much to secondary legislation, but overcrowding standards are ideally suited to that form of settlement.
It is important to have absolute standards. The issue is not about establishing when housing overcrowding becomes a risk, as in the housing health and safety rating system's proposed method of considering overcrowding standards, but about specifying what standards of space accord with wider policy objectives for children and families. It is also about our changed perceptions of space and privacy compared with those of 1935. For example, should it be recognised that husband and wife should not have to sleep in separate rooms to meet overcrowding standards? I certainly think that it should. It is very difficult to explain to older parents that they might have to sleep with their grown-up children rather than each other because of the gender segregation requirements. It should also be recognised that children under 10 count as people, not half-people. My hon. Friend the Member for Edmonton says that the cut-off age should be five.
We should recognise that families need a living room. They are entitled to some space—more if the family is large—to use for recreation, leisure, eating, doing homework and the like.
Mr. Clifton-Brown: I agree with the broad thrust of what the hon. Lady is saying. Something must be done about the problems, but how should it be done? I slightly disagree with what she said about the provisions not being in primary legislation. It seems to me that the Housing Bill that the Government are about to introduce would provide an ideal opportunity to deal with the problem, and it would update the Housing Act 1985, which is nearly 20 years old. Standards have moved on considerably since then.
Ms Keeble: It is a moot point where the provisions should be. I would just say that the Housing Acts passed after 1935 have always reinforced the previous standards. That is partly because there have been other

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priorities. Certainly, local authorities were applying different, more generous standards during the 1960s and 1970s. With all the changes taking place at that time, perhaps it did not seem quite so important to improve the statutory standards. Including those standards in legislation has made them very resistant to change.
If it is not possible to get absolute agreement on the standards to be enshrined in the Bill, it might be more helpful to have secondary legislation so that there can be detailed attention to that particular aspect of housing. It is right that over time we should constantly improve the standard of housing and recognise that people should have more space for recreation. It would be nice if they had space for proper dining facilities, for example. It is also important that we understand that the changes that we introduce now would be subject to change in future years.
We should make absolutely sure that we do not pass legislation now and then leave it for another 70 years before there is the opportunity to change something, just because we used primary rather than secondary legislation. We need to consider that risk carefully, but we must not say, "We can't get agreement to change the wording in the Bill so we aren't going to do anything." I suspect that that is what happened with previous Housing Acts.
Probably the most difficult issue is that there needs to be a process of implementation, during which there would have to be careful assessment of the impact of changing standards and how the goals could be achieved. My hon. Friend the Member for Edmonton also made the point about the need for a survey so that we can quantify the level of overcrowding and ensure that we know how that can be managed.
Some of the issues involved in tackling overcrowding concern management of the housing stock, such as management policies for transfers, arrangements for housing homeless people, how we manage homelessness, and what we do about grown-up children with babies who are living with parents and grandparents. We also have to consider the design of new homes, including proper provision for larger families.
One option that I do not believe is open is to leave the standards untouched. They are offensive, they cause immense hardships for families with children—the very families that other areas of Government policy are so keen to support—and discriminate unfairly against particular ethnic minority communities. They are also virtually impossible for people at the sharp end in the communities to challenge, because of the different ways in which the various pieces of housing legislation work. I hope that careful consideration will be given to that matter.
Mr. Love: Is not one of the most important considerations the fact that the incidence of overcrowding in Greater London coincides with the incidence of the deepest child poverty in this country? One intensifies the other. If the Government have set themselves a target of reducing child poverty, there must be some action on overcrowding.
Ms Keeble: I agree. It is clear that overcrowding is about child policy, not just housing and family policy. Overcrowding and economic disadvantage are related. Also, there is a failure to take into account the pressures on the most disadvantaged families. The case in my constituency that I cited, in which one of the children living in those circumstances had special needs, is typical of a number of families. A family with children with special needs often needs extra space to manage the equipment and the behavioural problems. I hope that such issues can be taken forward by a really careful consideration of, and improvement in, the overcrowding standards. I also hope that this subject will be covered in any forthcoming housing Bill, and that we will at last bring our overcrowding standards not just into the 20th century, but into the 21st century.
2.21 pm
Ms Karen Buck: May I draw Members' attention to my entry in the Register of Members' Interests? I congratulate my hon. Friend the Member for Northampton, North (Ms Keeble) on securing this important debate. She has shown a great deal of interest and concern about the issue, and is to be congratulated on giving us an opportunity to discuss the matter again today. I also congratulate my hon. Friend the Member for Edmonton (Mr. Love) on all the work that he has done in bringing the issue forward.
Overcrowding is one of the most serious and pressing concerns for those of us representing constituencies facing a housing shortage. It has knock-on consequences for a number of the Government's agendas for tackling social exclusion, including agendas for health targets, educational achievements and antisocial behaviour. There are few areas of concern that the Government are rightly seeking to address, and into which they are putting resources, on which overcrowding does not have an impact.
I have made my next point before when speaking on housing issues in this Chamber and in my constituency. Overcrowding is one of the most serious causes of racial tension—I am sure that some of my colleagues face racial tension issues—for the simple reason that, at a time when there has been a great deal of media and political interest in immigration and asylum, the chronic housing shortage and its consequences create a sense among many people living in unacceptable and appalling conditions that immigration and asylum seekers are to blame for their plight. I shall draw attention to why that view is not true. However, I have no doubt about the unfortunate consequences of the situation in terms of public policy.
I hope that the contributions made today, and those that I am sure many of us will continue to make, can do something to get this terribly serious problem on to the Government's agenda. The problem with housing is that most people are either satisfactorily housed—thank goodness for that—or see housing as a market need. Many people who are buying their own houses will see their ability, or inability, to have the house that they want as a market transaction. Housing therefore simply

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does not get the same attention as education and the health service. However, as my hon. Friend the Member for Northampton, North and I have said, the impact of housing shortage where it is most acute is undermining so many of our attempts at progress on those other agendas.
In an intervention, my hon. Friend the Member for Edmonton drew attention to the particular issues in London. There are impacts on other cities and parts of the country, and there are pockets of serious rural overcrowding to which we could draw attention, but there is no doubt that this problem impacts specifically and detrimentally on the capital. In London, overcrowding is almost four times as frequent as outside it, and there was a 21 per cent. increase in overcrowding levels between the 1991 and 2001 censuses. When we bear in mind that the 2001 census in London, Manchester and a few other places was woefully inaccurate, that does nothing to give us confidence that we have found the real scale of the problem. It is probably a great deal worse than census data give us cause to believe.
According to that data, which we shall have to use until we have any better, there has been a 21 per cent. increase in overcrowding levels in London compared with a 22 per cent. decline in the rest of the United Kingdom. I am extremely pleased about that decline, but we are grappling yet again with a serious regional imbalance. We are often stymied by the fact that we put forward policy solutions to a problem that are in danger of being dismissed because they have a particular regional impact. I hope that my hon. Friend the Minister understands that those of us seeking to address this issue can do so only from the facts and experience of our own localities. The seriousness of the problem should not be masked by a national set of averages that, if examined, show that the rest of the country has enjoyed a decline in overcrowding levels in recent years.
The two boroughs in my constituency are among the worst affected in terms of increases in overcrowding. There has been a near doubling of overcrowding among tenants of registered social landlords in Kensington and Chelsea, and the amount of council stock deemed to be overcrowded has increased from 9 to 14 per cent. in Kensington and Chelsea and from 8 to 12 per cent. in Westminster. As my hon. Friend the Member for Northampton, North said, we have to remember what those statistics represent: absolute human tragedies.
Mrs C has two children, one with autism and one with heart disease. Their school has advised me that
"at the moment, their living conditions are severely hampering not only their social, but also their mental and physical development".
Another constituent wrote to me recently to say:
"My parents have allowed my family to temporarily stay in their property and as a result I share a 3 bedroom flat with 9 people … I occupy one small bedroom and share a double bed with my husband and 4 year old son, my two year old occupies a cot and frequently wakes in the night, disturbing everyone. My father is a pensioner with Parkinson's disease, depression, hypertension and bladder problems … my mother is also a pensioner … Two of my brothers are in full-time education and attempting to study for examinations."
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A third constituent, Mrs. S, writes:
"I stressed all the support sent from my GP, Social Worker and from you regarding my health. My physical and mental state is seriously deteriorating. I am sinking into a deep depression as I battle with my housing situation daily. I am at breaking point! And the children are suffering too. Yes I now have constant heating and hot water",
for which she is grateful,
"but there are still the problems of the flights of stairs, lifting, carrying and climbing for four people sleeping in the one bedroom. No space for the children to play is made more apparent as the baby is very mobile now. The noise in the flat is worsened by the fact that there is no soundproofing. I cannot take any more. I am desperate and very vulnerable at this time."
As my hon. Friend said, even people suffering from such levels of overcrowding cannot for the most part become registered as statutorily overcrowded under the present legislation. As we have heard, children under one year of age do not count, despite the fact that they take up sleeping room and become mobile as they begin to crawl. Children under 10 count as a half. I referred the family of a Mrs. M to the environmental health office for an assessment, but the reply that I received stated:
"The ages of the children mean that the family currently has 4.5 'persons' in that the 3 younger children each currently count as 0.5 of a person."
I am sure that my hon. Friend the Minister will understand that when constituents receive a letter telling them that a nine-year-old child counts as only half a person, it causes them great irritation. The child in question may be, as in the case of my constituents, aged nine and a half with special educational needs. Three of the family's four children have special educational needs relating to language and speech development disorders, which are not counted for the purpose of overcrowding. The rules make it impossible to compound either many different levels of medical need—because medical points are allocated for only one person in a household—or the impact of overcrowding on the family's medical problems. The result is that they cannot secure statutory overcrowding points.
My hon. Friend rightly drew attention to the fact that under the 1935 legislation housing authorities are allowed to require the living room to be used as sleeping accommodation, regardless of the impact that that would have on the family's social life or privacy, or on children's ability to get a proper night's sleep or to study. However, things are slightly worse than that, because under legislation there have been instances when it has been decided that the kitchen could be used for sleeping.
A reply to a letter inquiring about a constituent stated that the lounge and two bedrooms were clearly included as sleeping accommodation, but that the difficulty for the environmental health department was whether to use the kitchen-diner as a living room, since there were a table and chairs in the room and it therefore seemed to be used for more than just cooking. It is possible for an environmental health department to decide that if a kitchen-diner is used for eating, it can therefore be used for sleeping. I would not know, because the information is not monitored across the board, in how many instances such a ruling has been made.
The problem is that even if a family can get through the equivalent of the biblical eye of the needle and qualify as statutorily overcrowded, they still cannot move, because of the shortage of accommodation. The

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family of Mr. A in my constituency is statutorily overcrowded and has received the maximum additional points that are available. There are seven people in a two-bedroom flat, and they have medical points because the gentleman in the family has ischaemic heart disease. The family have not been allowed to move and are still 11th on the housing waiting list, having been on it with maximum points for about four years. A letter from the sure start unit in the ward where the family lives states:
"I do not understand why the family has not been able to move … the family are statutorily overcrowded with 2 adults and three children"—
it is in fact four children—
in a one-bed flat … the family is surviving in the most distressingly cramped conditions … Charlie … aged 11 years, and Faith, aged 5 go to sleep in their parents' bed and then, when they are ready for bed, the parents transfer them to a sofa bed in the lounge room … the two youngest children sleep in a cot beside their parents' bed … "
The mother
"is one of the main supports for her mother in law who lives nearby … who has cancer".
There are therefore good reasons for the family not to welcome a letter from the local authority asking whether they would be interested in being considered for a move to the north of England.
Another family, living in north Kensington and statutorily overcrowded in a housing association property, are a couple with four children over three years old. They live in a one-bedroom flat. I asked the environmental health department to assess the flat for overcrowding. Its view was:
"The recognition of statutory overcrowding will not provide an early offer of permanent local housing."
I was informed that the head of housing needs in the borough—who is an excellent housing officer and has been of enormous practical help to me over the years—has none the less advised in this instance that
"there are many hundreds of families with similar overcrowding currently registered for larger accommodation on the Council's Housing register."
Ms Keeble: Perhaps the Minister could confirm my understanding that if people are statutorily overcrowded and register with the local authority for a transfer, the matter ends there. Priority is granted, but there is no automatic right to rehousing as one might normally expect following a breach of a statutory standard. Once people apply for housing, they lose their immediate rights and the obligation to rehouse them ends.
Ms Buck: My hon. Friend is right. In some ways, it is worse than that. Her point leads me to my next sentence. Last year, the chief housing officer for the housing association wrote to me as follows:
"It would not be in your constituents' interest if enforcement action was taken in respect of statutory overcrowding as this would require us to evict the family for breaching the covenant requiring them not to overcrowd the dwelling."
According to statutory overcrowding legislation, it is the tenants' fault that they are overcrowded. In my experience, private tenants and tenants housed by registered social landlords and local authorities are
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often technically in breach of their housing obligations if they are overcrowded. They are therefore the ones who are at fault, and they can be evicted. In practice, that does not happen, especially where children are involved. In this instance, however, the housing association's comment flags up a particular problem.
There is a serious and worsening crisis, especially in London. Given the nature of the legislation, it is extremely difficult for families to qualify as being statutorily overcrowded. When they do, it is almost impossible to move them. In many cases, families are told that their only option is to consider moving to the north of England. Some would welcome that, and I assure hon. Members that I have nothing against the north of England in this respect. However, many—probably the overwhelming majority—of these families have extremely strong local ties. Many of them are working, despite the conditions in which they live, and many are from minority ethnic communities with strong community links. Many, such as the family with the three children with special needs in language development, have strong ties with the health service and schools, which provide them with vital support for their children. Uprooting such families and moving them to another part of the country is simply not an option.
If we are to deal with the problem of overcrowding, we must treat it as important, monitor it and set targets. It is right that families living in substandard housing should be a target in the monitoring of child poverty. Defining homelessness and overcrowding as forms of housing need and as targets in tackling child poverty is also well overdue. If we do not commit ourselves to updating the legislation and to monitoring the impact of overcrowding and the problems arising from it, the issue will continue to stay below the radar. I join my hon. Friends in asking the Minister to reconsider the matter and to pursue it.
It is not satisfactory simply to wrap up the problem by using the standards that the Government propose. A few months ago, the Minister's colleague wrote that
"to raise the issue of overcrowding standards in isolation from other factors would not deal with the problem".
I suggest that if we do not raise these issues, and deal with them, the hard core of chronically overcrowded families will simply be ignored, and they will continue not to receive the attention that they deserve.
Will the Minister also undertake to consider the role of registered social landlords? Housing associations are increasingly becoming the primary providers of social housing, and we are finding that they have different standards in relation to overcrowding. I have seen many cases in which families in overcrowded accommodation finally receive their one chance of an offer. Their case is made to the housing association, but they are rejected because the association says that they are overcrowding the accommodation. For example, the association will not consider housing more than six people in a three-bedroom property. That means that a family with seven or eight members in the worst housing need, with no prospect of receiving an offer of four-bedroom

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accommodation, is least likely to receive an offer because of the way in which the RSLs operate their own overcrowding standards. Obviously, we do not want to overcrowd accommodation more than we need to, but we must recognise that it is unacceptable to leave a certain cohort of households, which are in a chronic condition, at the back of the queue because of the way in which housing association rules work.
I now return to my opening point about some of the tensions, particularly racial tensions, arising out of the housing shortage. We must recognise that stock shortage is at the heart of that problem. There has not been a massive increase in the number of families who have presented themselves as being homeless and come through the homelessness route. The heart of the overcrowding problem is not London's rising population, but the decline of housing stock over the past 10 or 20 years. A recent parliamentary question about the total social landlord dwelling stock in England and Wales showed that the number of properties available for rent in London has fallen by 23,000 since 1997. If those 23,000 units had been available to us, we would have been able to relieve a great deal of overcrowding and homelessness.
Part of the problem is that Housing Corporation rules make it impossible for larger properties to be built in high-value areas such as London. We desperately need to procure and purchase four and five-bedroom accommodation to deal with larger families who are not offered three-bedroom accommodation. Although that would lessen overcrowding, they are turned away. We cannot produce that stock because of Housing Corporation rules and the way in which capital finance works.
It is time to grasp the nettle. The situation is intolerable for tens of thousands of overcrowded London residents, particularly those at the sharp edge, who are close to statutory overcrowding limits, or just over them. I hope that the Minister will raise these issues with the Department. I hope also that she will make the case for updating legislation, and for some of the rule changes and resources that are necessary to relieve the problem.
Several hon. Members rose—
Mr. Deputy Speaker: I feel compelled to remind the Chamber that we conventionally begin the first of the three wind-up speeches 30 minutes before concluding a debate. There are only 18 minutes left, and two hon. Members are seeking to catch my eye. I hope that they will bear that time constraint in mind when they are speaking, and when they accept and respond to interventions.
2.42 pm
Mr. Kerry Pollard (St. Albans): I congratulate my hon. Friend the Member for Northampton, North (Ms Keeble) on securing this important debate. Most of us believe that the provision of secure, well-founded and affordable housing is one of the most important issues with which we must deal. It is particularly critical in the east and the south-east.
Overcrowding is a big issue. In my constituency, some extended families use overcrowding to move up the waiting list. Parents give their children, who often have a
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child of their own, notice to quit, which leaves the young family homeless, and therefore a higher priority than an overcrowded household. That shows that there is a lack of affordable housing.
It does not matter how housing is allocated if the supply is insufficient to meet demand. This year, my area was fortunate enough to receive the highest allocation in the region: £18.2 million. It is one of the most expensive areas in the country for land prices and building costs, and there is a lack of skilled workers, but we are doing some good things. One of our more innovative schemes is due to be completed soon; I hope to persuade the Minister to cut the ribbon. It is for 52 two-bedroomed flats on a former electricity site, 40 per cent. of which are for key workers. No public subsidy has gone into the scheme. The flats will be kept for rent in perpetuity so that successive tenants can enjoy the advantage of an affordable home.
We recently granted planning permission for a mixed development on an old Territorial Army site, 35 per cent. of which will be affordable homes for rent. We are also developing small sites and lumping several together so that they can benefit from the economies of scale that normally accrue to large sites. I am also trying to persuade the local council and our local population that some of the land on an old aerodrome site of 300-plus acres, which was mined for gravel, should be allocated for housing, even though it is technically green belt. That land is also the subject of some speculation about the provision of a rail freight terminal: a 24-hour-a-day, 365-day-a-year operation. It seems to me that a few hundred houses, a bypass to the local village and some formed woodland would be a better option.
I want to raise two other issues, the first of which concerns empty homes. It is estimated that 750,000 homes are empty, with more than 80 per cent. in the private sector. Houses next to empty homes can suffer devaluation by as much as 10 to 20 per cent. according to the Royal Institution of Chartered Surveyors. The Local Government, Planning and Land Act 1980 gives the right to order disposal of empty public property. That process involves a public request ordering disposal.
As more than 80 per cent. of empty homes are in the private sector and not covered by the Act, now is perhaps the time to include them. Private owners served with a PROD could use the property themselves, let it, sell it or provide a justifiable reason—such as a planning reason—why it needs to stay empty. Even if only one quarter of empty homes were brought into use, that would equate to 180,000 extra homes.
The second issue is VAT on refurbished homes. VAT on new buildings is zero, yet on refurbished homes it is 17.5 per cent. We all know of homes that could be refurbished, but which it might be cheaper to knock down and rebuild because of the VAT. Many of us have been putting that argument for some years without any sign that it is understood or listened to by my right hon. Friend the Chancellor of the Exchequer. Regeneration is rightly given a high priority by the Government. That would be greatly helped by the scrapping of VAT on refurbishment.
Overcrowding is a symptom of housing under stress. I welcome the Government's plans for major house building in certain areas. However, I would plead that cities, such as St. Albans where the housing need is as great as anywhere in the country, continue to receive substantial grants for new affordable homes.
2.46 pm
Ms Oona King: I congratulate my hon. Friend the Member for Northampton, North (Ms Keeble) on securing the debate. As a councillor, as an MP and as a Minister she has shown real commitment to helping families who live in overcrowded conditions. During her time as Minister, she visited the Boundary estate in Bethnal Green and listened to the experiences of a number of families living in overcrowded homes—families in which three or even four children shared a single bedroom; or families in which parents or siblings slept in the living room every single night. The health, well-being, educational attainment and employment prospects of those families—in other words, their entire future—are blighted because their homes too small.
The survey of English housing estimates that there are more than 17,000 overcrowded households in London. In Tower Hamlets, we have approximately 8,000 overcrowded households. That is the most severe level of overcrowding in the country, and is accompanied—unsurprisingly, as there is a direct link between the two—by the highest density of poverty in the country.
The vast majority of those overcrowded households are young families with two or three children waiting for a family-sized home to become available. Unfortunately, as my constituents know to their great cost, they have to wait for an unacceptably long time. Some have already waited more than 10 years. Some have waited for almost 20 years. I am sorry, but I will do what other MPs have done and illustrate the problem by referring to families with whom I come into contact. That is because it is so difficult to portray the level of human suffering involved. I am not using the worst cases; I usually use the worst examples, but I thought that this time I would go for the averagely bad.
Mrs. A lives in a small two-bedroom flat with her husband and four children. There is not enough room for all the children to have separate beds, and the boys and girls have to share a room. Mrs. B also lives in a small two-bedroom flat. Mr. B is elderly and disabled, and lives with his disabled wife, adult son, adult daughter and baby grandson. Once again, there is not enough room for everyone to have a bed, and there is not enough room for facilities to deal with Mr. and Mrs. B's disabilities. There is obviously no privacy for the adult son and daughter. Predictably, both those tenants have come to me asking for help to get the one available vacant house in their area. At least one of them will be disappointed; from my experience both of them are likely to be disappointed.
Mr. C lives with his wife and two children, aged five and two, in a one-bedroom flat on a high floor of a tower block. A third child is expected in three months. There is insufficient room for the existing children to have a bed each, and it is difficult to see how space could be made for a cot for the third child. I took a former Minister with responsibility for housing to a property in Tower Hamlets where an extended family of 16 people were living in two bedrooms—and I am sorry to report to my
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hon. Friend the Member for Northampton, North that none of the families that we visited have yet been rehoused in larger, family-sized accommodation.
Mr. Love: Is not the important point that none of those cases counts as statutorily overcrowded? That shows just how completely out of date the system is, as it cannot deal with modern circumstances.
Ms King: That is precisely the point. The accommodation of the last family that I mentioned, with 16 people in two bedrooms, is of course regarded as statutorily overcrowded, and another family on the Tower Hamlets waiting list who require five bedrooms also currently live in accommodation that is classed as statutorily overcrowded. However, my hon. Friend is exactly right: all the other cases that I have mentioned do not count as statutorily overcrowded.
I am sure that the lack of progress is one of the reasons why my hon. Friend the Member for Northampton, North initiated a review of the current statutory definition of overcrowding. As has already been said, the definition ignores babies and expects living rooms to be permanently available for people to sleep in. For the benefit of my hon. Friends, I should add that 70 years ago, the Labour party described those very same standards as intolerable in the 20th century, and a Labour Member of Parliament said that this House
"ought not to let it go forth that we regard it as a satisfactory state of affairs that people should normally have to sleep in living rooms."—[Official Report, Standing Committee A, 19 February 1935; c. 54.]
That was 1935, yet the same standards are still with us.
The review of those standards that my hon. Friend the Member for Northampton, North initiated gave hope to overcrowded families in Tower Hamlets that the Government were turning their attention to their needs. However, after she moved on to the Department for International Development, no progress was made with that review.
Since then, we have been told that overcrowding will be addressed through the new housing health and safety rating system. Unfortunately, the HHSRS cannot provide that review, not only because the number of hazards due to overcrowding and a lack of space are likely to be dwarfed by the number due to factors such as fire risk, damp and cold, but because the HHSRS inevitably involves a subjective assessment of conditions in a property. I hope that the Minister will correct me if I am wrong, but the only objective yardstick against which environmental health officers can measure hazards that arise from overcrowding and lack of space is the room and space standards in the current statutory definition—the very same definition that the Minister with responsibility for housing described as outdated. That is why I hope that the Minister will follow her predecessor's lead and signal that she is prepared to consider updating that definition, as that would give hope to families in my constituency.
The Housing (Overcrowding) Bill introduced by my hon. Friend the Member for Edmonton (Mr. Love) does not give overcrowded families the right to insist that they are prioritised for rehousing ahead of homeless families, yet the fear that that might happen has delayed the Government's movement. A remedy of that nature is

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specifically excluded from the Bill, because it is recognised that it might have unacceptable outcomes. However, local authorities already accept that such families have a right to a larger home, and in so doing they apply higher overcrowding standards than the statutory minimum. All that we are asking, therefore, is that the Government recognise that standard in law.
A modernised statutory definition will not add to the burdens on local authorities, but will help us to see more clearly what the problem is and where it exists.
If I thought that we could solve the problem of overcrowding with current or predicted resources, I would be less concerned about updating the statutory definition. However, despite the fantastic increases in Government investment in housing, we are still nowhere near doing that. Tackling overcrowding does not yet have the priority that it deserves. We are making huge investments: over the next three years we shall increase the total housing resource to £11 billion, we are on target to reduce the number of non-decent social homes by 1 million by 2004, and, through the transfer options, we are unlocking huge amounts of investment in social housing. I congratulate the Government on that. Tower Hamlets has had a welcome and much-needed 300 per cent. increase in investment in social housing, but it needs more.
I suggest to the Minister that the forthcoming housing Bill offers the chance to give decision makers an incentive to move overcrowding up the agenda. Across southern England, updating the standards would help to energise our campaign to end child poverty. Let us not forget that 48 per cent. of this country's children in poverty live in inner London. I know that many in the rest of the country do not believe that—they think that all the streets are paved with gold—but it is a fact. If we are to meet the Government's target of dealing with child poverty, we have to tackle one of the biggest issues that faces those children—overcrowding. It has to be moved up the agenda. That would help black and Asian families, who are seven times more likely to experience overcrowding than their white counterparts. Once one has faced up to a problem, one can begin to tackle it, and retaining a statutory definition that is so outdated and so rarely breached only helps us to convince ourselves that overcrowding is not a problem and does not need to he tackled. We need to set a new threshold—a gold standard—to aim for. The bedroom standard used in the survey of English housing is that standard, and the forthcoming housing Bill will provide the perfect opportunity to put it on the statute book.
I shall briefly offer some solutions. Admitting the scale of overcrowding is the first step in tackling it. The next is building affordable homes in the numbers that are needed. I have argued previously that the only way to tackle the housing crisis is to double our output of affordable homes. That would mean doubling our investment again, and I know that the money cannot be found immediately, so I suggest helping to generate an immediate increase in the number of council and housing association lettings. We need some short-term emergency measures to free up family-sized accommodation for families suffering severe overcrowding.
During a debate in June, I suggested an expansion of the seaside and country homes scheme. In the Minister's reply, he told me that Housing Organisation
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and Exchange Mobility Services, which manages the scheme, has begun working with Girlings Retirement Options to give elderly people further options. I would be grateful for details as to how that has progressed.
Since the local restriction of right to buy, cash incentive schemes have become really popular in Tower Hamlets, with the result that more tenancies, including four four-bedroom tenancies this year, have been returned to the council to be re-let. A cash incentive is a cheap and efficient way to help tenants of social housing to become home owners. It empowers tenants by giving them choice over the size of their new homes. Please may we have more? The money for that has been cut, and although Tower Hamlets has subsidised it, we need it to be increased.
My last point concerns occupation. As well as there being many people who want to leave London, we have the advantage that a surprisingly high number live in homes that are not fully occupied. In London, 28 per cent. of council and registered social landlords' stock is officially under-occupied. The present incentive—between £500 and £1,000 for each bedroom—is not adequate; we need to increase it if we are to get people out of those properties. I should be grateful if the Minister would write to me on the points that I have drawn to her attention. We desperately need to tackle the terrible problem of overcrowding now.
2.59 pm
Matthew Green: I, too, congratulate the hon. Member for Northampton, North (Ms Keeble) on having secured the debate. It is very timely in view of the forthcoming housing Bill, which will, as has been said, present a good opportunity to make changes.
I shall avoid covering much of the ground that the hon. Members for Regent's Park and Kensington, North (Ms Buck), for Edmonton (Mr. Love), for St. Albans (Mr. Pollard) and for Bethnal Green and Bow (Ms King) have covered, because they have given excellent examples from their constituencies. I cannot do that: while we have a severe shortage of affordable housing in Ludlow, overcrowding is not as great a problem as it is in London. Let us consider the extent of it. About 500,000 households in the United Kingdom would be regarded as overcrowded if we adopted the bedroom standard. That is a significant number; it is about 3 per cent. of all households in the UK. In London, the figure is about 6 per cent. As we heard from the hon. Member for Bethnal Green and Bow, the percentage is much higher among ethnic minorities. I understand that, by that definition, up to 30 per cent. of Bangladeshi households would he overcrowded. None of us can regard that as acceptable in the 21st century.
We have heard, rightly, about the effects of overcrowding, particularly those on health. The transmission of respiratory and infectious diseases and the increase in mortality and death rates are closely related to overcrowding. It is always connected with the spread of infectious diseases, either through the air or by physical contact. Measles, mumps, chicken pox, diphtheria and most respiratory conditions are more easily spread in overcrowded conditions, as are those that are spread by physical contact such as scabies. Longitudinal studies show that overcrowded housing dramatically increases the odds that young children will develop severe ill health in later life.

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We know, too, about the emotional effect on families. There is good evidence that it causes developmental delays in babies and young children. The stress of sharing bedrooms leads to tension and an increase in the breakdown of family relationships. That can result in an increase in homelessness among the teenage children of families in overcrowded homes. Overcrowding contributes to homelessness; it does not compete with it. It also has a large impact on education. If children do not have quiet space in which to do homework and their sleep is often interrupted, they are less able to concentrate at school. They then perform badly, and have behavioural problems. Consequently, their educational attainment suffers by comparison with that of children who are not from overcrowded homes.
The problem is clear, well known and well documented, and it is growing. Why has it reached this point? Overcrowding was, by most measures, in decline until the early 1990s. It is linked to a reduction in the availability of affordable housing of all types, which happened because the right-to-buy policy decimated the council housing stock and also, where there were preserved rights, that of registered social landlords. Perhaps more worryingly for the Government, the number of new social houses built has declined since 1997. The housing and planning research centre estimates that between 83,000 and 99,000 affordable homes need to be built every year in order to meet demand. Even if we add together Housing Corporation-approved development grant, the effect of the transitional arrangement on the local authority social housing grant and houses from planning gain, about 50,000 homes will be built in the next 12 months, which will meet half of the estimated need. The shortfall will be at least 33,000 homes and will probably be more like 50,000 homes.
Those are the problems. What are their solutions? All hon. Members who have spoken have rightly said that the housing Bill is an excellent opportunity to introduce a modern statutory definition of overcrowding such as that outlined in the Bill introduced by the hon. Member for Edmonton. If I have the privilege of serving on the Committee that considers the housing Bill, I will try to ensure that such a definition is brought forward.
I understand that Ministers have some difficulties with a new definition. The Minister for Housing and Planning has said that the definition cannot be modernised in the housing Bill because such matters
"cannot be raised in isolation from other factors. Some of the current proposals would have the effect of imposing a quite unrealistic demand on the resources of the local authorities and diverting them from the excellent decent homes programme and their responsibilities to homeless families, who often live in far worse conditions than overcrowded households."—[Official Report, 22 October 2003; Vol. 411, c. 631.]
I have some sympathy with his views.
There is a way to deal with the problem. We could put a definition in the Bill with a sunrise clause stating the number of years before the new standard is implemented, which would give the Government breathing space in which to commit extra resources or to deliver extra affordable homes to allow the standard's introduction not to cause perverse effects. No one in the Chamber wants a new definition to cause perverse effects.
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If the Minister for Housing and Planning is arguing that the definition should not be included in the Bill because it will immediately cause perverse effects, a sunrise clause is a possible solution that he should examine seriously.
Ms Keeble: Will the hon. Gentleman accept that overcrowded families often become homeless, which is one way out of their problems?
Matthew Green: I accept that. The current definitions also cause perverse effects. I am attempting to give Ministers a means by which they can accept a new definition without causing themselves problems.
The supply of affordable homes lies at the heart of the matter. Every time an affordable home is built, it has a double effect on reducing overcrowding. If some people are moved out of an overcrowded home, the problem is solved for two households.
The Government are not doing enough on supply, and the answer involves more than throwing more money at the system. Planning gain is one of the major ways in which we can deliver more affordable homes. The hon. Member for St. Albans discussed a site in his area that contains 30 per cent. affordable homes. I say, "Well done," but that is not going far enough.
Mr. Pollard: It is 35 per cent.
Matthew Green: I thank the hon. Gentleman for that correction.
In some parts of the country—for example, my constituency—local authorities have made that figure 50 per cent. on sites containing two or more houses. One problem is that the Government's guideline suggests applying the percentage rule to sites containing 19 or more houses. We must apply that percentage throughout the country. Given the growth in house prices, there is sufficient affordability in the system for planning gain to deliver the extra houses. The Government must be stronger in driving through a higher percentage on all sites to ensure that planning gain is recovered from the system. We need not only a few local authorities situated here and there doing that but large numbers of them in high-demand areas. Otherwise, developers will avoid developing in one area and shift across to the next one. That is where the Government can have a significant impact.
Mr. Love: Indeed, the Mayor of London carried out a detailed study on the matter. It showed that a 50 per cent. target was feasible in many parts of inner London, but other parts of inner London and parts of outer London could not sustain such a target. I have sympathy with the hon. Gentleman's comments, but success will depend on the region.
Matthew Green: The proposal would be sustainable in south Shropshire. I suspect that the study should be reviewed.
Finally, we must give councils the choice to scrap the right to buy in their areas, because we must stop the decline of social housing. The Government have taken some action, but they have not gone far enough. Give councils power to replace the right to buy with a right to

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invest in social housing. That will inject more capital into the registered social landlord sector and provide more affordable housing.
3.10 pm
Mr. Geoffrey Clifton-Brown: This has been an excellent debate. I congratulate the hon. Members for Northampton, North (Ms Keeble), for Regent's Park and Kensington, North (Ms Buck), for St. Albans (Mr. Pollard) and for Bethnal Green and Bow (Ms King). It is a pity that we did not hear from the hon. Member for Edmonton (Mr. Love). I congratulate him on his Housing (Overcrowding) Bill, his persistence as chairman of the all-party homelessness and housing need group and the work that he has done on the subject. It is common ground among us all that something must be done about the problem.
I came across an interesting article by James Gleeson and Maya Martinez. The headline conclusion was that
"London has three times the overcrowding problems of elsewhere in England, with one in 20 households now affected, according to 2001 census data."
There is doubt about whether the census data understate the scale of the problem in London, but they do make the point that while the problem is getting worse in London, it is probably getting marginally better in the rest of the country. The article comes up with a shocking statement that although
"only 2 per cent. of white families in London live in overcrowded conditions, for ethnic minority households the figure is over 14 per cent.—climbing to around 25 per cent for some Asian groups."
The point has already been made about the severe effect on children. We know that the problems of families who are homeless or living in overcrowded conditions are, in some instances, becoming much worse. Indeed, in his excellent speech in the House to introduce his Bill, the hon. Member for Edmonton said that
"until the late 1980s, the number of overcrowded households fell steadily year on year. In the past decade, the acute shortage of affordable accommodation has meant that many families have found themselves severely overcrowded but with little possibility of a move to larger, better-quality, family-sized accommodation."
He went on to say that
"500,000 households are overcrowded, of which about a third are in the capital."
Those figures have already been given by the hon. Member for Ludlow (Matthew Green).
The hon. Member for Edmonton then made the point that I have just made about child overcrowding. He stated:
"Many families experience severe effects on their health, welfare and well-being as a result of overcrowding. According to recent research, there is a high prevalence of skin disorders and infectious diseases. Owing to a lack of space, children are at much greater risk of having accidents, and the stress of living in such cramped conditions can place a severe strain on family relationships."—[Official Report, 22 January 2003; Vol. 398, c. 323-4.]
I am sure that we all totally agree with that. The question is: what is to be done?
The hon. Member for Bethnal Green and Bow rightly asked the following question:
"To ask the Deputy Prime Minister on how many occasions since 1985 he has (a) received a report from a local housing authority and (b) directed a local housing authority to prepare and submit a
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report on the extent of overcrowding in their district, under section 334 of the Housing Act 1985".—[Official Report, 19 December 2002; Vol. 396, c. 956W.]
I am sorry to get slightly technical, but it is important to recognise that there are powers under section 334 of the Housing Act 1985, which allow local authorities to undertake a survey of overcrowding in their area, draw up a report for the Secretary of State on the nature and extent of the problem and make proposals to provide the required number of dwellings. No reports appear to have been drawn up or submitted to the Secretary of State since those provisions were consolidated, and no Government have taken specific action to address the housing needs of those in overcrowded accommodation.
We need to take action to know the extent and scale of the problem. I hope that one outcome of today's debate will be the Minister telling us that she is taking real action to secure concrete data on the problem so that we know where it exists, how severe it is and which houses do not meet the 1985 standards, let alone the English housing condition survey standards. We need to have a handle on the problem, and once we have, as the hon. Member for Ludlow rightly said, we need to introduce primary legislation that will enable the Secretary of State by regulation to introduce a standard that can be incorporated over a period of time according to what resources are available.
We also need to apply that to the private sector. In making these remarks, I am conscious that whatever we do with the private sector, we need to encourage more private sector investment in the residential sector. That is an important way of being able to produce more affordable homes. On page 17 of the report on overcrowding from the Select Committee on the Office of the Deputy Prime Minister, it is stated:
"Proportionately more private rented homes are in poor condition than in the other housing sectors. Ownership is highly fragmented: most landlords rent out only one or very few homes, and have little chance to become expert property managers. Many turn to letting agents for help but agents' standards of confidence and probity vary greatly."
We have to think very carefully about how we are to deal with the private sector to help it to overcome such problems.
Although the Select Committee dealt with overcrowding and recommended a standard, the Government do not seem to have responded. The report was excellent, and it is an excellent way of going about our business to have the housing Bill subjected to pre-legislative scrutiny in that way. I quote what the report says on overcrowding at paragraph 32:
"Clauses 123-128 amend existing legislation on overcrowding in HMOs. Oona King MP's memorandum noted the effects of overcrowding on the health, welfare, education and employment prospects of occupiers. Yet as we heard from Shelter the problems caused by overcrowding outside of HMOs cannot be identified by the HHSRS"—
the housing health and safety rating system.
The report continues:
"We recommend that the Government take forward Shelter's recommendation that the Bill be used to modernise the current statutory overcrowding standards."
Members on both sides have suggested that the Bill could be an ideal opportunity to address the problem. We need to hear from the Minister whether it will be so used. If not, I do not think that we can wait another 18 years. The

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standards—or, at least, the mechanisms for gaining an indication of what the problem is—were laid down in the 1985 Act. We look to the Government for action on the problem. [Interruption.]
Mr. Deputy Speaker: Order. A Division has been called in the parent Chamber so we will suspend for a maximum, I hope, of 15 minutes. However, if participants in the debate return within that time we can start early, as soon as they are assembled.
3.17 pm
Sitting suspended for a Division in the House.
3.29 pm
On resuming—
Mr. Deputy Speaker: We have lost 12 minutes, so we need to award 12 minutes' injury time.
Mr. Clifton-Brown: I feel rather like a contestant on "Just a Minute" when the whistle has blown meaning that I have 10 seconds left. In those 10 seconds, I shall just quickly sum up what I think needs to be done.
We must introduce more measures to encourage the private sector to invest in its existing housing and new housing. We need more measures to encourage the public sector to build more affordable houses, and in that respect we have already produced proposals to extend the right to buy. We need to deal with the problem of empty houses. Mention has been made of 750,000 empty houses. We need to deal with the powers that we have in the 1985 Act and part 7 of the Local Government Act 2003 in order to require local authorities to draw up housing strategies that include the issue of overcrowding. We should require regional housing boards to give priority to tackling overcrowding in developing the housing investment strategy. These recommendations come from Shelter.
A new housing poverty indicator should be developed as part of the Government's measurement of child poverty and that should include an overcrowding element. Overcrowding should be included among the indicators used for the index of local deprivation. I appeal to the Minister to tell us how a new definition could be introduced into the Bill, over what time scale it could be introduced and how much it would cost. The Government have been addressing the problem for some time. Now is the time, if I may say so to the Minister, for action.
3.31 pm
The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister (Yvette Cooper): I pay tribute to my hon. Friend the Member for Northampton, North (Ms Keeble) for securing the debate on this issue. When she was a housing Minister, she took a close interest in the matter. It is an area on which a series of hon. Members have spoken, drawing on considerable expertise, as well as constituency experience. My right hon. Friend the Minister for
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Housing and Planning has agreed to meet my hon. Friend to discuss the issues. I am sure that we shall discuss the issues further, and we shall respond in due course to the Select Committee's report, to which hon. Members have referred.
We have to recognise that overcrowding can cause serious problems for families. My hon. Friend referred to examples concerning children unable to do their homework. Hon. Members referred to health problems, family relationship problems, significant traumas and stress that can arise, and, particularly those from London, described the circumstances of their constituents. My hon. Friends the Members for Bethnal Green and Bow (Ms King) and for Regent's Park and Kensington, North (Ms Buck) referred to examples from their constituencies of distressing cases of overcrowding.
It is estimated on the basis of the 1935 measures that 25,000 households are statutorily overcrowded. On the bedroom standard used by the survey of English housing, an estimated 2 per cent. of households—about 500,000—would qualify as overcrowded, mostly in the social housing sector.
Mr. Love: My hon. Friend mentioned that those were estimates of statutory overcrowding and overcrowding according to a more liberal standard. Would she give consideration to the Department's carrying out some more focused research into the levels of overcrowding and the impact that it has on all of the issues that we have discussed, such as health and education?
Yvette Cooper: I am happy to consider research issues. My hon. Friend the Member for Edmonton (Mr. Love) has done a great deal of work as part of his research for his private Member's Bill. Hon. Members will be aware that the Government try not to overburden local authorities with the collection of data, given the amount of data that they already have to provide.
The Government know that a significant number of overcrowded households are in London. My hon. Friend the Member for Regent's Park and Kensington, North was right to say that it is different in other parts of the country. London has specific housing problems. We must recognise that there is a problem but be very honest about how we address it. Overcrowding is not an isolated problem; it is often a symptom of wider problems, such as under-supply of affordable housing, as many hon. Members have said.
Families may be living in cramped conditions because they cannot afford to move to a larger flat or home, or because the demand for social housing is too great and too many other families are waiting for a home. They may be homeless families, or families in bed-and-breakfast or temporary accommodation. Overcrowding is part of the more significant problem of housing supply, which must be addressed, in London in particular.
Homelessness acceptances are another aspect of the same problem. They have increased to almost 31,000 in London. Bed-and-breakfast numbers have been reduced as a result of specific action taken by local authorities to address the problem of families stuck in cramped and inappropriate accommodation. It is one of the most severe aspects of the London housing problem. We must recognise that overcrowding is part of a wider issue, which involves meeting the decent homes target.

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The underlying problem is the need for affordable housing supply, particularly in the capital. That is why the sustainable communities plan set out a major investment programme expanding the provision of affordable housing in London and the south-east. The Government have established investment programmes in housing supply across the board with 200,000 homes in addition to those already planned. There has also been significant investment to increase the number of affordable homes, supporting the London Housing Board strategy of investment in key worker homes.
The hon. Member for Ludlow (Matthew Green) raised the issue of planning gain. We are keen to use planning gain to expand the numbers of affordable housing units. That is why we are considering further section 106 agreements and consulting on empty homes, which was an issue that was raised by my hon. Friend the Member for St. Albans (Mr. Pollard).
We have the wider Kate Barker review—
Matthew Green rose—
Yvette Cooper: I am aware of the lack of time, so if hon. Members will allow me to make progress, I will give way to the hon. Gentleman if I have time.
Overall, £5 billion will be invested in affordable housing between 2003–04 and 2005–06. That is double the investment in 1997. As hon. Members have said, the matter is partly about resources. The Government are substantially increasing the investment in affordable housing across the capital and the south-east.
Improvements are being made to the most extreme aspects of the problem. Rough sleeping has been reduced by two thirds and there have been significant reductions in the number of homeless families with children who are in bed-and- breakfast accommodation. We must consider how we address all aspects of the problem—temporary accommodation, homelessness, houses not meeting the decent homes standard, and overcrowding.
Ms Oona King: Will my hon. Friend give way?
Yvette Cooper: If I can specifically address the issues concerning overcrowding raised by hon. Members and if I have time, I will give way.
My hon. Friend the Member for Regent's Park and Kensington, North specifically asked for changes to the statutory definition of overcrowding. It is not acceptable to defend a 1935 definition of overcrowding that is out of date. I have some sympathy with many of the points that hon. Members have raised.
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I want briefly to explain the Department's concern about the proposals that have been made. We are investing resources in the London housing problem as fast as we are able. Changing the overcrowding standards will not create any extra homes or expand the housing supply any faster. The concern is that to set statutory definitions at a particular level would be to divert resources away from addressing the issue of bed-and-breakfasts, the homelessness problem and the wider problem of decent homes. As we invest in the London housing market, we need to ensure that, as well as tackling problems surrounding the bed-and-breakfasts and homelessness, we tackle overcrowding problems. We need to consider further how we can ensure that overcrowding is addressed alongside bed-and-breakfasts and homelessness.
Mr. Clifton-Brown: Will the Minister give way?
Yvette Cooper: I am conscious that I have just one more minute. I am willing to respond further after the debate, but I want to make some final points.
We recognise the strengths of hon. Members' arguments. As we try to expand the affordable housing supply in London and the south-east, we must recognise the needs of all the different groups. We will be having further discussions about these issues over the next few months. Our approach has been to say that all the issues should be addressed together as part of local homelessness and housing strategies. We need to consider further how overcrowding is addressed as part of those strategies. Certainly, putting those strategies on a statutory footing will strengthen the case for that.
We are also considering the matter as part of the housing health and safety rating system. I recognise that hon. Members have raised concerns about that, but it is important to bring overcrowding into the health and safety system in a stronger way than before. The guidance to local authorities will make it clear that, for example, GP or hospital referrals will be relevant to the hazard assessment. I recognise that there is considerable concern from hon. Members about the matter, and my right hon. Friend the Minister for Housing and Planning and I will have continued discussions with them.
I hope that I have explained the Government's concerns on the issue and I congratulate hon. Members again on raising such important questions. [Interruption.]
Mr. Deputy Speaker: I thought for one moment, as I was coughing, that we were going to have a by-election as well as a leadership election. Hon. Members must forgive me. I feel fine now.

Housing (Islington)
3.42 pm
Jeremy Corbyn: I am grateful to you for granting this debate on housing in my borough, Mr. Deputy Speaker. I have agreed with the Minister that my right hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) will also contribute to the debate.
The context is simply this: although the inner-urban constituency I represent projects an image of wealth, metropolitan chic, cappuccino bars, wine bars and places where Labour leaders do deals, unfortunately, the reality for a large number of people who live in the borough is not quite the same. Islington's is very much a tale of two halves. Many of the people whom my right hon. Friend and I represent are extremely poor and live in seriously overcrowded accommodation.
The problems of housing in my constituency are the reverse of the problems in other parts of the country. We have a massive shortage of housing for rent, either by the council or by registered social landlords. We have a huge housing waiting list and problems of children and families living in bed-and-breakfast accommodation or short-term leased accommodation. Few families are rehoused off the waiting list, and only those in serious housing stress have any chance of being rehoused. In the past few weeks, a bombshell has been delivered to us in connection with the condition of one of the major estates in my right hon. Friend's constituency: the Packington estate. He will speak about that later.
I will briefly cite three sets of statistics that will help to outline the nature of the problem. The first relates to homelessness acceptances. In 1997—the first year of the Labour Government—949 families were accepted in my borough. By 1999, that figure had risen to 1,298. In the latest year for which information is available, 1,314 families were accepted. That is a 400-plus increase in the number of families that the local authority accepted for homelessness.
The second set relates to temporary accommodation. In 1998, there were 737 families in temporary accommodation in my borough. In 2001, there were 1,481, and the number this year is roughly the same. In other words, the number of families in temporary accommodation has almost doubled. Some of that accommodation is deeply unsuitable, but all of it is very expensive, and it costs the housing benefit budget a great deal of money.
The third set of statistics relates to new lettings. In 1997, there were 2,000 new lettings. In 1999, that number had dropped to 1,500. In 2001–02—the last year for which Islington council could provide statistics—there were 1,084 new lettings. In other words, there has been a huge increase in the number of homelessness acceptances, an increase in the number of families in temporary accommodation, and a halving of the number of new lettings made available. We have just had a very interesting debate on housing overcrowding, and I must say in parenthesis that roughly 6 per cent. of all council accommodation in London is more than seriously overcrowded. I do not have figures for my constituency, but the evidence is that it is massively overcrowded.
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Behind those bald statistics lie many tragic stories. My right hon. Friend and I could give a great many examples of families living in grossly overcrowded accommodation. In August, I visited a family with four children living in a registered social landlord housing block that was grossly overcrowded. The family were living in a one-bedroomed flat in very poor conditions. I asked the eldest girl how she did in her GCSE exams. She said that she had tried hard and found them difficult, but had found it impossible to study at home because there was simply no room to do so. How on earth can she be expected to achieve as well as the child of a middle-class family with his or her own personal computer and everything else? We condemn her for underachieving in school, but we should condemn ourselves for allowing her to live in such conditions. A few days ago, I visited another family with four children in a two-bedroomed flat on a local authority estate. One of the children had serious learning difficulties and definitely needed her own bedroom and decent facilities. What offers are available to her?
Very few options are available to such families, except, too often, that of moving outside London. The bald figures make it easy to suggest that people should move away, given the empty properties in the north-east and north-west and the overcrowding in London. However, it simply does not work like that. Jobs, education, family connections and communities are involved. I want some recognition of the massive housing needs in inner London, especially in my borough, and Government assistance to help to solve the problem.
There are also problems associated with the right to buy. In an average year in my borough, some 700 to 800 properties are sold, valued at an astoundingly low price despite the Government's decrease in the amount of discount available. Even in the last year for which figures are available, the average sale price was £71,000. Many of those properties are then sold on a few years later, and if one reads the property press, one will see the very high prices that even ex-local authority stock now fetches. There are probably some 10,000 families on the registered waiting list in my borough, but in the last year for which figures are available, only 214 properties were made available for new rent. That means that the number of properties made available for rent is roughly one third the number of those that are sold, and that the numbers of people in homelessness and in short-life rented accommodation have increased. The information that I have is that we, as a society, are spending an awful lot of money subsidising housing benefit for people to live in substandard, overcrowded private rented accommodation, when we should be investing far more in rented stock.
I ask the Minister to comment on some aspects of the problem. The Government have provided a very large amount of money for the improvement of existing council stock in Islington. I think that about £140 million has been provided in the past four years. I am grateful for that money—the new roofs, windows, doors and security systems, and landscaping and other improvements to some estates are very welcome, and I appreciate them. However, I hope that he recognises that any future cuts in the major repairs allowance will impact badly on people in the remaining estates that

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have not been improved or repaired. Those people look to MPs and the Labour Government to provide them with better housing conditions. I hope that he will be able to persuade the Treasury of the value of investment in good-quality homes—in particular, for young people to grow up in.
My concern is that amid all the problems, very little is being built or developed. That is happening for several reasons, one of which is that the planning gain issue allows only a quarter of new developments to be for affordable rented housing. I am not very keen on those words and prefer the words "council housing", but never mind; that is the legal term. Miraculously, most developments in Islington come in at 14 units, so the 25 per cent. rule simply disappears—hence the present tiny numbers for development.
The council is unwilling, unable or at least not very keen to develop new properties. Since the Liberal Democrats gained control of Islington council in 1999 they have been obsessed with selling any property that they can get their hands on in order to lower the council tax slightly—although it still went up a great deal this year. They do not appear to have a housing strategy, and I should be grateful if the Minister commented on why the council is allowed to sell vacant council property and any other saleable building that it can get its hands on when there is a desperate housing shortage and housing needs should be addressed.
I attended a meeting organised by the Federation of Islington Tenants Associations a couple of weeks ago to debate a transfer to an arm's-length management organisation. It is unpopular among the tenants, and attendance at the meeting was quite good. The tenants take the view that the local authority is best placed to be the landlord because it is the most accountable body, and they are deeply concerned that the council is apparently allowed to go ahead with an ALMO application without holding a ballot of all the tenants. I should have thought that at the very least a proper ballot consultation with all the tenants in the borough should have been insisted on.
Estate transfers are a further issue. I believe strongly in the provision of public sector housing for people in housing need. Council housing has, by and large, done good work and provided good homes. When my right hon. Friend the Member for Islington, South and Finsbury chaired the local housing committee in Islington, there was a considerable increase in stock, as there was when the Minister for Children was housing chair and bought a large number of street properties. Many of those were expensive to rehabilitate and repair, but provided excellent homes for families in housing need. It is therefore with some concern that I note the major proposal for the transfer of the Tollington estate to North British Housing—or Places for People, which is its arm's-length subsidiary.
I have had meetings with Places for People and raised several concerns. Last week I was at a public meeting of tenants on estates that my right hon. Friend the Minister for Housing and Planning visited in the summer. They were concerned about losing accountability and about the fact that in order to pay for the demolition and reconstruction of part of the estate, whereby they would end up with flats that might be of better quality but would be no larger, 300
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properties would be built—on an already overcrowded estate—for sale on the open market. I ask the Minister to consider seriously whether expecting tenants to pay for the reconstruction of their estate through the sale of land for the construction of properties that are to be sold on the open market is a sensible way to tackle the housing problems of a densely populated inner-city area.
As for the issues surrounding the performance of the company concerned, I have in front of me a letter about the way in which the Housing Corporation has placed Places for People under supervision because of concerns about its corporate governance at group board level. We should be seriously concerned if the largest estates in the borough are to be subject to a housing transfer application when the board of the housing association itself has been placed under supervision because, I understand, of mismanagement. Many tenants will vote against the transfer because of concern about the worse conditions overall that they think will arise, because of higher density, because of the record of the organisation concerned, and above all because of the loss of accountability in the way in which their housing is run.
We had a Labour Government in the 1920s in which John Wheatley played a great role in the construction of council housing—we have a John Wheatley house in Islington in recognition of his role. After the war, we were able to conquer much of the housing shortage. The Labour Government of 1974 to 1979 had a very good record on innovative, good-quality housing developments. I just want the children of working-class families in my borough and elsewhere in London to have the chance of having somewhere decent to live.
That requires us to grasp the nettle. We should not hand housing over to expensive, private sector solutions. Instead, we should invest in good-quality housing so that more and more people do not face the prospect of living in short-term bed-and-breakfast accommodation or, because it is their only offer of housing, having to move far away from where they have grown up and from their families and communities. We need investment in inner-city communities for those communities to thrive. I make that plea to the Minister today on behalf of the people in housing stress in my borough.
Mr. Deputy Speaker (Mr. Frank Cook): The hon. Member for Islington, North (Jeremy Corbyn), who is presenting this so far splendid debate, has been kind enough to alert me to the fact that he and the right hon. Member for Islington, South and Finsbury (Mr. Smith) consulted the Minister with a view to intervention. That is fine and all in order, save that we must be careful not to overrun. I would be remiss in my duties were I not to alert everyone to the fact that this debate must finish at 12 minutes past the hour.
3.57 pm
Mr. Chris Smith: Thank you for allowing me to contribute to the debate, Mr. Deputy Speaker. I am very grateful to my hon. Friend the Member for Islington, North (Jeremy Corbyn) for giving me the chance to speak briefly.

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I strongly endorse the passionate case that my hon. Friend has made for the need for substantial new investment in housing in our borough. Week after week, he and I meet constituents in desperate housing need—people living in overcrowded conditions in inadequate accommodation, in flats that are in urgent need of repair and renovation, on estates that have seen better days and from which many people wish to move away. It is now extremely difficult for the children of existing council and housing association tenants to have any chance at all of remaining in the borough in anywhere other than the parental home. The need is urgent.
I am grateful to the Government for the substantial additional investment in the borough during the past six or seven years. The money for housing work in the borough has been more than doubled, but it is still not enough. I hope that the funding will increase in the coming years. There are two urgent needs to be met. The first is the improvement of existing estates. Some £400 million-worth of repair, improvement and maintenance work is required to bring the estates up to the standards that the Government expect by 2010. The second need is to create new accommodation for people in need of it.
Having made that general plea, I want to raise one specific issue relating to the large Packington estate in my constituency. Only in the past three or four months has it been discovered that that estate was built on a large-panel construction basis. It contains gas systems and it is six storeys high. It has only just been discovered—although it should have been discovered 30 years ago—that the estate does not meet the health and safety requirements introduced following the Ronan Point disaster some 30 or 35 years ago. Following consultation with the Health and Safety Executive, the council has decided that, in order to abide by the regulations, the Packington estate must be demolished and redeveloped.
The estate is very large, with hundreds of flats, and the tenants will face substantial upheaval. I received a letter recently from a 73-year-old man who has lived on the Packington estate for 43 years. He faces being completely uprooted at a time in his life when that is the last thing that he wants, and the same is true of many tenants on the estate. However, the Packington's tenants are not the only ones for whom there will be problems: tenants everywhere else in the borough will face real difficulty, because the rehousing requirements from the Packington will pre-empt the resources available for rehousing and new accommodation for people who need it across the rest of the borough. The decreasing figure of 1,000 or so new lettings that my hon. Friend cited for the past year will be reduced even further as a direct result of the demands that the Packington redevelopment will create.
I hope that the Minister will discuss the Packington estate with the borough as a special case, and perhaps raise the need for special funding treatment to ensure that not only is the redevelopment the best for the Packington tenants, but it does not have a seriously adverse impact on the remainder of the borough's housing stock.
4.1 pm
The Minister for Housing and Planning (Keith Hill): I begin, as is conventional, by congratulating my hon. Friend the Member for Islington, North (Jeremy Corbyn) on securing this debate on matters that are important for all who live in Islington. This is not the first time—farfrom it—that he has raised the issue of housing in the borough and the problems that many of his constituents face in securing good-quality housing at an affordable price.
I am also aware of the deep concern felt by other London Members about the matters that my hon. Friend has raised. Not least among them is my right hon. Friend the Member for Islington, South and Finsbury (Mr. Smith), who drew attention to two key issues: the need to improve existing estates to the decent homes standard, and the need for new homes. He raised his concerns about the Packington estate and its future. I undertake to pursue the matter and will be in touch with him shortly.
I am conscious of the relative brevity of the time available to me, but I cannot resist first responding warmly to the points about capital investment that my hon. Friend the Member for Islington, North made. It must be said that he has often been critical of Government policy on funding for housing, so the fact that he now congratulates us on the money that we are putting into housing improvements is an encouraging sign that our policies are, in his view, perhaps just beginning to bear fruit.
Since coming to office, we have more than reversed the decline in housing investment over which the previous Administration presided, to such an extent that funding in 2004–05 will be about three times the sum that was provided in 1997–98. Last week, my right hon. Friend the Deputy Prime Minister announced £2.1 billion a—huge sum—over the two years for housing in London to meet our commitment to provide more affordable housing in the capital. That will provide more than 10,000 affordable homes each year, including homes for the key workers we need to deliver high-quality public services, and will help to bring existing homes up to a reasonable standard of decency. The total spend will of course be considerably more, because of private finance that can be levered in by housing associations.
I turn now to the issues surrounding decent homes and private sector investment that my hon. Friend raised. Even with the massive increase in investment in London's housing since the Government came to power, it is clear that there is no realistic prospect of the backlog of work required of authorities such as Islington in order to meet the decent homes target being met by public subsidy alone. Increasingly, we need to lever in more investment from the private sector.
There are a number of ways in which local authorities can attract private funding to enable them to meet the decent homes objective. The three options available are: setting up arm's-length management organisations, also known as ALMOs; private finance initiative schemes; and stock transfer. My right hon. Friend the Deputy Prime Minister has repeatedly made it clear that those are the only options. Each of them makes the best use of the available resources by separating local authorities' strategic housing responsibilities from their role as

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landlord. That provides a strong incentive for better performance, ensures a sharper focus on the two distinct housing functions, and helps to guarantee tenants a greater role in the future management of their estates.
Islington council has considered the various options and decided that seeking ALMO funding is the best way to attract additional funding. It successfully bid in the last ALMO bidding round, and in August was offered £24.9 million in additional Government support for 2004–05 and 2005–06, with the possibility of further allocations in subsequent years subject to a satisfactory Audit Commission inspection of the ALMO once operational. I know that some in the borough—my hon. Friend may be one of them—see the ALMO as a backdoor form of privatisation. I want to assure him that that is not the case. ALMOs provide improvements to housing stock and the housing service by the front door. Council homes will remain council owned, and tenants will remain tenants of the council.
Although a tenants' ballot is not a legal requirement for an ALMO since there is no change of landlord, the necessary statutory approval for the ALMO to start work will not be forthcoming unless I am satisfied that the majority of tenants across the borough understand the implications and support the proposal in general. Officials in my Department and an independent tenant adviser are working with the council to help tenants reach an informed judgment, and to develop a mechanism to test tenants opinions and address their concerns.
I would also like to assure my hon. Friend that Islington's ALMO allocation is not set in concrete. It is a provisional allocation based on information known at the time of the bid. ALMO funding is allocated two years at a time, and allocations can be revisited if circumstances change. For Islington, and other ALMOs in the latest round, we have explicitly acknowledged that allocations may need to be reviewed if the eventual decisions on the distribution of management and maintenance allowances—on which we consulted this summer—have a significant effect on the overall level of resources available to ALMO authorities.
I now turn to the more specific issue of stock transfer. Islington is considering some smaller-scale stock transfers to supplement investment for the improvement of social housing. Tenants benefit from stock transfer because provisions are built into the new landlord's business plan for proper maintenance and future repairs. Homes are subject to a programme of catch-up repairs to bring them up to a modern standard. That investment is possible because, as private sector organisations, registered social landlords can borrow outside the public sector borrowing constraints, unlike local authorities. Increased investment also means that any backlog of repairs can be carried out and better living conditions achieved more quickly than if the properties had remained in local authority ownership.
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Earlier this year, my hon. Friend raised concerns with my predecessor about the proposed transfer of the Tollington estate in his constituency. As he said, I visited that estate in July. I realise that the refurbishment programme will cause some disruption to tenants, but the council and the proposed new landlord are consulting tenants on a range of proposals to keep disturbance to a minimum. There are also plans to improve the existing community facilities on the estate. Nevertheless, we will agree the transfer only if a ballot of tenants shows that a majority supports it. My hon. Friend has recently written to me about the funding arrangements for the transfer and the forthcoming tenants' ballot. I have sent him a detailed reply covering both issues.
In the time remaining to me, let me say more about the central issue of investment in housing, which was raised by both my right hon. Friend the Member for Islington, South and Finsbury and my hon. Friend the Member for Islington, North. At the beginning of my speech, I mentioned the considerable increases in investment in housing in London. We anticipate that the number of social houses constructed in the next two years will be 50 per cent. greater than the current number. However, there will continue to be competing needs within London, and we are determined to ensure that resources are distributed in the best interests of our communities.
That is why we introduced new arrangements in the communities plan for regional housing boards to advise on how resources should be allocated to address strategic housing priorities in each region. The London housing board faces an extremely difficult task, and I congratulate it on the way in which it managed to get the key London players to work together to publish a regional housing strategy in July, which set out proposals to tackle London's housing problems. The scale and complexity of meeting housing demand in London merits a new approach. Costs, supply and demand are spread unevenly across London. Joint working between boroughs on a sub-regional and regional basis is essential. The London housing strategy strongly endorses a sub-regional approach. Sub-regional partnerships have been established in London, and all sub-regions are producing housing strategies.
Islington played a key role in developing the north London housing strategy, which I had the pleasure of launching last month. On the strength of the London housing strategy and the board's funding recommendations, we have decided to allocate almost £1.5 billion for affordable housing over the next two years, of which £371 million will be for key workers. My hon. Friend raised concerns that the direction of money to key workers will mean that fewer new houses will be available for social renting to tackle homelessness in London. We do not underestimate homelessness in London, but that will not be the consequence of the policy.

Wind Turbines (Dorset)
4.12 pm
Mr. Robert Walter: I am delighted to have the opportunity to introduce the debate on wind turbines in Dorset, and in particular in my constituency. I am grateful to the Speaker's Office for making this time available. I found out only yesterday that I had secured this slot because somebody else dropped out.
The topic is important, but when I speak about it, I am often accused of being a nimby. There are proposals on the table to erect up to 35 wind turbines, each more than 100 m tall, in the lower Winterborne valley in my constituency. The site is located between Blandford Forum and Dorchester and is very close to the villages of Winterborne Kingston, Winterborne Zelstone, Anderson and many other smaller settlements. The proposal worries constituents from all over my area. There is also a proposal to create a wind farm at Cucklington in Somerset, which is in the constituency of my neighbour, the hon. Member for Somerton and Frome (Mr. Heath), who is present today. That would have a significant impact on villages in my constituency, and in the general area of the Blackmoor vale, which runs through both of our constituencies. Villagers in my constituency including residents of Buckhorn Weston, Kington Magna, Stour Provost, Silton and Bourton are concerned about the development.
I am not a nimby. I am not against shopping centres or car factories; I just do not think that they should be built in the lower Winterborne valley, and I do not want wind turbines, those industrial monsters, coming into the Winterborne valley either. They have their place, but it is not in this most beautiful part of England. In our area of southern England we have a national park, the Dorset heritage coast and several areas of outstanding natural beauty, and the sites chosen for the development are the filling in the sandwich between those areas, which is one of the reasons why some of them have been chosen. The arguments would be just as strong and the issues would be the same if we were considering an area of outstanding natural beauty or a national park.
The Government's 2003 energy White Paper spells out good reasons for and sensible methods of reducing the environmental pollution arising from electricity generation. It encourages us to reduce consumption, increase conservation and equipment efficiency, clean up dirty processes and turn towards renewable sources in an attempt to secure a 60 per cent. reduction in carbon emissions by 2050. However, it appears to be obsessed by the technology of onshore wind power, which, although well established and relatively cheap, is still subsidised through the renewables obligation. It is by far the most controversial source of energy, because of the impact of massive numbers of ever larger turbines on the British countryside, which apart from being home to millions, is a priceless, high-quality asset. It is also, particularly in Dorset, home to an international tourist industry.
To date across Britain there are already about 1,000 wind turbines, which disfigure some of our finest landscapes to meet less than 0.5 per cent. of our energy needs, and even that capacity has to be backed up by conventional sources ready to be brought on line when the wind fails to blow—often in the coldest winter weather when demand is at its greatest. There are
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proposals for turbines of unprecedented size—more than 100 m in height—which, because they reach for stronger winds further from the ground, are to be targeted in areas previously said to be insufficiently windy, as is true of the sites in Dorset and Somerset.
The Government's UK all-renewables target for 2010 is to increase output from the present 3 per cent.—nearly all of which comes from hydroelectric schemes in Scotland—to something like 10 per cent. In July, the Secretary of State for Trade and Industry announced the round 2 offshore wind initiative, which will produce half that total, leaving only 2 per cent. to come in seven years from all other sources. That includes existing consents and the many other rising technologies, such as marine currents, solar and biomass.
That being so, I believe it is unacceptable that the consultation draft of planning policy statement 22 on renewable energy in England is forecast to dismantle protection for the buffer zones around nationally designated areas, and to instruct planning authorities to assemble ambitious and irreparably damaging target scenarios for thousands of immense wind turbines. The largest projects will be propelled to consent outside the democratic planning system by the Department of Trade and Industry-controlled Electricity Act 1989. That will lead to the destruction by Government decree of our finest countryside for no reason other than the appeasement of the onshore wind power industry and the establishment of green tokenism by a Government. That is deeply offensive to all lovers of the countryside.
The Minister for Energy, E-Commerce and Postal Services, on a week-long tour of the country examining renewable energy, yesterday issued a press release in which he said:
"We have placed the environment at the heart of energy policy."
He added that we all now understand better our impact on the natural environment, and spoke of climate change and its effects, but he ignored the visual impact of these developments. In its policy position statement issued last month, the Campaign to Protect Rural England stated:
"The English countryside will not be immune from the damage done by global climate change caused by excess greenhouse gases such as carbon dioxide in the atmosphere … Unlike conventional fossil fuel power stations, wind turbines can generate electricity without producing carbon dioxide."
It went on to say:
"CPRE believes there is a role for wind energy in providing electricity in the UK, but their intermittency and major visual impact limit the potential contribution of onshore turbines. Their location and extent need to be carefully controlled."
The CPRE concluded:
"At sea, wind turbines can operate at higher efficiency and will have reduced impact on cherished scenery. But we cannot rely on wind power alone to provide for our energy needs. There needs to be much more investment in harnessing a range of more predictable and reliable sources of renewable energy, such as the tides."
The issue does not just affect the UK. In a policy statement issued in February, the International Federation of Industrial Energy Consumers said about renewable energy in the EU:
"IFIEC welcomes the attention being given to renewable energy technologies, which should have a role in Europe's future energy supply options. It is important, though, to keep a balance between technological progress, security of supply and environmental protection issues."

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It highlighted some special aspects of the promotion of wind power that are relevant to the case I am raising by stating:
"It must not be forgotten that wind power has an important limitation. The usage of the installed capacity is highly unstable and insecure being totally dependent on wind conditions at any given time. Thus, the average volume of power generated from wind farms is far less than the design capacity."
The IFIEC added that the
"uncertainty associated with wind generated power means additional costs",
because
"installed wind power capacity can not replace any other installed capacity. Due to the insecure generation volume, it is always necessary to back it up with reserve generation capacity. This means dual investment in generation capacities"—
the "other installed capacity" being, possibly, carbon fuels. Other reasons for the additional costs were that
"grid capacity has to be installed for the potential maximum load",
even though that will "hardly ever" be achieved, and that the
"decentralised locations of wind farms leads to inefficient investments".
The IFIEC concluded:
"All these mean additional costs for the electricity utilities and grid operators, which are then passed to the consumers through the electricity price."
I have several questions for the Minister about the developments in Dorset. Wind turbines operate for only 28 to 30 per cent. of the time, so there has to be back-up capacity to meet the grid's needs for the remaining 70 to 72 per cent. of the time. Do the Government agree with that statement? If so, what is the most suitable method of generating electricity to fill that gap? How much does the provision of back-up power for the remaining 70 to 72 per cent. of the time reduce the environmental benefits of using wind power? What is the level of subsidy to electricity generated by wind turbines, taking into account the guarantee of access to the grid and the need to meet the cost of keeping back-up capacity?
Do the Government support the position that, under the Electricity Act 1989, the big wind turbine companies are entitled to bypass local planning authorities if the theoretical maximum generating capacity of a group of turbines exceeds 50 MW? Is not the true capacity of such a group 28 to 30 per cent. of that theoretical maximum? In the event that the Government consider it in order to bypass local planning authorities, how can groups comprising substantial numbers of my constituents appeal against either a decision in my local case, or any Government decision to grant planning permission under the 1989 Act? I make no excuse for telling the Minister that several groups work in and around my constituency; for example, Dorset Against Rural Turbines, of which I am the honorary chairman, and Save the Vale, in the north of my constituency.
Mr. David Heath: The hon. Gentleman has spoken about Save the Vale, which extends into my constituency, covering Cucklington, Stoke Trister, Pen Selwood and other villages in the Blackmoor vale in Somerset. Does he agree that
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whatever the merits of wind turbines—I actually think that there are many—they cannot override normal planning considerations of landscape value? Would it not be better to have a national and a local strategy for identifying the right sites in planning and landscape terms than to leave such decisions to an opportunistic and adventitious application process?
Mr. Walter: I agree with the sentiments the hon. Gentleman expresses. He is absolutely right to say that local people should have a say in the matter, and the process should not just be negative. Some positive strategy should come either directly from central Government or through the regional offices. Sadly, that seems to be lacking at present.
Finally, can the Minister tell me how wind turbines are perceived in other European countries, particularly in Germany and in Denmark and other Scandinavian countries, which appear to have halted their development?
Government policy on renewable energy, including the carbon emissions reduction targets that we discussed, is to be applauded in principle. However, in practice, through the choice of onshore wind turbines in unsuitable locations as a quick and easy option, that policy is causing utter mayhem by creating an artificial race, by distorting the marketplace and by destroying the countryside and entire communities' amenity value. There have been high-profile examples in Cumbria, and now in my own constituency, with the largest ever applications from National Wind Power and Your Energy for 32 turbines more than 100 m high.
There are significant weaknesses in the Government's policy, including false savings in carbon emissions; wind variations causing onshore wind turbines to work for less than 30 per cent. of the time, thereby requiring back-up capacity and resulting in no savings in CO2 emissions; liabilities to the taxpayer and consumer in cost and capital grants; and, most particularly, concerns about the preservation of the countryside and about community well-being. Increasing use of inland and lowland sites ruins the vanishing countryside and seriously affects the well-being of many communities in Dorset and elsewhere.
If wind turbines have to be used, they should be put offshore, as recently announced in a major Government policy initiative. We should aim to reduce excessive consumption through better education and greater awareness, and revise or delay the targets that have been set in order to allow more time, as the hon. Member for Somerton and Frome suggested, for a comprehensive approach that uses other energy technologies that are coming on stream, such as biofuels, biomass, tidal, wave and solar.
4.28 pm
The Parliamentary Under-Secretary of State for Trade and Industry (Nigel Griffiths): I congratulate the hon. Member for North Dorset (Mr. Walter) on securing this debate. He has a strong interest in the issue in his capacity as the chairman of Dorset Against Rural Turbines. As he generously revealed, my hon. Friend the Minister for Energy, E-Commerce and Postal Services is unable to be here because he is going round Britain promoting renewable energy strategies.

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I welcome the hon. Gentleman's very strong support for the principles of the Government's policy on renewable energy. Renewable energy is at the heart of the Government's energy policy. The White Paper "Our energy future—creating a low carbon economy" reinforces our commitment to renewable forms of energy. The Government have set four energy goals: to put ourselves on a path to cut the UK's carbon dioxide emissions by some 60 per cent. by 2050; to maintain the reliability of energy supplies; to promote competitive energy markets in the UK and beyond; and to ensure that every home is adequately and affordably heated.
Renewable forms of energy will contribute to the achievement of all those objectives, in particular the reduction in carbon emissions, and to assuring future security of energy supply by diversifying the sources of electricity on which we can rely. They will also create new businesses and jobs, not only in energy generation, but in component construction and support services. In our White Paper, the Government confirmed our target of 10 per cent. of UK electricity being supplied from renewable sources by 2010, and set the aspiration to double that share to 20 per cent. by 2020. The main vehicle for reaching the target is the renewables obligation, under which electricity suppliers are required to supply a specified and growing proportion of their sales from eligible renewable energy sources. In addition, the Government are to spend nearly £350 million over the next four years supporting renewables that are not yet commercially competitive.
The 10 per cent. target is ambitious because we are starting from a low base. In 2002, only 1.7 per cent. of the UK's electricity was generated from renewable sources eligible for the renewables obligation. However, we are doing all we can to meet the target. Both onshore and offshore wind development will be critical to achieving that. Onshore wind power generation is an established technology and will make a major early contribution, while offshore wind developments are a growing industry with a vast potential. While I note the hon. Gentleman's preference for wind farms to be located offshore, both offshore and onshore wind developments are needed to form a balanced and significant input to the targets of 2010 and beyond.
We expect that wind energy will provide the vast majority of the growth necessary to reach our 2010 target, and will make the largest contribution to it. Our total wind capacity is close to 600 MW, while other projects together offering more than 1.25 GW capacity have received consent, and there are more in the pipeline. Achievement of the 2010 target would mean that UK wind-generating capacity could power one in six households.
The hon. Gentleman raises the subject of wind turbines proposed for the Winterborne area of north Dorset. My Department is aware of a proposal by National Wind Power Ltd. to apply for consent under section 36 of the Electricity Act 1989 to construct and operate 23 wind turbines at Muston Down with a combined capacity of about 65 MW. It is also aware of a smaller scheme proposed by Your Energy for a wind farm comprising 11 turbines at Lower Winterborne and the possibility of another smaller one
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in the same broad area. Those will require permission under the normal planning regime. I understand that the Lower Winterborne proposal is being considered by the local planning authority.
Let me set out the procedure for proposals for power stations with capacity greater than 50 MW. Such proposals are considered by the Secretary of State for Trade and Industry under section 36 of the Electricity Act 1989. When granting such a consent, the Secretary of State can direct that planning permission be deemed to be granted under the Town and Country Planning Act 1990. National Wind Power has not yet submitted an application for consent to build a wind farm at Winterborne. In the event of a relevant local planning authority objecting to an application, the Secretary of State has a statutory obligation to call for a public inquiry into the application to be held. In considering an application, the Secretary of State takes into account the environmental impact, the views of the local community—including the relevant local planning authority and individuals—and the advice of statutory bodies such as the Environment Agency, the relevant countryside and nature conservation bodies, and heritage bodies.
In view of the possibility of other proposals neighbouring the one proposed by National Wind Power, the Department of Trade and Industry has requested that the environmental impact assessment statement, which accompanies the application, should consider the cumulative impact of all proposals in the vicinity. As the hon. Gentleman will appreciate, until an application is made and the views of those commenting on it are considered, I cannot say what decision will be taken. Likewise, it would be inappropriate of me to comment on those proposals in detail. The only assurance I can give him and his constituents is that their views, together with all other interests that arise in relation to development proposals, will be fully considered before any decision on an application is taken.
The Government are concerned about the landscape of Britain—it is in no one's interest to spoil it. Although we want to increase the use of renewable energy installations to reach our renewable energy target, that does not mean that we want development to take place where it would be inappropriate. The Government provide guidance to local planning authorities to help them to assess proposed wind farms and other such installations. That is included in planning policy guidance note 22 on renewable energy. That guidance will be updated, and the new guidance, called planning policy statement 22, is due to be published by the Office of the Deputy Prime Minister as a consultation paper in early November. It will reflect the advances made in wind energy since the current guidance was published, and it will incorporate wider Government policies on energy, specifically carbon reduction. Similar legislation exists for Scotland and Wales, and all the guidelines clearly state that visual and other impacts should be considered in the siting of wind turbines.
Wind farm developers are required to consider all environmental aspects of wind energy projects, including those raised by the hon. Gentleman. Most small wind farms, and all large wind farms, are required to produce an environmental impact

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assessment, which covers all the issues as part of the application for planning permission. The environmental impact statements produced as a result of those assessments are available to the public. Landscape architects are often consulted on the layout of wind farms, and they aim to ensure that the farms seem coherent and do not appear cluttered in the landscape. They consider the effect of the turbines against the skyline and from important viewpoints or beauty spots.
It has been suggested that the benefits of onshore wind farms are dubious, but I am advised that that is far from true. There are more than 80 onshore wind farms in the UK and together they provide enough electricity to power almost 400,000 homes. That is a useful contribution to our energy supplies. It is true that the electricity produced from wind power is more intermittent than electricity from power stations that run continuously. On average, an onshore wind turbine has a load factor of about 30 per cent., while the figure is a little higher offshore. That intermittency has implications for the design and operation of the electricity network, but we should keep a sense of proportion. Wind farms in the UK are geographically dispersed throughout the country and tend to be located in areas with a high wind resource. That dispersion significantly reduces the intermittency factor of wind-driven generation, since it minimises the possibility of all wind farms failing to generate electricity at the same time.
It should also be remembered that traditional generating plants, such as gas or nuclear, undergo occasional shutdowns for essential maintenance. That type of generating loss is more difficult to cope with than the intermittency of wind, because the amounts of electricity involved are typically of a greater magnitude. When the effect of that type of shutdown is compared with the intermittency of dispersed wind farms, the variation in output from wind generation is minimal. Furthermore, key research is continuing into storage technologies that will support intermittent generation and provide power to the network when conditions are less favourable, as will hybrid generation plants. Such developments will improve the overall performance of wind generation and limit the reserve necessary to maintain electricity supply in the event of either the accidental loss of a generating unit, or higher than expected demand.
As the proportion of intermittent generation increases, the cost of maintaining stable supplies also increases. We accept that those costs need to be managed in new ways, and we are already funding research into that through the DTI's renewable energy programme and the Engineering and Physical Sciences Research Council's sustainable power generation and
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supply, or SUPERGEN, programme. As part of our current capital grant programme, in 2002 we allocated an additional £4 million to facilitate the demonstration of new control, storage and metering technologies.
It is important to address the concerns that have been raised regarding public attitudes towards renewable energy, including wind farms. The DTI commissioned research into public attitudes towards renewables, and the findings are broadly encouraging. Overall many people have favourable views on renewable energy, and the vast majority feel that the Government should promote its use. Those who are more knowledgeable tend to be more positive. Although the research identified a number of concerns about visual impact and impact from noise, it is interesting that those who currently live in the vicinity of a wind farm tend to be more positive than the general public.
We have concentrated on onshore wind energy this afternoon. As I said at the outset, we expect the bulk of the increase in renewable energy capacity to be from wind power. It is also important to say a little about developments offshore. In July, the DTI invited the Crown Estate to offer sites in the Thames estuary, the greater Wash and the north-west to developers in a competitive bidding process. The deadline for submitting proposals was 15 October, and the bids are now being assessed. I am pleased to have been informed that the initial indications from developers are promising. In the meantime, the projects resulting from the first round of offshore licensing are moving ahead.
I mentioned my hon. Friend the Minister for Energy's renewables tour. On Monday he visited North Hoyle, off the coast of north Wales, where the first major UK offshore wind farm will come onstream next month. Last week, he announced that four more offshore wind farms have received planning consent: those are at Lynn, Inner Dowsing, Cromer and Gunfleet Sands, all of which are off the east coast of England. Yesterday, at the British Wind Energy Association annual conference, he announced the award of six capital grants, totalling £59 million, to developers of offshore wind.
We should not, however, ignore the potential of other renewable sources to make their contribution, particularly in the longer term beyond 2010. The Government therefore support a wide range of renewable technologies, including biomass, solar photovoltaics, and wave and tidal energy, through the renewables obligation, our capital grants and the research and development programmes—
It being eighteen minutes to Five o'clock, the motion for the Adjournment of the sitting lapsed, without Question put.