House of Commons
Prayers
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Oral Answers to Questions
Glyn Davies (Montgomeryshire) (Con)
1. How many households he estimates will be taking part in the feed-in tariff scheme by 2015 following implementation of his reforms.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
We now estimate that, thanks to our reforms, there will be nearly 1 million installations under the FITs scheme by 2014-15, compared with only 350,000 under the old scheme. Final numbers will of course depend on future technology costs and market growth. As for household share, 97% of current installations are classified as domestic, and it is likely that the majority will continue to fall into that category.
Glyn Davies
The feed-in tariff regime, as recently reformed by the Secretary of State, strikes a fair balance between those who install solar PV and the consumer who meets the cost. It will result in far more installations and it will be more popular. Does my right hon. Friend agree that, in a democracy, striking that balance in achieving his renewal energy targets and the consequent support of the people should always be his objective?
Mr David Hanson (Delyn) (Lab)
The way in which this has been handled has been a bit of a disaster. I accept that the Minister has made some changes, but they have been detrimental to the overall confidence in the scheme. Putting that to one side for a moment, may I ask him to look seriously at enabling bigger entities such as community centres, schools and other community facilities to benefit from the scheme, to provide a kick-start over and above that given to the householders who participate in it?
Mr Davey
In our proposals, smaller community projects will benefit from the decision to apply only the lower aggregated tariff to generators with more than 25 installations. We are now consulting on a definition of “community” and on how that could be used, including a possible tariff guarantee process and a higher rate for community-owned multi-installations, compared with commercial ones. I have to say to the right hon. Gentleman that that type of community approach was not in the old scheme.
Mr Peter Lilley (Hitchin and Harpenden) (Con)
2. What assessment he has made of the procedures adopted by the UN Intergovernmental Panel on Climate Change for its fifth assessment report.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
The Intergovernmental Panel on Climate Change recently revised its procedures in response to an independent review by the InterAcademy Council. The revisions address the key recommendations of the review and put the IPCC in a stronger position to prepare its fifth assessment report, but there is absolutely no room for complacency.
Mr Lilley
I am grateful to my hon. Friend for his answer, which none the less remains complacent. When the InterAcademy Council reported, it proposed radical reforms that would
“fundamentally reform IPCC’s management structure while enhancing its ability to conduct an authoritative assessment”,
and criticised IPCC authors for reporting
“high confidence in some statements for which there is little evidence.”
Most of the InterAcademy Council’s recommendations have been rejected, however. Why are the Government not pressing for them to be implemented?
Gregory Barker
My right hon. Friend will know that, as a result of the reform procedures, an executive committee has been formed and a new conflict of interest policy has been created. The communications strategy has also been elaborated on much more strongly. I accept that this is by no means perfect, but we now have much greater faith in the IPCC and we look forward to seeing its fifth report.
Mr Jim Cunningham (Coventry South) (Lab)
3. What assessment he has made of recent trends in energy prices.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
The Department of Energy and Climate Change publishes estimates of retail energy prices in our “Quarterly Energy Prices” publication. In general, in line with wholesale costs, most prices have gone up in recent years. However, domestic gas and electricity prices have recently both been cut by just over 2%, although prices will still be up by about 15% for gas and 8% for electricity compared with a year earlier.
Mr Cunningham
Is the Minister aware of the Big Switch campaign to reduce the energy bills of thousands of people through collective purchasing, and does he support it?
Charles Hendry
We most certainly do. No one in the House has done more for collective purchasing than my right hon. Friend the new Secretary of State. This is a trend that we are very keen to encourage, as it will help consumers dramatically by enabling them to switch effectively. It will form an important part of a functioning market.
Mark Pawsey (Rugby) (Con)
Industries using large amounts of energy—such as Cemex, which manufactures cement in Rugby—are concerned about the relatively high energy prices here compared with other parts of the world. Will the Minister update the House on the steps being taken to ensure that the energy prices paid by British industry remain competitive?
Charles Hendry
My hon. Friend makes an extremely important point, which is relevant to Members on both sides of the House. What the Chancellor announced before Christmas was a package of about £250 million to support energy-intensive industries. More detail is being published this week, and there is a call for evidence so that we can see exactly what support is required for which industries.
Mr Mike Weir (Angus) (SNP)
It is not just gas and electricity prices that are rising, as those off grid who use refined oil as a home fuel are having a bad time of it. Given the increasing concentration in that market, has the Minister given any thought to making direct contact with the suppliers to see whether they will identify and offer assistance to vulnerable groups within their client base?
Charles Hendry
The hon. Gentleman raises an interesting point. The Office of Fair Trading looked into this market last year. It was evident in the previous winter that the system had not worked as well as it should have done. We are seeing increasing centralisation of ownership. The OFT has said that it is willing to look again at examples of market failure, and it has asked Members of Parliament to submit evidence to it of where that might be happening.
Michael Connarty (Linlithgow and East Falkirk) (Lab)
4. When he expects energy companies to secure investment for new nuclear power stations.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
The timing of investment decisions in new nuclear is a commercial matter. The Government are encouraging investment in new nuclear through a range of actions, including its proposals on electricity market reform. The Government have also committed to working with relevant developers to enable early investment decisions to progress to timetable, including those required ahead of electricity market reform implementation.
Michael Connarty
I thank the Secretary of State for that tortuous and absolutely uninformed answer. As secretary of the nuclear industry all-party group, I strongly support this industry, but the problem is that progress has been stalled for some time as it would appear that there has been not much talking and no action. The Government have to do more, because we are seeing the resources in this industry and the commitments to investment and technology going elsewhere and not coming to the UK as we hoped when we started to think sensibly about using this very low-carbon source of energy.
Mr Davey
I have to say that I am extremely surprised by what the hon. Gentleman has said, given the Labour party’s record on this issue, as it dithered and delayed for all its time in office. I do not recognise the situation he describes. Three consortia are putting forward proposals for 16 GW of new nuclear. Let me tell the hon. Gentleman that people are investing serious money in this industry and that we are making real progress.
Priti Patel (Witham) (Con)
May I welcome my right hon. Friend to his new role as Secretary of State? How confident is he that Britain will possess the world-class skills necessary to create a thriving UK nuclear industry?
Mr Davey
I am very confident. When I joined the Prime Minister for the Anglo-French summit in Paris recently, we were signatory to 12 commercial agreements, which included agreements with further education colleges that will be helping with that supply chain. However, it is not only FE colleges that will be involved, as there are supply chain improvements for training British employees in this new industry all over the country.
Mark Durkan (Foyle) (SDLP)
Apart from the wider policy issues arising from the Government’s attempting to skew investment towards nuclear through the carbon price floor, has the Secretary of State been able to consider the particularly adverse implications in the context of investment for energy in Northern Ireland, given the serious implications stemming from the single electricity market there.
Mr Davey
I have to disagree with the hon. Gentleman. The carbon price floor is important if we want to move to a low-carbon future, to which I am completely committed. We understand the impact of the carbon price floor on energy-intensive industries. The Minister of State, Department of Energy and Climate Change, my hon. Friend the Member for Wealden (Charles Hendry) is talking with his colleagues in Northern Ireland to try to mitigate those issues.
Bob Blackman (Harrow East) (Con)
23. Clearly, Labour Members forget that they dillied and dallied on nuclear power for 13 years. Following the UK-French summit, what action is my right hon. Friend taking to accelerate putting base load nuclear electricity into our grid, which is of course the cleanest form of energy we can have?
Mr Davey
I am continuing the policies set out by my predecessor, who gave strong support for that. I have to tell my hon. Friend that when I was reading my brief on this issue, I had only one worry: the design of many of these new nuclear reactors is called European pressurised reactors, and I know that Europe can create pressures and get reactions in this House—but I hope that on this occasion, we can unite.
Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op)
Is the Secretary of State aware of the concern that if Areva were to win the contract to build the reactor at Wylfa, the supply chain work may not be likely to go to UK companies? Given the comments in the Business Secretary’s confidential letter to the Prime Minister, which received some publicity earlier this week, what do the Government intend to do to maximise the opportunities for UK firms in the supply chain by encouraging contractors to buy where they build?
Mr Davey
The Government have been focusing on this with great intensity from the Prime Minister down. Indeed, when we held discussions with our French colleagues and EDF, we made it clear that we expected there to be British involvement in the supply chain, and that is beginning to happen. I refer the hon. Gentleman to the many agreements that were signed in Paris, including a ground-breaking £400 million deal on nuclear projects between Rolls-Royce and Areva.
Charlie Elphicke (Dover) (Con)
5. What steps he is taking to lower consumer energy bills.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
First, we are directly helping about 2 million vulnerable households with their bills through the warm home discount scheme, and many more households are benefiting from subsidised energy efficiency measures under the carbon emissions reduction target scheme. Secondly, later this year the green deal and the energy company obligation will provide energy efficiency measures at no up-front cost to households. Thirdly, we are looking to help consumers get better prices by harnessing their collective purchasing power.
Charlie Elphicke
I thank the Secretary of State for that answer. On consumer energy bills, does he agree that it is wrong in principle to finance carbon commitments on the back of the poor, which was the policy of the previous Government, and that we need a more imaginative way forward?
Mr Davey
I agree with my hon. Friend. I am a liberal, but I strongly believe that collective action can help solve some of society’s ills. That is why I promoted collective purchase and switching as consumer affairs Minister and am continuing to do so as Secretary of State for Energy and Climate Change. It is a shame that the party of Keir Hardie and Aneurin Bevan forgot the power of collective action in its 13 years in government.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
It is interesting that the Secretary of State referred to the CERT and Warm Front schemes, which Labour introduced and the Government are scrapping. I welcome today’s announcement on funding for green deal training, however. It is a good first step towards delivering the apprenticeship scheme that a Labour amendment added to the Energy Bill. Yesterday, however, DECC released figures showing that 7 million homes still need cavity wall insulation, yet the Government impact assessment for the ECO shows that under the green deal cavity wall insulations are set to plummet by 67% next year. At our last question time, I warned that that will lead to a loss of 3,000 jobs. What is the Secretary of State going to do to ensure that these jobs can be safeguarded?
Mr Davey
The green deal and the ECO are extremely good proposals. They replace proposals that had a place, but which were not as effective as our proposals will be—[Interruption]—because our proposals are in a package and we have a range of other regulations to help on energy efficiency. We will conduct another impact assessment to show how beneficial our measures are for jobs and the industries concerned.
Gordon Birtwistle (Burnley) (LD)
Does my right hon. Friend agree that the project in Burnley to clad hundreds of Calico Homes, which is funded by British Gas, Calico and this Government, is the right way forward as it will save money, keep the houses warmer in winter, keep energy bills down and help achieve the aim of having green energy?
Mr Davey
My hon. Friend is a huge champion of energy efficiency in his constituency, and he is absolutely right. It is the ECO scheme that is making such policies possible. As a result of such measures, we can move on to solid-wall insulation, which for too long has been a poor second cousin.
Graham Stringer (Blackley and Broughton) (Lab)
AF Consult estimates that huge savings could be made by changing the energy mix away from windmills. Why does the Energy Secretary not truly dash for gas and utilise the huge shale gas resources that are in Lancashire?
Mr Davey
We need to balance a range of priorities in energy policy, including energy security, affordable bills and tackling climate change. That is why this Government have a portfolio approach to energy generation. We are looking at low-carbon technologies, including wind power, carbon capture and storage, and new nuclear.
Simon Hughes (Bermondsey and Old Southwark) (LD)
6. What steps he is taking to promote competition in the energy market.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
We are working with Ofgem to deliver clearer bills and simpler tariffs, to help consumers engage effectively in the energy market. We have cut red tape for small suppliers to help them compete, and we are looking at Ofgem’s recently published proposals to increase liquidity in the wholesale market.
Simon Hughes
When Ministers and I were in opposition and Labour was in power, we spent much of our time trying to get the Labour Government to make sure energy companies understood the simple principle that when energy prices went up they were justified in increasing prices to our constituents, but when those prices went down they should also bring their prices down for our constituents. Will the Minister assure us that the Government will force Ofgem and the energy companies to understand the rule that consumers must benefit when prices go down, just as they are penalised when they go up?
Charles Hendry
Ofgem is already working on this issue. Indeed, its proposals for much greater clarity and for a much simpler range of tariffs are a core part of achieving in this area. In the course of that, it will ensure that consumers find it much less confusing to switch and can see whether they are getting a better deal, and that is a very important part of making this market work properly.
Dr Alan Whitehead (Southampton, Test) (Lab)
Does the Minister have a timetable for the agreement on who will be the counter-party for the contracts for difference under the proposals for electricity market reform? If not, how will he resolve the issue in time for legislation to be put before this House?
Charles Hendry
As the hon. Gentleman knows, we published a technical update for the market reform proposals before Christmas, which set out how we would work with companies that need to make final investment decisions this year to help them identify the strike price under the market reform proposals. We recognise that legislation needs to go through Parliament and we are looking to achieve that in the next Session, but we are also clear about the fact that early decision makers need to have that clarity and we have committed to making sure they have it.
Caroline Flint (Don Valley) (Lab)
Clearly, electricity market reform must improve competition in the energy market. The Minister told the Select Committee that
“we need to get legislation through as quickly as possible.”
I suggest to him that the most important thing is not getting it done quickly, but getting it done right. Given this Government’s record of legislative mismanagement, will he today agree to publish after the Queen’s Speech a draft energy Bill for pre-legislative scrutiny, so that this House can ensure that the Government’s proposals deliver the electricity system our country needs?
Charles Hendry
One of the most important things for international investors is for there to be as much cross-party support as is possible in this sector. The Government therefore want an energy Bill that commands support on both sides of the House. We are keen to engage constructively with the right hon. Lady, her shadow team and the Select Committee to examine the options for pre-legislative scrutiny closely and see how we can get the maximum possible support for our measures. I am sure she will understand that we do not want to delay the Bill unduly, but we think that that sort of cross-party support will be an integral part of its success.
Anas Sarwar (Glasgow Central) (Lab)
7. What recent forecast he has made of future levels of fuel poverty.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
Between 2004 and 2009 the number of households in fuel poverty rose from 2 million to 5.5 million across the UK. The Department will publish the 2012 annual report on fuel poverty statistics on 17 May. It will show the actual level of fuel poverty in 2010 for England and the UK, and projected levels for England in 2011 and 2012.
Anas Sarwar
I thank the Minister for that answer. He may be aware that our Labour administration in Glasgow city council has introduced the winter warmth dividend, giving every 80-year-old £100 to help them with their winter fuel bills, so making up for the cut madeby this Government to the winter fuel allowance. Will he join me in congratulating Glasgow city council on protecting the most vulnerable and not cutting the support they get, as this Government have?
Gregory Barker
On the contrary, this Government are massively increasing the support for the fuel poor. For example, our warm home discount will reach far more households than the previous Government’s plan. I welcome any measure to help tackle fuel poverty, but, fundamentally, we are going to do that by retrofitting the homes of the fuel poor and improving the fabric of those homes, rather than just handing out more money to try to keep up with ever-rising fossil fuel prices.
Mark Reckless (Rochester and Strood) (Con)
What may be the impact on fuel poverty of EU regulations closing down coal-generating capacity, for instance with E.ON’s announcement today that the facility at Kingsnorth, in my constituency, will close by March next year?
Gregory Barker
We are not expecting any impact as a result of that. Obviously, there is a constant need for a new generation of technologies to emerge. What we want, both for the fuel poor and for this country’s energy security, is a broad mix of fossil fuels, renewables and nuclear. We think that that is the best route forward.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
When the previous Labour Government left office, 1 million fewer households were living in fuel poverty than in 1997. The Tory Government have scrapped Warm Front, the carbon emissions reduction target, the community energy saving programme and social tariffs, and they have cut the winter fuel allowance. As a result, the level of fuel poverty has risen from one in five households to one in four. The Minister, who is responsible for tackling climate change, has said that the energy company obligation would deliver far more for the fuel poor than any measure introduced by Labour, yet the Government’s own figures show that, in a best-case scenario, the ECO will lift just half a million homes out of fuel poverty. With energy bills at record levels, why are the Government turning their back on the fuel poor?
Gregory Barker
It is ridiculous for the hon. Lady to pretend that the number of fuel poor did not rise from 2004 to 2009 from 2 million to 5.5 million. It would be good, on this really important subject, if, rather than trying to score cheap partisan points, we could build a new consensus. We are bringing forward some very important measures on fuel poverty and we are determined to really make a difference.
John Pugh (Southport) (LD)
8. What recent assessment he has made of the use of incineration for power and heat generation.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
There is no place for old-style incinerators in our future energy mix but there are an increasing number of new energy-from-waste technologies being deployed that offer real potential for local low-carbon and environmentally friendly generation of electricity and heat.
Gregory Barker
My hon. Friend is absolutely right. There has been a sea change in safety and environmental standards as well as in the type of technologies that can now be deployed. These smaller, new technologies often have a role to play, particularly in our vision of an ambitious roll-out of decentralised energies and of communities taking more responsibility for and greater ownership of their own energy-generating assets.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Is the Minister aware that there are some very good energy-from-waste operations at the moment that, with a little co-operation with local authorities and a little help from the Government, could be converted into combined heat and power to heat local communities, hospitals and town centres? That is what happens in Sheffield and it could happen in many other places.
Gregory Barker
The hon. Gentleman makes a very good point. I have visited the site in Sheffield and it is a beacon of what can be done and of the benefit that we can get from such assets. We want to see a big expansion in CHP, not forgetting the hierarchy that means that before considering energy from waste, we should prevent, reuse, recycle and recover. We think CHP has a big future and will bring forward further proposals to encourage it.
Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)
9. What recent representations he has received on his decision to reduce the feed-in tariff for solar PV.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
I met 25 stakeholders when the FITs consultation was launched on 9 February and I intend to meet them again on 27 March. As of 5 March, we have received 18 written responses to the consultation on the solar PV cost control mechanism and six to the consultation on non-PV technologies and scheme administration issues.
Cathy Jamieson
I thank the Minister for that answer, but small companies in my constituency are still contacting me about the chaos over the ending of the feed-in tariff scheme and they want to know what the Minister will do to listen to their comments and to work with small businesses as well as some of the larger stakeholders to find the way forward.
Gregory Barker
The hon. Lady will know that there has been a significant level of deployment—contrary to some of the scare stories and predictions that were circulating before Christmas—in January and February and that continues. We have now put forward a consultation document that is gathering broad support for putting in place a sustainable framework that will result in a bigger scheme that offers better value. As a result, there will be far more PV under our reform proposals than there was under Labour’s very expensive scheme. We are keen to involve small and medium-sized businesses as much as possible.
Stephen Mosley (City of Chester) (Con)
Earlier this week I was in Berlin with the Select Committee on Science and Technology to look at the energy infrastructure in Germany. Will the Minister confirm that Germany is proposing to cut the feed-in tariff rates to below the UK level with just two weeks’ notice?
Gregory Barker
My hon. Friend is absolutely right. The German cuts are now going further and faster than those that we are proposing. We think that solar is a very dynamic technology that is up to the challenge. If costs continue to come down and it becomes competitive with fossil fuels by the middle of the decade, as we believe it might, we could see 22 GW of solar capacity installed by 2020.
Mr Andrew Turner (Isle of Wight) (Con)
10. What his policy is on encouraging onshore wind energy production.
Chris Heaton-Harris (Daventry) (Con)
13. What his policy is on encouraging onshore wind energy production.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
A responsible energy policy for this country is one that includes onshore wind. Well-sited wind farms, offering the benefits to local communities that we are introducing, are one of the cheapest ways of cutting our dependence on imported gas over the next decade and keeping emissions down.
Mr Turner
I thank the Minister for that answer. Is he aware of the new blade tip generation technology, which is more efficient than traditional turbines and can be installed with no lasting adverse effect on the countryside? Will he support moves to manufacture this innovative form of renewable energy on the Isle of Wight in support of the eco island initiative?
Mr Davey
I am grateful for my hon. Friend’s question. It is good to see examples of the economic benefits that wind power can bring. We are aware of companies developing new technologies for turbines, including for small-scale wind power generation such as the blade tip technology he cites. The support we provide for wind power generation in the UK will encourage use of appropriately sited and efficient wind developments.
Chris Heaton-Harris
Can the Secretary of State confirm that if we add the number of existing turbines to those going through the planning system, we have enough in place to hit his Department’s 2020 targets? If that is the case, does that not suggest that the level of subsidy for these things is too high?
Mr Davey
I thank my hon. Friend for his question. He and I may disagree about the significance of onshore wind, but I appreciate the measured way in which he has engaged with me and the Prime Minister on this issue. I can tell him that 5 GW of onshore wind power generation has already been built, that there is planning consent for a further 6 GW and that planning permission is being sought for 7 GW-worth of projects, only some of which will be approved. Given that the ambition was for 13 GW, most of the development that the country needs is indeed already on the table. As for subsidy, the subsidy levels go down as costs go down, and we are proposing a 10% reduction in subsidies for onshore wind.
Mr Dennis Skinner (Bolsover) (Lab)
The previous Energy Secretary opposed the idea of limiting how close wind farms could be to homes and residential areas, as is the case in Scotland. What is this Energy Secretary’s view?
Jim Shannon (Strangford) (DUP)
Given the news the Minister has just given regarding the progression of energy production from onshore wind, can he assure us that wildlife migratory routes will not be inhibited by the establishment and development of wind energy production? I want to make sure that wildlife will not be harmed by energy provision and development measures.
Andrew George (St Ives) (LD)
May I congratulate my hon. Friend on securing his new position? He said that wind is the most efficient form of renewable energy, but what will the Government do to ensure that communities benefit from new wind energy projects?
Mr Davey
First, we need to make sure that communities are listened to during the planning process, and the planning reforms will do that. We are committed to ensuring that local communities capture the full economic benefit from hosting renewable energy projects, particularly the retention of all the business rates that these installations pay.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
11. What discussions his Department has had with National Grid on the undergrounding of new electricity cables.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
The Department and National Grid have discussed National Grid’s new approach to network infrastructure, which emphasises mitigating visual impacts. The Department has arranged for National Grid to fund an independent study comparing the costs of undergrounding and overhead lines. We also revised the text of the relevant national policy statement to require greater consideration of alternative approaches before it was approved by Parliament.
Dr Poulter
I thank my hon. Friend for his answer. I am sure he is aware that increasingly robust evidence has been gathered by the Institute of Engineering and Technology that the cost of undergrounding pylons is a lot less than National Grid has previously suggested. May we count on his support and the support of the Government to ensure that pressure is brought to bear on National Grid to underground pylons and not ruin the beautiful British countryside?
Charles Hendry
My hon. Friend makes a very important point. I think National Grid was very pleased to commission that report from the IET to get independent analysis of the costs. I know that there is a significant multiple from undergrounding or taking cables sub-sea, but we have required, through the national policy statement, that mitigation aspects and alternative approaches be looked at to preserve our precious landscape.
Richard Graham (Gloucester) (Con)
12. What assessment he has made of the likely effects on household energy bills of changes to the feed-in tariff scheme.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
We estimate that our new, reformed scheme, upon which we are currently consulting, will add just £8 to the average household energy bill in 2020. That is around £50 less than FITs would have cost if we had continued with the previous policy. Obviously, there is a great deal of uncertainty in these numbers, which depend on future technology costs and market growth.
Richard Graham
Hard-pressed constituents of mine in Gloucester will be grateful for the Minister’s answer. Does he think there are lessons to be learned from Germany in terms of the total amount of energy consumed by households? If we replicated the amounts used in Germany, that would heavily reduce bills in this country.
Gregory Barker
My hon. Friend is right. In Germany, although electricity prices are higher, not least because of the support for renewables, bills are broadly comparable with those in the UK because domestic energy efficiency is much better. That is exactly the sort of transformation that we are determined to drive forward in the UK with the launch of the green deal later this year.
Nigel Mills (Amber Valley) (Con)
14. What steps his Department is taking to reduce energy costs.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
We are helping around 2 million vulnerable households through the warm home discount scheme and many more households through other schemes. The green deal and the energy company obligation will provide energy efficiency measures at no up-front cost. We are also looking to help consumers obtain better prices by harnessing their collective purchasing power.
To help businesses with their energy costs, the Chancellor announced a package of measures worth £250 million over the current spending review period.
Nigel Mills
I am grateful for that answer. Will the Minister join me in welcoming Rural Action Derbyshire’s bulk-buying scheme for domestic heating oil, which aims to bring communities together to deliver savings to heating oil customers?
Charles Hendry
I am delighted to join my hon. Friend in supporting this particular scheme. It is exactly the sort of scheme that we want to see coming forward. It gives consumers greater buying power; it helps them to negotiate a better price; it is good for them and it is good for the market.
Barry Gardiner (Brent North) (Lab)
A reduction in energy costs is one way of addressing fuel poverty, but with rising world commodity prices it is unlikely to be seen in the future. The other way of addressing fuel poverty might be to make direct payments to the more vulnerable, but again, given the financial situation, that is highly unlikely. Therefore, energy efficiency is critical. Will the Government look at making energy efficiency measures compulsory and putting them in place across the board?
Charles Hendry
We have made enormous strides on this through the green deal. We have recognised that in the United Kingdom our gas prices are the lowest in the EU15 and our electricity prices are about the third lowest in the EU15, but the total bill is much higher because our homes and businesses are very energy inefficient. The green deal was the first comprehensive measure introduced by Government to address this and to be rolled out across the housing stock. I know that the hon. Gentleman welcomes the ambition that we are setting out, and we are determined to make this fundamental change.
Mr Aidan Burley (Cannock Chase) (Con)
15. What discussions he has had with private contractors on the construction of the next generation of nuclear power stations.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
My Department regularly meets companies from different parts of the supply chain to discuss the next generation of nuclear power stations and how they can contribute to meeting our energy security and carbon reduction goals.
The UK Government are committed to ensuring that UK companies are in a position to compete for the business opportunities that new nuclear can provide, both in the UK and globally.
Mr Burley
My constituents will welcome the news that Ministers are working with the supply chain and nuclear reactor vendors to help create and support a globally competitive supply chain. What steps is the Minister taking to ensure that the majority of the UK’s new nuclear plants are constructed, manufactured and engineered by British companies? Will he pledge to include socio-economic factors in the invitations to tender, as so many other European countries do in theirs?
Charles Hendry
We are keen to learn to be more like the French and to understand how we can do that more effectively in these matters. We work closely with companies such as Areva and Westinghouse, which have assured us that they have a real commitment to developing supply chains here in the United Kingdom. We are working with local enterprise partnerships to ensure that the skills base is there. The partnership between Areva and Rolls-Royce is a fantastic example of how we can develop that in the United Kingdom and then those skills can be taken to the rest of the world.
Paul Flynn (Newport West) (Lab)
This time last year there were 54 nuclear reactors operating in Japan. Today there are three. Does not the anniversary of the terrible accident there last year convince the Minister that nuclear is the most fragile, unreliable power source?
Charles Hendry
No single source of energy is capable of withstanding the force of a multiple earthquake and tsunami. Those were very exceptional circumstances. We asked our regulator, who is well respected, to look into this and see what lessons we could learn, and we came to a different conclusion. We understand why the Japanese Government came to the conclusion that they did, but we see nuclear as an important part of a low-carbon future. We are therefore keen to take this forward, but we will never compromise on safety standards.
Pauline Latham (Mid Derbyshire) (Con)
16. What discussions he has had with the Secretary of State for Business, Innovation and Skills on the Green investment bank.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
I have regular meetings with Cabinet colleagues to discuss a wide range of issues. My Department works closely with the Department for Business, Innovation and Skills on the Green investment bank, given the bank’s potential to play a major role in catalysing private sector investment in the low-carbon economy.
Pauline Latham
I thank the Secretary of State for that answer and welcome him to his new post. I have been championing Derby as a potential location for the Green investment bank, because we have had one or two knocks to our confidence in Derby and lost some jobs. [Hon. Members: “Too late.”] If I am too late—I have not heard the announcement—I would like to suggest that the Secretary of State works with his colleagues to see what other investments the Government can make in Derby to return confidence to the area.
Mr Davey
I know that my hon. Friend is a real champion for Derby and is trying to get investment into the city, but I must tell her and the House that the Secretary of State for Business, Innovation and Skills has announced that the headquarters of the Green investment bank will be located in Edinburgh, with its main transactions team based in the London branch.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
In his discussions with the Secretary of State for Business, Innovation and Skills, did the Secretary of State make an assessment of the number of nuclear power stations, green chemicals plants, wind farms or tidal power generators that would be located in the City of London, and does that account for his decision to locate the Green investment bank there?
Mr Davey
I think that the hon. Lady needs to read the Secretary of State’s written ministerial statement, which sets out his reasoning in detail. We spent a long time looking into the matter because there were 32 proposals and we wanted to do them justice. I refer her to the statement.
Julian Smith (Skipton and Ripon) (Con)
24. Many people in Yorkshire who worked really hard to attract the Green investment bank to Leeds will be gutted by this decision. To compensate for this bad news, will the Secretary of State and his Department commit to giving the Yorkshire carbon capture and storage cluster as much support as possible over the coming months?
Mr Davey
I know how hard my hon. Friend works to promote investment in his constituency and I am sorry that he is disappointed, but he will realise, as I am sure the whole House will, that the Green investment bank will be investing across the country and, therefore, driving our low-carbon economy.
Mr Charles Kennedy (Ross, Skye and Lochaber) (LD)
May I unambiguously and warmly welcome—it will be welcome across the whole of Scotland—the decision to site the Green investment bank in Edinburgh? Does the Secretary of State agree that this will also give a further shot in the arm to other sites in Scotland, such as Kishorn in my constituency, that are pursuing renewable energy initiatives with great employment prospects? I congratulate the Government. This is a very good start for my right hon. Friend in his new post.
Mr Davey
I thank my right hon. Friend for his welcome. He is right. Edinburgh is an established centre for financial services and it couples that skill with a thriving green sector. That is why I believe my right hon. Friend the Secretary of State for Business, Innovation and Skills has chosen it. I know that my right hon. Friend the Member for Ross, Skye and Lochaber (Mr Kennedy) has been a champion of investment for Kishorn point and welcome the planned investment for redeveloping the point.
Nic Dakin (Scunthorpe) (Lab)
17. What recent assessment he has made of the level of investment in low-carbon technologies in the UK.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
In February, Ernst and Young upgraded the UK to fifth in the world for overall attractiveness for renewable energy investment. Cleantech Group estimated UK venture capital investment in clean technology in 2011 to be around $566 million, ranking us third in the world after the United States and China. We have forecast that 4 GW of renewable electricity will become operational in the coming year, which represents a doubling of installed capacity since May 2011.
Gregory Barker
In advance of the establishment of the Green investment bank, Green Investment UK will, thanks to the Chancellor’s Budget, invest up to £775 million in the green economy in the next financial year alone. This will be a huge boost, along with the other proactive measures that the coalition is taking to boost green growth.
Mr Matthew Offord (Hendon) (Con)
What assessment has the Department made of the sustainability of the woody biomass subsidy, particularly given the availability of virgin UK timber?
Gregory Barker
I take my hon. Friend’s point extremely seriously, as do my colleagues. That is why we have a programme looking at the sustainability of the supply chain. I would be happy to welcome him to the Department to meet our officials so that we can fully address any concerns he might have on the matter.
Kelvin Hopkins (Luton North) (Lab)
The best low-carbon technology is probably insulation. A recent report on energy conservation suggests that we could save the economy more than £1 trillion by investing in insulation instead of in nuclear power. Has the Minister looked at that report?
Gregory Barker
I agreed with every word, almost until the end of the hon. Gentleman’s question. He is right that energy efficiency, including insulation, is an absolute no-brainer. We have failed to do as much as possible in the past. With the green deal and the energy company obligation, we hope to transform the energy efficiency of homes and businesses in the UK.
Jim McGovern (Dundee West) (Lab)
18. What plans his Department has to reduce energy costs for (a) low-income and (b) other consumers.
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
We are committed to helping people, especially those in low-income, vulnerable households, to heat their homes more affordably. We are helping about 2 million low-income households through the warm home discount scheme this year. In October, we announced the joint “Check, Switch, Insulate to Save” campaign to help all consumers save money this winter. We are also looking to help consumers harness their collective purchasing power.
Jim McGovern
I thank the Minister for his response. As the real value of wages stagnates and unemployment increases, energy prices are a real problem for people in my constituency, particularly those on low incomes. Dundee Labour party has pledged to negotiate a 20% reduction in energy prices if it is elected to lead the council in May. I ask the Government to take the lead from Dundee Labour party and do everything that they can to reduce energy prices, so that those on low incomes do not have to make the awful choice between eating and heating.
Charles Hendry
I would be more than happy to have a meeting with the people from the hon. Gentleman’s constituency in Dundee to understand more about the scheme that they are putting forward. As he will be aware, last year gas prices were, on average, 30% higher worldwide than the year before and oil prices peaked at their highest ever level in sterling just last week. Global prices have been going up and we therefore need to find new, imaginative ways of helping consumers. Such collective purchasing agreements can be an important way of reassuring people and of ensuring that they get the best deal. I would be delighted to meet those people.
Robert Halfon (Harlow) (Con)
Thank you, Mr Speaker. The Government define fuel poverty as a person spending a tenth of their income on fuel. Motorists in Harlow who are on average earnings spend a tenth of their income on petrol and diesel costs. Does that not mean that motorists on low and average earnings are facing fuel poverty? Will the Government do everything that they can to continue down the path set by the Chancellor in the last Budget, and reduce the cost of petrol and diesel at the pumps?
Charles Hendry
My hon. Friend makes a point that will resonate across the House. Members of Parliament from every constituency, be they urban or rural, are very concerned about this issue. As I said, oil prices peaked at their highest ever levels in sterling last week. We are therefore facing a global issue. My right hon. Friend the Chancellor has been listening actively to what is being expressed on this issue and will make further announcements in the Budget.
Nadhim Zahawi (Stratford-on-Avon) (Con)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Energy and Climate Change (Mr Edward Davey)
This is my first departmental Question Time as Secretary of State for Energy and Climate Change. Since my appointment in February, I have been rather busy, following on from the successes of my predecessor. I have opened the world’s largest offshore wind farm off the coast of Cumbria, launched the energy efficiency deployment office to help the Government deliver their energy efficiency policies, and published reforms to the feed-in tariffs scheme. In addition, the Department of Energy and Climate Change and Ofgem have published a report on cutting the costs of offshore wind connection.
Nadhim Zahawi
I welcome my right hon. Friend. Will he confirm that the Government are committed to exploring the full range of possible renewable technologies —marine, tidal, geothermal and so on—as part of a portfolio approach to a mixed energy economy, which plays to the strengths of this country both economically and environmentally?
Mr Davey
My hon. Friend is right that this country is blessed with huge potential for renewable industries. We can therefore seek a transition to the low-carbon economy, support energy security and build a green economy, which will benefit businesses, create jobs and increase our exports to the world.
Caroline Flint (Don Valley) (Lab)
The Labour Government committed £60 million to supporting manufacturing for offshore wind in this country. In October 2010, the Government promised to continue our scheme. Eighteen months on, when there are reports that manufacturers are holding off on investing in offshore wind in Britain because of uncertainty about Government policy, why has only one grant been awarded and why does 98% of the budget remain unspent?
Mr Davey
The Government are supporting the wind turbine industry in this country. It was under the last Government that a factory closed, the Vestas factory in the Isle of Wight. The right hon. Lady needs to examine our record, which is very strong. We are seeing more and more investment in the industry.
Caroline Flint
I asked a pretty straightforward question. The Government have signed up to a £60 million budget, and so far only one grant has been provided. Why is that the case, and why does 98% of the budget remain unspent?
Twice this week I have asked the Government why they are failing to back British businesses, and twice they have had no answer. After his leaked memo, we now know that even the Business Secretary agrees with me. On Monday, I said:
“We have to do more to develop our supply chain and to support manufacturing in this country”.—[Official Report, 5 March 2012; Vol. 541, c. 597.]
On Tuesday, the Business Secretary said that
“there is as yet little attention given to supply chain issues.”
That is a straight quotation from his memo. Is not the truth that the Government’s mixed messages and failure to get behind British businesses mean that jobs and investment in industries that could come to this country are now going overseas?
Mr Davey
The right hon. Lady is wrong on this point. Many companies from around the world are looking to the UK as the premier place to invest in the offshore wind industry. She is talking down great places such as Hartlepool that want to attract investment in the industry. We are looking at the supply chain, and we have set up the offshore wind developers forum, which has pledged that 50% or more of the work in the supply chain will be in Britain.
Nigel Mills (Amber Valley) (Con)
T5. Will the Secretary of State update the House on measures to support the training of installers, assessors and suppliers of green deal home improvements?
Mr Davey
I am grateful to my hon. Friend for his question, because I have today announced £3.5 million to train green deal assessors, delivering on the Deputy Prime Minister’s announcement last March of the creation of 1,000 green deal apprenticeships. That money will help hundreds of people gear up for the green deal and ensure that the scheme is a real success on the ground. I have also announced today £10 million of innovation funding to improve the energy efficiency of non-domestic buildings.
Paul Flynn (Newport West) (Lab)
T2. Will the Minister congratulate the firm of Mabey Bridge in Chepstow, which was started last year? It has just doubled its work force to 200 and has a full order book for 35 wind power towers. Will he take this opportunity to denounce the doubters on his Back Benches and give a clarion call of support for wind as a job-rich form of energy that is British, eternal and clean?
The Minister of State, Department of Energy and Climate Change (Charles Hendry)
The hon. Gentleman gives a perfect answer to the right hon. Member for Don Valley (Caroline Flint). That is an example of a company investing to take advantage of the opportunities that exist. I was delighted to be able to open the factory extension last year and to meet the company again last week. It is doing a tremendous job, and it is a great British success story.
Chris White (Warwick and Leamington) (Con)
T6. In Warwickshire, we are fortunate to have many people who are seeking to design community-based renewable energy solutions, ranging from solar panels on public buildings to hydroelectric power. In the run-up to the Budget, will the Minister ask the Treasury to consider extending community investment tax relief to matters such as investment in community energy, which delivers both social and economic benefits? That could provide a significant incentive for people to invest in such schemes.
The Minister of State, Department of Energy and Climate Change (Gregory Barker)
I thank my hon. Friend. He, like me, is a great champion of community energy, but I am afraid he is tempting me down the path of forecasting the Budget, which is a somewhat career-limiting move for junior Ministers. I can say, however, that we have established a community energy contact group to discuss those issues, about which he knows I am particularly passionate.
Julie Hilling (Bolton West) (Lab)
T3. Does the Secretary of State support WWF’s earth hour on 31 March, when across the world, everyone will be encouraged to switch off lights for one hour to highlight the issue of climate change? What will he do to promote earth hour?
Elizabeth Truss (South West Norfolk) (Con)
T8. Many of my constituents are concerned about the number of proposals for biomass plants that are springing up in an area of high-value agricultural production. In these times of concern about food security, what steps is the Secretary of State taking to ensure that we do not use high-value crops in such plants?
Mr Davey
The Government will not allow the growth of bio-energy to compromise food security. There are many other feedstocks for bio-energy, including wastes. Crops for energy can be grown in ways that do not compete with food, for example, through using marginal land. We want our farmers to share the economic opportunities offered by bio-energy as well as realising the benefits of clean, secure energy for the country.
Mrs Linda Riordan (Halifax) (Lab/Co-op)
T4. Why will just 3% of families at risk of fuel poverty this year get the help to which they are entitled from the warm home discount scheme?
Gregory Barker
I do not recognise the figure that the hon. Lady gave. The warm home discount scheme is proving a real success, but it is just one in a suite of policies that aim to help the poorest and most vulnerable families. However, if she has new evidence, I would be happy to meet her to discuss it.
Alun Cairns (Vale of Glamorgan) (Con)
T9. The replacement of the levy exemption certificate with the carbon support price will have an adverse effect on industrial combined heat and power plants, which often feed energy-intensive industries such as Dow Corning in my constituency. What action is the Minister taking to overcome that, and will he offer reassurance that CHP plants will not be worse off under the new regime?
Gregory Barker
We are determined to support CHP, which we see as having an important future in our energy mix. As announced in last year’s Budget, the Chancellor will set out how CHP will be treated under the carbon price floor in the Budget this month. That will form part of our wider strategic aim of reducing emissions in industry, which we will explore further through our forthcoming heat strategy.
Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)
T7. I have previously raised in the Chamber the number of people who are on prepayment arrangements and expensive tariffs. The Minister assured me that that would be monitored. May we have an update on how many people have now switched to direct debits?
Gregory Barker
More information is coming in on that all the time. I had a meeting with Ofgem and suppliers recently. I am keen to harvest that information and I am happy to share it with the hon. Lady and the rest of the House as soon as more becomes available.
Miss Anne McIntosh (Thirsk and Malton) (Con)
Where are we with nuclear waste? If nuclear power is essential to deliver low-carbon economies, where is the Department in its programme and level of investment for disposing of spent nuclear fuel?
Charles Hendry
My hon. Friend raises one of the most critical issues at the heart of the nuclear debate. The Government have taken forward significantly the programme for the long-term deep disposal system for our legacy waste in this country. We are trying to advance that programme by at least a decade and discussions are continuing about that. We also recently published the waste arrangements for any new nuclear operators, with which they will have to comply for their plants to go forward.
Mrs Anne McGuire (Stirling) (Lab)
The main source of biomass in the UK is wood, and the renewables obligation is distorting the competitiveness on price. Having had very good meetings with the Minister, I recently met representatives of the industry, who tell me that the issue is now critical. What progress has been made?
Charles Hendry
As my right hon. Friend the Secretary of State said, just as we are determined to ensure that biomass does not compromise food security, we also want to ensure that biomass activities can have other good uses, for example, in wood panelling, furniture and building. There is a very strong industry, particularly in Scotland and the north of England, and we have been pleased to have good engagement with the right hon. Lady and the industry. I want to reassure her that we will continue with that because we want an outcome that benefits all parties.
Mr Dominic Raab (Esher and Walton) (Con)
In response to a freedom of information request, the Department confirmed that seven documents were prepared for the Copenhagen summit that show the cost to the UK of a 30% cut in EU emissions. When he was Energy Secretary, the Leader of the Opposition made the ludicrous claim that disclosure would damage international relations, and he vetoed it. Given the Minister’s personal commitment to a more transparent approach under FOI, will he publish the seven documents so that taxpayers know the costs that they would bear?
Gregory Barker
I will certainly look into the issue that my hon. Friend raises about Copenhagen. If it is possible, I will publish the documents.
Mr Iain Wright (Hartlepool) (Lab)
Will the Secretary of State update the House about the memory stick that was lost in India, which contained plans for Hartlepool nuclear power station? What has been done about the matter?
Charles Hendry
Let me reassure the hon. Gentleman that we have looked into the matter. Any loss of a memory stick is a matter of concern, but we have looked at the information that was contained in it, and it was not critical. Although the loss is inconvenient and irresponsible, it poses no threat to national security.
Mr David Amess (Southend West) (Con)
As the promoter of the Warm Homes and Energy Conservation Act 2000, which tasked the Government with eliminating fuel poverty, I know that my hon. Friend will share my disappointment that the previous Labour Government failed to do that. Now that we have the report, will he act on the Macmillan recommendations about vulnerable cancer patients?
Gregory Barker
My hon. Friend is a huge champion of fuel poverty—[Laughter]—and is absolutely right to be proud of his record in addressing that issue. I should have said that he is a champion of action on fuel poverty. He also is absolutely right to raise concerns about the treatment of vulnerable customers, including those with cancer and other potentially fatal illnesses. I would be happy to meet him to discuss that further.
Dr Alan Whitehead (Southampton, Test) (Lab)
The Secretary of State has today informed us where the headquarters of the Green investment bank will be, but has he also broken the news to Edinburgh that it will host not a bank but a cash-limited fund until at least 2017? Does he intend to go to the Treasury on behalf of Edinburgh to seek permission for the green investment fund to become a bank substantially before that date?
Dr Thérèse Coffey (Suffolk Coastal) (Con)
I was concerned to read the scaremongering in The Guardian today about how nuclear power station sites are at risk of flooding. My understanding is that there has been no cover-up of the Department for Environment, Food and Rural Affairs report on flooding, but we know that the Department of Energy and Climate Change has taken action through the Weightman report to say that coastal defences must be maintained. Does the Minister agree that such scaremongering is not helpful to residents in Suffolk?
Charles Hendry
I can give my hon. Friend an absolute assurance on this. We will not compromise on safety in any respect with regard to new nuclear power stations. That is an integral part of the national policy statements and the planning process. We have the most effective and toughest regulatory system anywhere in the world and one of the most highly regarded international inspectors is leading the process. We will not compromise on safety in those areas.
Barry Gardiner (Brent North) (Lab)
Green economic development will be the central focus of the United Nations conference in Rio in June. Given that, which Ministers will attend? Now that the Brazilian Government have changed the date to 15 June in deference to the Queen’s diamond jubilee, will the Prime Minister himself attend?
Mr Speaker
Just before we move on to the business question, I have to notify the House, in accordance with the Royal Assent Act 1967, that Her Majesty has signified her Royal Assent to the following Acts:
Supply and Appropriation (Anticipation and Adjustments) Act 2012
Live Music Act 2012
Public Services (Social Value) Act 2012
Domestic Violence, Crime and Victims (Amendment) Act 2012
Welfare Reform Act 2012
Consumer Insurance (Disclosure and Representations) Act 2012
Bank of Ireland (UK) plc Act 2012.
Business of the House
(12 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Ms Angela Eagle (Wallasey) (Lab)
Will the Leader of the House please give us the business for next week?
The Leader of the House of Commons (Sir George Young)
The business for the week commencing 12 March will be:
Monday 12 March—Motions relating to the Backbench Business Committee, a Committee on Standards and a Committee of Privileges, the code of conduct, all-party groups and scrutiny of certain draft orders.
Tuesday 13 March—Opposition day (un-allotted day) (half day). There will be a debate on a motion relating to the Health and Social Care Bill. This debate will arise on an Opposition motion. Followed by consideration of opposed private business nominated by the Chairman of Ways and Means.
Wednesday 14 March—Consideration in Committee and remaining stages of the Water Industry (Financial Assistance) Bill.
Thursday 15 March—Motion relating to the introduction of charging for Big Ben Clock Tower tours followed by a motion relating to reform of the common fisheries policy. The subject for these debates has been nominated by the Backbench Business Committee.
The provisional business for the week commencing 19 March will include:
Monday 19 March—Consideration of Lords amendments followed by a debate on a motion relating to the waste water national policy statement.
Tuesday 20 March—Consideration of Lords amendments.
Wednesday 21 March—My right hon. Friend the Chancellor of the Exchequer will open his Budget statement.
Thursday 22 March—Continuation of the Budget debate.
Friday 23 March—Continuation of the Budget debate.
The provisional business for the week commencing 26 March will include:
Monday 26 March—Conclusion of the Budget debate.
Tuesday 27 March—Motion relating to assisting dying. The subject for this debate has been nominated by the Backbench Business Committee.
I should also like to inform the House that the business in Westminster Hall for 22 March 2012 will be:
Thursday 22 March—Debate on services for young people.
Ms Eagle
This week, the chair of the Committee on Standards in Public Life criticised the Prime Minister’s failure to ask the independent adviser on ministers’ interests to investigate allegations made against the right hon. Member for North Somerset (Dr Fox), the then Defence Secretary—a course of action that the Opposition urged him to take at the time. Does the Leader of the House agree that since the office was established it has become clear that it would be far simpler and more transparent if the independent adviser could initiate an investigation? Will the Leader of the House find time for an urgent debate on the ministerial code so that we can determine what Parliament should do when the Prime Minister himself breaks the ministerial code?
The Institute for Fiscal Studies states that the Government’s proposals to cut child benefit are “fundamentally unfair”. For some families a pay rise will actually result in a significant cut in household income. Is this the Prime Minister’s definition of fairness? This is a mess entirely of the Government’s own making. They rushed out a press release for cheap headlines ahead of the Tory party conference without bothering to look at the detail, and it is hard-working families who will pay the price. This week, the Opposition forced a parliamentary debate, but we did not get an answer from Treasury Ministers, so will the Government now find time for a debate on what on earth they mean by “fairness”?
That would give them the opportunity to explain why, from April, they are penalising almost 500,000 children with draconian cuts to child tax credits. At the moment, because of tax credits, a couple where one parent works and the other looks after the children are £59 a week better off. It pays to work. From April, they will be £14 a week better off on the dole—this despite the Government’s claims that they want to make work pay. Will the Leader of the House explain how that is fair?
May I wish everyone a happy international women’s day and welcome the debate later today, for which I thank my hon. Friend the Member for North East Derbyshire (Natascha Engel)? Does the Leader of the House agree that the Justice Secretary should clear his diary to attend it? The Legal Aid, Sentencing and Punishment of Offenders Bill will halve the number of women entitled to legal aid in domestic violence cases. The Opposition have set out proposals to reduce the legal aid bill without penalising the most vulnerable. Will the Leader of the House explain how the Government’s proposals are fair?
One person who does not think it fair is the junior Education Minister, the hon. Member for Brent Central (Sarah Teather), who spends her day voting for Government cuts and then goes delivering leaflets in the evening asking, “Who can you trust to stop the cuts?” The answer is clearly not the Liberal Democrats. Will the Leader of the House arrange for an urgent debate on Government communications to the electorate to enable her to explain herself?
A letter from the Business Secretary to the Prime Minister this week mysteriously found its way into the public domain. The Business Secretary thinks that the Government lack a “compelling vision”. Middle-income families are being hit by cuts to child benefit. Hard-working families are being penalised by child tax cuts. Women are being shut out of the legal system. The Business Secretary is right. That is not a compelling vision for Britain. Is it any wonder that the Prime Minister’s guru, Steve Hilton, the man who authored the statement,
“Let sunshine win the day”,
has fled to California in search of it?
This week the Prime Minister’s top aide leaves the country; last week the Deputy Prime Minister’s chief economic adviser resigned to go travelling the world. Can the Leader of the House therefore find time for a debate on why so many senior Government advisers are fleeing the country?
The Business Secretary said he thought his letter was “helpful”, and I suppose it was—in the sense that it was helpful for the Business Secretary’s party profile ahead of the Liberal Democrat spring conference. May I also be helpful to the Leader of the House? He knows I always try to be. Every time I have raised the Health and Social Care Bill, he has cited parts of it that he thinks have merit. Is he not concerned that doctors, nurses, royal colleges, public health organisations, patients, GP groups and now even the Cabinet Secretary think the Bill should be dropped? Instead of proceeding with this disastrous Bill, here is a helpful suggestion: just drop it and start again.
Sir George Young
Let me start with the ministerial code, which sets out that if there is an alleged breach, the Cabinet Secretary can make some initial investigations. That is exactly what happened in this case. As a result of those initial investigations, the facts were put into the public domain, my right hon. Friend the Member for North Somerset (Dr Fox) resigned and there was therefore no need to refer the matter to the independent adviser—something that, I note in passing, the previous Prime Minister did only once. The shadow Leader of the House will also know that the Public Administration Committee is currently holding an inquiry into the ministerial code. We await the outcome of that inquiry with interest.
On the issue of child benefit, we debated it on Monday —we had a half-day Opposition day—and it featured regularly in the exchanges at Treasury questions on Tuesday. Our view is quite clear: it is not fair that somebody on £20,000 a year should pay, through their tax, for the child benefit of someone who might be earning five times as much. That is the view that we put forward in that debate, and we are very clear that those who are better off should make a contribution to paying down the financial deficit. The same issue was also raised in relation to child tax credit in the debate on Monday, and again at Treasury questions, and we made our position quite clear. To put it in the broader context of universal credit, even couples working 16 hours a week will be some £36 a week better off when universal credit is introduced next year.
On international women’s day, the hon. Lady may have seen that we have announced a new offence of stalking—an amendment has been tabled to the Protection of Freedoms Bill. On Monday we had a written ministerial statement about domestic violence disclosure—the so-called Clare’s law. We will take no lectures from Labour Members about women. They did nothing about the glass ceiling or the differential. I welcome the debate that is about to take place on international women’s day.
On legal aid, the hon. Lady will know that the Legal Aid, Sentencing and Punishment of Offenders Bill is in another place. Legal aid in this country, at some £39 a head, is way above what is spent in France or Spain, at some £5 a head. The Labour party consulted on reducing legal aid, but never got round to doing it. However, we are protecting the most vulnerable members of society in the legal aid scheme.
On the letter from my right hon. Friend the Secretary of State for Business, Innovation and Skills, I am not sure whether the BBC has changed its definition of “breaking news”, but this was, in fact, originally reported several weeks ago in a newspaper. However, I think the whole country was much more interested in the news on Tuesday that Nissan was bringing an additional 2,000 jobs to the north-east—a clear vindication of the Government’s decision to put support for manufacturing at the heart of our economic strategy.
I am responsible for many things; I am not responsible for leaflets that get distributed in the London borough of Brent. However, it is certainly the case that had the Labour party been re-elected at the last election, it would have had to make some cuts. Labour would not have been able to maintain the investment in, for example, the numbers of police on the front line.
So far as Steve Hilton is concerned, yes, he is going; but the good news is that he is coming back. Also, he is not leaving next week, and I pay tribute to the number of creative new ideas that he has injected into the first two years of the coalition Government.
Finally, on a serious note, the whole House will want to honour the memory of two previous Leaders of the House, Robert Carr and Norman St John-Stevas, who died recently. They were not only effective politicians of their day, but fine parliamentarians who left an enduring mark on this place, and the resurgence that the House is currently enjoying, both in the Chamber and on the Committee corridor, would not have been possible without the changes that they put in place all those years before.
Mr Speaker
Order. A very large number of colleagues, as usual, are seeking to catch my eye, but I remind the House that there is a statement to follow and important business, significantly subscribed, thereafter, which means that there is a premium upon brevity. We will be led in that important mission of brevity by Karen Bradley.
Karen Bradley (Staffordshire Moorlands) (Con)
Last week I was honoured to join Falco UK, a manufacturing business based in Staffordshire Moorlands, in celebrating 20 years of existence and in looking forward to a further 20 years-plus. It is a great proponent of apprenticeships and training, so will the Leader of the House find time for a debate about small manufacturing businesses and their contribution to apprenticeships?
Sir George Young
I understand that in my constituency the firm makes bicycle racks, in which I have a professional interest, and I applaud not only what it does in making bicycle racks but, as importantly, what it is doing for apprenticeships. There are more than 400,000 apprenticeships this year, and as I have said before we all have a role to play in encouraging employers in our constituencies to do exactly what my hon. Friend is doing in hers, and in encouraging young people who are currently unemployed to take up the apprenticeships that become available, financed in part by the Government.
Natascha Engel (North East Derbyshire) (Lab)
The Leader of the House has announced a debate on Monday about the operation of the Backbench Business Committee, motions for which were placed on the Order Paper on Tuesday night. He will be aware that today is the closing date in a call for evidence by the Procedure Committee, which is also reviewing the Backbench Business Committee’s operation. The Backbench Committee itself is producing a report imminently on its operations over the past year and a half, so why have the Government chosen to hold a debate now about its operation, rather than waiting so that the House might be much better informed and come to its conclusions just a little later?
Sir George Young
I very much welcome the review of the Backbench Business Committee, which is being undertaken by the Procedure Committee, and of course we will want to respond to its report in due course. The answer to the question that the hon. Lady poses, “Why are we debating the matter on Monday rather than waiting for the report?”, is set out in the Procedure Committee’s Ninth report of Session 2010/12. It made several recommendations for changes to the Backbench Business Committee, and the Government in their response said:
“The Government propose to allow time for consideration of proposals to this effect towards the end of the current Session.”
In other words, if Members want to make changes to take effect at the beginning of the next Session, they cannot wait for the report of the Procedure Committee, because that will come too late. That is why we are putting the motions before the House on Monday. It will be for the House to decide what to do with them, but if we want to make changes, we are going to have to do so quite soon; we cannot wait for the Procedure Committee’s report.
Mr Edward Timpson (Crewe and Nantwich) (Con)
Will my right hon. Friend find time for a debate about this week’s announcement of £330 million in efficiency savings, which the Government are now able to spend in the NHS on new units and equipment, including at Crewe’s Leighton hospital, whose bid, which I was pleased to support, successfully secured £25.2 million for new operating theatres, an intensive care unit, a labour suite and a CT scanner, much to the delight of clinical staff?
Sir George Young
I am grateful to my hon. Friend, who I understand spent four days working in the hospital and gives the bid his personal support. That is a good example of how one can reinvest savings in front-line services, and by reinvesting the money that we have saved we are able to put more than £330 million into projects that will help more than 2.5 million patients per year. My hon. Friend has given a very good example of how that assistance is feeding through.
Sir Alan Meale (Mansfield) (Lab)
I am sure that the Leader of the House will join me in paying tribute to our brave fallen, who have died over the past couple of days in Afghanistan, but at the same time I am sure that he is appalled by the actions in Benghazi, with the wanton destruction of many of the war graves in our cemeteries. Will he have a word with his colleagues at the Foreign and Commonwealth Office to ensure that the strongest representations are made to the Libyan Government, and will he in the near future find time for a debate about that most important work?
Sir George Young
The hon. Gentleman has drawn attention to a very serious matter. It is important that the damage is repaired immediately, and I pay tribute to the work of the Commonwealth War Graves Commission. Representations have been made to the Libyan Government expressing our dismay at what has happened and urging them to take every step to prevent any recurrence. I cannot promise an early debate, but it might be an appropriate subject for a debate on the Adjournment commending the work that is done by the commission.
James Morris (Halesowen and Rowley Regis) (Con)
Many small manufacturers in my constituency are in the good position of running at full capacity to fulfil their order books. May we have a debate in Government time on what the Government are doing to provide such businesses with credit in order for them to continue to expand, export and grow?
Sir George Young
I commend the work that is going on in my hon. Friend’s constituency and the full order books that he mentioned. There will be an opportunity after the Budget statement to debate the assistance that we are giving to manufacturing that flows from the advanced manufacturing growth review that was published a year ago. There will also be an opportunity to debate the issue of credit available through the banks, perhaps against the background of the national loans guarantee scheme that is shortly to come into effect, making £20 billion available to the banks for onward lending at preferential rates of interest to businesses such as those in my hon. Friend’s constituency.
Sir Gerald Kaufman (Manchester, Gorton) (Lab)
Has the right hon. Gentleman seen early-day motion 2826, which stands in my name?
[That this House condemns New Look Windows of Manchester for taking money from clients to carry out work on their property, for botching the job in a way that makes matters worse than they were before, including creating a fire hazard and for keeping their hands on the money they were paid in advance for their work; and warns potential customers to have nothing to do with this dodgy firm.]
The EDM exposes the swindling activities of New Look Windows, a company in Manchester which, when engaged by a constituent to repair his windows, not only made a mess of it but created a fire hazard where none existed before and has kept the money that it demanded be paid in advance. Will the Leader of the House condemn this disgraceful behaviour and refer it to the appropriate Minister for action?
Sir George Young
I have now seen early-day motion 2826 on New Look Windows. I understand the concern that the right hon. Gentleman has expressed, as has a fellow Manchester Member. I will draw the issue to the attention of my right hon. Friend the Secretary of State for Business, Enterprise and Skills. The trading standards officer at the local authority might also take an interest in the matter to see whether any appropriate action could be taken at that level.
Andrew Jones (Harrogate and Knaresborough) (Con)
May we have a debate about the impact of the Schmallenberg virus and the way that it is hitting farming incomes? The virus is affecting sheep, and in the current lambing season a proportion of lambs are being stillborn or born deformed. This is very relevant in my constituency and right across north Yorkshire, as we have many hill farms, and while the virus is currently only in the south of England, it is spreading very rapidly.
Sir George Young
I understand the concern expressed by my hon. Friend, which may be shared by other Members with farming constituencies. The matter was raised during the exchanges with Department for Environment, Food and Rural Affairs Ministers a week ago. All the evidence suggests that the disease was brought into the UK from infected midges blown across the Channel; we have seen no evidence that it came from imported livestock. We are closely tracking the disease and will continue to work with partners across Europe and the UK to develop our knowledge of it.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Yesterday the whole House was shocked and stunned to hear of the death of six soldiers—young men—in Afghanistan. We are particularly hard hit in Yorkshire, where five of those young men came from; three were from my own constituency of Huddersfield. Is it time for us to have a serious, thoughtful debate about what is going on in Afghanistan? The House will know that I am not one to say that we should cut and run, because those young men gave their lives for a great cause, but it is time for mature reflection at this stage.
Sir George Young
I understand the sentiments expressed by the hon. Gentleman, which I know are shared in all parts of the House. Today the Foreign Secretary is giving evidence before a Select Committee, and I have no doubt that he will be cross-questioned on these issues. There will also be an opportunity to raise them during the regular quarterly statements on Afghanistan by the Foreign Secretary or the Secretary of State for Defence. There may be an opportunity for a more general debate on foreign affairs if the Backbench Business Committee can find time for one.
Mr Marcus Jones (Nuneaton) (Con)
This week we have seen the fantastic news that Nissan is creating 2,000 jobs in the north-east and that Jaguar will be building the new XF Sportbrake in the west midlands. Both those companies have had support from the Government’s regional growth fund. May we have a debate on the effectiveness of the regional growth fund?
Sir George Young
I am grateful to my hon. Friend, because Labour Members have made some derogatory remarks about the effectiveness of the regional growth fund, but we have just heard at first hand from him about its benefits, with the extra jobs that it is creating in his constituency and the assistance that it is giving to the motor manufacturing industry, which is now a major manufacturing export industry and part of our strategy of rebalancing the economy so that we are less dependent on financial services.
Mr Nigel Dodds (Belfast North) (DUP)
The tragic news from Afghanistan that we heard yesterday highlights the need for continuing support to the families of servicemen and servicewomen, who do such a tremendous job on behalf of our country. May we soon have a debate about the military covenant and what support is being given to servicemen and women and their families throughout all parts of the United Kingdom, because, as the Leader of the House will know, in some devolved regions the level of support differs from what happens in England?
Sir George Young
I understand the right hon. Gentleman’s concern. He will know that we have now enshrined in statute an obligation to report annually on the military covenant, and it would be appropriate to include the issues that he raises in that review. I will see whether it is possible to have a debate on the military covenant, given that we have to review it every year, and see whether we can reflect on the regional disparities.
Geoffrey Clifton-Brown (The Cotswolds) (Con)
While I would defend to the hilt anybody’s right to peaceful protest, a permanent encampment is a different matter altogether. The City authorities have now cleared the Occupy London site around St Paul’s, and the sites around Parliament square have largely been cleared. Today it looks fantastic as it is being prepared with flagpoles, but one or two eyesores remain on the pavements, which are the responsibility of Westminster City council. Will my right hon. Friend join me in urging the council to make sure that they are cleared as soon as possible?
Mr Speaker
I am sure that the hon. Gentleman is looking for either a statement or a debate on the matter.
Sir George Young
Following the passage of the legislation that we introduced last year, Westminster City council took action to remove the encampments. I think that there is an injunction that protects one residual encampment and that the case is being heard later this month. If the council is successful, as it hopes to be, that remaining encampment will be removed, and then we can begin to restore Parliament square to the glory that many of us remember—a place that can be enjoyed by tourists and visitors—and remove some of the problems that Members and staff have encountered with the noise that used to emanate from the site, which I hope that we have now dealt with.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
My 10-year-old constituent Joseph Duffy has cerebral palsy, epilepsy and learning difficulties. He was recently reassessed for disability living allowance, which he has received from the age of two. On Tuesday, his parents were informed that as a result of that reassessment he will lose his higher-rate mobility and higher-rate care components and instead receive nothing. The Motability car that the family depend on will be taken away at the end of the month. May we please have an urgent debate on the way in which benefit reassessments are being carried out when they lead to shockingly bad decisions such as this one?
Sir George Young
Of course I understand the distress of Joseph Duffy’s family. We have not changed the rules concerning DLA, and there is an opportunity for the hon. Lady’s constituents to appeal against the assessment if they believe that it is unfair. We have asked for an independent assessment of the work capability assessments, and we are implementing the recommendations of that independent review as they come forward. The answer to the hon. Lady is that if she believes that an injustice has been done, there is an opportunity to appeal against it.
Julian Smith (Skipton and Ripon) (Con)
May we have a debate about the defiance of the Highways Agency in opposing a decision by the excellent roads Minister, my hon. Friend the Member for Hemel Hempstead (Mike Penning), to reinstate two brown signs on the A1 upgrade at Masham? The agency is quoting a cost of tens of thousands of pounds for those brown signs, which clearly the community and businesses in the local area cannot afford.
Sir George Young
I will make some inquiries of the Secretary of State for Transport. We all know that many sites in our constituencies depend on brown signs to generate traffic, and that when those signs are removed or damaged, that has an impact on the destinations concerned. I will pursue the matter with my right hon. Friend to see whether it is indeed the case that the Highways Agency is defying something that it should not be defying and to see whether we can get these brown signs restored.
Jim Sheridan (Paisley and Renfrewshire North) (Lab)
Can we have a debate on the merits of bonus payments to public sector workers? The Mayor of London has agreed bonus payments for London tube drivers working during the Olympics, but he has failed to agree similar terms for other public sector and, indeed, emergency workers. Given that the Government have overall control of taxpayers’ money, how does that unfairness fit into their fairness agenda?
Sir George Young
That sounds to me like a matter for the Mayor of London. We believe in devolving decision making, and it is a matter for the Lord Mayor to decide how he distributes bonuses to the staff for whom he is responsible—
Sir George Young
The Mayor. The Mayor of London; I am sorry. The Government believe that there is a role for bonuses in the public sector in order to reward performance, but that they should be on an acceptable scale. I am sure that the Mayor of London—Boris, who I hope will be re-elected—will be tuned into this exchange and that he will respond to the hon. Gentleman’s concern in due course.
Iain Stewart (Milton Keynes South) (Con)
May I make an early request for a debate to mark the centenary of the birth of Alan Turing, the celebrated Bletchley Park code-breaker and pioneer of modern computing, in order to celebrate his achievements and to consider whether it would be appropriate to grant him a pardon for the so-called crime of which he was convicted?
Sir George Young
We all applaud the work that Alan Turing did at Bletchley Park in my hon. Friend’s constituency during the war. I think I am right in saying that my hon. Friend also paid tribute to Alan Turing in his maiden speech and referred to an apology that had been made by the previous Government for what had happened to him. I understand that an application for a royal prerogative of mercy was made on the basis that the offence should not have existed but, sadly, one cannot give a royal prerogative on those grounds. I will have another look at this, but I am not sure that there is a case for intervention by my right hon. and learned Friend the Secretary of State for Justice. That could happen only if fresh evidence came to light to show that the conviction should not have taken place. The argument that the offence should not have existed in the first place is not normally a ground for prerogative.
Bill Esterson (Sefton Central) (Lab)
Developers in my constituency are queuing up to build on green-belt land and on urban green spaces, encouraged by the Government’s new planning framework and supported by Tory and Lib Dem councillors as recently as in yesterday’s planning committee meeting. My constituents want to know whether they have any chance of defending themselves against such developments. Please may we have a debate on the Government’s planning reforms, to discuss the changes that they have made following the consultation?
Sir George Young
There is a specific protection in the national planning policy framework for the green belt, so I am not quite sure where the hon. Gentleman is coming from. We will be making a statement on this matter in due course, and announcing our conclusions after the consultation exercise on the NPPF.
Brandon Lewis (Great Yarmouth) (Con)
The New Anglia enterprise zone is set to open in the next few weeks, and it aims to create 2,000 new jobs by 2015, growing to almost 15,000 in its lifetime. This is a clear example of a Government policy that is creating real new jobs in the private sector. May we have a debate to highlight the opportunities that will be created by the enterprise zones across the country?
Sir George Young
I hope that my hon. Friend will have an opportunity in the debate on the Budget to draw attention to the benefits of enterprise zones. We announced some 24 enterprise zones with the specific objective of generating employment in the areas that needed it, and I am delighted to hear of the impact of the EZ in his constituency, and of the extra jobs being created. I hope that many more will be created on the back of the ones already in existence.
John Healey (Wentworth and Dearne) (Lab)
The Leader of the House will be aware that the Information Tribunal meets today to consider its decision on the Government’s appeal against releasing the risk register for their huge NHS upheaval, which I requested back in November 2010. Will he confirm that, if the Government lose, they will respect the law and release the register? Will he also confirm that the House will not be asked to consider Lords amendments to the Health and Social Care Bill without the benefit of that important information?
Sir George Young
I cannot give the right hon. Gentleman an undertaking on that last point, because I do not know when the tribunal will deliver its ruling. The Bill is scheduled to have its Third Reading in another place on, I think, 19 March, and we would then hope to deal with it here, so I cannot give him that particular undertaking. I hope that he will understand, however, that it is important for Ministers to be able to consider policy options, and to get frank advice from civil servants on their impact, without those options going into the public domain. We need sufficient space to develop our thinking and our policy options, which is why the Government opposed the right hon. Gentleman’s application. We will have to wait and see what the tribunal ruling comes up with.
Mr Peter Bone (Wellingborough) (Con)
Further to what the excellent Chair of the Backbench Business Committee, the hon. Member for North East Derbyshire (Natascha Engel) said earlier, all Members of the House have received an e-mail from the Procedure Committee asking them to submit their comments on the reform of the Backbench Business Committee by today. However, the very issues that we have been asked to comment on are those in the motion that the Government have tabled for debate on Monday. This is going back to the bad old days of the Executive overruling Select Committees. Whatever wishy-washy answer I get, this is not acceptable. Will the Leader of the House agree not to bring forward that motion on Monday?
Sir George Young
I am not sure that there is any point in my rising and coming to the Dispatch Box, as my hon. Friend has already discounted my reply. I must point out to him that, on 8 February, I made it absolutely clear that
“the Government believe that it would be appropriate for the House to address the anomaly whereby members of the Backbench Business Committee other than the Chair…are elected by the House as a whole rather than by Members of the political party to which they belong before the next elections of members. The Government propose to allow time for consideration of proposals to this effect towards the end of the current Session.”
That is exactly what we are doing. It will then be a matter for the House to decide, in the light of the debate on Monday, whether it wishes to adopt the proposal on the Order Paper. I note that my hon. Friend has tabled an amendment to the motion indicating a contrary view.
Chris Bryant
I do not know what the Leader of the House knows about the contents of the Budget that lead him to believe that we shall need a debate on assisted dying the next day. May I ask him about the Backbench Business Committee debates that we have had in which the Government have let motions go through, because they knew that they would lose a vote on them, but have then gone on to do absolutely nothing about them? So far, we have had five, including one on prisoners’ voting rights, one on circus animals and, last night, one on the death of Sergei Magnitsky. Is there a means whereby the House can ensure that, when it has agreed a motion, the Government must follow up on it?
Sir George Young
The Minister of State, Department for Environment, Food and Rural Affairs, my right hon. Friend the Member for South East Cambridgeshire (Mr Paice) released a statement on circus animals last week, making it clear how we were responding to the vote in the House last year. The hon. Gentleman will have seen what the Under-Secretary of State for Foreign and Commonwealth Affairs, my hon. Friend the Member for North East Bedfordshire (Alistair Burt) said on behalf of the Government at the Dispatch Box in response to the motion on Sergei Magnitsky last night. It is of course always open to the Backbench Business Committee, if it feels that the action has not been substantive enough, to re-table a motion with another vote. In response to what the hon. Gentleman said at the beginning of his question, I must point out that it was not the Government’s decision to debate assisted dying on the last day, but it is a serious subject on which many Members will welcome a debate.
Charlie Elphicke (Dover) (Con)
May we have a debate on business investment in the UK? Last week, I visited Megger, a high-tech manufacturing and export powerhouse in Dover that makes diagnostic testing instruments. I saw at first hand the massive investment that it has put into its manufacturing process, and it struck me that we could create more jobs, more productivity and more economic success by further boosting business investment in the UK.
Sir George Young
I am delighted to hear of the success of the firm in my hon. Friend’s constituency. Medical technology is an area in which we have a competitive advantage and in which we are making progress in the export market. I hope that it will be possible to have further debates, on the back of the Budget statement, on exports and on the steps that the Government are taking to enable such firms to flourish and create more jobs.
Ian Murray (Edinburgh South) (Lab)
My constituent Mrs Abdulgader’s three children were abducted in Libya by their estranged father during the uprising there. She has all the legal documentation necessary to have them returned, but the Foreign Office says that there are no consular personnel on the ground and that the legal institutions in Libya have yet to be re-established. May we have a statement in the House on what the UK Government are doing to support those Libyan institutions, so that Mrs Abdulgader’s children can be returned to Edinburgh?
Sir George Young
I am very sorry to hear that the hon. Gentleman’s constituent’s children have been abducted; I know what a serious issue that is. I will make inquiries in the Foreign and Commonwealth Office to see what representations we are able to make to the Libyan Administration, and what powers are available to them to track down the children and bring them back to this country. I will ask the appropriate Minister in the FCO to contact the hon. Gentleman.
Henry Smith (Crawley) (Con)
Earlier this week, I met US Treasury officials in Washington who share my concern that the SWIFT—Society for the Worldwide Interbank Financial Telecommunication—financial transaction system is still being used by Iranian banks, despite sanctions. May we have a debate on the effective use of the SWIFT system so that we can ensure that countries such as Iran which promote terror are not able to operate under it?
Sir George Young
It is important that the financial sanctions agreed against Iran are not undermined or subverted in any way. I will ask my right hon. Friends at the Treasury to take up my hon. Friend’s point and see whether there is any action we can take to ensure that the appropriate UN resolutions are enforced.
Mr Gerry Sutcliffe (Bradford South) (Lab)
May we have a debate on the definition of Britishness? The Leader of the House may be aware of a Channel 4 documentary with the inflammatory title “Make Bradford British”. It did not succeed in the way the programme makers wanted the programme to move forward. It would be interesting to have a debate on this topic, perhaps accompanied by a survey of Members beforehand, to find out whether any of us would pass the current citizenship test.
Sir George Young
A test brought in by Labour Members, I might add. I would welcome such a debate on Britishness. I cannot promise Government time for it, but given that a writ was moved in Bradford yesterday for a by-election, I am sure that there will be adequate opportunities during the campaign to debate those sorts of issues. Indeed, that campaign might have started a few minutes ago.
Chris Skidmore (Kingswood) (Con)
The South Gloucestershire Labour group claimed to be in favour of a council tax freeze, but when it came to the vote, it behaved in exactly the opposite way and voted it down. It claimed to be in favour of protecting the Kingswood green belt, but when it came to the vote, it failed to back it, potentially causing uncertainty and havoc within the local core strategy. This is not only irresponsible; it is misleading to the public. At a time when we want to empower local communities, may we have a debate on the accountability and responsibility of local councillors to the public?
Sir George Young
The local councillors in my hon. Friend’s constituency are accountable to the electorate, which I am sure will have taken note of the points he has made. Let me say in passing that local councillors are subject to the Nolan principles of high standards in public life, and if they do not live up to those high standards, they should expect appropriate sanctions through the ballot box.
Kevin Brennan (Cardiff West) (Lab)
Now that the Information Commissioner has reported, may we have a statement from the Education Secretary on the private e-mails he sent, using his alter ego of “Mrs Blurt”, to two advisers in his Department, discussing Government business and trying to avoid the Freedom of Information Act? The Prime Minister said that sunshine is the best disinfectant; when are the Government going to start acting that way?
Sir George Young
The hon. Gentleman might have seen the statement put out by the Department for Education at the weekend, cleared by the permanent secretary, which said that special advisers were not required to maintain records of deleted e-mails. All civil servants routinely delete or archive e-mails, taking account of their nature and content. I am not surprised that that is what happened in this particular case. On the broader issue, the Cabinet Office will issue advice shortly in the light of what the Information Commissioner announced in December.
Alun Cairns (Vale of Glamorgan) (Con)
The European Parliament has called for lower mobile data roaming charges—shortly to be discussed at the European Council. Will the Leader of the House arrange for a statement in the Chamber by the relevant Minister so that we can understand the Government’s latest position on this issue?
Sir George Young
My hon. Friend has made such a statement redundant, as he has been successful in securing a debate on Wednesday 14 March in Westminster Hall, to which the Government will respond. He will know that we have the interests of consumers and competition uppermost in our mind in the negotiations. We have two basic principles: that wholesale price caps should not be set below cost, and that there should be a sufficient margin between wholesale and retail price caps to enable competition. I look forward to my hon. Friend’s debate.
Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)
May we have a debate on the Government’s e-petitions system—an excellent initiative aimed at keeping the Government in touch with the British public? The Leader of the House will know that the e-petition “Drop the Health Bill”, which was organised by my constituent Dr Kailash Chand OBE, has not resulted in the debate that he wanted, despite its now reaching 171,000 signatures. I know that the right hon. Gentleman will refer me to the Backbench Business Committee, but the Prime Minister promised debates on these things, and this is another promise broken. What people want to know is this: what is the point of having this system if the Government will not listen to the British public?
Sir George Young
I do not think anyone could say that we have not had adequate debate on the Health and Social Care Bill in recent weeks, and there will of course be a further opportunity when we consider Lords amendments to it. As the hon. Gentleman implied, this is for the Backbench Business Committee, and I quite understand why it took the view that the matter had already been debated adequately, and therefore chose other subjects. On this particular occasion, I am happy to endorse the decision of the Backbench Business Committee.
Priti Patel (Witham) (Con)
From early April, owners of pleasure boats using red diesel, including those along the beautiful Essex coastline, will no longer be able to take their vessels outside UK waters owing to a new diktat from Europe. May we have a debate about the considerable practical and economic difficulties that these boat owners will face, so that we can listen to their concerns rather than simply comply with more regulation from Europe?
Sir George Young
This is a complex issue. My understanding is that the use of red diesel with full duty paid to propel pleasure craft is a UK procedure permitted within UK waters, and that it is not illegal to use red diesel outside UK waters. However, if a pleasure craft with red diesel is used outside UK waters, its owners need to be aware that it will be subject to national legislation, including any restrictions or prohibitions of the member state in whose territorial waters it is being used. That is perhaps an incentive to stay within UK territorial waters.
David Wright (Telford) (Lab)
Thousands of jobs in Telford are linked to Government IT contracts, notably that of Her Majesty’s Revenue and Customs. May we have a statement—oral or written—on the future structure of contracts for IT support services for HMRC and other Departments?
Sir George Young
I believe that this matter falls to my right hon. Friend the Minister for the Cabinet Office and Paymaster General, who is in charge of IT procurement contracts, for which we are seeking to get better value for money. Cabinet Office Ministers will be at the Dispatch Box on Wednesday 21 March, when there will be an opportunity for the hon. Gentleman to pursue this matter in greater detail.
Mr David Amess (Southend West) (Con)
May we have a debate on why there is no Easter Adjournment debate? I had thought that these debates were set in stone, and I really think that the Easter break of three weeks, during which time we will be unable to raise important constituency matters on the Floor of the House, is unacceptable.
Sir George Young
The concept of having a debate on why there is no debate is a novel one. I know that my hon. Friend is a regular participant in the pre-recess Adjournment debates, but the Government have made the last day before the Easter recess available to the Backbench Business Committee, which weighed the option of using it in the traditional way that my hon. Friend prefers against the alternative of providing time for a debate on assisted dying. The Backbench Business Committee has done what it is perfectly entitled to do, and decided to have a debate not on pre-recess issues, but on assisted dying. That is a matter for the Backbench Business Committee—a consequence of the Government’s giving away powers to it, enfranchising the Back Benchers.
Paul Flynn (Newport West) (Lab)
The main justification given yesterday by Ministers for our continuing presence in Afghanistan was that it protected the United Kingdom against Taliban terrorist attacks. May we have a debate in which the Government can present to the House and the nation their evidence of Taliban plans for terrorist attacks on the United Kingdom, so that we can ensure that the country knows that there is some good reason for our continuing presence in Afghanistan rather than its being for the convenience of politicians? Our brave troops should not remain in Afghanistan for a day longer than necessary.
Sir George Young
Afghanistan was a failed state in which al-Qaeda was allowed to flourish and launch deadly attacks against citizens of other countries, including this one. We have an interest in ensuring that Afghanistan is no longer a failed state, but one that can police and look after itself. That is why we are there. There are many opportunities to cross-examine Ministers on this subject. As I said a few moments ago, my right hon. Friend the Foreign Secretary is before the Foreign Affairs Select Committee as we speak.
Mr Andrew Turner (Isle of Wight) (Con)
Will the Leader of the House make time for a debate on the wholly inadequate way in which the Boundary Commission has published responses to the public consultation this week? More than 5,000 responses for the south-east region are included, but there is no way for people to be able to identify which of them are about, for instance, the Isle of Wight rather than somewhere else. Can we do something about that?
Sir George Young
As an MP in the same region, I understand the issue my hon. Friend raises, but the Boundary Commission for England is independent of the Government, so we cannot order it to do anything. My understanding is that there would have been some difficulties in doing what my hon. Friend wants, as linking proposals in the way suggested might have prejudiced the second round of consultation. That is why the information was presented in the way that it was.
Anas Sarwar (Glasgow Central) (Lab)
I am sure the entire House will wish to join me in sending our deepest sympathies to the families of the fallen heroes in Afghanistan of the past few days. I am sure everyone will also wish to join me in utterly condemning the comments of a Scottish political activist who said yesterday that our fallen heroes deserved no sympathy as they are a “bunch of child killers” and that the majority of our servicemen and women are “racist, arrogant, undereducated thugs” who joined the armed forces for the “thrill” of killing human beings. That demonstrates the ugly side of nationalist politics in Scotland. Please may we have an urgent debate on online abuse and hatred? No matter what views we may have about individual interventions overseas, what should never be questioned is the bravery, compassion and heroic service of our young men and women, many of whom, sadly, give the ultimate sacrifice for love of our country.
Sir George Young
The whole House will join the hon. Gentleman in unequivocally condemning those insensitive remarks. They are wholly inappropriate. I do not think we need a debate in the House, as I think the whole House agrees that those comments should never have been made.
Mark Pawsey (Rugby) (Con)
I know that the Leader of the House pays close attention to the regional breweries represented in Strangers Bar—as, indeed, do you, Mr Speaker. I am therefore sure that it will not have escaped his attention that, in the middle of an exciting six nations rugby union tournament, the current offer is Webb Ellis bitter, produced by the Wood Farm brewery in my constituency, all of whose beers bear a connection to the game which has its birthplace in my constituency. May we have a debate on the role of breweries in establishing regional identities?
Sir George Young
I approach this matter with some caution, as the last time beers were raised at business questions, that got more coverage than any subject I have discussed in two years and resulted in the removal of a beer from the Strangers Bar. I understand that subsequently sales of that particular brew took off, and that the coverage it received was about the best thing that ever happened to that beer, whose name I dare not mention.
We look forward to hosting both the rugby league world cup in 2013 and the rugby union world cup in 2015. I pay tribute to the Webb Ellis ale brewed in Rugby, and also to the good work of rugby clubs in towns and cities across the country both from a sporting and a tourism perspective.
Barry Gardiner (Brent North) (Lab)
Over the past decade, some 300,000 children have been kidnapped and turned into child soldiers by the Lord’s Resistance Army in Africa, led by Joseph Kony, who is the International Criminal Court’s No. 1 target for capture. As the Leader of the House will know, young people around the world have dedicated 20 April to publicise that fact, calling it Kony 2012, in order to put pressure on Governments to take action to bring that criminal to justice. Will the Leader of the House ensure that a statement is made at about 20 April on what the Government are doing to assist in these efforts?
Sir George Young
I hope that at Foreign and Commonwealth Office questions three days before, on 17 April, there may be an opportunity for my right hon. Friend the Foreign Secretary to address this matter, perhaps in topical questions, if the hon. Gentleman is present then. I will forewarn my fellow Ministers in that Department both of the date and the likelihood of this subject being raised.
Bob Blackman (Harrow East) (Con)
Today is the Jewish festival of Purim and the Hindu festival of Holi. Purim commemorates the deliverance of the Jews from an evil King of Persia—there is, of course, a contemporary parallel with the President of Iran, who wishes to wipe Israel off the map. Holi commemorates the deliverance of Prahlad, whom Holika took into a funeral pyre in an attempt to kill him. However, Holika was consumed by the fire and Vishnu delivered Prahlad to safety. Will my right hon. Friend deliver a message to Hindus and Jews everywhere that this demonstrates the victory of good over evil?
Mr Speaker
Some people might think that the hon. Gentleman has already done that, but I am sure the Leader of the House will be happy to reply.
Sir George Young
Both the Hindu and the Jewish communities are good examples of well-integrated communities that have made a great contribution in business and in commercial and professional life. The House joins them in commemorating and celebrating the two festivals of Purim and Holi.
Mr Denis MacShane (Rotherham) (Lab)
May we have a debate on the resolution of the House that is to be found in column 928 of yesterday’s Hansard? It calls on the Government to bring forward legislative proposals to freeze the assets of Russian officials connected to the death of Sergei Magnitsky and to impose a travel ban, but in yesterday’s debate the Minister made it quite clear that the Government did not have the faintest intention of accepting the resolution. This marks a turning point for the Backbench Business Committee. This was not a Westminster Hall debate or to do with an early-day motion. You, Mr Speaker, were bullied by the Russian ambassador and saw him off with great firmity. I want our Foreign Secretary not to be the Kremlin’s stooge, and instead to stand up to it by implementing this resolution of this House of Commons in this matter.
Sir George Young
Well, we have just had a debate on the matter. I am not quite sure whether the right hon. Gentleman wants yet another one. The House had a debate: there was a motion on the Order Paper, it was carried unanimously and the Government made their position absolutely clear. I do not agree with what the right hon. Gentleman said about the Government proposing to disregard totally that which the House resolved unanimously.
Chris White (Warwick and Leamington) (Con)
The video games industry is a major employer in my constituency—several hundred people in Warwick and Leamington are employed in the sector—but it needs support if it is to continue to thrive. The industry body, TIGA, and a number of Members have been calling for video games tax relief in order to encourage growth and establish a level playing field in respect of international competitors. As the Budget will be delivered soon, will the Leader of the House provide Government time for a debate on video games tax relief, so that we can boost exports and create new jobs?
Sir George Young
I commend my hon. Friend on his ingenious pre-Budget representation to my right hon. Friend the Chancellor of the Exchequer, and I will certainly ensure that he is aware of the bid my hon. Friend has just made. I pay tribute to the work of the video games industry, which is another successful industry that is doing well under the coalition Government.
Ian Lucas (Wrexham) (Lab)
Tomorrow morning, I will meet Remploy workers in my constituency who heard yesterday that this Government are taking away their jobs. Will the Leader of the House, whom I believe to be a reasonable man, assist me by enabling me to say to them that the Government will permit a debate in Government time on Remploy, so as to enable the employees and their representatives across the UK to make representations to the Government?
Sir George Young
We had a statement yesterday, as the hon. Gentleman knows as he asked a question. The Government do not plan to have a debate on Remploy, although it is perfectly open to the Opposition to choose Remploy as the subject for debate on an Opposition day—they have one next week. The hon. Gentleman will have heard in yesterday’s exchanges that the last Labour Government closed 28 Remploy offices. He will also know that the policy of switching resources away from financial institutions that lose a lot of money and towards people is supported by the disability organisations. He will know, too, that we have ring-fenced the budget for assisted employment for those with a disability and found an extra £15 million for access to work. The tailored support we are giving to those affected by the current closures far exceeds the support given to those affected by the closures under the last Administration.
Robert Halfon (Harlow) (Con)
Following yesterday’s successful fair fuel lobby day when hundreds of motorists lobbied their MPs, may we have a statement on fuel prices? Although we acknowledge that, thanks to the Chancellor’s tax cuts, fuel prices are 10p lower than they would otherwise have been, lower earners are still paying a tenth of their income to fill up their family car and small businesses are spending a third of their income on such costs.
Sir George Young
Matters of taxation are matters for the Chancellor, who will shortly be making his Budget statement. I applaud the work that my hon. Friend has done through his e-petition at the end of last year. No doubt because of his eloquence, the increase that was scheduled to be introduced in January has been postponed and the one for August has been cancelled. I am sure that motorists up and down the country are grateful to him for his campaigning zeal, and that the Chancellor of the Exchequer will have heard the representations that he has just made.
Glyn Davies (Montgomeryshire) (Con)
There is growing concern in my constituency about the impact of high energy prices on the fuel poor and on business competitiveness. Will the Leader of the House arrange for an early debate on the impact of onshore wind subsidies for developers on the poorest people in our society and on the competitiveness of British industry?
Sir George Young
We have just had questions to Department of Energy and Climate Change Ministers, where I understand these issues may have been raised. My hon. Friend will know that the subsidy to the wind farms is being reduced. I will pass on to my right hon. Friend the Chancellor of the Exchequer the points that he has raised, which may be relevant to his Budget statement.
Nigel Mills (Amber Valley) (Con)
Could the Leader of the House find time for a debate on reforming our rotten system for European elections? On three occasions, it has left my constituents, who voted on a closed party list, with an MEP who switched parties halfway through a Parliament and was still allowed to retain the seat—that is a disgraceful situation.
Sir George Young
I hate to disappoint my hon. Friend, but I cannot promise an early debate on the electoral system for the European Parliament. Speaking from memory, I believe that once we had opted out of the old system, whereby we had MEPs for seven or eight constituencies, into the new one, there was no going back. The issue that he has raised is one more for party management than for the House of Commons.
Rail Reform
(12 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Transport (Justine Greening)
With permission, Madam Deputy Speaker, I would like to make a statement on the railways. Our rail network matters—to our quality of our life, our national well-being and our country’s future prosperity. For this Government, it is a simple equation: good transport equals good economics. But, too often, we find ourselves frustrated and disappointed when the cost, punctuality or comfort of rail travel do not come up to scratch. I believe that the Government and the rail industry can and must do more for passengers and taxpayers. Of course, investment has a huge part to play, too. That is why we have been investing in our transport infrastructure, which is one of the best ways to support business, generate growth and create jobs. For rail, that has meant the biggest modernisation programme since the Victorian age, with £18 billion invested in this spending review alone.
However, it is not enough only to invest in the railways; it is also vital to make sure that they are set up for success. So, today, I am setting out our plans to do precisely that, with the publication of our rail Command Paper, “Reforming our Railways: Putting the Customer First”. I have taken the “Ronseal” approach to the name, as the strategy will do what it says on the tin: put the customer first. The hallmarks of our railway must be high standards and low costs. It must be a railway that offers the best services and the best value. That means a rail network that is efficient, effective and affordable. Nevertheless, in his rail value-for-money study, Sir Roy McNulty concluded that our railways are among the most expensive in Europe, despite the strong and steady growth in the number of passengers using them. Sir Roy identified inefficiencies worth £2.5 billion to £3.5 billion a year—of course, the people picking up the tab for that costly inefficiency are passengers and taxpayers, so reform is long overdue.
Passengers rightly want to know that we have a plan to end the era of the inflation-busting fares seen over recent years, and taxpayers rightly want to see railway subsidies reduced to help us to tackle the fiscal deficit. My message to everyone today is clear: the days of spiralling and unjustified rail costs are coming to an end. Under this Government, the rail industry will be able to compete for future investment only if its long-term cost issues are addressed and if it can earn the right to grow. I am pleased to say that Network Rail is already due to deliver £1.2 billion of efficiency savings by 2014, with at least a further £600 million expected by 2019. But, as Sir Roy so clearly set out, we need to go further. The railway as a whole needs to become less dependent on Government subsidies, which is why we want the industry fully to close the efficiency gap of £3.5 billion per year identified by Sir Roy by 2019. We are about managing and reducing costs, balancing budgets, targeting investment where it can drive long-term growth and jobs, and delivering more capacity and better service for the investment that goes in.
The time is right for reform. I believe that we are in a good position to build on recent efficiency gains to improve the performance of the industry further and to improve the passenger experience. The programme of work that will decide rail outcomes and funding for the five-year period from 2014 is now well under way, and that sits alongside a period when we will see the biggest round of re-franchising since the privatisation of the industry. Both represent a further opportunity to change our railways for the long-term better.
Today’s Command Paper sets out our ambitions for Britain’s railways, and the agenda for change that both the Government and industry will follow in the months and years ahead. By reforming the industry, we will achieve substantial savings. Those savings will allow us to cut and then abolish above-inflation rises in average regulated fares, and they will ease the burden of the railway on the broader public purse. I believe that, taken together with my decision to limit the most recent increase in regulated fares, that will have a positive long-term impact on household budgets.
For reform to be really effective, there needs to be closer collaboration between the infrastructure managers—in other words, Network Rail—and those who provide passenger services, which are generally the train operating companies. Only through better joint working will we reduce costs and improve the customer experience. The industry is already pushing for better alignment between track and train. We look forward to the industry bringing forward partnerships that are equipped and incentivised to deliver not just better services, but better value. The rail industry, led by the Rail Delivery Group, has also declared itself willing and able to respond to the strategic and operational challenges that the railway faces. Such leadership across the industry will be essential if we are to get the most out of our reforms.
Rail franchises will be reformed, with greater transparency on costs and efficiency—again, that is to ensure the best value for fare payers and taxpayers. Franchises will be longer, giving train operators the flexibility they have been asking for—more time to make the biggest investments—to deliver what passengers want, within a sustainable budget. We will also move to a more transparent, modern and flexible approach to fares and ticketing. We are launching a consultation today to take views on how those key aims can be achieved; it is time to bring fares out of the 1970s and into the 21st century. We will expand smart ticketing to give more passengers the kinds of benefits that travellers in the capital already enjoy with Oyster cards. Working with industry, we will roll out smart ticketing across England and Wales, and across different operators, thus increasing convenience for passengers. Smart ticketing is also pivotal to introducing a more flexible system tailored to customers, with a wider choice of tickets and season cards, as we recognise the reality that not all journeys take place five days a week during rush hour.
If we duck the reform challenge, it will not just be rail users and the public purse that pay the price; ultimately, the rail industry and the wider economy will suffer, too. So we want everyone working in rail, be it management or front-line staff, to help to make these reforms work. By reducing costs and increasing demand—set alongside this Government’s huge investment in railways—there is genuine potential to boost jobs across the industry.
Of course, it is important to reform governance, too. Network Rail is giving greater decision-making powers to its regional route directors, making it more responsive to local conditions and increasingly focused on day-to-day train operations at the local level. We welcome Network Rail’s efforts to find new and more efficient ways of managing its assets, including long-term concessions to third parties for the management of parts of the network. Network Rail is also rightly taking steps to reform corporate governance, including its management incentives package, so that it is more accountable to passengers and freight customers. I would also like to welcome its sensible decision, to be announced shortly, voluntarily to appoint a public interest director, who will ensure that the concerns of taxpayers are fully reflected at board level and help to strengthen the role of members.
It is time to give communities more control over local services, so today we are also consulting on devolving decisions about the railway to sub-national bodies. Our joint consultation with the Office of Rail Regulation on a greater role for the ORR in regulating passenger franchises closed recently. With a smarter regulatory approach, our aim is to remove Government from day-to-day industry involvement by adopting a more unified regulatory structure for the railways and we will publish our conclusions in due course.
Facing up to reality, saving fare payers and taxpayers £3.5 billion a year, reforming our railways and putting the customer first: that is what the Command Paper is all about. By working together on this package of reform, I believe that industry, the regulator and Government can generate the savings and the change we need. Lower costs, better services and ticketing that offers greater choice and flexibility, as well as a rail industry built to last because it is efficient, effective and affordable: that is what the Command Paper will deliver and I commend it to the House.
Maria Eagle (Garston and Halewood) (Lab)
I thank the Secretary of State for advance sight of her statement and repeat our thanks to Sir Roy McNulty and his team for their work. We did not agree with all his conclusions and, if we had been in government, we would not have accepted all his recommendations. It was a valuable piece of work, however, that is helping to drive a number of reforms in the industry that we welcome.
Passengers have every reason to be concerned about the direction that the Secretary of State has just set for the rail industry, with year after year of inflation-busting fare rises, ticket offices closed, fewer staff on trains and at stations and cuts in investment in the rail network. In each case, the interests of private train companies are being put before those of passengers and the principle that we established in government of a clear separation of infrastructure and maintenance from private profit is being abandoned, for the first time giving private train companies the whip hand over Network Rail. That is a dangerous experiment that takes the industry on the road to breaking up and selling off Britain’s railway infrastructure, all because this is a Government who are simply unwilling or unable to stand up to vested interests on behalf of passengers. [Interruption.] The question that the Government have yet to answer is this: if we are all in this together, why is the burden yet again to fall on the fare payer and not on those who are already making huge profits—[Interruption.]
Madam Deputy Speaker (Dawn Primarolo)
Order. The Secretary of State was listened to politely without Front-Bench heckling and I expect the shadow Secretary of State to be heard without heckling from those on the Front Bench or anywhere else.
Maria Eagle
Thank you, Madam Deputy Speaker.
The question that the Government have yet to answer is this: if we are all in this together, why is the burden yet again to fall on the fare payer and not on those who are already making huge profits that are lost to the industry and that help to drive up the cost to the taxpayer of running our railway?
We cannot support these reforms. In the coming weeks we will set out our own alternative approach to reforming the rail industry, but for today I would be grateful if the Secretary of State answered a number of specific questions of concern to passengers and commuters about her proposals.
On fares, the National Audit Office has warned that the Government’s fare rises, which are adding to the cost of living crises facing households, are just as likely to increase the profits of train operators as reduce costs for the taxpayer. Will the Secretary of State confirm that the entire cost of holding fare rises at just 1% above inflation for the rest of this Parliament and strictly enforcing that cap would be less than the £543 million her Department handed back to the Treasury as a result of an underspend last year? Will she therefore abandon plans to increase fares by 3% above inflation in 2013 and 2014?
The Secretary of State said today that the days of above-inflation fare rises are coming to an end, so will she explain why the tender documents for the new franchises assure bidders that they can increase fares by up to 6% above inflation every single year of those 15-year franchises? Will she confirm that, under the plans she has set out today, train companies will be given even more freedoms on fares, including the right to introduce a super-peak ticket, which will hit hard-pressed commuters in particular?
I welcome the commitment to extend smart integrated ticketing that can be used on trains and buses, enabling the rest of the country to catch up with London. The fact that that will enable part-time workers to benefit from new flexible season tickets is particularly welcome, but will the Secretary of State explain how that will work outside London if she remains unwilling to take steps to regulate the bus network outside the capital as we proposed?
On the level of services, will the Secretary of State explain why the inter-city west coast franchise tender document allows daily service reductions of up to 10%? Will that not lead to even greater overcrowding than passengers already face? Will she explain why the final tender documents for the new franchises have also watered down the performance obligations since the earlier draft? The requirement to improve performance over the life of the franchise has been replaced by a requirement to do so unless
“good evidence can be provided as to why this is not achievable.”
Surely passengers expect the Government to insist on improvements, not simply to police the excuses that the train operating companies come up with.
Does the Secretary of State understand the concerns about the train companies’ new freedoms to close ticket offices and cut the number of staff on trains and platforms? Will she explain why the new franchises ask bidders only to consider maintaining the same level of CCTV on trains?
The structural reforms to the industry are also deeply worrying. Does the Secretary of State understand the concerns that the restructuring she proposes has a massive accountability gap at its heart? Genuine backing for devolution, which the Government have ducked today, would see transport authorities deciding the best way to deliver rail services in each region. Should that not permit alternatives to the existing franchise model to be explored, including not-for-profit and mutual options? Does she agree that for devolution to work those authorities need a fair deal on costs, subsidies and risks? This cannot be—as is suspected—about devolving responsibility for cuts.
Will the Secretary of State explain how the decision to allow deep alliances between train companies and Network Rail, with private train companies having the whip hand, fits with the need for democratic accountability? I know the Conservative party is determined to complete the job it started with its botched rail privatisation, but does she not accept that the decision we took to create Network Rail as a not-for-dividend body has served the industry well? Why is she willing to turn back the clock and take us back to the bad old days by creating what are effectively a series of mini-Railtracks? Where is the accountability to passengers, taxpayers and Parliament? How can there possibly be a level playing field in future franchise competitions if the incumbent is part of a single management team? Does she not see the clear conflicts of interest that are evident throughout her proposals?
How will Network Rail continue to support the interests of freight operators and their need to access the network in a system where private train operators manage the network in each region? Will the Secretary of State explain why long-term concessions will not simply add to the costly fragmentation of the industry? Why does she believe that breaking up and selling track piece by piece will improve performance and safety?
This long-awaited rail strategy is a wasted opportunity to address the structural issues left from the botched rail privatisation. Instead of tackling the fragmented structure of the industry that was the legacy of privatisation, the Government are instead creating an even more fragmented and costly structure with more interfaces, more need for lawyers and consultants, less accountability, and, at the same time, more freedoms for train companies to hike fares and cut services, booking offices and front-line staff. Even at this late stage, I hope that the Secretary of State will think again and instead seek to build consensus on the future of the rail industry, based on devolution and genuine local control with communities and passengers in the driving seat, stand up to private companies, not cave in to vested interests, and put passengers before profits. It is not too late for her to do that. I hope that she will think about it.
Justine Greening
Obviously, I listened with interest to what the hon. Lady said and I hope that she will at least accept that the current situation, with a rail industry that Roy McNulty says costs £3.5 billion more than it needs to owing to inefficiency, is something that we should tackle. I note that she says she is going to come forward with an alternative and it is important that she does that because if she is turning her face against this approach, she is saying that it is okay for fare payers and taxpayers to pay that £3.5 billion in perpetuity. I think that is broadly what she was saying, but I shall await with interest her alternative proposal, which she needs now to provide.
The hon. Lady talks about the burden falling on the fare payer, but that is exactly what happens now. That is one reason why there has been so much pressure for fares to go up year on year. Let me remind her that her party also recognised that problem, which is why it commissioned Sir Roy McNulty to do that work and why it struggled with the issue too, itself overseeing years of above-inflation rail fare rises. What all of us in the House should be looking towards, with the strategy we have produced, is how to tackle these issues. We want fares to remain affordable. I have stressed on a number of occasions and at several points in the documents we have released today that it is absolutely key that we make sure that fares remain affordable. The underlying objective we are trying to achieve is the end of inflation-busting fares. We also want to cut down on the level of public subsidy, as we would prefer that money to go towards reducing the deficit or into investment in other areas.
I am pleased that the hon. Lady welcomes the flexible season tickets. If we are able to push forward on smart ticketing across the country, people will be able to use that sort of ticketing not only on the railways but potentially on buses too. The Under-Secretary of State for Transport, my hon. Friend the Member for Lewes (Norman Baker), who has responsibility for buses, will be producing a strategy that includes all those opportunities in the coming weeks.
The hon. Lady mentioned ticket offices. I understand that many passengers strongly value the face-to-face channel that a ticket office provides, as can be seen in the documents. However, I remind her that when her party was in office there were large-scale reductions in ticket office opening hours. In 2009, Labour Ministers approved cuts to opening hours at 70% of South West Trains ticket offices. The Command Paper has a section on how we want stations to improve, including by having crèches at stations where that is a sensible idea. Face-to-face channels are important for people buying tickets, which is why one of the ideas in the paper is to investigate whether people could buy tickets at their local post office, library or shop, as people can with Oyster in London. All those things should mean that people have more, rather than fewer, opportunities to buy tickets face to face.
In the rest of the fares and ticketing consultation—and I stress that it is a consultation—there are some really good ideas for moving ticketing into the 21st century, including on how we can make sure that the approach to ticketing reflects working practices today and the fact that people work flexibly and part-time, rather than expecting them to fit into a ticketing approach that would be better placed in the 1980s.
I am pleased that the hon. Lady asked about devolution and decentralisation because that is possibly one of the most exciting parts of all this in the long term for local communities. It opens up an important debate about how franchises might be more spec’d up in the long term and controlled by local communities. I assure her that this is about giving local communities opportunities, not about passing on some underlying problem. Indeed, the Government are absolutely clear that we need to tackle the underlying problem of inefficiency in our railways. That is what the document is all about.
The hon. Lady raised concerns about alliancing. I think that getting the industry to work together is a common-sense approach to tackling some of the inefficiencies that exist, which are directly funded in the end by fare payers and taxpayers. Today, when asked, she was not able to rule out her party wanting to renationalise the railways, but I think that we need to make the pieces of the jigsaw fit together better. Simply throwing them up in the air again would only waste time and make it harder for the industry to take the responsibility that we want it to, and I do not think that that would be the right way forward.
Finally, I understand the hon. Lady’s concerns about freight and we are absolutely committed to making sure it is a core part of the network going forward. One of the underlying reasons for high-speed rail is to make sure we have capacity on the core network for freight. We need to make sure there are safeguards in place regarding any of these changes so that the freight industry can continue to do what we want it to, which is to re-mode on to trains.
Madam Deputy Speaker
Order. I am sure the whole House is very grateful for the Secretary of State’s comprehensive reply to all those points. I hope therefore that there will now be short questions and brief answers, so that we can get all Members in.
Sir Alan Haselhurst (Saffron Walden) (Con)
I welcome the thrust of my right hon. Friend’s statement, but can she offer me some encouragement that the West Anglia line, which has lacked capacity improvements since its third and fourth tracks were torn up in the wake of the Beeching report, now has a better chance of having its track capacity enhanced?
Justine Greening
I believe that the performance on that line is starting to improve, but the document we are issuing today is all about making sure that train operating companies are in a position to deliver, and are working with Network Rail to deliver, better services for passengers in a more efficient way.
Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)
I welcome the Secretary of State’s willingness to look at the rail sector overall, but how much funding do the Government intend to remove from supporting the rail service? Will she explain exactly how the spiralling cost of rail fares will be addressed, overcrowding will be reduced and extra capacity can be produced where it is required, such as across the north?
Justine Greening
We recognise that we need to tackle the underlying inefficiencies in the railways, which Sir Roy McNulty identified as totalling around £3.5 billion. I also recognise that some of the network provides a broader public good and that there will therefore be a need for public subsidy. However, we need to make sure that that represents good value for taxpayer money. We are concerned about overcrowding. That is why we are investing in 2,700 new carriages, which will provide extra capacity. That is why the overall £18 billion of investment going into the industry is so crucial; that is one way in which we can improve performance. Of course, making sure the industry is financially sustainable is absolutely critical too.
Simon Wright (Norwich South) (LD)
Can the Secretary of State confirm that plans are progressing for the electrification of 800 miles of rail track? How does that scale of ambition compare with the achievements of the previous Government?
Justine Greening
That is an interesting question. I think we all understand that electrification can bring a broad set of benefits. The previous Government electrified 39 miles of line in 13 years—that is about 3 miles a year—and we have already announced that 800 miles of line are to be electrified. I hope that answers the hon. Gentleman’s question.
Mr Alistair Darling (Edinburgh South West) (Lab)
Does the right hon. Lady accept that in this industry successive Secretaries of State have found that announcing efficiencies is much easier than actually achieving them? If we do not achieve them, fares will go up or investment will suffer. Does she accept that it is absolutely essential to continue the investment that started 10 years ago, which included upgrading the west coast main line—something that had not been done for 30 years—because the east coast main line and commuter services will need to be upgraded? We must not forget the lessons of the 1990s, when 10 years of no investment had absolutely catastrophic consequences for the industry.
Justine Greening
I think that the right hon. Gentleman is right. One problem in the past has been that, every time a Government have wanted to drive efficiencies in the rail sector, they have rearranged the whole railway structure, whereas what we need to do is get the pieces that are there working better.
The right hon. Gentleman mentioned the west coast main line, which is a good example of how things can go wrong. It was pencilled in to cost £2 billion; it ended up costing £9 billion and took significantly longer than was anticipated. It is a good example of why we cannot go on like that and why we have to work with the industry and challenge it to work better itself.
Mr Edward Leigh (Gainsborough) (Con)
Exactly. Does the Secretary of State agree that politicians are useless in any industry at picking winners, and will she reassure us that this Conservative Government remain committed to a privatised industry in which competition and a market-driven approach have driven record growth in numbers, and that there will be no return to the bad old days of British Rail with stultifying ministerial control?
Justine Greening
The Labour party may not be prepared to rule out nationalisation, but I am.
Mr Tom Harris (Glasgow South) (Lab)
I am disappointed in the statement. In the time I have been in the House, I have never heard a ministerial statement so lacking in substance. This is not a statement; it is a coincidence of ink patterns on a bit of paper. The Secretary of State says that she wants £3.5 billion of efficiency savings by 2019, but she has not given us a single way of saving one penny. Was she even in the House yesterday when the Prime Minister told the nation that government was about making tough decisions? Where is a single tough decision in this statement? She does not have any solutions; all she has come up with is a series of clichés and warm words put together by civil servants not wanting to offend anyone.
Justine Greening
I recommend that the hon. Gentleman read the documents that we have published, which have a lot more of the detail that he wants. I am not going to take any lectures on tough decisions from someone who, when asked about Network Rail bonuses, said:
“Bonuses … are a matter for the company’s remuneration committee, not for Ministers.”—[Official Report, 24 June 2008; Vol. 478, c. 174W.]
I do not think that showed any backbone whatsoever.
Mr David Evennett (Bexleyheath and Crayford) (Con)
I warmly welcome my right hon. Friend’s statement today and the approach to our railways. Does she agree that we need more reliable journeys and better passenger experiences on all our trains, but particularly on our commuter routes? May I urge her to help to enhance access to stations and to improve the resilience of the network in winter weather?
Justine Greening
The industry has put substantial investment into improving winter resilience, and of course, having done that, as we could have guessed, we have had one of the mildest winters in recent years. We are much better prepared to keep the trains running in snow and bad weather than we were in the past. Reliability and punctuality are incredibly important. Today’s statement is as much about that as anything else, because a more efficiently run railway will be able to perform better.
Katy Clark (North Ayrshire and Arran) (Lab)
The Scottish Government have just closed their consultation with similar proposals that will involve station closures, reductions in staffing and higher fares. What implications will the announcement today have on Scotland, especially in relation to the block grant, with Barnett consequentials, and on cross-border services?
Justine Greening
I was up in Scotland only last week, having some helpful discussions about high-speed rail and improving connectivity with Scotland on the railway network. Scotland has a devolved settlement for transport, but I have no doubt that the Scottish Government will look carefully at my proposals today. I am always happy to talk to the Scottish Government about how we can work together to get better value out of those cross-border services.
Mr Tobias Ellwood (Bournemouth East) (Con)
Is it not curious that Labour Members always choose to gloss over their responsibilities when we debate these issues? It is their report that we are debating—the McNulty report—which says that there are £3 billion of efficiencies to be had. I congratulate my right hon. Friend on the leadership that she is showing in bringing together the Government and the rail networks to achieve better service for our customers.
Justine Greening
I appreciate my hon. Friend’s kind words. As the right hon. Member for Edinburgh South West (Mr Darling) set out, we have no mean challenge ahead of us, but we know the direction that we want to travel and how we are going to get there. The key now is to make sure that we implement that and that I work with the industry as it gets on with this.
Hugh Bayley (York Central) (Lab)
I think I am the only Member in the Chamber today who served on the Bill Committee that considered the Railways Bill that privatised the railways almost 20 years ago. We were told at the time by Conservative Ministers that privatisation would drive down costs and increase efficiency, but we know now that that was not at all the case. Privatisation cost thousands of railway jobs. I still have hundreds of railway jobs in my constituency, but what assessment has the Secretary of State made of the number of jobs on the railways that will be lost as a result of her statement, nationally and in my constituency?
Justine Greening
There has never been a better time to be working in the railway industry. We have record investment going into the industry; it is unprecedented since Victorian times. I have spoken to both Network Rail and the TUC about how we can work harder to develop careers in the railway industry and get more women working in the industry—only 13% of Network Rail’s employees are women. There is a huge opportunity ahead of us, not just for passengers and taxpayers but for staff. I hope that everyone can work together to deliver efficiency improvements from which everyone benefits.
Dan Byles (North Warwickshire) (Con)
I thank my right hon. Friend and warmly welcome the statement, which shows a clear commitment to improving the existing rail network. However, we cannot completely separate the high-speed rail project from rail reform. Will my right hon. Friend reassure the House that the colossal sums of money being invested in high-speed rail will not in any way minimise the investment going into the existing railway system?
Justine Greening
They will not. We have an ambitious programme, as I have said to the House, and high-speed rail sits alongside that. It is complementary, and it is critical that we do not just improve the existing system but look ahead to the capacity that we will need on a new network.
Kate Hoey (Vauxhall) (Lab)
Is not one of the reasons why train fares in Europe are much lower than here that many countries still have public ownership of their railways? Does the Secretary of State accept that the statement is just a green light for the mostly foreign-owned train operators in this country to have a feeding frenzy on raising fares so that they can keep the fares down in their own countries?
Justine Greening
I do not accept that at all. I have a huge amount of respect for the hon. Lady, but this is not the time to rearrange the industry in the way that she suggests. We need to look at the pieces and then make sure that they work more effectively together. Sir Roy talked in his report about the different levels of working that the industry could do, and we are keen to see the industry work more closely together. I am sure that when the hon. Lady reads the report she will see some of the potential routes that that could take. I do not agree with her; I think the key to success now is getting the industry to collaborate more and for us to support it in doing that.
Julian Sturdy (York Outer) (Con)
McNulty suggested that rail company franchises should be less prescriptive and allow more freedom to respond to the market. Does my right hon. Friend agree that that will bring more investment into services such as the east coast main line, which was left in limbo by the previous Government, and more certainty to my constituents in York, who rely heavily on it?
Justine Greening
We need to strike that balance between granting longer franchises so that it is worth train operating companies improving services for passengers and putting in investment even when that takes a bit longer to come through because it is a bigger improvement and a bigger investment. That is absolutely right. My hon. Friend’s other point is well made; things change and we need a flexible franchising approach because, as we have seen, growth in demand and passenger numbers in the past decade has been substantial, so we need to make sure that our franchising can reflect and adapt to that.
Mr Clive Betts (Sheffield South East) (Lab)
Perhaps the Secretary of State will agree that one of the best ways to improve efficiency on the railways is to make better use of under-used track? One of the best ways to do that in urban areas is to develop tram trains, which has been done successfully in other countries while we are still considering the possible introduction of a pilot. Can she say when the pilot for the tram train in South Yorkshire is due to start?
Justine Greening
I cannot, but I will write to the hon. Gentleman to set that out very soon. I know exactly the project that he refers to and I know that it is in plan. I will tell him exactly when he can expect it to happen.
Mr Marcus Jones (Nuneaton) (Con)
Will my right hon. Friend confirm that, alongside the action that she is taking with the rail industry to reduce the cost base of running our railways, the £18 billion investment programme of upgrades and improvement, including the Nuneaton to Coventry upgrade announced last year, will go ahead?
Justine Greening
Yes, it will. That is one of the reasons why it is such an exciting time to be involved in the industry, because this unprecedented investment is being made. It is a huge opportunity for people working in the industry and for passengers. We will hopefully get the benefits of all those investments and people will really see the difference it can make to their commute and their travel when they get on the train.
John McDonnell (Hayes and Harlington) (Lab)
I worry about the right hon. Lady using the Ronseal method, because painting over the cracks in the industry might come back to haunt her. One of the implications of the statement is that 12,000 jobs are at risk, mainly those of station staff. In addition, it reintroduces the profit motive to the provision of the infrastructure, which caused the Potters Bar, Hatfield, Paddington and Southall rail crashes. Has there been an independent safety assessment of today’s proposals?
Justine Greening
Safety will always be of paramount importance as we consider any of these changes. We are currently spending £3.5 billion, money that is coming out of the pockets of fare payers or taxpayers, and that is pure inefficiency. I think that not being prepared to tackle that is irresponsible. I understand that the hon. Gentleman might have some concerns about my proposal, but is he is saying that passengers should pick up the tab for £3.5 billion? If he does not like the proposal, it is incumbent on him to come up with an alternative.
Mr Matthew Offord (Hendon) (Con)
The response of the unions to the McNulty report was to make some wild claims in my constituency about the closure of the ticket office. Does the Secretary of State agree with me, and with commuters on the Thameslink line in my constituency, that what they want is increased technology that allows them to buy tickets more quickly, simply and easily? They would also like to see staff brought out from behind glass panels in order to increase the personal security for people on the platforms, as we have seen on the tube.
Justine Greening
My hon. Friend is right. A variety of people now use the railways, and the ticketing system needs to keep up with that, but I will take this opportunity to stress again that we understand the importance of face-to-face contact, which many customers value when buying tickets. We will ensure that we bear that in mind as we approach any decisions on ticket offices.
Gavin Shuker (Luton South) (Lab/Co-op)
Sir Roy McNulty identified fragmentation in the industry as one of the major reasons why costs in the UK are so high. What will her plans to further fragment the industry do to those costs? Will they improve outcomes for passengers or increase the amount we pay in subsidy for the railways?
Justine Greening
We are not further fragmenting the industry; we are encouraging it to work collaboratively and more effectively. If by talking about fragmentation the hon. Gentleman is criticising our proposals to decentralise some decision making, I think that he is wrong.
Gavin Williamson (South Staffordshire) (Con)
The ticket office at Codsall station was closed a number of years ago and has been replaced by the fantastic Codsall station pub. My right hon. Friend has talked about allowing post offices the opportunity to sell tickets, but will she look at letting the Codsall station pub sell tickets?
Justine Greening
That sounds like a good idea that my hon. Friend’s local community might like to take forward. I encourage him to look through the document, which contains a section on how we want to see stations improve more generally.
Kelvin Hopkins (Luton North) (Lab)
I had the pleasure of meeting Sir Roy McNulty on two occasions after his early conclusion that our railways are up to 40% more expensive to run than continental railways. I suggested to him that the simple and obvious difference between them is that they are publicly owned and integrated and ours are privatised and fragmented. I suggest to the Secretary of State that we will not overcome our problems or reduce costs until our railways, too, are publicly owned and integrated.
Justine Greening
I do not agree with the hon. Gentleman. Realistically, his approach would simply involve throwing the jigsaw pieces back up in the air, which would mean years of delay and uncertainty, and of course passengers and taxpayers would continue to have to foot the bill for that, which I think would be unacceptable. We have today set out a proposal on how we will get a grip on the £3.5 billion of inefficiency. Until the Labour party has an alternative, fare payers and taxpayers would prefer it to get behind our proposals and help to make them happen.
Robert Halfon (Harlow) (Con)
I welcome my right hon. Friend’s statement and what she said about smartcards. Will she consider extending Oysterisation to outer London towns, such as Harlow, which would benefit commuters? May I also ask her to increase investment in rolling stock, when financial conditions allow, so that we can have more trains at peak times running from London to Harlow and vice versa?
Justine Greening
I am sure that my hon. Friend is aware that we earmarked £45 million in the autumn statement to enable us to extend the use of smartcards and Oysterisation further in the south-east. With regard to capacity, we are making a substantial investment with 2,700 new carriages. I would be happy to sit down with him and get his views on how his local area could benefit from that.
Sir Bob Russell (Colchester) (LD)
Fortuitously, this afternoon I am to meet representatives of Network Rail and Abellio to discuss the deterioration of the service between Colchester and London. Does the Secretary of State agree that the reality and the rhetoric are on different tracks and that if we are to reform our railways and put customers first, the fragmentation of the industry post-privatisation must be addressed? They need to talk to each other more than they do at the moment.
Justine Greening
My hon. Friend is absolutely right. That is the whole point of what we are talking about today: greater collaborative working and formal alliancing where we think that could drive better performance and better value for taxpayers’ money. It is time for the industry to step up to the plate and work together to ensure that our railway system is more efficient than it has been in the past.
Brandon Lewis (Great Yarmouth) (Con)
I warmly welcome my right hon. Friend’s statement. She mentioned the section in the report on train stations—paragraph 4.39. Great Yarmouth, like many towns across the country, has a station that is much in need of repair. May we take it from the report that in future we can look to some new, out-of-the-box thinking on innovative ways to improve our stations for passengers in future?
Justine Greening
It is time to think more innovatively. We should look at how train-operating companies can work more effectively alongside Network Rail than they have previously been able to do in order to improve the stations that their passengers use every day.
Alun Cairns (Vale of Glamorgan) (Con)
The Transport Committee in the previous Parliament accused the previous Government of breathtaking complacency. Will the Secretary of State reassure me that the significant savings that will be made as a result of the proposals she has set out today will lead to lower fares, greater reliability and more investment in rail services in general?
Justine Greening
We will be moving in that direction. Our aim is first to reduce the above-inflation fares and then to get rid of them. Of course, a huge amount of investment is being made in all the other key things my hon. Friend talked about, which I am very supportive of and, indeed, excited about. I think that it is a great time for the railways. The sort of investment that is being made to improve passenger capacity and experience is unprecedented, and we will ensure that we get every bang for the buck out of it that we can for the public.
Mr Peter Bone (Wellingborough) (Con)
I thank the Secretary of State, as I think the whole House will, for making copies of the report available before the statement, which was very much appreciated.
Is it not wonderful that we have heard socialist ideas from the Opposition Benches? They suggest that we should renationalise the railways and everything will be wonderful. Have they forgotten that under British Rail they were managing decline and putting prices up? Under privatisation far more people have wanted to get on the trains, so the solution is to find more capacity, not renationalise.
Justine Greening
My hon. Friend is right. We have seen huge increases in passenger demand. What we have heard today is really a battle between the Government Members representing common sense and the Opposition Members, representing the past.
Charlie Elphicke (Dover) (Con)
I welcome the Secretary of State’s determination to put the customer first. Does she agree that for too long the railway industry has been imprisoned by provider interest, whether greedy, bank-owned train leasing companies, bonus-hungry managers or dinosaurs and luddites from the trade unions, while the previous Government walked on by? Is it any wonder that our railways are among the most expensive in Europe?
Justine Greening
In many respects it has been an impossible situation, and certainly one that cannot continue. We cannot allow £3.5 billion of inefficiency a year to go unchecked and always to be paid for by taxpayers and fare payers. That is what this document and this strategy are all about tackling.
Bob Blackman (Harrow East) (Con)
My right hon. Friend will be aware that the RMT has threatened a national campaign of resistance, including industrial action if necessary. What message does she have for those trade union dinosaurs and for the hard-working staff in the rail industry about the potential benefits?
Justine Greening
I urge everybody to work with us to improve the railways for the sake of passengers and taxpayers. That is the decision that we all have to take. It is simply unacceptable that every year £3.5 billion of inefficiency is paid for by people across the country who cannot afford it. We have to get a grip on that, and we will do so by working together. I hope that the unions will see that there is a huge opportunity to work with us on this. There is massive investment and there is room for jobs and growth. We just need an industry that is financially sustainable so that that can take place.
Point of Order
Kerry McCarthy (Bristol East) (Lab)
On a point of order, Madam Deputy Speaker. Yesterday, a number of people who came here to lobby their MPs about the Save the NHS rally were prohibited by House of Commons security from wearing T-shirts saying “Save the NHS”. People were told to put them on inside out and, in one case, T-shirts were removed from someone’s bag, presumably on the grounds that there is no place for politics in Parliament. Will you clarify the position on this matter? My understanding is that Mr Speaker has said that people should not be prohibited from wearing such T-shirts. It is a ridiculous curb on free expression.
Madam Deputy Speaker (Dawn Primarolo)
I am grateful to the hon. Lady for her point of order. I am aware that Mr Speaker has expressed a view on the wearing of T-shirts and the types of slogans that may be on them. If she will forgive me, I need to consult Mr Speaker to ensure that there is a clear ruling on the wearing of T-shirts with slogans, which would be of help to Members, the public and the security staff who enforce such undertakings. I hope that she will bear with us for a little longer.
Backbench Business
International Women’s Day
(12 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Dawn Primarolo)
Greetings to all Members of the House on international women’s day. This is such a popular debate that it is necessary to have a five-minute time limit on speeches. If there are interventions, I am afraid that the time limit will have to go lower than five minutes. However, I am sure that we can all co-operate and ensure that everybody who wishes to participate in the debate manages to speak.
Fiona Mactaggart (Slough) (Lab)
I beg to move,
That this House has considered the matter of International Women’s Day.
Each year, the United Nations declares an overall international theme for women’s day. This year’s theme is “Empower Rural Women—End Hunger and Poverty”. It is right to recognise that giving power to women is one of the most effective ways of ending poverty, but it must be real economic and political power, because when women get close to power, men too often take it back. We saw that in the Arab spring, when brave women who led the early protests were subjected to sexual assault.
Giving power to women ends hunger, because women’s money gets spent on children. Although we expect 1 million more children to be born in Britain over the next decade than in the last, this Government have targeted children. Children are due to pay more than bankers towards dealing with the deficit. Welfare reform, which is trumpeted as a plan to make work pay, is hitting the poorest working families with children, many of whom will lose tax credits worth £3,800 because they are unable to find more working hours. The Chartered Institute of Personnel and Development has found that one in five companies has cut down on hours, whereas only one in 17 has increased them. The Government have not even exempted families where one parent is caring full time for a disabled child from the demand that at least 24 hours are worked to qualify for such tax credits.
At the other end of the pay scale, mothers are due to lose their child benefit. Child benefit replaced the tax allowance because it was recognised that delivering child support to a mother is the best way of reaching children. Soon, Britain will be one of the only countries in the developed world that lacks a universal mechanism whereby people who do not have children contribute to the costs of child rearing through the tax and benefits system.
Harriett Baldwin (West Worcestershire) (Con)
I thank the hon. Lady for giving way. I am a bit disappointed that this is becoming a political rant, when there is so much to celebrate about women in this country. Does she think it is right that I receive child benefit when I earn £65,000 a year? Will it be in her party’s manifesto at the next election to bring it back?
Fiona Mactaggart
I am old enough to remember the invention of child benefit. It ended a child tax allowance system that advantaged the richest more. The great thing about child benefit is that it says that all of us are responsible for children. It ought to be universal. It is, in effect, a tax allowance for children. It is quite wrong to suggest that it is a benefit from which richer people should be exempted. Everyone who has children should be responsible for them.
Fiona Mactaggart
I want to give everyone the opportunity to get in. Although I am happy to take interventions, I think that I should resist so that more Members have a chance to—
Fiona Mactaggart
I have just explained why I am not giving way.
We are told that the proposed universal benefit will make work pay, but for whom? It will end the tradition, built up in the Labour years, of paying family benefits to the main carer in the household, who is usually a woman. Men will be the default recipient. As a result, women and children will get less.
Fiona Mactaggart
I have explained why I am resisting. I want to give more people a chance to make the contribution that they want to make. I think that that is right in this debate. I am talking about the real situation for women today. I would like to be able to celebrate the progress that women have made; I am explaining why I fear the situation is going backwards.
As I was saying, women are paying 70% of the cost of deficit reduction, with £13.2 billion coming from women and £5.7 billion from men. Women are being squeezed out of the labour market. Record numbers of women are jobless. The biggest jump in unemployment has been among older women aged 50 to 64—up by 20,000 in the last quarter. At the same time, unemployment among younger women went down.
We are facing a crisis for this group of older women. They have faced the shock that their pensions are to be deferred and they need to use these crucial years to build up their pensions. However, they will find it hard to find a new job. Often, women are losing jobs in the public sector, where there is a better record on equal pay than in the private sector. That means that women’s snail-like progress towards equal pay risks sliding backwards. Older women are sandwiched between supporting their children, who are staying at home longer, saddled with university debt, because they cannot afford their own housing, and supporting their elderly parents, who are being failed by a health service made increasingly chaotic by Government reform. The next debate will focus on carers, so all I will say is that this Government’s failure to grasp the challenge of care has delegated responsibility for it to the nation’s women, which just is not fair.
If the prospects for women at work and for women’s income are gloomy, what about elsewhere? Everywoman Safe Everywhere, a commission chaired by the former Member of Parliament for Redcar, shows how women have become less safe. There has been a 31% cut in refuges and services that tackle domestic violence. Some 230 women are turned away from a refuge on a typical day. The suggestion that housing benefit will no longer cover the service provision in refuges is a further threat to refuge provision. When women move on, they will be entitled only to the single room rate of housing benefit.
I will never forget the Iraqi woman refugee in Slough, a qualified radiographer, who was slowly being made mad because she was so scared by living in a house, and sharing a kitchen and bathroom, with young men who had no respect for her religion or her privacy. We are about to do that to women who are leaving refuges.
Removing from the DNA database the samples of men who have been accused but not convicted of rape, when we know both that convictions are hard to secure and—
Fiona Mactaggart
I will, but the hon. Lady must understand that by intervening, she is reducing the time for other speakers.
Andrea Leadsom
I will be very quick. Does the hon. Lady welcome the Government’s determination to open more rape crisis centres for women?
Fiona Mactaggart
Absolutely. In order to make more time for other speakers, I cut the bit of my speech that I had written in which I welcomed that, and I cut other things as well. I have frequently praised the Government for putting on a secure basis the funding for rape crisis centres, which used to arrive under the previous Government but was utterly unpredictable. That is the one thing that the Government have done that will make women safer, and I welcome it.
Mrs Helen Grant (Maidstone and The Weald) (Con)
Does the hon. Lady welcome Clare’s law?
Fiona Mactaggart
I do, and I welcome the efforts of my right hon. Friend the Member for Salford and Eccles (Hazel Blears) in championing it on behalf of her constituent who was a victim. I am glad that it will be brought in. In a way, I would have liked the announcements that were made today at some reception in Downing street to be made in this debate. The Government should have told us here what they were going to do, which would have provided an opportunity to debate their plans in the international women’s day debate.
As I was saying, removing from the DNA database the samples of men who have been accused but not convicted of rape, when we know both that convictions are hard to secure and that rape is a serial crime, is irresponsible. Other public sector cuts, from railway stations to street lights, will make neighbourhoods more frightening for women.
Here in Britain, a separate theme has been identified for international women’s day—“Connecting girls, inspiring futures”. I really wish that we offered girls here in Britain a more inspiring future, but I am afraid that this generation of young women will probably be the first to do less well than their mothers.
Claire Perry (Devizes) (Con)
Does the hon. Lady agree that one of the least inspiring things that we could do would be to leave a giant deficit for those girls to pay off with their future taxes?
Fiona Mactaggart
There are other ways to tackle the deficit than to target women and children. I do not think it right, on this day, to argue that it is right to do that. If we make the world more unequal, we make a sad future for our daughters. I acknowledge the hon. Lady’s work on, for example, pornography. I have been proud to support her campaign to enable mothers to protect their daughters and sons from pornography on the internet. There are things that we agree on, and we should celebrate them, but we should not use that celebration to paper over the risk that pay is becoming more unequal, opportunities are becoming fewer and women are becoming less safe. That is not a reason to celebrate on this international women’s day.
Mrs Helen Grant (Maidstone and The Weald) (Con)
Since the introduction of the Forced Marriage (Civil Protection) Act 2007, there have been 257 forced marriage protection orders, five recorded breaches and one person sent to prison, and in 2010 alone 1,735 people were supported by the Government’s forced marriage unit. The youngest victim was 12 and the oldest 73. In just a few short years, that legislation has made a positive impact, and demand for orders continues to rise. However, there are still major problems with education, discovery and implementation. Not enough is being done on prevention, and ongoing scepticism greets women and children when they report forced marriage.
Consideration is now being given to how to make the breach of a forced marriage protection order a criminal offence, and, going even further, to whether forced marriage should be a criminal offence. Criminalisation might seem to colleagues a popular and reasonable option, showing the public a tough approach against an alien and wicked practice, but I urge caution.
My 23 years as a family lawyer leave me with some doubt that criminalisation would improve matters for victims. Indeed, it could be a backward step. The Domestic Violence, Crime and Victims Act 2004 criminalised the breaching of a non-molestation injunction order. There were very good intentions behind that, but there were many unforeseen consequences. Important comparisons can be made between that legislation and what is being contemplated now in relation to forced marriage.
I was a busy domestic violence practitioner at the time, and I made three principal observations. First, the police were often slow and reluctant to pursue breaches because of perceived more serious crimes such as robbery and burglary. The Crown Prosecution Service was also slow or reluctant to do so because of the need to satisfy the high criminal burden of proof, namely “beyond reasonable doubt”, and because of the evidential difficulties of crimes that often happen behind closed doors.
Madam Deputy Speaker (Dawn Primarolo)
Order. Would the hon. Member for Maidstone and The Weald (Mrs Grant) like to sit down? I think it is best for Members to leave the chairing of the debates to the Deputy Speaker, but if the hon. Lady is giving way to Charlie Elphicke, she needs to sit down while he is speaking.
Charlie Elphicke
I thank my hon. Friend for giving way. There are many loving relationships, and there has been a revolution meaning that there are more women in the workplace than ever before, and also in relationships in which the children are cared for and deeply loved. Men even change nappies, as I did. Should we not celebrate the good things about men and women, and about women in the workplace?
Mrs Grant
Of course we should. I absolutely agree with my hon. Friend.
In consequence of the authorities’ reluctance to pursue breaches of injunction orders, victims were again and again left thinking, “Why did I bother getting my injunction order?” Perpetrators were left thinking, “I got away with it”.
My second observation was that pursuing a civil action required the victim to be in the driving seat, which could be a completely empowering experience. She made the decisions and provided the instructions, supported by her own legal team. In contrast, in criminal cases the victim is merely a witness for the prosecution. She has no control over the proceedings, she is given very little information and she has no legal team to support her. In fact, being a prime witness for the prosecution is an isolating experience and frequently leads to the withdrawal of evidence and the collapse of prosecution cases.
My third observation was that domestic violence, like forced marriage, could involve close family members—mothers and fathers, sisters and brothers, uncles and aunts. Whereas victims were prepared to obtain civil orders to protect themselves, they were often reluctant to pursue a breach, because it would lead to a criminal conviction for the perpetrator and far-reaching consequences for the victim, her family and sometimes the community. Indeed, in a survey in 2011, Dr Aisha Gill of Roehampton university found that 57% of respondents said that victims would be less likely to seek help if forcing someone to marry became a criminal offence. Advocates also argue that victims stand more chance of reconciling with their families if a protection order is invoked rather than a criminal prosecution.
Those three observations, together with anecdotal evidence from professional colleagues and the judiciary, suggest that criminalisation of non-molestation injunction orders has left far too many victims without redress and with a real sense of injustice. I remain unconvinced, too, that there is a gap in the law that needs to be filled. In forcing someone to marry against their will, numerous other criminal offences may be committed—assault, abduction, aiding and abetting a criminal offence, cruelty, failure to secure attendance at school, false imprisonment, theft, rape, kidnapping, threats to kill, harassment, blackmail and murder. That list shows that we already have a range of criminal laws that can be used to prosecute in a forced marriage context.
For all the reasons that I have stated, I am concerned that criminalisation of forced marriage could lead to under-reporting, the export of the crime abroad and the practice being driven substantially underground. There is no quick fix.
Mrs Grant
I am sorry, I will not.
We need to deal with cultural expectations of duty and honour and work with communities, schools and agencies to change attitudes and behaviour towards women and their right to choose their own partner.
Good progress has been made in the past three years using the civil law. It would be a travesty if such work were undone. The criminal law may punish the perpetrator, but it does little to protect the victim and can often cause no end of collateral damage. In Scotland, recent forced marriage legislation already criminalises breach of an order. We therefore have a prime opportunity to pause, observe and review, and avoid creating yet another criminal offence, which could so easily defeat the object of our very best intentions.
Mrs Mary Glindon (North Tyneside) (Lab)
On this day of celebration across the world, I would like to speak about an organisation known to us all, which now plays an important part in the lives of thousands of young women in this country: the Scout Association.
Girls and young women have been able to join the scouts for more than 20 years and last year, more girls than boys became scouts. That rise in young women’s membership has been highest in the Explorer section, which takes its members from among 14 to 18-year-olds. Nationally, half the adult scout leaders are women.
Although as a child I was only in the Brownies for a short while and never made it to the girl guides, I am a strong supporter of scouts and guides. I have seen at first hand the work that scouts have done in my constituency, particularly in deprived areas. I recently visited a new unit at St Stephen’s RC primary school in Longbenton, where the head teacher, Stephen Fallon, had discovered that some of his pupils had been responsible for antisocial behaviour in the local community. Working with Northumberland scout association, he has set up a new unit, which provides both girls and boys with opportunities in their young lives that would not otherwise be afforded them. Those opportunities are helping make those children good young citizens in North Tyneside.
As a result of that visit, I agreed to become an ambassador for Northumberland scout association and have learnt about Lookwide, the association’s development project, which specialises in working with disaffected young people aged between nine and 25 by providing them with a personal development programme. Those young people are not expected to join the scouts, but they gain a wide range of valuable life skills, combined with accredited and non-accredited qualifications, which put them on the right track for a fulfilling adult life. Many are progressing to employment, training and apprenticeships, which they would not have thought possible before joining the programme.
The scouting movement believes
“that young people develop most when they are ‘learning by doing’, when they are given responsibility, work in teams, take acceptable risks and think for themselves.”
I am glad that a movement with such a positive agenda to help young people reach their full potential decided to open its membership to girls and young women 20 years ago.
On international women’s day, I believe it is right to acknowledge and celebrate the Scout Association, which, across 261 countries worldwide, is giving so much to millions of young people, including more than 60,000 girls and young women in the UK who can have a better life and future because of it.
Amber Rudd (Hastings and Rye) (Con)
It is a pleasure to follow the hon. Member for North Tyneside (Mrs Glindon). I share her enthusiasm for the scouts and the guides.
Why is there no international men’s day? I cannot be the only Member to have been asked that, not just by acquaintances but by one or two Members. Let me say that it made me wonder why they think like that, before hon. Members hazard a guess about what side of the argument I might take. Why do they think that? The answer is that there is much to celebrate. If we look at ourselves professionally in the country, 42% of all doctors are women, although the figure for consultants is only 31%; in the law, 60% of current trainees are women, but only 21% of partners and only 22% of judges are women. If we consider the FTSE, only 15% of directors are women—that has already been much trailed and debated in Parliament. However, the figure was 5.8% in 2001—again, we must celebrate the progress that has been made. We are making a tremendous effort in all parties with the team led by Lord Davies on the 30% aim. Of civil servants, 53% are women, although that figure is only 35% at senior level. We have much to celebrate, but major problems remain.
We have much to celebrate when we consider the young people in our education system. Every year, when GCSE and A-level results are announced, we hear about the segmentation of the genders and how well the young women have done. In 2011, the girls outperformed by the boys at A-level by 78% to 74%. That is encouraging. In exams and at entry level, women are doing well, but in senior positions, they are not doing so well. For me, that is one of the main reasons why we need an international women’s day. We still have the problem of getting women into senior positions. The Suffragettes thought that the answer was to get the vote, but 100 years later we find that that is not the case. We have not achieved that equality, which they would be amazed to see still eludes us.
The media seem to think that the debate is about whether feminism means wearing high-heeled shoes or pole dancing. In my view, it does not. We must not let that mask the seriousness of what is going on and the economic difference that persists between men and women. Women earn 75p in the pound to every man.
Claire Perry
Does my hon. Friend accept that when we consider a group of women in their 20s who are childless graduates, the gender pay gap has reversed, and that they now out-earn their male counterparts? Something sinister is happening as women go up the career chain—perhaps it is child care. Perhaps we should all focus our efforts on sorting that out.
Amber Rudd
Some people say that we do not need an international women’s day or quotas and so on because they see younger women doing so well at A-level and at entry levels. However, they fall down at more senior levels.
Dr Eilidh Whiteford (Banff and Buchan) (SNP)
Does the hon. Lady agree that gender segregation in the workplace is one of the major reasons why women do not make career progress?
Amber Rudd
I think that the main reason why women do not make real progress is child care. We often debate on the Floor of the House who has better answers to that, but we know that child care went up by 50% under the previous Government. I am longing for more initiatives from the Government to build on those we have because I believe that child care is the big problem that prevents women from getting on.
This afternoon, we will hear about individual campaigns and particular issues championed by hon. Members. It will be an exciting afternoon. Many women Members of Parliament have got young women from their constituencies shadowing them. I have Amy Gibbons and Alice Williams from Parkwood in Hastings shadowing me today. I know that they are most welcome here.
We need today to reinforce the message that Members must continually champion women’s lives. Tremendous progress has been made, but the position is still unfair nationally and internationally; the world is still lop-sided. We have an important role to play in highlighting that.
Internationally, 19% of parliamentary seats are held by women, and only 16 of the world’s directly elected 188 leaders are female. Does it matter? You bet it matters. When colleagues here say, “We don’t necessarily need more women MPs—I can speak for the women”, one might tactfully suggest that they look around the Chamber today to see who is speaking up for the women. From whom will we hear this afternoon about individual issues that matter to women and their communities? The answer is, of course, women.
What key issues do I hope will be discussed this afternoon? We will hear about pay, child care and opportunity. We heard earlier from my hon. Friend the Member for Maidstone and The Weald (Mrs Grant) about safety, which is another key issue for women. So many women are not safe in their houses. The United Nations has said that one in three is likely to be a victim of sexual assault. Violence against women causes more deaths and disabilities in women aged 15 to 54 than cancer, malaria, road accidents and war. Tremendous progress has been made, but we must never let that make us complacent.
We need international women’s day, not to be just like those countries, such as China, Russia and Vietnam, that make today a national holiday—would not that be a nice idea? Some countries make it a national holiday for women. Perhaps that would get the attention of some of our colleagues.
The serious point is that the personal is political. We need to do more to help women, not just in the workplace, although it is important, not just in schools, but in their homes. We must never take our eyes off the ball.
Valerie Vaz (Walsall South) (Lab)
It is a pleasure to follow the hon. Member for Hastings and Rye (Amber Rudd). Her two constituents will be extremely embarrassed by that name check. It is international women’s day and it is good to see women on both sides of the House. There is cause for celebration, because the Secretary of State for Transport is here, despite her previous duties, and it is good to see her.
I did not get a chance to speak on the motion in the House yesterday to present an humble Address to Her Majesty the Queen on the occasion of her diamond jubilee, but it is fitting, as we celebrate international women’s day, that she is a woman and she has been—[Laughter.] I was going on to say that she has been our figurehead for all that time. The last monarch to celebrate a diamond jubilee was also a woman: Queen Victoria. I add my good wishes to those given yesterday.
We are here today to praise and celebrate good women—not only those who are well known, whom I will come to, but those who are unknown, such as the single mothers who bring up children against all the odds, and who through no fault of their own must hold two important jobs: as main earners and as home workers keeping a household together. They are an inspiration, just like Aung San Suu Kyi, who spent 15 years under arrest. We must keep raising her case to ensure that whatever happens to her in the elections, she is there to ensure change in Burma.
I am also inspired by some of the young women I have met who are involved in the “Because I am a Girl” campaign. There are 75 million girls who are not in school. Girls are still denied a basic education. They need to be in school, not carrying water. As Gandhi said, if we educate mothers, we educate the nation.
What about economic justice? The use of microfinance is important because it empowers women in a financial setting. It is a force for good only when it is properly regulated and women are supported, so that they are not burdened by the debt. We need to do more—the figures are there for all to see—because women’s unemployment is at its highest since 1988 at 1.1 million.
We must follow Sweden and Norway by getting more women on to boards; I echo what the hon. Member for Hastings and Rye said on that. Following the report by Lord Davies of Abersoch, only 21 women have been appointed to board positions out of a possible 93 posts. The Cranfield institute of management found that 89% of the FTSE 350 companies have no women executives. Widening the pool of talent from which to draw is an engine for growth that will benefit this country.
There is more to do for women in science. As someone who did a science degree, I am concerned because only 5.3%, or one in 20, of all working women are employed in science, engineering and technology compared with 31.3% of all working men. The most recent figures show that women are only 12.3% of the work force in SET occupations. I am sure that you, Madam Deputy Speaker, and other hon. Members will know, because I have raised this in Prime Minister’s Question Time, that the UK Resource Centre for women will lose its funding by 2012. I have taken that up with the Prime Minister and he is going to be looking at it.
I am confident that all of us across the House will ensure that we support women in future. I was pleased to meet 11 Tanzanian women MPs as part of a cross-party Commonwealth Parliamentary Association delegation. They were excited to meet and shadow us. Of Tanzania’s MPs, 36% are women, and they were laughing at us because we have only 22%. They want to increase the figure to 50%. Who cares if there are quotas so long as women get the posts and the experience in position? That is all that matters.
I pay tribute to other women, such as Caroline Adams, who is working across parties to help women MPs in the new and emerging democracies such as Tunisia following the Arab spring, because they need support too.
Finally, not for nothing are the scales of justice held by a woman. It is our right to be treated as equal and to ensure that the next generation continues to make strides in equality. It is not only our right, but our duty, to get justice and equality for the next generation.
Jo Swinson (East Dunbartonshire) (LD)
It is a pleasure to follow the hon. Member for Walsall South (Valerie Vaz).
I always find these debates a challenge, because we have 90 minutes to discuss the topic of international women’s day—“Half the world. Discuss” in an hour and a half. There is far too much to say, so I wanted to share three stories of three international women whom I have had the pleasure to meet in the past three years.
In 2010, I went to Grozny with the esteemed Labour peer Lord Judd to investigate the human rights situation in Chechnya. Of all the meetings we had—we met high-profile people, human rights ombudsmen and so on—the most memorable was with a mother who came to see us wearing a thick black woollen coat and a dark pink patterned head scarf. She sat down and placed into our hands photographs of her brother, her son and her daughter, who had all been “disappeared”. She was not sure whether they were rotting in a Siberian jail on trumped-up charges or whether they had been assassinated or executed. What struck me was her bravery. At great personal risk, she came to tell that story to visiting parliamentarians, because she wanted to make sure that others did not have the same experience. That culture of impunity and the human rights abuses in Chechnya are still a source of great distress, but such women are courageously making sure that they tell the story.
Last year, at an event attended by various hon. Members and organised by the hon. Member for Stourbridge (Margot James), I met Selay Ghaffar, who is the Afghan executive director of Humanitarian Assistance for the Women and Children of Afghanistan. She spoke movingly about the battles she is facing to get justice for women and girls who are married off at the age of 12 or 13 and effectively treated as slaves. For the slightest offence, as it were, they can suffer horrendous violence, for which there is no justice or redress. Her work is done at great risk. She was on her way to the Bonn conference, which my hon. Friend the Minister attended, to ensure that the voice of women in Afghanistan was heard.
Just last month, along with the hon. Member for Sheffield, Heeley (Meg Munn), I went to Kurdistan in Iraq, where we spoke with women parliamentarians. The Kurdish MP Shawnem Barznji was absolutely inspirational when she spoke about the battle she had fought. She brought together women MPs in Kurdistan, and increasingly the clerics—she ultimately got the support of the President—to tackle violence against women and to get a law passed that would ban female genital mutilation. That was not an easy alliance to build, but it was inspirational to see what was being done. From chatting to women MPs in Kurdistan, I can tell hon. Members that we share many of their frustrations as parliamentarians—they also face confidence issues, which I often hear from women in politics here in the UK.
Those are just three of the 3 billion or so women in the world, but they are representative. In every country around the world, whether they are journalists, mothers, campaigners, representatives, activists, carers, entrepreneurs or friends, women make that difference. We know that women are suffering. Women bear the brunt of many of the world’s problems, whether from climate change, poverty, conflict or the impact of violence. However, there is cause for optimism. The women whose stories I have described; the women we see every day in our constituencies who make such a fantastic difference in our communities; and the many women who inspired the Arab spring give us cause for hope for the future. Women are making a difference, and it is right that we take the opportunity of international women’s day to celebrate those women and redouble our commitment to equality at home and abroad.
Seema Malhotra (Feltham and Heston) (Lab/Co-op)
Today is the 101st international women’s day, and I am pleased to join hon. Members in speaking up for the needs of women and our aspirations for the progress of women all over the world. I pay tribute to the many women in my constituency for all their work—I know that women are doing the same work in other constituencies too—in holding together families, businesses and communities.
We have made progress since the first international women’s day in 1911, which was a time when women in Britain did not even have the right to vote. The third of the millennium development goals, which were adopted as part of the UN millennium declaration in 2000, promotes gender equality and empowerment of women, with three main areas of focus: the ratio of boys to girls in education; the share of women in waged employment; and the seats held by women in national Parliaments. I wish to speak briefly about the third focus and its relationship to the former.
I am delighted that we can have this debate, because women’s progress in society is also linked to women’s progress in political life. Equality will not be achieved without a focus on increasing female representation in politics. Despite growing numbers of female parliamentarians, equal participation remains far off. At the end of January 2011, the UN estimated that worldwide women held 19% of seats in single or lower Houses of Parliament. This poor statistic is mirrored in Britain, where we make up 51% of the population but, as my hon. Friend the Member for Walsall South (Valerie Vaz) mentioned, only 22.3% of the House of Commons—I think that I might be responsible for that 0.3%.
Since 1918, only 366 women have been elected to the House. In 1997, 101 Labour women were elected, and they changed the game in the UK, leading to a renewed focus on women in Parliament on both sides of the House. They helped to lead the debate and bring a fresh and distinct voice to our politics. Women’s voices helped Labour to increase the length and pay of maternity leave, and introduce paternity leave; to create more than 3,000 Sure Start centres, such as the one in Southfield run by the amazing Noveen Phillips in my constituency, making it easier for mothers to return to work following pregnancy; to introduce equality legislation ensuring that the public sector proactively promoted equality; and to introduce the national minimum wage, which was an outstanding gain for nearly 1 million women.
It is of serious concern, therefore, that under current Government policies women across Britain are being hardest hit and will bear two thirds of the deficit cuts, which will impact on women’s employment. Indeed, women’s unemployment in Britain is now at its highest level for two decades and has passed the 1.1 million mark.
I pay tribute to the work of the Fawcett Society and others in keeping the fight for women at the forefront of society. However, if we are to ensure that women’s voices are strong in political debate and decision making, political education and engagement of women are also vital. I am proud of the work of the Fabian Women’s Network and Young Fabian Women in running new programmes for political education and mentoring to develop understanding and the influencing skills of women in all walks of life. I also pay tribute to other organisations, such as Operation Black Vote, dedicated to increasing representation in politics.
Without a continued focus on investment by the next generation of politicians, national Parliaments will be all the poorer, and we will have less representation of women’s voices, which is vital if women are to progress in all areas of society. We know that when women thrive, all of society benefits and succeeding generations are given a better start in life. On international women’s day, we are reminded of the imperative and our responsibility to act with renewed urgency to address gender imbalances and women’s access to power across the world in order to see greater economic and social progress.
Claire Perry (Devizes) (Con)
It is nice to welcome some members of the brotherhood into the House. I hope that they do not get too bad a headache from all the oestrogen circulating.
I imagine that my colleagues are waiting to hear me rubbish the Opposition claims that the Government are unfriendly towards women. Although I wholeheartedly believe that that is complete and utter nonsense, I will take these short minutes to do something else. We live in the seventh richest country in the world. Today, most of us travelled here freely, can speak freely, chose this career freely, and can choose how to educate our daughters and access world-class health care throughout our lives. Millions of women around the world do not have those freedoms, and I think, as leading parliamentarians, we should be debating that today.
I want to focus on Afghanistan. Of course, we cannot mention that country without thinking about the awful tragedy that took place yesterday. As an MP for a constituency with many military personnel, I know how devastating this news will be to the friends, families and communities of those lost. All of us will join in sending our thoughts and prayers to those families. As we heard, however, the mission will continue as planned, and in the process the forces will continue to change unimaginably the lives of people in that country, especially women.
It is hard to imagine what life was like before the current international security assistance force campaign began. It was illegal to educate women—hence Afghanistan still has only a 13% literacy rate for girls, compared with 43% for men—and there is endemic sexual and domestic violence, with 87% of girls and women having suffered domestic violence. I do not need to remind Members of the appalling age at which many young girls are forced to marry. Afghanistan has the highest lifetime risk of dying in child birth in the world—women have a one in 11 chance of dying in child birth. It is truly unimaginable, stone-age care.
Progress has not been perfect, of course, but now, after the intervention, 40% of children at school are girls, one quarter of teachers are women, 27% of MPs are female—as mentioned, they are doing better than us on female representation in Parliament—and 72% of women believe that their lives are better now than before.
I have a personal interest in the matter. Joining me in the Gallery today is Farahnaz Afaq from Afghanistan, along with her school mates and headmaster from Dauntsey’s school. She is an 18-year-old girl from Kabul whose parents left the country when it was clear that they could no longer secure an education for their children. I met her recently in my constituency, and I was gobsmacked. For such a young person to have seen so much, learned so much and acquired such wisdom while travelling the world trying to get an education is absolutely extraordinary. She tells me that she is desperate to return to Afghanistan so that she can take back her learning to the girls and women of that country.
I will share with the House what Farahnaz said when I asked her what was the most extraordinary thing she has seen since coming to Britain. She said, “I saw a woman driving a bus, and I could not believe that such a thing was possible.” It is that kind of perception that we must always focus on when we talk about women’s rights and progress. We must remember what it is like for so many millions of women around the world.
Margot James (Stourbridge) (Con)
Does my hon. Friend agree that it is vital that the Department for International Development and all our Government agencies do everything possible to sustain some of these improvements in Afghanistan after the troops withdraw in 2014?
Claire Perry
My hon. Friend, as always, presciently anticipates what I was coming to. May I put on the record, though, how proud I am of the Government’s commitment to maintaining the 0.7% level of international aid spending?
We are at a turning point in Afghanistan. Some 86% of Afghan women now fear the Taliban returning. We have a set draw-down plan for coalition forces, with combat operations ceasing in 2014, and there is a widespread fear that this will be an open door for lawlessness and a return to stone-age beliefs when it comes to womankind. What matters even more, then, is political leadership in the peace process, and this is where we can make a difference. Last night, I attended the launch of the parliamentary network on women’s rights in Afghanistan and heard how critical it was that at the upcoming summits in Chicago and Tokyo women’s voices were heard and listened to in establishing the long-term peace and security process in Afghanistan.
On this day, when we celebrate the progress that women in Afghanistan have made, I want to make a plea to the Government. Will Ministers please take the lead in asking that women are fully represented on the Afghan delegations to the summit? ActionAid has called for 30% representation, but I would like it even higher. Will the Government please work with other international partners to take every opportunity to make reference to the importance that women can and must play in securing a long-term peaceful solution for Afghanistan? I would also please ask all colleagues across the House to put aside their differences and join me in sending a message to the women of that country: we recognise you, we admire you and we will support you.
Barbara Keeley (Worsley and Eccles South) (Lab)
I am sure that I speak for women on this side of the House when I say that we support the sentiments expressed by the previous speaker.
I want to talk about women in sport. Sport is an important part of life for many people, but it is something in which girls and women do not participate as much as boys and men. Many people might be unaware of that. Women’s sport accounts for only 5% of the total media coverage of all sport. It is that absence of coverage that perhaps led to the BBC’s “Sports Personality of the Year” programme producing an all-male shortlist for this year’s final, which quite rightly caused a wave of outrage. I hope that the BBC will not make that mistake again, particularly now that many of its sports programmes are made in Salford.
I am undertaking a Sport England sports fellowship with the Women’s Sports and Fitness Foundation, a great organisation that is helping me to understand the issues of women in sport, so that they can be raised more often—indeed, it is great to raise them here today. We are keen to launch, if we can, an all-party parliamentary group on women in sport. I am pleased that the Cross Bencher Baroness Grey-Thompson has agreed to act as co-chair of the group, because she is a great icon for women’s sport. I hope that many of the Members here today will join the group—I have a form with me, if anyone wants to sign up.
I hope that the woefully small amount of media coverage received by women’s sport will be rebalanced somewhat during the London Olympics, but we also need a long-term change, because despite the focus on the Olympic legacy, the number of women taking part in sport or physical activity has been declining over the past four years. This is an important issue, because sport can improve health and fitness, while inactivity can lead to obesity and heart disease, and affect quality of life. The latest Sport England survey shows that just 29% of women take part in sport once a week, compared with 41% of men. Indeed, the figure for women’s participation has fallen by 2%, from over 31%. That amounts to 6.3 million women, compared with 8.5 million men. The figures also show that 9 million women take part in sport only once a month, compared with 11.5 million men.
We can therefore say that there is indeed a significant gender gap, and research has shown that it is caused by many different barriers. They include practical barriers, such as lack of time, child care, money or transport, but we know that there are also many personal barriers to participation, such as worrying about what one looks like, not having the right clothing or equipment to play sport, or lacking self-confidence. We know, too, that there are social and cultural barriers. Sport in this country tends to be dominated by a male culture, and there are also restrictions based on gender. In football, for example, girls are not allowed to play in mixed teams after the age of 13 in this country, whereas in countries such as Norway, Sweden and Northern Ireland, there are no age restrictions. Indeed, it took a campaign and many petitions on behalf of girl footballers to get the Football Association to raise the age limit from 11, which it did recently.
It is significant that of the 12 million women who want to play more sport, 6 million currently play no sport at all. The latent demand for sport is higher among young women than young men. It seems that the current delivery of sport is not meeting women’s preferences. Perhaps that should not surprise us, when we know that 78% of the positions on the boards of sports national governing bodies are held by men; only 22% are held by women. That affects the ability of those sports bodies to understand and meet the needs and preferences of women.
As for girls, by the age of 15 they are only half as likely as boys to meet recommended activity levels in sport and fitness. I therefore want to talk about the Us Girls project, which is an investment being made by Sport England, as part of the “Active Women” campaign to tackle the gender gap in sport. Us Girls projects will offer young women aged 16 to 25 innovative and engaging ways to become more active in sport and fitness more often. Some 62 organisations will work together to get 30,000 girls and young women across the country participating in sport. That is a great initiative. I hope that Members here today will support Us Girls projects in their constituencies, because more needs to be done to break down the barriers to sport for women, make it more appealing, make women aware of the importance of being active, and develop more healthy and fit role models.
Let me conclude by mentioning some of those role models: Rebecca Adlington, who won gold in the swimming; Sarah Stevenson, the world tae kwon do champion; Keri-Anne Payne, who won the 10 km open water event; Chrissie Wellington, who last year won her fourth Ironman world championship; and the England women’s cricket team and Charlotte Edwards, who just completed a 3-0 whitewash against New Zealand in the one-day international series. May they never be ignored in competitions ever again.
Madam Deputy Speaker (Dawn Primarolo)
Order. We have to start the wind-ups shortly. I am keen to ensure that everybody gets in, and I hope that the Front Benchers might co-operate. If they could take eight minutes each, and if I now cut the time limit for Back-Bench speeches to four minutes, we will just about fit everybody in.
Margot James (Stourbridge) (Con)
It is a pleasure to follow the hon. Member for Worsley and Eccles South (Barbara Keeley), whose interesting speech about women in sport has prompted me to remind the House that Saudi Arabia is bringing a team of athletes to the Olympics that contains no women. We should reflect on the terrible situation that women in that country face in trying to pursue their sporting aspirations.
Staying with the international theme, I attended a conference on women’s rights in the developing world some 20 years ago. It opened my eyes to the fact that, even in the most abject poverty, women are still not equal to men. The position of women and girls—in terms of their rights and basic needs that are not met —is far worse than that of the men and boys in the same, poor communities. A chance encounter at that conference enriched my life and opened my eyes. Wanjiru Kihoro, the leader of a group of exiled women from Kenya living in London, spoke on behalf of a women’s empowerment group called Abantu, and asked if anyone could provide the group with office space in London. We had some spare space, so a month later they all moved in, and they stayed for about six or seven years.
Margot James
It was. It was absolutely marvellous, and it gave me the opportunity to work directly with those women on their work in Africa. They worked through a network of women’s organisations across the continent, and I went with them to South Africa and Uganda. They wanted me to train women in media skills, lobbying skills and business skills. I was humbled, because what did I know of their situation? Indeed, I always feel that I learned so much more than the women whom I trained.
I am pleased that the UN has named the theme of this women’s day as “Empower rural women: end hunger and poverty”. Rural women and girls make up a quarter of the world’s population, and rural girls are twice as likely to be forced into child marriage and experience teenage pregnancy as girls in urban areas. Despite the efforts of many laudable NGOs and charities, the problems of women struggling in poverty have not gone away, and the gains made are often fragile to say the least, although there have been improvements, about which we have heard this afternoon. Some 20 years ago, there was little understanding of the way in which development policies impacted on women and men, and boys and girls differently. Our capacity to make a difference has been hugely improved by the understanding that unless we tackle the cultural and legal obstacles to the education of girls—their health status, the age at which they marry and bear children, their access to land and resources, which should be on an equal basis to men—poverty and discrimination will persist, and persist for entire communities, not just for the women and girls in those communities.
Microfinance has been successful at providing women with access to the basic raw materials that will enable them to become more independent, and I hope that later in the debate we hear more on those matters, but my time is up.
Helen Goodman (Bishop Auckland) (Lab)
What a pleasure it is to see you, Madam Deputy Speaker, in the Chair during this international women’s day debate.
The hon. Member for Stourbridge (Margot James) made some excellent points about the issues in the countries of the south, and my hon. Friend the Member for Slough (Fiona Mactaggart) made some excellent points about the way in which the coalition Government are trying to turn the clock back to the 1950s in this country. I do not need to repeat what she said, but the policy is backfiring spectacularly, because it is inspiring a whole new generation of feminists to fight for their rights, and I shall tell the House about three of them.
The first is Lucy O’Sullivan, who has researched women’s representation in government and concluded that women Ministers make a real difference to the effectiveness with which women’s interests are represented in practice. She has also tracked the number of women Ministers whom we have had. During the 1980s and 1990s we were bumping along at 5%; then in 1997 we jumped up almost to 20%; and by April 2010 we had seen a steady increase to the point where 30% of Ministers were women. However, after the May 2010 election that figure crashed by 50%, and now it is at a 14-year low, as a result of this coalition Government.
The second example of the new feminism is the campaign to increase the number of women in the media. I am sure many hon. Members will have seen the research demonstrating that only 22% of newspaper articles are written by women. Broadcast magazine has a good campaign, called “Expert Women”, to get more women into the media, and the one trade union with a woman general secretary, Michelle Stanistreet of the National Union of Journalists, is holding a meeting next week to organise the fightback to improve women’s representation in the media.
Colleagues on both sides of the House will know of my concern about the issues of body image—I was pleased to join the all-party body image group that the hon. Member for East Dunbartonshire (Jo Swinson) established—and about the urgent need to close down “ano” websites, which encourage young women to starve themselves, so they may be surprised at my third example of the new generation of feminism. It is Cosmopolitan magazine—a collective made up entirely of female journalists. Alongside its “We use the F word—do you?” campaign, it has now set up a petition for equal pay, and I advise all hon. Members to go to its website and sign it. It states that
“it’s scandalous that the pay gap still exists. Laws on equal pay have existed for more than 40 years yet women working full-time…are still paid on average 14.9% less… At the current rate of change a baby will not achieve equal pay until she is 97 years old. Enough is enough.”
So will the Government take up its challenge to make equal pay auditing compulsory next year?
Jane Ellison (Battersea) (Con)
I do rather worry that today has been a missed opportunity to strike a more bipartisan note. I myself shall not be tribal, although some previous contributors have been.
I shall make three practical suggestions, loosely linked by the idea of asking awkward questions, which I like to think we are all quite good at. My first theme, which Members will not be surprised about, is female genital mutilation, and I thank many Members in the House today and others for their support over the past year, because a lot has happened since I spoke about FGM in last year’s international women’s day debate. I feel that we have a sense of momentum, and I thank Members for that.
I want to ask for something practical, because we have to keep the issue high on the agenda. The all-party group on genital mutilation has drafted a template letter, which Members can send to health and wellbeing boards or to other commissioning groups, and it asks lots of practical questions about the strategies that have been put in place on safeguarding, commissioning and dealing with women and girls who might be threatened with, or have suffered, FGM. May I urge hon. Members to send that template letter, or their variation on it, to their local groups and boards?
Even in London, I am amazed at the number of times that people look at me blankly when I raise the issue. Sometimes they do not even know what I am talking about, despite being senior health professionals and so on, so we have to keep pushing; we cannot assume that it is on everyone’s agenda.
My second practical point is a bit of leap, but one thing that I worry about when I look at the Arab spring, which other hon. Members have touched on, is how women’s rights are not on an upward trajectory but are potentially going in the other direction. There is evidence of that in Egypt, with many clerical groups pushing for the further institutionalisation of FGM there.
I therefore have a very practical suggestion, which I put into practice when I attended a briefing with one of our ambassadors recently—slightly I suspect to his surprise. We should tell all our ambassadors and high commissioners—wherever they are but particularly those in key countries—to ask why they are not seeing delegations of men and women. If they are seeing only delegations of men, they should politely and nicely—diplomats are very good at being polite and nice—ask why; and if they are not seeing women they should seek out the authentic voice of women. If they see only male delegations and talk only to male politicians, they will not hear the views of the people; they will hear the views of men in those countries. So it is important that the Foreign Office asks those questions of its diplomats.
My final point is about the way in which we do politics here in the UK, because we can take a lead. We should agree cross-party, and begin a discussion before the next general election, on how we do our politics and with whom we interact, because too often we see community leaders who say that they speak for their community but speak only for men. We female politicians, in particular, should demand to hear the authentic voice of male and female community leaders. There is no point demanding equality in the boardroom if we accept inequality in our community centres.
Mary Macleod (Brentford and Isleworth) (Con)
I am delighted to follow my hon. Friend the Member for Battersea (Jane Ellison), who has done an incredible amount of work on FGM, for which I applaud her.
This is a day for celebrating the contribution of women, as well as for reflecting on what more we can do to support women and girls throughout the world. My hon. Friend the Member for Devizes (Claire Perry) spoke eloquently about Afghanistan. Only recently there was pressure from Muslim clerics in that country for the adoption of a strict code of conduct, stating that
“men are fundamental and women are secondary”,
which underlines the fact that we have much work still to do to protect women’s rights there. I shall focus my few remarks, however, on two areas: first, on building aspiration, whether in schools, business or politics; and, secondly, on protecting women.
It is important that we build aspiration from a young age. As my hon. Friend the Member for Hastings and Rye (Amber Rudd) said, we, as part of the all-party women in Parliament group, have welcomed many girls to Parliament today, and that has been lovely. From my constituency, I have girls here from The Heathland, Brentford, Chiswick, Isleworth and Syon, Hounslow Manor and Gumley schools, and I hope that between us we can inspire a few of them to become Members.
It is so important that girls are aware of the full range of opportunities available to them and how they can make best use of their talents. I would like us to do more to encourage girls, especially in science, engineering and technology. Whether it is through setting up more work experience or shadowing events, we can try to build their aspirations and open up a whole world of opportunity to them. The new careers service that will be fully operational by April 2012 will provide high-quality advice to those of all ages online, by phone and in the community, and much work needs to be done there.
As for women in business, we have already heard about the Lord Davies report. We need to keep up the momentum in focusing on companies, especially regarding the critical lack of women executive directors in the pipeline. Another way to increase the role of women is to support them in setting up their own businesses. The Government have done good work with mentors and the Women’s Business Council, but I would like us to do more to promote and celebrate role models, extend child care support for the self-employed, and continue to work on entrepreneurial skills in schools. As regards the number of women in Parliament, this country is still ranked 49th in the world, and much work needs to be done to change that.
My final point is about protecting women. That is largely to do with domestic violence, which is totally unacceptable in our society. The Government are committed to tackling this through their document “Call to end violence against women and girls: action plan”, but a lot still needs to be done. There have been recent campaigns to highlight abuse in teenage relationships, as well as the consultation on stalking and the piloting of Clare’s law. We need to help victims of domestic violence to rebuild their lives.
Earlier today I was at an event organised by Hestia, which has just produced a report, “From victim to survivor”, highlighting some of the key things that can be done for domestic violence victims. For example, those who are in refuges should be given priority for housing in the local area. Bed and breakfast is not suitable for them; they need to get into longer-term, stable housing. Perhaps councils need to appoint housing officers who have been given training in dealing with domestic abuse. There is much that we can do collectively to help to support victims of domestic violence so that they can rebuild their lives and this country can be a better place.
Andrea Leadsom (South Northamptonshire) (Con)
I am delighted to be the last Back-Bench speaker in this debate.
Today is a day for celebrating women in all their multiple roles across the world. I want to highlight three women in particular: one who is a carer, one who is a worker, and one who is a leader. Julie Jones, who has just become Tesco Mum of the Year, has adopted five children from her best friend, who sadly died shortly after her own husband. This single mum with three teenage boys of her own has adopted another woman’s five children—what a fantastic thing to do. Congratulations and good luck to her.
A woman who is a worker is successful 22-year-old Habiba Mentane, who lives in Somalia. Thanks to micro-finance, she has taken her entire family from being nomadic, poverty-stricken people looking for food wherever they go to being farmers who are now able to grow their own vegetables, sell the surplus, and create some kind of a life for themselves. Congratulations to her and to the many thousands of other women like her who support their own family in that way.
The third person I would like very sincerely to congratulate is Her Majesty the Queen on the occasion of her diamond jubilee. She is a woman who has faithfully served the country for 60 years and presided over a Commonwealth of nations. May she live for another 60 years! I am sure that she will not share that wish, but we would love to keep her for as long as possible.
There is so much more that could be done for women, and I want to focus on three areas: equal representation, equal pay, and equal status. Worldwide, women hold 19% of parliamentary seats. In Saudi Arabia, a woman cannot vote. Not only that, but they may not drive—we can imagine what that would mean for us in this country. We think that it is pretty tough here because only 22.3% of parliamentarians are women, but at least we can drive, and at least there is a good smattering of sisters in this Chamber; it is wonderful to be part of that. I have so many friends in all parts of the Chamber, and it is truly delightful to be in that position, particularly after 25 years in finance, which unfortunately remains very much a man’s world. So thank you for that, colleagues and friends!
On pay, 70% of the world’s unpaid labour is performed by women. That is shocking—what on earth is going on? In the UK, we think it is tough because the median income of a full-time working woman is 91% of that of a full-time working man, but that is not as bad as other women in the world have it. There is more to do, but things are not so bad here, and we should celebrate that.
Status is absolutely key. Other Members have mentioned Afghanistan. I was very shocked to hear about the proposal by the Afghan Council that a man should be allowed to have sex with his wife on every fourth night. In other words, if she says no, he can rape her, and that is official. That is an absolute shocker; it should not be permitted in this day and age or at any time in any country. Rape is all too often a weapon of war, and human trafficking is all too often targeted at women and girls—the most vulnerable in our society.
The United Nations predicts that teaching girls in Africa to farm would lead to a 20% increase in agricultural yields. This is not just about the rights of girls; it is also about the potential for feeding the world and doing better in the world. There is a very long way to go from where we are right now, but we have made progress. We are extremely fortunate in this country, and I feel extremely fortunate to be part of a very engaged and active parliamentary group.
Kate Green (Stretford and Urmston) (Lab)
I start by echoing the remark made by my hon. Friend the Member for Bishop Auckland (Helen Goodman) that it is a great pleasure to see you in the Chair for this debate, Madam Deputy Speaker. I congratulate my hon. Friend the Member for Slough (Fiona Mactaggart) and other hon. Members, including the hon. Member for Hastings and Rye (Amber Rudd), on their efforts to secure the debate. I also want to thank the Backbench Business Committee for making time for it to take place on international women’s day. It is absolutely right that we should allocate time in the parliamentary calendar to mark this special day each year.
Hon. Members have rightly drawn our attention this afternoon to a whole range of national and global issues that affect women. It has been clear that common themes and experiences unite all women, here and around the world. They include women’s democratic representation, their economic independence, their access to health and maternity care, their choice of when and whether to form a family, and their right to freedom from fear and violence. Those concerns unite women right across the world, yet still, here at home, there are shortcomings that the Government have an obligation to address.
Ministers have taken the opportunity today to publish an update to the violence against women action plan, and I welcome the attention and priority that the Government continue to give to this issue. I hope that Ministers will also take the opportunity to read the Labour women’s safety commission report entitled “Everywoman Safe Everywhere”, which has also been published to mark international women’s day. The report was published following the establishment of a commission by my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) last November, after we had identified concerns that the criminal law was not strong enough to protect women and punish perpetrators, and in response to reports that vital services on which women rely were being closed.
We were shocked at what we discovered. We identified significant cuts to provisions that keep women safe, and chaos in commissioning resulting in the loss of specialist services and expertise. We found that preventive work in schools, and with perpetrators, was under threat. It is also ironic that, on international women’s day, there should be an announcement of further cuts in the number of railway station staff, which will make women feel more vulnerable when they are out and about. Furthermore, 500,000 street lights are being turned off at night to reduce costs. In identifying those concerns, our commission has been able only to scratch surface. We are therefore calling on the Minister to carry out an audit across the country to assess exactly what is happening in every local community so that she can fulfil her responsibility as a Minister to keep every woman safe.
I welcome the Government’s announcement today of their intention to sign the European convention. I am concerned, however, that 10 months down the line, they are still only working towards signing it, but it is none the less good to hear that intention confirmed today. In the past, they have tried to water down the convention—for example, by limiting its provisions so that they would apply only in peacetime. There is also a lack of clarity on the Government’s stance on forced marriage. The hon. Member for Maidstone and The Weald (Mrs Grant) highlighted some of these issues in her speech. It would be useful if the Minister could clarify the Government’s intentions in relation to signing the convention. When can we expect that to happen and, importantly, when do Ministers intend to give effect to its provisions?
Ministers have also today announced new provisions on stalking, but campaigners might feel disappointed because it is not clear that the new measures will be any stronger in practice than the terms of the Protection from Harassment Act 1997. Will the new offence, which is to carry a six-month sentence, be heard only in magistrates courts, or will it be triable either way? Will she explain how the new offence relating to “fear of violence” is different from that covered in section 4 of the existing Act, which the police have confirmed they have had difficulty using to prove the existence of fear of violence? Will the Minister tell us how many convictions occurred last year under that Act and how much more effective she expects the new legislation to be?
There is still much that we need to do to protect, improve and promote the interests and well-being of women in this country and around the world.
Tom Brake (Carshalton and Wallington) (LD)
Does the hon. Lady realise that the issue of women in prison has not been raised in the debate? It is an area on which the Corston report was making good progress—and I hope that this Government will make good progress on it, too.
Kate Green
As I am sure all hon. Members do, I greatly admire the work of the noble Baroness Corston on women in prison. One suggestion she made, which would have drawn this whole agenda together, was the appointment of a champion for women within the penal system. It would be very encouraging—I hope the right hon. Member for Carshalton and Wallington (Tom Brake) would agree—if Ministers adopted that suggestion, ensuring that an individual was charged with giving priority attention to women in custody and within the penal system.
Although I welcome today’s debate and the many powerful contributions from hon. Members, I say that women should not have to wait—not even until the 102nd international women’s day—for measures to secure their safety, economic position and well-being. When we come to celebrate next year’s international women’s day, I hope we will celebrate far greater progress for women’s equality—both here at home and right across the world.
The Minister for Equalities (Lynne Featherstone)
May I say first that the Home Secretary is very sorry not to be here to celebrate international women’s day? She is just back from Jordan and has to attend the JHA—justice and home affairs—meeting.
I thank my hon. Friends and hon. Members for all their contributions; I hope they will forgive me if I do not enumerate them one by one. International women’s day is a day for celebration, and I want to set out and celebrate what the Government are doing. We have heard many good contributions today and, sadly, some negative ones from Labour Members. Indeed, they have chosen to be very negative about the impacts of decisions that this Government have been forced to take to reduce the record deficit left to us by them. As my hon. Friend the Member for Hastings and Rye (Amber Rudd) pointed out, if we do not take action, it will be our daughters who have to pay for it.
Let me say that we are lifting 1.1 million of the lowest paid workers, more than half of whom are women, out of income tax altogether—and with more to come. We are increasing overall NHS spending by £11.5 billion in real terms. As part of that, we are recruiting over 4,000 new health visitors and doubling the number of places on the family nurse partnership programme by 2015. We are protecting key support for older women—with winter fuel payments, free eye tests, free prescriptions, free bus passes and free TV licences for the over-75s—and permanently increasing cold weather payments to £25.
Furthermore, we have re-linked earnings with pensions —something called for for years, which did not happen under the Labour Government. We are providing an extra £300 million for child care support under universal credit. Labour Members mentioned child care, yet against this terrible economic background we have maintained the entitlement to 15 hours a week of free education and care for three and four-year-olds. We are also extending the entitlement to 15 hours a week of free education and care for 260,000 of the most disadvantaged two-year-olds. We are funding online and telephone support services for families, and are providing over £28 million for specialist local, domestic and sexual violence support services. [Interruption.] As the hon. Member for Slough (Fiona Mactaggart) said—[Hon. Members: “Give way.”] I will not give way; I have very little time. I am sorry, but everyone else has had their say and I am going to have mine.
We are spending £900,000 on helplines and providing £10.5 million over the next three years for rape support centres. Today, my right hon. and learned. Friend the Justice Secretary announced the locations of five new centres. As the shadow Minister mentioned, we are also creating two new specific criminal offences of stalking. We are tabling amendments to the Protection of Freedoms Bill for Lords Third Reading so that those new offences can be enacted as soon as possible.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
Will the hon. Lady confirm that there will be two separate offences, and that the first offence will have a maximum sentence of only six months, and that in order for the second offence to carry a sentence of more than six months the police will be required to prove that someone is in fear of violence—which was objected to by the all-party parliamentary group, which said that that approach would not work?
Lynne Featherstone
This measure will be effective. It was welcomed by women and women’s groups across the board at No. 10 Downing street this morning. There will be two offences. One will carry a sentence of up to six months, and the other a maximum sentence of five years. This is good news—and it is a great shame that the Opposition do not have the grace to welcome it.
We are also working on gangs and girls, teenage abuse and forced marriage. We are putting women at the heart of the economy, too, through the Work programme, the new universal credit and the new national careers service, in order to give women the help and support they need.
The hon. Member for Feltham and Heston (Seema Malhotra) is no longer in her place, but I take issue with her statement that there has been an increase in women’s unemployment. There are 50,000 more women in work now than a year ago.
In November, my right hon. Friend the Home Secretary announced that the Government will provide resources for 5,000 volunteer mentors.
Lynne Featherstone
No, I will not.
Those mentors will help new business start-ups, and there will be help for women in rural areas, too, where we have provided a £2 million fund over the next three years to support women setting up and expanding their businesses. We are establishing a women’s business council as well.
We are going further. We are extending the right to request flexible working to all, establishing a new system of shared parental leave, and promoting equal pay and good practice in the workplace. With the help of Lord Davies, we are increasing the number of women on company boards.
Because disadvantage and the stereotyping of women do not start and end in the workplace, we are also tackling how women are portrayed in the media. The Government’s body confidence campaign—for which I know there is support on both sides of the House—is gaining momentum and is now receiving global recognition following an event I hosted on the issue at last week’s UN commission on the status of women. We are also tackling the commercialisation and sexualisation of children, working with a wide range of stakeholders to bring the use of sexualised images in line with what parents find acceptable. I am sure Members on both sides of the House are as sick as I am of women being portrayed either as sexual or servile.
The coalition Government recognise that investing in girls and women in the poorest countries is transformational both for economic growth and in meeting all the millennium development goals.
Mrs Eleanor Laing (Epping Forest) (Con)
Will my hon. Friend give way on that point?
Lynne Featherstone
I thank my hon. Friend for reminding me to pay tribute to UN Women. Our country is one of the biggest sponsors and supporters of that organisation.
The Secretary of State for International Development has ensured that girls and women are at the heart of the UK’s international development programme. We can all be very proud of that, and I am extremely proud of what I can do through my role as champion for tackling violence against women overseas, whether that involves going to Bonn to raise issues to do with Afghanistan, or raising issues in respect of the Arab uprising. There is still much to do in tackling forced marriage, female genital mutilation and so-called honour crimes, but I know that Members on both sides of the House support taking action against those practices.
We are taking some very difficult decisions, but they are necessary decisions that are required to bring our country back from the brink. We are making sure that the cuts are shared fairly and that the most vulnerable are protected, and we are going further to ensure that women have a voice and are treated with fairness and respect in the workplace and in society so that they can be a vital part of our future economic growth, and we are working internationally with allies across the world so that women can be part of the world’s future.
Fiona Mactaggart
This has been a powerful debate, and many diverse points have been raised, ranging from sport to Afghanistan to women’s economic power. It will not be possible to address them all. When I introduced the debate, Government Members were provoked by my approach, yet during the debate we have proved that we are indeed tribal, but we are for the tribe of women. The overwhelming majority of contributions have shared a series of values that say that it is not good enough just to assume that a particular policy will meet the needs of women but that we actually need to examine things carefully. Such an approach was demonstrated, for example, in the intelligent analysis by the hon. Member for Maidstone and The Weald (Mrs Grant) of the possible risks of trying to deal with forced marriage carelessly.
I am, in a way, therefore disappointed by the Minister’s summing up. Hon. Members would have been able to tell from my initial remarks that I profoundly disagreed with it, because she made the easy mistake of saying that when we have done something, we have achieved it—that is not the case, as we all know. We can be proud of some bits; I am glad that the Government have made some announcements—for example, those made today about tackling violence against women, which will include some improvements. That is great, but it is not good enough for us all to be satisfied with minor improvements and small changes, or with a system where, as unfortunately has happened in the argument about dealing with the deficit, women have tended to be the victims. Such a situation has occurred because the voices of women have not been around the table.
There are very many strong, intelligent and powerful women in this Chamber today. I say to all of them, whatever party they support and whatever side they are on, that they should make sure that the voices of women are heard and that they should analyse every policy that is put before them through the lens of the difference it will make to women. If a policy advances the cause of women, it advances the cause of the whole society. If a policy advances the cause of women, it promotes the welfare of children. If a policy advances the cause of women, we actually make a more civilised and better society in Britain today, and with that we will have an international women’s day truly to celebrate.
Question put and agreed to.
Resolved,
That this House has considered the matter of International Women’s Day.
Adult Social Care
(12 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Sarah Newton (Truro and Falmouth) (Con)
I beg to move,
That this House believes there is an urgent need to reform the current system of providing and paying for the care of adults in England and Wales; recognises that social care, unlike the NHS, has never been free at the point of need irrespective of income; notes the central role of informal carers in the provision of care; welcomes the Coalition Agreement pledge of reform and legislation; further welcomes the plans for better integration between adult social care services and the NHS; welcomes the extension of personal budgets; urges the Government to ensure that fairness is central to reform, including access to advice, advocacy, assessment of need, care services as well as funding options; recognises the need to break down the barriers to portability; and further urges the Government to publish its White Paper as soon as possible, and to bring forward legislation.
I am pleased that both the care Minister, the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) and the shadow Health Secretary will be joining us today, and that they have entered into talks to agree a way forward on the reform of our social care system. It is vital that today we show our Front-Bench teams just how much support there is in all parts of this House for their important work. Both teams need to know how important this Parliament feels it is to continue and conclude the talks, so that a White Paper and Bill can be produced as soon as possible.
Today’s debate should also be about our vision: our vision to enable adults living with disability or a chronic illness, or those people who are frail in their later life, to have the support they need to live as full a life in their community as possible. That is something that concerns us all, as it strikes at the heart of the values of our society. There are Members here today who have a lifetime of experience, inside and outside Parliament, tackling the issues we will be discussing today, so I will keep my remarks short to allow their valuable contributions to be made.
Central to this debate is the person who needs care and the people around them supporting them, principally their family members, close friends and neighbours, and the wider community. Of course, care provided by nurses, care workers and other professionals is vital, too. In the few minutes available, I shall focus on the care of the elderly, as colleagues with greater knowledge than I will talk about the care of younger adults, those with chronic illnesses and those living with disabilities. Too often in debates about social care we delve straight into the design details of the services provided by local and national Government. Often, such services were designed many years ago, in response to a very different society, when people died of illnesses and conditions that are now lived with; a society where people lived shorter lives. One of the greatest achievements of the 20th century was a significant increase in life expectancy and the challenge of the 21st century is to respond and to redesign care and support services so that they are fit for this century and the next. That is important not only for the people who need them now but for the young people who have already been born who will make it into the 22nd century.
Let us be honest: if we were designing services to support families who care for their elderly and disabled family members, would we have designed the system we have today? Despite the undoubted good intentions of previous Parliaments, our system has developed in fits and starts since the 1920s. It is disjointed and does not deliver joined-up help for the cared for or for carers and it can be utterly frustrating for care and health professionals.
It has been estimated that a total of £145 billion a year of public money is spent on the elderly in social care, NHS and welfare payments. That is £3,000 for every man, woman and child in this country. It does not appear to me that elderly people and their carers are receiving the quality of services and care that such a sum could provide if it were spent differently and more efficiently.
Harriett Baldwin (West Worcestershire) (Con)
Is my hon. Friend going to make the point that this problem will keep on increasing? We are all living longer and one in three girls born today can expect to live to the age of 100.
Sarah Newton
Yes. As I mentioned, it is a great achievement that people are living longer, but that will obviously present huge challenges in adapting our society as people live for so much longer.
Unfortunately, growing old or living with an illness or disability is frightening to too many in our country today—frightening both to the people involved and to their loved ones who support them. There is fear about physical and mental frailty, about the quality of care they will receive from the NHS and social services and about whether they will have to pay and how they will afford to do so. We need to alleviate as much of that fear as possible by creating services and a way of paying for them that are fair and easily understood by people of all ages, that deliver high-quality care and support to carers and in which those who are employed feel respected and appreciated.
To achieve that aim requires a vision and a plan that everyone understands. That plan should be fair and should offer a route from where we are today to where we want to be. It will then require all political parties, over a period of time, to implement it. That will deliver the lasting, consistent and sustainable reform that despite many good intentions has eluded all Governments for many years.
I believe that the Government have recognised the challenge and taken a number of steps forward. There is a pledge in the coalition agreement to reform care services and funding and, following the excellent work of the Law Commission and the commission led by Andrew Dilnot, we have been promised a White Paper this spring and a Bill soon after. That process will very much depend on the determination of the Opposition to work constructively with the Government.
The Government have also ensured that while a longer- term solution is found to the current funding issues more money is being given to councils, and they have committed £2 billion. The Health and Social Care Bill will enable the integration of social and health care and, through the health and wellbeing boards, local commissioning of new care pathways will be made possible. I have seen some highly effective piloting work in Cornwall through the “Changing Lives” approach to joined-up services, which is based around the person and their carers.
The Government have launched a carers strategy and a dementia strategy with funding attached, but it is very frustrating that the money provided for those services is not always finding its way to the people who need it most. I am a passionate supporter of localism and returning power from Westminster to people and their communities. I believe that services for people in Cornwall should be designed and delivered in Cornwall, but we must recognise that this is a revolution. Although some professionals in the NHS and councils are relishing the new opportunities, some are not, as many of them have served in these important public services for years and are used to the command and control management of the past. It is difficult for some people to change and these are big cultural changes.
At a time when large-scale efficiency savings are needed in the services that support older people, reform is more important than ever. The nurses, social workers and carers I know are all motivated to deliver a high-quality service but I think Ministers will need to give clear direction about the commissioning of new pathways—new pathways that explicitly deliver integrated and joined-up care and new pathways developed on the evidence from the innovative work being provided not only by doctors, nurses and social workers but in partnership with other organisations such as Age UK, Macmillan and a host of other not-for-profit organisations. Within the new framework of outcomes, new outcomes should enable better integration.
Those new outcomes and pathways will need funding. We know that for every £1 spent on social care, £2.65 is saved from the NHS budget, so not addressing the inefficient split of funding between the NHS and social care will mean that we continue to waste more and more money.
Mary Macleod (Brentford and Isleworth) (Con)
On funding, does my hon. Friend agree that we should look at having more respite care for carers, especially elderly carers, some of whom do a 24/7 job and need extra support?
Sarah Newton
My hon. Friend makes a very good point, which has been addressed in the carers strategy.
Each year we should aim to use more NHS money on social care, and more money from the NHS budget could be given to councils for the integration of services led by health and wellbeing boards. Eventually, I would like to see the pooling of budgets. Social care has never been free at the point of need, and we know that the NHS will always be free at the point of need irrespective of anybody’s ability to pay. That is enshrined in the Health and Social Care Bill. Despite that, however, most people do not think they will have to pay for care and it can come as a dreadful shock, especially to the one in 10 people aged over 65 who end up paying more than £100,000 for care. Dilnot came up with a framework of shared and capped costs for individuals needing social care—shared costs between the individual and the state. I am sure that framework is receiving a great deal of attention from the Front-Bench teams, but I expect that however well the cross-party talks are going, it will take several years to introduce such a system if agreement can be reached. In the mean time, there is an urgent need to design a fairer system based on shared responsibility to pay.
There are uncontroversial steps that would not require substantial new resources and that could be taken now as part of a longer term plan. The legal framework and assessment processes that are used to decide who is entitled to what help could be sorted. We also need to fix the means test that we use to decide what we expect people to pay. That would help families to understand what help will be available and who needs to pay for what. Families would then be able to plan accordingly. The Government could ensure that people had access to independent advice on the best way of planning and paying for care and they could bring in a universal deferred payment scheme that would tackle the issue that so many people dread—selling their home to pay for residential care during their lifetime.
Margot James (Stourbridge) (Con)
I congratulate my hon. Friend on securing this debate and on all the work she does on this issue. Under the present system, people do have to sell their homes sometimes; does she agree that in such cases it would be far better if some of the accommodation were available to purchase on a leasehold basis so that the individual would still have an asset to pass on?
Sarah Newton
That is an extremely interesting idea, and I would expect no less from someone with such knowledge in this area. I am sure the Minister will want to take that point on board.
Going back to means-testing, we really need to face up to one of the biggest problems facing families—the meanest of means tests in this country: the test for residential care. Making the simple change of raising the upper threshold of the means test to £100,000 would benefit those on modest incomes who are heavily penalised under the current system. It would enable families who have worked hard all their lives and accumulated relatively modest assets—often the first generation of their family to do so—to have something to pass on to their children and grandchildren. It is an understandable and human desire to want to help the next generation. That change would cost £100 million. In this economic climate, such a figure might be too much all at once, but a staged increase in the upper limit would be a step in the right direction.
We are taking this approach to delivering the excellent policy of increasing the personal allowance for taxpayers to £10,000. Apart from spending NHS money more efficiently, there are other sound economic reasons for redirecting public money into social care. While the vast majority of care is given freely, more than 1.5 million people are employed in providing care. We need to recognise better the valuable and challenging work they do. I know that the Minister is doing good work on training and quality standards. Many care workers are paid low wages, so investment in this sector would have the direct impact of putting more money into the pockets of some of the poorest paid workers.
We also need to enable more working age informal carers to combine their caring responsibilities with paid employment. This is even more important as the pension age rises. Much emphasis is put on enabling working age parents to care for their children and remain in paid employment—with flexible working, help with child care costs and financial support through the tax system. We need to put as much emphasis on enabling working age people with other caring responsibilities to remain in employment. Otherwise, we are going to have ever-increasing out-of-work benefit costs to pay.
While I do believe that the Government are starting to develop the processes that could deliver better and fairer access to services and higher quality care, bolder and more determined action is needed to enable more rapid change. I hope that the Minister and the shadow Secretary of State for Health will listen carefully today and bring back to Parliament a shared vision and a clear plan on how together we as a country and as a society are going to create a good place for us all to grow old in.
Barbara Keeley (Worsley and Eccles South) (Lab)
May I start by congratulating the hon. Member for Truro and Falmouth (Sarah Newton) on leading the debate and on the way in which she has just opened it? It is good to work with her on the all-party group on social care. In debates such as this we work together to ensure that social care receives the focus that it needs to have in the House.
I want to discuss two aspects of the future of social care. The first is the current crisis in care and the need to bring in extra resources to close the funding gap. The second is the recommendations of the Dilnot report, which the hon. Lady has already touched on, which mainly focused on dealing with the catastrophic cost of sustained high-level care and support.
On the funding gap, the Minister told me and the Health Select Committee recently:
“We don’t accept the position that there is a gap. We have closed that gap in the spending review.”
However, Age UK’s “Care in Crisis” report says:
“This year spending on older people’s social care in England has fallen by £500 million and the funding gap is growing. … We project that by 2011-13 the Government would need to spend £1 billion more than this year to stop the situation getting any worse. … The current system is at breaking point.”
Research by Age UK showed that 82% of local authorities now provides care only to those with substantial or critical needs. Fewer than one in five local councils still provide care for those with moderate needs. I have to say I am happy that that includes my own local authority of Salford.
The Economic and Social Research Council centre for population change has looked at the issue of unmet need for social care. It concludes that, regardless of the data source used,
“there is significant unmet need for care among older people.”
For example, 66% of people aged over 65 who need help with bathing were not receiving any support. That figure was based on data from 2008 and since then we have had front-loaded cuts to local authority budgets. I am sure that, although there is no up-to-date estimate, there are greater levels of unmet need than the figure I have given.
The Association of Directors of Adult Social Services has reported £1 billion of cuts to adult social care budgets in 2010-11, with further cuts predicted for next year.
This week many of us were involved when about 1,000 campaigners and 60 organisations lobbied Parliament for the urgent reform of social care and an end to the care crisis. For the first time, thousands more who could not attend Parliament joined the lobby online. A statement from those care and support organisations to MPs and Ministers said:
“Our social care system is broken. It cannot cope with a rapidly ageing population and positive impact of people living longer with illness and disability. Those who use our social care system can no longer tolerate a social care system which leaves many with no support and others with poor quality services. The public are angry that they can face huge care charges and end up losing all their savings or being forced to sell their home.”
One of the 1,000 people who came to Parliament to lobby MPs was a deaf-blind woman from Manchester who got up at 5 am to travel down because she said she was so worried about the future of social care. The Care and Support Alliance said that MPs heard personal experiences from people who need care but are receiving none, disabled people unable to access the support needed to live independently, families paying huge bills for care and carers pushed to breaking point.
I wanted to test the situation in my local area before the debate. Over the past few days I checked with three organisations that support older people and carers in Salford and the neighbouring area in Greater Manchester. This drew a depressing but familiar picture of services worsening, mainly due to budget cuts, but also due to cuts and organisational changes brought about by the NHS reforms. A staff member at Parkinson’s UK in Greater Manchester told me about her clients, people who have worked hard all their lives but are now struggling to pay for services that are essential to them. In some cases she had to apply for grants to help people with Parkinson’s buy a profiling bed or even pay off debts.
The staff member told me about a couple struggling to pay for the care needed by the husband, who has Parkinson’s. To help get him out of bed and dressed costs £22 an hour, and having someone sit with him while his wife does the shopping costs £11 an hour. Another carer of someone with Parkinson’s and dementia had her respite care cut from two weeks a year to one week. She feels that she cannot cope without those two weeks of respite. The staff member also told me that budget cuts mean that people with Parkinson’s can wait for a year for a stair lift, and she knows one man who has to go to bed at 7 pm because later in the evening his mobility gets worse and he cannot manage the stairs.
The staff member also told me that NHS efficiency targets mean that GPs are switching to cheaper brands of drugs for patients with Parkinson’s, but many of these are less effective. One person she told me about was admitted to hospital after becoming ill following a switch to a cheaper, less-effective medicine. The hospital staff had told her to “be firm with her GP” and insist on the more expensive brand. We have to be realistic that that is a difficult thing to do. NHS budget cuts in the local area have meant the loss of the community matron service, a service that was used by Parkinson’s UK staff for many of their clients but has now ended. In Salford—I have raised this point before—the primary care trust ended the pilot of active case management for people with long-term conditions, which was proving popular and effective.
Locally, Age Concern has told me that it has now lost the funding for a “Friends for Life” pilot scheme, which was part of the national dementia strategy. Its dementia support service has a planned income reduction of 40% over three years. It has had to make seven staff redundant and reduce its dementia support. Funding for day centres is being reduced by one fifth and will then be ended owing to the switch to direct payments from individual budgets. We all support personalisation and individual budgets, but not if it is a cover for cuts. I was disturbed to hear of a couple of cases where that is happening. In one case I was told about, a carer who had previously had two hours of respite care was given a budget of £9 and told, “Do what you want with the money.”
Our carers’ centre manager in Salford told me of her own experience of such cuts, this time to the personal budget of a family member she cares for with a learning disability who lives in Sheffield. Following what she described as a “fairly perfunctory” re-assessment that was done solely with the person with the learning disability, with no input from a carer or guardian—that is an important point—the personal budget was cut by £10,000. In that case, the carers’ centre manager was able to lodge a complaint and get legal help from a community care lawyer, but she knows that such an intervention would not be possible for other carers. These examples are what we mean when we talk about a care system in crisis.
However, those are not the worst examples. As I mentioned earlier, we know that some 800,000 older people are left without basic care. They have been described as
“lonely, isolated and at risk”.
Those are the words of 60 experts in social care in their recent letter asking the Government to make social care reform a top priority. We therefore know that the problem of unmet need is getting worse. Much of the additional burden will fall on unpaid family carers, many of whom are already overburdened. Statistics from the NHS Information Centre show that the proportion of carers providing more than 50 hours a week has doubled in the past 10 years. I think that that is the level at which it can be counted as a 24/7 caring job, as was discussed by the hon. Member for Brentford and Isleworth (Mary Macleod).
Many organisations have sent us briefings for this debate. There is a consistent call for a solution to the care crisis. Carers UK calls for the capped costs model that the hon. Member for Truro and Falmouth talked about. It sees a cap on costs as essential. It favours the cap being set at £35,000, which it feels would give carers and families the ability to plan for care arrangements and costs, and provide an opportunity for the development of care insurance products. I agree with that assessment and would caution against setting the cap at a higher level, such as £60,000, which has been discussed in the media. That is the value of some properties in Salford, so it could mean a family losing the entire value of their home, which would be wrong.
Carers UK believes that if families know that costs will be capped, they might be more willing to buy care and support earlier. That would help to promote independence and reduce the pressure on carers, which can result in ill health, giving up work or reducing working hours. It is thought that it will be harder to produce that shift in behaviour and move towards a new market in insurance products without a capped costs model.
Care and Support Alliance members argue for an additional £5 billion to be put aside over the next three years to meet the growing demand for social care. The cases that I have mentioned show that there is a clear need for additional resources to meet the growing demand, address the unmet need and tackle the shortfall in resources that has been growing for some years.
The Dilnot commission was given the task of making recommendations on how to achieve an affordable and sustainable funding system for care and support. Its report confirmed what has been said repeatedly for years: the current system is unfair and unsustainable, and without reform it will deliver ever-poorer outcomes for individuals and families. That includes the 1,000 people we saw here this week. The report also said that the funding of social care is inadequate and that people are not receiving the care and support that they need.
Although we may not have time to discuss this today—I certainly will not—the provision of advice and information is poor and very limited. People struggle to find financial information and advice, and there is little information and advice for carers. Worst of all—perhaps we can understand this—because the system is complex and difficult to understand, most people do not plan for, or even think about, the future care provision that they may need.
There is much consensus around the capped costs model. There is support for setting a cap at £35,000 and, as the hon. Member for Truro and Falmouth mentioned, for setting an asset threshold for means-tested support at £100,000. There are other important aspects, such as the need for national eligibility criteria and the need for local authorities to meet the eligible needs of carers. I think that those points are equally important. What still needs to be discussed, and I am not sure whether we will get into it today, is how to pay for the capped costs model and the additional resources that are needed to close the funding gap.
Care and Support Alliance members believe that there is a public appetite for reform. I think that we must take the debate across the country and ensure that the issues and solutions that I have talked about start to be debated. I have spoken about social care issues for the past seven years and I believe that they are now well understood. The 60 organisations that have lobbied Parliament this week have been lobbying on these issues for many years. The people in those organisations and the people they represent are tired of being consulted on the future of social care. What they want is action.
Andrew George (St Ives) (LD)
I congratulate my colleague on the Health Committee on her contribution to the report on social care. Does she agree that underlying the issue of care in crisis is an issue with the work force, who often work on the minimum income, are poorly regarded and are subjected to a lot of unfavourable reporting in the press? Does she think that we take them for granted when we look at the overall sector?
Barbara Keeley
Indeed, the work force issues are very important. I will not have time to discuss them today, but perhaps other Members will. The things that we hear about, such as tasks being reduced to one-minute periods and visits being cut down to very short periods, must make it a distressing and difficult job. We also have to recognise that personalisation leads to people working in an isolated way. Whereas before they might have been part of a local authority work force, they are now individually employed by care agencies and may not see anyone else. There are some new issues for us to consider, including the one that the hon. Gentleman mentions.
In 2009, after much consultation, my party brought forward plans to establish a national care service. As my right hon. Friend the shadow Secretary of State knows, Labour’s proposals for funding social care were treated as a political football, and there were some regrettable political attacks on them during the general election. That was unfortunate, and we cannot allow it to continue. I congratulate him on going back into the cross-party talks with great willingness, which must have been difficult knowing what happened to him during the election. We must work to achieve consensus across parties and across the country, because the issues that I have mentioned are becoming more pressing than ever before.
I believe I have found a unique way to link two speeches today, both of which you have heard, Madam Deputy Speaker. I talked earlier about women in sport, and this Sunday I will be running in a 10 km race to raise funds for Age UK’s “Spread the Warmth” campaign, which is aimed at making life better for older people in winter and avoiding needless deaths from the cold.
The Minister of State, Department of Health (Paul Burstow)
I am very grateful for the opportunity to speak in this debate. I start by thanking the Backbench Business Committee for granting it and my hon. Friends the Members for Truro and Falmouth (Sarah Newton) and for Stourbridge (Margot James) for securing it and leading it so well.
I have chosen to speak early in the debate because I want to spend the majority of it listening to colleagues. I undertake to respond to their questions in writing if necessary to ensure that we have a clear record of the Government’s position on these issues.
I pay tribute to the Care and Support Alliance. The lobby that it organised this week was a truly powerful event, because of the testimony of individuals who made the journey to Westminster to lobby their MPs. I had the pleasure of spending an hour being cross-examined by a large number of people on that lobby, and I found it a really useful opportunity to talk about social care.
I have been a Member of Parliament for more than 15 years and raised the issue of social care reform throughout that time. For far too long, it has been left in the “too difficult to do” drawer, and it is now due attention from the House and the Government. We must not make the mistake of putting it back in that drawer, which would be dangerously short-sighted.
What does high-quality social care mean? It means helping people to stay healthy, independent and out of hospital. As the hon. Member for Worsley and Eccles South (Barbara Keeley) said, it means reducing pressure on the NHS, but above all it means helping people to live the lives that they want—long, safe and comfortable lives with the maximum possible independence. That is why the coalition Government are determined to tackle social care, and we have already set to work on doing just that. We established the Commission on the Funding of Care and Support, chaired by Andrew Dilnot, to make recommendations on how we could develop an affordable and sustainable funding system for social care. My hon. Friend the Member for Truro and Falmouth outlined those recommendations.
Kelvin Hopkins (Luton North) (Lab)
There is constant emphasis on the importance of independence and of people living their own lives, but many people who depend on care want company. Some would prefer to live in decent, appropriate care than to be left on their own in their home and not cared for appropriately. Is the Minister not aware of that?
Paul Burstow
I am most certainly aware of that. Social isolation is a huge burden on the individuals affected by it and has huge consequences for health care. That is why, when I talk about independence, I also mean interdependence—the recognition of the value of family support and carers, and of the fact that people need to be active in their community throughout their life. Social care has a role to play in enabling people to do just that, rather than become institutionalised in their own home or a care home. I absolutely agree with the hon. Gentleman about that.
The Dilnot commission made a number of recommendations on the development of a system such as I mentioned, and my hon. Friend the Member for Truro and Falmouth described them well. In the spending review, we allocated an additional £2 billion by 2014-15 —£7.2 billion over the spending review period as a whole. In November 2010, we also set out our vision for social care reform, including the roll-out of personal budgets and greater personalisation. I agree that we need to ensure that that is genuinely about how we enrich people’s lives, not just an opportunity to reduce the available resources to individuals. We are also investing £400 million over four years to help to give carers much needed breaks. We are ensuring that the NHS is held firmly to account for delivering the money in the coming year by making sure that it has to account directly to carers’ organisations locally, and agree with local authorities the plans to provide breaks, spell out how many there will be and the size of the budget for that purpose.
It is also important to dispel a myth about social care, which has been hanging around for far too long—that, in some way, it is just like the NHS and free. As my hon. Friend the Member for Truro and Falmouth said, it is not free and never has been. If people assume that the state will pick up the bill, they are unlikely to prepare themselves. If they do not prepare and they need help, the impact can be truly devastating for them and their families: life savings wiped out, family homes full of memories sold off, and thoughts of a comfortable retirement turned to dust.
We therefore recognise the problem, which is getting worse. Our population is ageing, and that should be a cause for celebration. Too often, debates about ageing in our media are couched in terms of demographic time bombs and the like. However, the current care and support system is not fit for purpose. I agree with the Care and Support Alliance about that. It is broken, and patching and mending it is no longer acceptable.
However, reforming social care will not be easy. As has been said, it will require bold thinking and difficult decisions. The Dilnot commission shed much needed light on the reality of social care funding. Soon, we will publish a White Paper and a progress report setting out our response to the recommendations.
Barbara Keeley
Perhaps the Minister will enlighten us on what is meant by “spring”. There is speculation that spring might extend to May, June or July. When I was in government, I spent a lot of time answering questions about what spring meant in relation to Government reports. Will he tell us what it means now?
Paul Burstow
On that basis, the hon. Lady knows the answer that I would give and I shall therefore not tire her by saying what she would have said if she were in my place. We are anxious to publish a White Paper as soon as we can in a way that ensures that we have successful dialogue with the Opposition on funding. Those two matters are interdependent.
We are considering not just funding reform, but the legal structure that governs social care, which must be updated. The Law Commission has done a sterling job of making recommendations for replacing the patchwork that has built up in the past 60 years with a legal framework fit for the 21st century. A new social care law will bring clarity where today there is a complicated and confusing system, facilitate personalisation and support staff, service users and carers.
Beyond that, we need high-quality, integrated care, which focuses on early intervention, prevention and the needs of the individual. Better care is about not just spending more money, but spending it much more wisely. The Health Committee made that point powerfully to us. Some councils do that well; others could do it better. That is why the Government are jointly funding with the Local Government Association work to support councils to release savings while improving the care and support they provide.
The Health and Social Care Bill will foster far greater integration between the NHS, social care and, importantly, other public services. Health and wellbeing boards will bring together democratically elected local councillors, directors of children’s services, adult social services and public health services, clinical commissioning groups, and, importantly, the public through Healthwatch, to improve services in our communities. They will identify local needs now and for the future and, importantly, be accountable for setting the strategy to meet those needs. The unprecedented transfer of money from the NHS to social care is creating new opportunities for joint working.
However, we have a long way to go to improve the quality of social care, especially for older people. Clinical audits on fractures or continence care; the parliamentary inquiry into the human rights of older people in health and social care; and damning reports by charities such as the Alzheimer’s Society and Age UK all point to the fact that health and social care in England is far from universally excellent. In too many cases, it is very far indeed from being excellent. There can be no excuses and no mitigating circumstances. Yes, there are excellent staff working in our services, but some staff need to be challenged, and some need to leave the profession because they do not do the right thing. We need to be honest. We need to applaud the good, but to shine a light where there is no good.
It is not a matter of not having enough staff. In some places—
Paul Burstow
I will in a moment, because I made a point in direct response to my hon. Friend.
In some places, full staffing complements perform badly, while places under considerable staffing pressure perform exceptionally well.
Paul Burstow
I will give way to my hon. Friend, who I know works hard on these matters.
Andrew George
I am very grateful to the Minister, whom I respect. Poor standards need to be rooted out wherever they exist, whether among the lowest-paid care workers or the highest-paid managers, but does he accept that the care system is based on workers who work antisocial hours, who are often untrained and unsupported, and whose salaries are appallingly low?
Paul Burstow
I accept that we have a largely untrained work force—or they are not as trained as they should be. This is the first Government to set down the need for training standards for health care assistants and care assistants. We have signed off the funding to allow Skills for Care and Skills for Health to do that essential work for the first time.
On transparency, we need to know what is happening within caring organisations. Transparency is vital to improving the quality of services on offer and to holding providers and commissioners to account. As is happening already in the NHS, we need more information and data to improve the quality of social care. Without those, how can local authorities, individuals or their families hold providers to account?
That is why we published the adult social care outcomes framework last April, which was developed in partnership with the Association of Directors of Adult Social Services, the Local Government Association and others. I thank all those involved in developing that new tool, which has the potential radically to improve the quality of social care in England. The outcomes framework will enable local authorities to hold providers to account, and in turn enable local people to compare and contrast performance on social care in one part of the country with performance in another, and to hold their councils to account.
In the past, the emphasis has been on patients and people who use services bending to the convenience of service organisations. That must change, and it must do so faster than ever before. By focusing on the individual and integrating services around them, we can begin to break down institutional barriers that for too long have held back the improvements in care that the country needs.
Many people’s lives could be so much better. We are right to celebrate the fact that our population is living longer, and often living longer better, but we can do much more to ensure that we add quality to the extra years that the success of our health and other systems have delivered. That is why the best social care means the difference between a life of dependency and life lived with independence and dignity—the difference between a life endured and a life enjoyed, or a life in which potential is not realised or unlocked and a life in which it is.
Social care is among the most pressing issues facing us today—I believed that when I first came into the House. I hope that, during this Parliament, this Government, working in partnership with others and the Opposition on funding, can reach a consensus that can be delivered, and that we can translate that into sustained action. That is how we can do something that has not been done for 60 years.
We have inherited laws that are out of date, which make it impossible for some people to navigate their way around our social care system. It is time to change. That is why the Government will publish our White Paper and set out our plans for legislation. I look forward to more debates on adult social care as time goes by, but today I look forward to listening to colleagues, and will respond to further questions.
Andy Burnham (Leigh) (Lab)
I, too, congratulate the hon. Member for Truro and Falmouth (Sarah Newton) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on bringing this important debate to the House. They make an impressive and persuasive double act for this most important of causes, and are right to challenge both Front-Bench teams as this is without doubt the biggest unresolved public policy challenge facing the country. So far, between us, Parliament has failed to face up to it, and as others have said the result is a developing care crisis in England.
We must all bear our share of the responsibility for allowing that to happen, but the best response is to resolve to find lasting solutions. This century of the ageing society demands it, and the earlier we do it, the better. If we do not, to Beveridge’s five giants of the last century we might add a sixth for the 21st century: fear of old age. We cannot let that happen, and people are looking to us all to put point scoring aside and to work constructively to find a solution. In that spirit, I welcome much of what the Minister said.
I commit the Opposition to doing the same, and as a sign of our intent, the Leader of the Opposition has appointed a member of the shadow Cabinet with specific responsibility for these matters. I refer to my hon. Friend the Member for Leicester West (Liz Kendall). The House might have noticed that she is not here today. I send her apologies. [Interruption.] The Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), is absolutely right. She has a good excuse: she is in Leicester with Her Majesty the Queen at the commencement of the diamond jubilee celebrations; otherwise of course she would have been here. I hope that I am an acceptable substitute.
Andy Burnham
Thank you.
I wish to demonstrate today Labour’s commitment to this issue. The House might remember, as my hon. Friend the Member for Worsley and Eccles South said, that I made reforming social care my top priority as Health Secretary, and I did that for a very personal reason: I have never forgotten my grandmother’s dispiriting journey through England’s care system and the battles that my mum fought to preserve her dignity. The day I visited her in a nursing home near where I lived to find that her engagement ring had been wrenched off her finger and stolen was the day that I knew something was seriously amiss with how we looked after our older people.
We all have our own personal experiences, and we all know that we have to do much better. Looking after other people’s relatives, particularly the most vulnerable in our society, should be one of the most highly valued and respected callings there is, but sadly the reverse is the case. England’s care provision is too often low status and low wage, with about 70% of the work force having no qualifications and many earning at or around the national minimum wage.
With every year that passes and every year that we do not achieve a lasting and better solution to the funding of adult social care, the cruel unfairness in the system gets worse and the quality of service diminishes even further. People are paying higher charges, and the most vulnerable, as the Minister said, are losing everything. Families are being wiped out physically, emotionally and financially by the situation, carers are under intolerable pressure and councils are struggling to cope with the demographic pressures.
But there is hope. I did not think that the White Paper and cross-party talks that I led before the election achieved as much as they might, but perhaps I was wrong, because they might have prompted the Government to establish the Dilnot commission, on which we congratulate them. We also congratulate Andrew Dilnot and his commission on the intelligent way they addressed their brief and delivered a solution that politicians on all sides can work with. It provides a basis for progress, and we should take it.
Since then, we have also had the Health Select Committee’s excellent report on social care, which made a persuasive case for integration. At present, the social care debate is happening in isolation from the debate about NHS reform, which is unhelpful. We are looking at a Bill called the Health and Social Care Bill, but there is not much about social care in it. Indeed, it is slightly odd that a Bill of this name is going through Parliament, yet a social care White Paper is not due until May, as my hon. Friend the Member for Worsley and Eccles South said. It is essential that we start viewing reform of social care and the NHS as two sides of the same challenge—how to provide integrated, people-centred and preventive care in the century of the ageing society.
The Committee’s recommendation of a single commissioner for older people was an important one, and I was pleased to hear the hon. Member for Truro and Falmouth endorse it. I do, too, not least because it was precisely what I would have done had I returned to the Department of Health as Health Secretary had we secured a different result at the general election. However, I am worried that this vision, which we share, is made more difficult by the Health and Social Care Bill and the new landscape that is developing.
Those are the issues that the Government need to address in the White Paper. We are grateful for the opportunity that the Minister and the Secretary of State have extended to us to take part in cross-party talks and to influence that debate, as well as the crucial issue of how to fund the Dilnot proposals. Speaking for the Opposition, I can assure the House that we will play a constructive and responsible role in those talks. However, I would also like to take this opportunity to place three caveats on the table. First, we need to make it clear to people that although the Dilnot package is an important step forward, it is only that. It is not the whole answer to the challenges that the country faces. Its introduction would make the system fairer than it is today and would deal with the catastrophic costs of care that the most vulnerable people face. However, people would still be liable for high charges, with the vulnerable paying the most.
Secondly, there has to be a recognition from all parties in the House that progress will come only with difficult decisions and nettles being grasped. We need to have a mature discussion with the public about those difficult options, rather than using them for point-scoring purposes. What stands in the way of progress is not the complexity of the issues—they are not over-complex—but the political will to advance a difficult argument. That is what has prevented us from making more progress than we should have. To push things along and give our talks some impetus, it would help if the Government committed to introduce legislation in this Parliament to implement whatever has been agreed. That would bring a useful focus to the cross-party talks. Thirdly, we believe that there is a genuine danger that the debate might focus only on funding the Dilnot recommendations, and not on the existing pressures in the system. That must be avoided at all costs, as my hon. Friend the Member for Worsley and Eccles South said. As one care charity told me yesterday,
“We can’t have jam tomorrow if we have no bread today”.
I, too, was concerned by the comments that the Minister made before the Select Committee on Health, specifically when he said:
“We don’t accept the position that there is a gap. We have closed that gap in the spending review. On the issue of unmet need, I am yet to find any agreement among academics on a definition of unmet need.”
Many councils would struggle to reconcile that statement with the reality of what is happening on the ground. Council budgets are being cut by more than a third over the course of this Parliament, and as we know, adult social care makes up the largest part of those budgets, at around 40%.
The Prime Minister is fond of quoting me on health funding at Prime Minister’s questions, but he only ever uses the bits that suit his purpose. If I may, I would like to give the House the full version of that quotation today, because what I was warning of was the danger of taking an unbalanced approach to public spending. Before the election, the Conservatives were saying that they would give the health service real-terms increases, over and above inflation—which have not, in fact, materialised—within a much reduced overall public spending envelope. My worry was that taking such an unbalanced approach could damage other public services, including those that are intrinsically linked to the health service. What I actually said was:
“It is irresponsible to increase NHS spending in real terms within the overall financial envelope that he, as chancellor, is setting. The effect is that he is damaging, in a serious way, the ability of other public services to cope: he will visit real damage on other services that are intimately linked to the NHS,”
such as social care. I believe that this is what we are seeing right now.
Paul Burstow
The right hon. Gentleman made those remarks ahead of the spending review in 2010. The spending review also gave the Government the opportunity to make announcements about social care spending, and it is when we committed £7.2 billion extra for social care support. We have to challenge local authorities to use those resources wisely. Indeed, I hope that he will join me in challenging local authorities to commit to spend the resources that the Government have allocated for social care on social care.
Andy Burnham
Yes, I will. There is no difference between us on that, but there is a difference between us on the funding position that the Minister has set out. The King’s Fund and others have identified that there is a £1 billion funding gap in adult social care in England, not just because of the money but because of the demographic pressures, which we cannot get away from.
The Government’s commitment was to give more money to the health service, but we have produced figures showing a real-terms cut in outturn last year, and we also notice that transfers—indeed, recent transfers—have had to be made to the social care system, which implies that the Government have left it short, and that there is an emergency propping-up of the system, revealing the flaw in their position.
Kelvin Hopkins
To reinforce the point that my right hon. Friend makes, on a recent visit to my local hospital I was told by staff that they have more than 20 elderly patients who are perfectly well enough to live in a care home, but the care homes will not accept them and the funding cannot be found for them. Care is free in hospital, but it costs outside, so those people are forced to stay in hospital, and that places extra costs on the NHS.
Andy Burnham
The two systems do not work in such situations. The health service is intrinsically tied up with the social care system, and if it collapses the health service cannot discharge people from hospital. It is a false economy.
As for what is happening on the ground, the Minister commented on funding nationally, but in reality eight out of 10 councils now provide care only for those with substantial or critical needs: they are restricting their eligibility criteria. Age UK estimates that that leaves 800,000 people without any formal support, representing plenty of unmet need, and the situation also leads councils to increase charges for home care. The average cost for a disabled or older person paying for 10 hours a week of home care is now £7,015 a year. Never mind a death tax, that is a stealth tax—or a dementia tax, as people pay more and more for the costs of care while they are alive. It is not fair, it is not right, and we should do something about it.
That is why we say to the Government that we must address the question of the local government baseline alongside that of Dilnot. There cannot be a choice; we have to do both. If we do not and we fund only Dilnot, a larger number of people will pay increased charges but with a cap on what the charges might be, and that will not feel like the leap forward or the social progress that the Care and Support Alliance and others are looking for. It will not help us to drive up quality in the care system, either, but we desperately need to do so.
Councils are being forced to stretch inadequate budgets ever more thinly, and that is leading to corners being cut. I shall illustrate that directly with an example from my constituency. Several years ago, Wigan council contracted out home care services in our borough, and staff were transferred to a number of private providers, which have changed hands over the years. Just after Christmas, home care workers in Leigh came to my surgery and told me how things had broken down over the Christmas period, leaving vulnerable people, frankly, unsupported. They showed me the timesheets that they had been given by the company they were working for, and one of them included four simultaneous bookings for 12 o’clock—a point that I think my hon. Friend the Member for Worsley and Eccles South made—on different sides of town, with no travel time built in. Impossible. If we look at the whole day, we find appointments within 10 or 15 minutes of each other, which are meant to include travel time as well as time for looking after older people. That is fundamentally unacceptable.
I was told about staff working extra hours because of that situation, and then not being paid. They said that equipment such as aprons and gloves was not being provided, and that staff were funding them out of their own pockets, which again is absolutely wrong. They also raised concerns about rotas being issued only the night before, and care assistants not having keys to get in to meet the service-users they were visiting. Across the board, there were terrible problems and vulnerable people were being left without support.
Members might think that the company in question is a small, local one, but in fact it is Alpha Homecare Ltd, which is wholly owned by Carewatch Care Services Ltd, a national company with 154 offices nationwide. That is an example from Leigh, but I bet that other Members could cite similar ones.
Lisa Nandy (Wigan) (Lab)
I too have been visited by employees of Alpha Homecare in my neighbouring constituency. Does my right hon. Friend agree that one of the real concerns is that because those women are so dedicated to their work and often pick up work out of hours, without being paid to do so as they told me, it masks the fact that the situation is probably much worse than it appears on paper?
Andy Burnham
That is absolutely the point. This is not responsible capitalism; it is the worst kind of capitalism—making money by leaving vulnerable people unsupported and, as my hon. Friend says, taking advantage of the commitment and vocation of those on the front line, who will not walk away from the people they care for. It is unacceptable to not pay them and let them buy their own equipment, and to make profits off the back of that kind of behaviour.
Sarah Newton
I hesitate to intervene because it is important that the many Back Benchers who are here today are able to share their views. However, although none of us could support the appalling situation that the right hon. Gentleman described, he will be aware that the commissioner—the local authority—has a responsibility for the quality of the service. If he is concerned about it—I would be absolutely furious if I were the local Member of Parliament—he can take it up with the council so that the contract can be cancelled, and ultimately refer it to the Care Quality Commission.
Andy Burnham
I am aware of the system for raising complaints. I have done that, and I will now be inviting the CQC to take a look at the situation. I mentioned it because it illustrates vividly the thrust of my remarks. It is not an isolated example; the quality is not there in the system.
The problem is that we are in danger of getting what we pay for, or what we do not pay for. As the pressure increases, councils are forced to make budgets go ever further, and they contract companies that do not provide the standard we are looking for. We would not accept it for our own families, and we should not accept it for any families—that is particularly so for us, with our responsibility to speak up for the most vulnerable in our society. Let us resolve in this Parliament to do something about it and to make overdue reform of the care system in England a reality.
Heather Wheeler (South Derbyshire) (Con)
I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) and the hon. Member for Worsley and Eccles South (Barbara Keeley) on bringing this debate to the House.
In South Derbyshire, social care is a very big issue, and I praise Derbyshire county council for grasping it with both hands. For the first time, an older people’s village is being built in my constituency, in Swadlincote. It will take anybody over the age of 55 when they do not need any care, until they need intermediate care, and then right until the end when they need dementia care. It is an absolutely brilliant new way of coping with care for the elderly, and I congratulate the council. Interestingly, there is now a strong debate about the typical old people’s homes that councils have run over the years, and people are concerned that the new style of looking after people will have to bed in a bit.
What is important about the older people’s village is not only that people will choose to buy or rent flats in it, or be put there by the state if they cannot afford it, but that respite beds will be available so that carers can have a break. People can have step-down or step-up beds, get themselves well again, and be able to look after themselves with total 24-hour care.
George Hollingbery (Meon Valley) (Con)
I want to develop my hon. Friend’s point a little more generally. As many colleagues will know, I am something of a bore on planning, but I think that the planning system has an important role to play in this in future. Does she agree that neighbourhood plans—the new local plans that are coming forward—are an essential part of catering for the needs of the elderly on an ongoing, 20 to 25-year basis?
Heather Wheeler
I am grateful to my hon. Friend for widening out the possibilities of my speech. I agree with him. As leaders in our areas, we need to direct people, as part of the consultations with their local development frameworks, to say, “This area could be zoned for bungalows”, or “That area could be zoned for an older people’s village”, or “That area, particularly if it has a section 106 agreement, could have some money allocated not only for the police, for education, or for a children’s play area, but for areas for older people.” We have recently had a planning application approved for a village for 2,500 people on a brownfield site, which included a zoned area for older people. The person who had the brilliant idea of building the village was inspired to do so by what he had seen his older relatives go through in their later years. He wanted to take a completely —dare I say it—holistic approach so that such people could in future grow old gracefully.
As well as championing what Derbyshire county council is doing on my patch, in connection with Trident Housing Association and South Derbyshire district council, I am also chairman of the all-party parliamentary group on local government. We will be conducting a new inquiry into social care, which will dovetail with the findings of the Dilnot report. We hope that, as an all-party group, we will be able to examine the issue a bit more widely and think outside the box, in order to be helpful to Ministers and give them as many ideas as possible. I know that a number of Members who are in the Chamber today will be sitting on that inquiry with me, and I am grateful for the all-party support.
When the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) came to speak to the all-party group, the room was packed. There were 70 people there, which is pretty good going for 2.30 on a Monday afternoon. People came from all over the country to hear him. It was a very uplifting afternoon, and I am grateful to him for giving us so much of his time.
This is an important issue for all of us, but it has been kicked around like a political football. The deficit is horrendous, and we all know that there really is not enough money in the world to deal with the problem, but the mood in the House leads me to hope that we will have some answers before the next general election in 2015. We need to put those answers on the table and get this done, for everyone.
Nick Smith (Blaenau Gwent) (Lab)
I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), and the Backbench Business Committee, on securing this debate. Adult social care is one of the most important social issues of our time.
The announcement by Ministers that the social care White Paper is coming soon—or soonish—is well timed. Given that there are an estimated 400,000 older people resident in UK care homes, I wish to concentrate my remarks today on residential care. The Dilnot report of last summer was well received. It struck the right balance between what an elderly person, their family and the state should pay and contribute to long-term care. Equally important for many were the report’s key premises that the current system of social care was underfunded and that additional funding and better targeting were urgently required. As Dilnot said, this is a price worth paying.
We all want to see a UK in which old people are respected and valued and can make the most of their final years. Alfred Morris, who became a Minister in the 1970s, said that
“if years cannot be added to the lives of the chronically sick, at least life can be added to their years”.—[Official Report, 5 December 1969; Vol. 792, c. 1863.]
People might want to move nearer to relatives or downsize as they grow older, so a national system makes sense. Dilnot was right to recommend the delivery of that objective. It would be unfair to call it a weakness of Dilnot, in that it was arguably beyond his remit, but he concentrates on the demand side of social care and how it is to be paid for. He does not consider the supply side and how it is commissioned and, importantly, how it is delivered.
We have recently seen too many examples of care for the elderly in residential care homes and hospitals that have been shameful. As many have said, we have to ensure that care is compassionate and respects the dignity of elderly residents. The care home business—and it is a business for many providers—has been a target for the quick-buck strategies of venture capitalists. Following the collapse of Southern Cross, another massive care provider, Four Seasons, has expanded. It now operates two homes in my constituency, but residents and staff are still worried about the outstanding debt liability of its parent company, Four Seasons Health Care. The Association of Directors of Adult Social Services has said:
“Care wouldn't have got the level of investment it has had without the use of private money…But in these very complex business structures, good governance is key.”
So, measures to ensure the effective oversight of the social care market to ensure stability and continuity are important for residents and relatives.
I would also like to emphasise the issue of NHS support for care homes. The British Geriatrics Society has published “Quest for Quality”, which identified
“unmet need, unacceptable variation and often poor quality of care provided by the NHS to older people resident in care homes.”
While some homes are well served by the NHS and “Quest for Quality” gives examples of good practice, it records:
“No model of coordinated health care has been developed to meet the needs of care home residents.”
Some residents in residential care have no access to key clinicians such as geriatricians or to community health services such as physiotherapy, podiatry and continence services for their long-term conditions. We have to ask how such expertise can be inaccessible to care home residents? This cannot be tolerated.
The solutions that have been proposed are familiar, and I have heard them several times this afternoon. They include co-ordinated teams of health professionals working together, patient and relative involvement and a partnership approach between health and social care workers. We know what works, but have failed to deliver the best care nationwide. We know, too, that early interventions cost less and emergency treatment costs more. Experts say that £40 million could be saved by a reduction in emergency admissions on hip fractures alone. Some care homes report that out-of-hours GPs tend to say, “Send to hospital”. In 2012, we should be doing much better than that. The report recommends that statutory regulators should scrutinise the provision of NHS support to care homes and the achievement of quality standards.
The Care Quality Commission currently has responsibility for regulating and monitoring care homes in England, with NHS health services providing support to such homes. The Care Quality Commission conducted its special review of the health needs of care home residents, which was published last week, although it was originally expected in 2010. When the CQC came to the Public Accounts Committee in January, I asked it when the report would see the light of day and why it was so far behind schedule. The chief executive told me:
“I suspect because of the complexity of the data collection and, to be honest, the fact that we have been focusing on trying to get the basic inspection processes up and running and right.”
Basic inspection processes are crucial but so, too, is the promotion of residents’ basic health care. This is not good enough.
Finally, in January I was co-signatory to a letter calling for doctors to record whether an injury from a fall, a pressure sore or an infection was present when a patient was admitted to hospital or developed while they were there. This is a simple and cheap mechanism for identifying in hospital a sub-standard quality of care.
Dilnot says that the care system is confusing, unfair and unsustainable, and that reform is urgently needed. I hope that the social care White Paper will build on good practice and deliver the reforms and the investment we need. Worry over the funding of residential care or over poor health care in the place they call home should be a thing of the past for our pensioners.
Chris Skidmore (Kingswood) (Con)
I start, like others, by congratulating my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this debate, bringing out the urgent need to tackle the issue of the future of social care, and ensuring that we face up to the responsibilities of looking after the elderly of today and tomorrow. We have heard humble messages from the Minister and the shadow Secretary of State about their willingness to work together. The spirit of cross-party agreement is encouraging.
As the right hon. Member for Leigh (Andy Burnham) said, these issues go right back to Beveridge in 1942, when the average life expectancy was 69 and social care was not an issue to be considered within the realms of the state. The right hon. Gentleman mentioned the “sixth giant”, and he is right that we need to revisit Beveridge for the 21st century and perhaps to look again at what Beveridge considered to be most important—the contributory principle. The contributory principle for social care will be all-important when we look at how to deliver social care reform.
As we know, reform is desperately needed. The arguments over the funding of our social care system are well practised, but let us rehearse some of the statistics, which are becoming more familiar with every debate we hold. The number of those aged over 85 will double by 2030, and during the course of this Parliament alone, more than 1.4 million people will turn 65—one in 10 of whom will have a long-term care need that will cost more than £100,000. We should also make it clear that this problem is not unique to the UK. Germany and Japan have recently taken radical action to reform their systems. However, the UK has a specific problem that makes finding a solution to the ever-growing problem of social care particularly difficult: most people simply do not understand the system. They do not understand that social care and the associated costs of getting older are not free, as the Minister stated, and nor have they ever been.
That point was made in the Dilnot report, and it cannot be stressed enough. I wish to highlight two of Dilnot’s recommendations. First, he states:
“To encourage people to plan ahead for their later life we recommend that the Government invests in an awareness campaign.”
Secondly:
“The Government should develop a major new information and advice strategy to help when care needs arise.”
The acknowledgement that more needs to be done to inform the public is welcome. In reality, until one is forced to interact with the system, there is a serious lack of information compounded by an assessment procedure that is often unrealistically complicated. For many elderly people, part of the shock that comes from being forced to sell their house to pay for care is the unexpected nature of that situation. In some respects, we are facing a problem of responsibility and of planning ahead. Although people are now accustomed to the idea of preparing for their old age with regard to pension provision, there remains an aversion to preparing for the eventuality of future frailty and ill health. Few of us wish to admit that we will grow old and frail and need help and support, before it is too late.
The solution to the funding crisis brought on by an ageing population will inevitably require individuals to pay more, and from an earlier age. Whatever we do to change the current system, it is absolutely essential that a much clearer picture of the relationship between contribution and entitlement—precisely as Beveridge set out—is at the heart of that.
Reform requires realism. Even if the Dilnot proposals are implemented in their entirety, they will not provide the full solution. Whatever cap on care costs is set, domiciliary care costs and annual living costs are not taken into account. A new system that is able to lever more private funding into the system will ensure that we can provide the best deal for the elderly, but it will require an understanding that we need to grow an insurance market to maturity that is then sustainable in the longer term. That will not happen overnight. This is a process that will take between 10 and 20 years.
The current Government have taken the first important steps to reforming the system. As hundreds of billions of pounds are being talked about in respect of the current euro crisis, it is easy to forget that the Government’s decision to give an additional £2 billion a year to social care in the 2010 comprehensive spending review was the greatest ever increase in social care funding, and will lead to a vast increase in resources. We are investing more than ever before in carers and respite care, recognising the huge contribution that they make to our country, selfless in their service to their partners, parents, families and relatives.
In addition, a greater focus on personalisation and individual budgets, combined with an increased use of resources such as tele-health, will put more control over care into the hands of individuals, ultimately allowing new providers to provide more tailored services, thereby driving down costs at the same time as improving quality. Placing the person at the heart of their care has the potential to transform social care services, which for too long have been led by inefficient monopolies.
The Prime Minister’s recent call for greater integration of health and social care is equally welcome. I am a member of the Health Committee, and we called for that in our recent report. If we fail to address the social care problem, the NHS will end up picking up the tab. Every unplanned hospital bed admission for the elderly is a mark of the failure of social care to prevent that from happening in the first place. We know that if we can reduce demand for hospital beds by just 10%, that could free up £1 billion that could then be redirected into community-based care services. We must recognise that hospital is not always the best place for care to take place and redirect resources to reflect that.
In preparing for the Committee’s social care report, we visited Torbay, and I was particularly struck by the experience of integrated care there. Torbay’s primary care trust and adult social services have been combined into Torbay Care Trust, following which five integrated health and social care teams were established. They seek to be proactive in managing patients and to work in partnership with GPs. In Torbay, a team was also introduced that was specifically charged with monitoring patients in hospital and discharging patients where there is pressure on beds—again, the team is working closely with clinical professionals. That has helped to cut out unnecessary lengthy hospital stays and delayed transfers of care. As a result, Torbay now has the lowest use of hospital bed days in the south-west region, as well as the best performance on the length of stay. The chief executive of the NHS, Sir David Nicholson, has said:
“I have seen the future and the future is Torbay”.
He did so because it is the elderly who will benefit most from integrated care. Complex long-term conditions complicated by age can be properly managed only with a collaborative approach.
John Pugh (Southport) (LD)
Torbay has, for some time, been a model of good practice and the fact that this good practice has not spread much further than the confines of Torbay is something of an enigma. Would the hon. Gentleman care to comment on that?
Chris Skidmore
Torbay was one of the sites for the pilots set up in alliance with Kaiser Permanente, which came over in 2003. Interestingly, it is instructive that one of the problems the NHS faces as an institution is that, although it creates fantastic pilots and the NHS innovation centre is working hard on rolling them out across a wider area, that process encounters significant delays. Good models of care should be spread out far more widely and far faster.
What most elderly people want from their health care system is simplicity. They do not want to be moved around constantly from pillar to post, waiting for specialists to see them; they do not want to see a host of different medical professionals, each of whom is unfamiliar with their case; and they do not want to languish in hospital beds when they could be more comfortable at home. The most important change must be a cultural one. There may have been a tendency in the past for health care to be reactive, responding to medical crises as they arise, but the future must be very different. To paraphrase John F. Kennedy, we do these things not because they are easy but because they are hard. We know that we face a challenge that will define the landscape of health and care for the decades to come—it is a challenge that all in this House cannot be willing to postpone.
Sir Alan Meale (Mansfield) (Lab)
I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on their tenacity in securing this debate. Hon. Members from all parts of this House should give them credit for their hard work and effort.
In this important debate, I wish briefly to raise the issue of people suffering from autism and Asperger’s syndrome. As hon. Members will be fully aware, those conditions are extremely serious. Both are lifelong disabilities and they affect sufferers in a number of different ways. I fully accept that some people who have either of those conditions are able to live semi-independent lives, with only partial support, but others—indeed most—need a range of specialist support throughout their lives. Although they do not represent everybody who needs adult social care, I am not talking about a small number of people. Approximately 1% of people in the UK have autism, and they and their families account for at least 2 million involved citizens in the UK, which represents, on average, approximately 3,000 people in every constituency in Britain.
Yet, even given those numbers, the National Autistic Society says that sufferers routinely struggle to access the services they need and that when they do access them the outcomes are largely poor. NAS research also shows: two thirds of all adults with autism say that they do not have enough support to meet their needs; more than 60% of these adults rely absolutely on their families for financial support, with approximately 40% of them having to live at home with their parents; and only 15% of people with autism are able to find full-time work.
Failures to provide such support are also very expensive to the ordinary taxpayer. According to the National Audit Office, if local services supported only 4% of adults with high-functioning autism, that would be cost-neutral, and if they supported only 8%, that would save the Government at least £67 million a year. As a number of hon. Members have said, the Dilnot commission on funding of care and support stated a number of good things, in particular that the present system was both unfair and underfunded. It called on the Government to increase spending on social care and to limit the cost and charges for those who need it.
The report’s key recommendations included the need for national eligibility criteria, with all those who enter adulthood with health and social need being eligible for free state support immediately rather than being expected to pay themselves. This is where I have a slight difference with the Minister, who said that it is not only about money. For many people who come to my surgery at their wits’ end, it is about money. Indeed, even those who had money do not have very much left in their late adulthood to spend either on themselves or on their loved ones, so money is very important.
In conclusion, I believe that the adoption of the Dilnot recommendations would lead to an entirely fresh approach that would deliver greater awareness of autism, and in particular of the sufferers’ needs, care and, of course, support. It would also put in place measures to relieve the short-term crisis in funding in social care.
Mr Robert Buckland (South Swindon) (Con)
The hon. Gentleman is quite right to raise important statistics about people with autism, but may I urge him, when he speaks passionately about it, not to refer to people as suffering from the condition but rather to acknowledge that they have the condition and have great potential and that what we should all be doing through the care system is ensuring that they realise that potential? Does he accept that?
Sir Alan Meale
I fully understand the direction that the hon. Gentleman is coming from, but let me just say that I am the son of a permanently and seriously disabled person and he was that way all of my life. I also served as a board member of the Portland training college for the disabled in Nottinghamshire and have been deeply engaged in matters connected with the seriously disabled for years. Believe me, when I use the terms “suffering” and “sufferers”, I mean them not in a derogatory sense but to highlight the plight of the people who I am talking about.
In conclusion, I believe that adopting Dilnot would put in place measures to relieve the short-term crisis in social care funding and, most importantly, establish sustainability for care and support in the longer term.
John Pugh (Southport) (LD)
I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) on starting this debate. I shall be relatively brief because I sense that this is just the beginning of a debate that we will have throughout this Parliament and probably beyond. The whole issue represents a huge financial challenge to Government and a demographic challenge to the country and it will not go away. I suspect that many of the bad stories we have heard about poor care will, if anything, multiply over the years to come as finances are stretched further.
There are obvious things that the Government can do and that they mean to do, such as developing the public health agenda as well as ensuring that healthy old age is a possibility and that more healthy ageing takes place. I think that the Government are serious in their intent. Obviously, as has been suggested by many hon. Members, they can also join up health and social care a little better than they are at the moment. We want care to be integrated more and costs—and people—to be shunted around rather less. I cannot always follow how the Health and Social Care Bill advances that aim, because, after all, we will have a new set of commissioners with limited experience in interacting with local authorities and we will necessarily lose some established commissioners and some established arrangements will collapse. That will create a difficulty, albeit a temporary one; we will have it for a little while yet.
As I tried to point out in my intervention on the hon. Member for Kingswood (Chris Skidmore), there is no obvious mechanism for spreading good practice. How many times have we said that Torbay is an exemplar but then pointed to very few places that have followed that example? There is a real issue with how we spread good practice. I accept that the Bill gives the commissioners the right mandate to integrate social care and health care, but I question whether they will have the right capacity. I listened to the Minister, who put faith in the health and wellbeing boards being able to join things together or to force people to act together who might otherwise not do so, but the big issue staring us all in the face is the cost of care, followed by the quality of care.
In some respects, quality of care is the easier fix. We could have effective regulation and the Care Quality Commission could do a lot better and be less overloaded, but I suspect that it will not be short of work given some of the things it is asked to do by the Bill. Let me take this opportunity to pay tribute to the Minister, who has done a great deal in his time in Parliament to emphasise the need to treat people in care properly. In particular, he has campaigned for people to be respected in old age and for the elders—I think that is the word he used; it is a very nice word—to be defended. In terms of improving the quality of care, he is alive to the need to ensure there is portability so that, when someone goes from one place to another, the care does not decline but remains at a constant and expected standard. There is also a need, which we all recognise—again, the Minister has this well within his remit—to provide a proper legal framework in which people can understand their entitlements and secure them.
Then we come to funding, which is the big issue. I am relatively familiar with this issue because I have experience of being in a local authority with a large demographic bulge towards the top end that has had some difficulty with past Governments over this. Local authorities usually argue that they can provide only what they can—that provision is subject to whatever resources they have—and they try to ration what they deliver according to what they have in the kitty. They cannot always do what people feel they should, so they prefer to do what they can, but Governments are often quite explicit in telling them that regardless of what they have they need to deliver on the entitlements that people expect. I am very familiar with this because when I was the leader of a local authority, when Lord Boateng was in Richmond house, I was once summoned to be roundly told off because my local authority had just lost a celebrated case against Help the Aged. In that case, this problem was precisely the issue: we knew what we could justifiably afford but it was far less than what we needed to deliver what people expected. The previous Labour Government laid down in no uncertain terms that regardless of what we had got, we had to provide the service that was expected.
That tension between local authorities and central Government has always been there and is not going to go away. I accept the point that the Minister made—if we have an outcomes framework and greater transparency, it will be more obvious to people than it is now exactly what is going on and what quality of service is being delivered by individual local authorities—but at the heart of this issue is the local authority settlement. One can say many things about the local authority settlement, but one thing it is not is transparent. It is something that people argue over time and again. My borough has always found its resources severely stretched because we have a high percentage of elderly people and we have never felt that any Government have given us a fair deal in that respect. So the debate goes on, and in some ways it is going to become more critical because at some of the local authorities that have had to make quite severe cuts, including mine, the costs of adult care are going to swamp their budget completely. They are going to have to give up delivering other services in order to fund adult care. That is despite Government top-ups, which are welcome.
There is also the phenomenon of some sheltered housing providers, which have been affected by the refocusing of Supporting People budgets, giving up providing services that people expect as part and parcel of sheltered housing. There are also the local authorities being driven to be more efficient and switching providers but in the process completely hacking off the people who want continuous provision and do not see the case for doing that.
We need a solution to what is a huge financial problem. The solution needs to be affordable, sustainable, fair and, obviously, cross-party. I think we all regret what happened at the last general election, when the cross-party consensus broke down for political reasons. That is where Dilnot comes in. The Dilnot solution seems to be viable: it allows for individual responsibility but also caps costs. That deals with the two big problems I have always come across with this issue. From time to time, I get constituents saying to me how unfairly they are being treated when other people, who have blown all their money before retirement on cruises or whatever, seem to get provision—the free-rider problem. Dilnot recognised that and endeavoured to deal with it. The report also deals with the other, probably larger, problem that people fear that the cost of care will run away with their entire income and they will end up destitute. I personally know people who genuinely hope to die before the money runs out, and that is an unfortunate end to one’s time on this earth.
If Dilnot or something like it is to work, insurance companies will have to develop the right products, as other hon. Members have emphasised. If one has discussions with insurance companies, one will find that they are of varied minds and that some of the products that Dilnot expects that they will offer are not the ones that they would ideally wish to provide or that they think they should provide, so there will be quite a debate there.
Another problem with Dilnot, which I think we can all see, is that in so far as it caps the overall costs, it presumably represents some sort of bail-out for the fabulously wealthy. People might see fairness in that, but they do not see that it should necessarily be the Government’s first priority in the current circumstances.
Then, lingering behind everything, the Treasury is simply worrying what it is all going to cost at the end of the day and wants some financial certainty, for quite good reasons. It is difficult for anyone to provide that, so all this is going to provide a rich menu for a future debate, and we are grateful to the hon. Member for Truro and Falmouth for initiating it.
Tony Baldry (Banbury) (Con)
I am grateful for the opportunity to contribute to this debate, not least as co-chair with Baroness Pitkeathley of the all-party group on carers. The first point I want to make is about the phrase “adult social care”. One of the difficulties in this area is that if we are not careful we develop a secret garden of policy and we all start to descend into shorthand—referring to Dilnot as though everyone understands the five paragraphs that follow from that. I thought that the shadow Secretary of State for Health made a good point when he said that, for many people, this is all about being afraid of getting old. I think that this should be about not adult social care but care of the elderly.
When the Law Commission was asked to define social care, the best that it could come up with was the phrase
“promote or contribute to the well-being of the individual.”
That was pretty otiose. We should focus on care for the elderly because we will need to enlist in our constituencies many more people to get involved in this, not least local councillors, with the introduction of health and wellbeing boards. I do not know about other hon. Members but, although I think that the provisions in the Health and Social Care Bill on integration are really good news—I will come on to that in a second—I do not sense that county councillors and others have yet woken up to the fact that shortly they will be part of the boards and will be involved in delivering integrated care. Part of the reason for that is that this has been a bit of a secret garden of policy. One of the things that Ministers will have to do in the near future is go out and talk to, in two-tier authorities such as mine, county councillors, but in others those councillors who are responsible for running social services, to get across the fact that the whole way in which services are delivered will fundamentally change.
About half the speeches this afternoon have been what I would describe as old-fashioned speeches to Ministers, saying, “Please can we have some more money?” The truth of the matter, as we all know, is that there is no more money. It is actually more challenging than that. We have the Nicholson challenge of 4% efficiency savings in the NHS over four years. We will make this work only if we completely rethink the way in which we deliver services. We all know of far too many people who are in hospital but could be moved elsewhere if intermediate beds were available. That would mean they could be moved out of acute beds, such as those at the John Radcliffe hospital or the Horton general hospital in Banbury, but that would require someone working out how to provide more community facilities and intermediate beds and how they would be paid for, and that will require a lot of rethinking by county councillors and GP commissioning bodies working together.
We have to start to put this in a language that everyone understands. When the White Paper is published in the “spring”—that leaves only April—there is a danger that we will all get fixated on Dilnot and the cap. It seems to me that that is just one part of the whole equation for improving care for the elderly and, increasingly, elderly people suffering from dementia. The figures on dementia are really pretty scary. Among the many organisations that produced briefings for today’s debate is the Alzheimer’s Society, which reports—I had forgotten this—that there are now nearly 750,000 people in the UK with dementia, and that figure is set to rise to over 1 million by 2021, when many of us expect still to be in the House.
Dementia costs the UK economy £20 billion a year. When I was first elected to the House, most Christmases I would visit the homes for the elderly in my constituency. The residents then were mostly spry widows in their 70s, but now all the homes are almost totally full of people suffering from dementia or age-related dementia. This is about how we care for the elderly and, increasingly, elderly people with dementia, many of whom are having to stay at home longer. Indeed, the Alzheimer’s Society says that more than half of the people suffering from dementia have not yet been diagnosed as such because their families or those are caring for them are probably disguising the fact.
Barbara Keeley
I do not know whether the hon. Gentleman thought that my speech was one of the old-fashioned ones asking for more resources, but he probably did. However, I gave three examples of cuts to services for people with long-term conditions: the support services for people with dementia that Age Concern was running; a community matron service; and active case management for people with long-term conditions. It is inexcusable for those to be cut. If the Nicholson efficiency reforms are causing those services to be cut there is no way forward, because those are the supports in the community that will keep people out of hospital. It seems crazy. I now have three examples, whereas at Christmas I had only one. I am distressed to think that those services are being cut, because they are the way to support those people in the community.
Tony Baldry
One of the advantages of having been in the House for a little while is that one spends some time on the Government side, some time on the Opposition side and some time on the Government side again—I hope not to be on the other side again but am quite content wherever. One of the things I have learnt is that which side one sits on does not change reality. The reality is that this challenge is so enormous that it will not be solved simply by all of us telling the Treasury, “You’ve given us £2 billion. Please can we have another £4 billion, or another £8 billion.” It will only be changed if we fundamentally rethink how we deliver services for the elderly. If all Members asked how many delayed discharges there were in the general hospitals in each of our constituencies, I suspect that we would find that it is a huge number—I am afraid that Oxfordshire is currently one of the worse offenders. We have to do better. We have to fundamentally rethink the whole way we deliver these services.
Andy Burnham
I agree with the hon. Member for Kingswood (Chris Skidmore), who talked about the contributory principle, because there has to be a partnership between the individual and the state. If the hon. Member for Banbury (Tony Baldry) is ruling out general taxation, which I agree with him on because it would not be fair to make the younger population pay yet another cost, does he not accept that one ultimately comes to some difficult options in raising the extra money to build a fairer care system? We all have to start being honest about that and put some difficult options on the table, so that the public can have a debate about them.
Tony Baldry
Of course, general taxation will continue to play a part because it will fund the national health service, including the services delivered in acute general hospitals and so forth. However, far too many elderly ladies who go into a general hospital with a stroke or a broken hip stay there for longer than they need to for their treatment and could go home. We all need to engage in a debate in our constituencies that breaks out of the secret garden and involves far more people, including elected representatives, voluntary organisations and others.
Finally, I want to talk about carers, because I do not believe that any debate on care for the elderly should take place without a discussion about carers. I am the co-chair of the all-party parliamentary group on carers, so the House would be surprised if I did not mention them. There are two things that carers want. The first is recognition, which is now becoming slightly better. We need GPs and others to help people to understand that they are carers and to ensure, wherever possible, that they apply for a carers assessment, so that we can give support to carers. That will be particularly important if we are asking people to spend more time living at home when they are suffering from dementia and other conditions.
There are simple things that can be done. One of the worries of people who care for someone with dementia is that they will wander off and get lost. Age UK in Oxfordshire is starting a new initiative that encourages people to text a number if they see Mr Smith wandering down the street. Most of us are a bit embarrassed or shy if we see a neighbour wandering off and do not think that we should apprehend him, even if we think that he might not know where he is going or that it is not in his best interests to wander off. The question is how to deal with that as a community. There are lots of complexities in these matters. The whole community has to get involved if we are going to have more people living at home.
The second thing that carers want—I have said this on occasions too numerous to particularise—is breaks. We must ensure that there is a decent system of respite care. If there is not, carers sooner or later break, and when they break, they break for ever. That means that people whom it had been possible to care for at home go into a nursing or care home, never to emerge. With judicious and supportive carers’ breaks and respite care, many carers can be supported to carry on caring for a long time. Carers need to be valued and deserve to be valued. At every opportunity, the House should say an enormous thank you to the hundreds of thousands of carers in this country.
Kelvin Hopkins (Luton North) (Lab)
I apologise for being away from the debate for a short time, Mr Deputy Speaker. I was speaking in Westminster Hall on another subject. Being in two places at once, even for a Member of Parliament, is rather difficult.
I have long had an interest in this subject. I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) on securing this important debate and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on her excellent speech. I also give full credit to the two Front-Bench spokesmen because I believe that they genuinely care about this matter and are not just speaking warm words. I appreciate that.
I will focus on residential care, but I believe that domiciliary care is also in a poor state. I know of many cases in my constituency of people not being looked after well under the new privatised, personalised approach to care. The contrast between that type of care and what people get from an NHS district nurse who goes around to tend to people is extreme. I have spent a day with one of my local district nurses—they are not called that any more, but Members know who I am talking about—and seen how a true professional, a public employee motivated by the public service ethos, treats their patients at home. That is how all sorts of care ought to be provided, rather than by private companies or private individuals who often have heavy work loads, are impatient and do not provide the care and sympathy that they should when they visit people in their homes.
The royal commission on long-term care for the elderly, which recommended that care ought to be free at the point of need on the same basis as the national health service, was absolutely right. The Government of the time rejected its recommendation, and went so far as to ensure that a couple of members of the commission voted against it so that it was a majority view, not a unanimous one. I personally think that was a terrible thing to do. I have raised it before in the Chamber and probably will again, because I think it was so wrong. Nevertheless, the royal commission recommended free long-term care for all, and I absolutely agreed.
I tabled an early-day motion in the 1997 to 2001 Parliament calling for the Government to adopt the royal commission’s recommendations. More than 120 Members signed it, most of them Labour Members, but other parties were represented as well. No notice was taken of it. The current Minister was one of the signatories. I tabled another early-day motion in the 2001-05 Parliament saying the same thing, and it got similar support. I hope I am not embarrassing him, but he tabled a similar motion when he was in opposition, which I supported. We were on the same side at that time, and I like to think that he is doing his best to push that agenda forward within the constraints of the coalition.
My position is absolutely clear: I believe that there should be free long-term care for all, provided by a professional care service of directly employed public service workers. That is how people would be served best, and it would be properly publicly accountable.
Paul Burstow
The hon. Gentleman is absolutely right that I signed early-day motions supportive of the royal commission, but I need to correct the record ever so slightly. He is giving the impression that the royal commission recommended that all aspects of long-term care should be free. I am sure he will want to acknowledge that accommodation and hotel costs were not intended to be covered by its proposal.
Kelvin Hopkins
I thank the Minister for his correction, and I think the situation is possibly similar in the health service.
I come to the problem of affordability. I remember that in the early days after 1997, the Government were trying to keep down public spending, and there was a crisis in the NHS because of under-spending. That crisis was inherited from the previous Government, but for the first two or three years after 1997 nothing happened. We got well behind in what we needed to do to fund the NHS.
During that Parliament, the standard rate of income tax was reduced by 1p, and nobody even noticed. I believe that at that time, 1p on income tax was the equivalent of about £3 billion, and that income was just lost. It could have been spent on long-term care or the health service, but the decision was taken to reduce tax. Later on, in the last Parliament, the then Chancellor decided to reduce the standard rate of tax by 2p. I am not suggesting that the standard rate of income tax is necessarily the way to pay for care, but it is not right to say that things are unaffordable when big tax cuts are being made. I believe that 1p on the rate would now raise about £4 billion or 2p about £8 billion—plenty to pay for free long-term care for all who need it.
Laura Sandys (South Thanet) (Con)
Of course money is important, but is this really just about money? Is it not really about how we believe the service needs to be delivered? We need to ensure that people are kept out of care, not in care. Until we re-engineer what we are delivering, we will not be able to consider the funding mechanisms. If we just fund what we currently have, we will be funding something that is broken.
Kelvin Hopkins
I thank the hon. Lady for her intervention, but I think that the system is broken because it is underfunded and we have forged ahead with privatisation. In my constituency, we had a wonderful care home, which I knew well because my mother-in-law lived there in the last few years of her life. She and the other residents loved being there. They had permanent, dedicated staff, all from the local community, who loved working there. All the health advisers and professionals who came into the home thought that it was wonderful. It was closed. The pretext for that was that it did not meet care home standards because it did not have en-suite facilities. It was a trick—a pretext for closing homes and forcing them into the private sector. That home was closed, the land was sold and all the residents went into private care, some of which was not very good.
Glyn Davies (Montgomeryshire) (Con)
I thank the hon. Gentleman for allowing me to intervene because it gives me an opportunity to contribute to the debate, a lot of which I missed because of the debate on the common agricultural policy in Westminster Hall that I had to attend.
The hon. Gentleman’s speech is about residential care homes. With the best will in the world, no matter how successful we are in developing domiciliary care, private sector residential care homes will play a big part in care for the elderly. Does the hon. Gentleman agree that, after the stories about the lack of regulation, including financial regulation, in private care homes in the past couple of years, we in Parliament will have to ensure that all residential care homes meet a certain standard for long-term sustainability so that people are not moved around without any real control?
Kelvin Hopkins
I agree with the hon. Gentleman entirely. The Care Quality Commission was encouraged to have light-touch regulation and to do only occasional inspections, of which the homes were usually warned. The inspections were not adequate, and many homes fell below the standards anybody would expect. If every care home was rigorously inspected, with spot checks from time to time, we might ensure that they lived up to the standards that we expect. However, it could cost a bit more because they might have to employ more qualified staff and so on.
We should professionalise the system and ensure that it is properly regulated and checked, even if it stays in the private sector. I personally prefer public provision, with people who are motivated by what I call the public service ethos. I have seen that working and I have seen what has replaced it. People come to my surgery and complain about being forced to move out of care homes that are being closed. That is especially difficult for those with dementia. People are pressed to go into other homes, which the residents’ families often find inferior. Some are good, but not all, and people are unhappy that three care homes in my constituency have closed.
The first home closed 10 to 12 years ago and I remonstrated with the local authority officer concerned. After an hour, he finally said that it was about costs: that private care homes pay lower wages, and that the staff work longer hours and have shorter holidays. I said that at least that was honest, but it was not right.
I disagree with my right hon. Friend the Member for Leigh (Andy Burnham) about young people paying. Most taxation involves redistribution to ourselves at other stages of our lives. When we pay national insurance contributions for pensions, we are in a sense saving for ourselves later through a state system. With the health service, we pay in when we can and take out when we need. It is a redistribution to ourselves. The young paying in now for long-term care is a sensible approach, especially as it will be proportionate.
Andy Burnham
The young would not be paying for their own care; we would be asking them to pay for the care of people who are already at an age when they might need the care system. In a world where those old people have built up valuable housing assets but young people cannot get on the housing ladder, is it right for us to say, “Here’s another tax for you to pay—for care for older people”?
Kelvin Hopkins
We must start getting the system right somewhere. We can adjust taxation provision in other ways in the short term, but in the long term we must have a properly progressive taxation system to pay for adult social care. I have just been to Denmark. Many Government Members and others say that high-tax countries are weak economies, but the tax take in Denmark as a proportion of gross domestic product is 18% higher than in Britain. The Danish have free tuition at universities, and students are paid €5,000 a year to go there up to the age of 25. I am not saying that we should do that, but I am making the point that taxation at that level, provided it is fair and progressive, does not ruin economies.
It is matter of choice. I have told the story of my young children many times in the Chamber. When my son asked for a second ice cream, my wife would say, “Mummy can’t afford it.” She was saying not that we could not afford it—we could—but, “You’re not having another ice-cream.” When people talk about affordability, they are saying, “We choose not to pay.” Those who constantly campaign for a low-tax society are doing down people who are in need. We must accept that if we want to be looked after when we are in need, we must pay taxes.
When people on the doorstep ask me what my problem is, I say, “I don’t pay enough tax.” I am sure other hon. Members do not say that. My income is now more than sufficient for me to live a very comfortable life, but the income of many young people is not sufficient for them. There is nothing wrong with shifting the burden of taxation to those who are on higher incomes or those for whom most expenses are over. It is unfashionable to say such things, but I happen to believe they are right.
I mentioned the care homes in my constituency, but another issue is that of payment. Our tax gap was not so long ago estimated at £120 billion a year. If we collected just 5% of that, we could pay for free long-term care without a problem. To be fair to the Government, they are starting to wake up to the need to close that tax gap—not enough, but a bit. We have left it alone for too long, because they do not want to upset rich people who are investing in the Cayman Islands or wherever.
The Government are starting to put a little pressure on and are employing a few more tax collectors. I know from my local VAT office that every inspector collects many times their own salary, so why not employ many more to get the VAT in? People recently went to prison for a tax fraud whereby they used VAT for import and export. Such people make billions out of hon. Members and our constituents. Let us round up a few of them and stop that loophole, and ensure that people who are well off and who should pay taxes do so.
I have known Andrew Dilnot for many years—he is a civilised, highly intelligent and wholly admirable man. He did a good job in his report of trying to find the fulcrum point—the Treasury might just wear what he is proposing, but if he went further it would probably say no. There is a parallel with Adair Turner, another intelligent, civilised man. He tried to change the pension system a bit. He knew that if he pushed the Treasury too far, it would react and he would not get what he wanted. Indeed, he had a hard job persuading the previous Chancellor to accept his proposals.
The authors of those reports try to come up with recommendations that will be acceptable to the Government and the Treasury instead of coming up with what they believe to be a strong position. The problem is not the electorate, but the Government and hon. Members on both sides of the Chamber. Ministers and officials will not accept the approach I suggest for a more civilised society.
Like all hon. Members, I do a lot of public speaking. I say, “What would you choose? Would you take the risk that your family member’s house will be compulsorily sold, and all the money used to look after granny, or will you pay a tiny bit more tax over a lifetime to make sure that granny is properly looked after without being forced to sell the house?” For wealthy people, that does not matter, but it does matter for many working class people, including first-time owner-occupiers. In many cases, they have bought council houses, which I do not believe is a good idea. They have a bit of equity in their family for the first time ever and it can be used to help their children—or grandchildren usually—to stay in the owner-occupied sector, but it is being eaten away by their being forced to pay for care for elderly relatives. Indeed, owner-occupation is now falling as a proportion of housing tenure. Whatever one thinks about owner-occupation or renting, that is happening, and a factor in that might be that people are being forced to sell houses to pay for care, and the equity is in effect being lost in rich taxpayers’ pockets, because they are the ones who can get away with not paying enough to ensure that granny is looked after.
We have to accept that people are living longer. We have not found a solution yet to Alzheimer’s or dementia. I hope that we do—it will solve many problems—but while we have not, we have to ensure that elderly people are cared for, which means that we have to pay for it properly. We will all get old one day, and we all might need this care one day. Certainly, for me and my family, I want to ensure that, as and when any of us need that care, it will be there for us and provided properly in a civilised and caring way.
Fiona Bruce (Congleton) (Con)
I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on the sensitive and caring way in which she brought this debate to the House. I also pay tribute to the 6 million unpaid carers in the UK. Unsung and often unseen, they are heroes and heroines who daily and sacrificially dedicate their lives to caring for others, often for 24 hours a day, seven days a week, 52 weeks a year. They deserve our utmost respect and appreciation, and I wish to record mine here.
I therefore wish to focus on the need to support carers in this era of an increasingly elderly population and greater longevity and with the exponential Treasury challenges that it will undoubtedly bring. Two million people currently move in and out of a caring role each year, but an ageing population and people living longer with chronic conditions mean that this figure is likely to rise significantly, so we must give serious consideration to how such carers, caring charities and community organisations can be better supported.
It is essential that we encourage a major cultural shift to consider how more support can be provided to carers, especially those who care for their families, and to charitable organisations that support carers. Caring charities, such as Crossroads Care Cheshire East, of which I am privileged to be patron, and the Prince’s Royal Trust for Carers, provide disproportionately greater value for money in the support they give than purely publicly funded social care services would ordinarily provide. As one former employee of the Prince’s Royal Trust for Carers told me, they supplement that work with volunteer support and the ability to act flexibly and go the extra mile, while all the time operating to high professional standards.
A significant caring role can affect a carer’s emotional, physical and financial health, but by supporting carers more positively, we can not only help them and those they care for but save the public purse considerable expense, which, as my hon. Friend the Member for Banbury (Tony Baldry) so eloquently said, will be increasingly important in the coming decades—to a degree that we have only just begun to glimpse. Crossroads Care Cheshire East writes:
“A clear agenda to support carers is an essential component of adult social care strategic planning.”
Caroline Hebblethwaite, who has been a volunteer worker with a caring charity in Cheshire, then an employee and now a full-time carer, speaks with unchallengeable authority and has told me of the many ways in which she believes we could support charities that in turn support carers more effectively. She says that longer-term funding commitments would help—beyond, say, two years—because shorter-term commitments make it difficult for organisations to plan and result in unhelpful churning, loss of experienced staff and disruption to well-established, cost-effective services. As Crossroads Care Cheshire East writes:
“Constantly having to reinvent well developed and user led services simply to fit another funding criterion is not a good use of time and money. Innovation is essential but experience should not be ignored.”
Both Caroline Hebblethwaite and Crossroads Care refer to the essential need for carer breaks. Crossroads says that carer breaks
“should not be paid for out of any benefits received by the person with care needs but should be a carer’s service for the benefit and health and wellbeing of the carer. It is not appropriate to assume that service users will use their own personal budgets to allow their carer a break—we know that often this does not happen. Without practical support carers and families will break down—this can be avoided by low level investment at an earlier stage.”
I will give examples of some of the many ways in which relatively low-level investment can be made.
Local authority funding could make a huge difference if a little more was channelled through carers charities, to be paid out at the discretion of the charities’ trustees. Caroline Hebblethwaite tells me that when she worked for the Princess Royal Trust, small grants paid directly to carers—not means-tested—made a disproportionate difference. She tells me, for example, of an elderly man caring full time for his wife for whom that small grant paid for a shed, in which he could pursue his hobby. It gave him that little bit of extra space and helped him to keep going. For another carer, there was a one-off spring clean, while yet another received computer literacy training, and another the occasional massage.
Provision to enable carers who work to remain in work—by having someone call in, just two or three times a day, to check that their loved one is all right—can make such a difference. A sitting service is also helpful, so that carers can go out. One way that local authorities can offer support—at a very modest cost, but making a real difference for those who care—is by funding befriending groups. Such groups enable carers to share experiences, but they need to be local, because carers do not have the time to travel far. Those that have helped in Cheshire include befriending groups that have provided talks on such matters as how to redecorate on a budget or how to make a hanging basket, and have even given advice on healthy eating. That might seem mundane, but it can make a real difference to carers, who often feel run down or a little bit depressed. Such small amounts of support can have a disproportionate benefit, and we need more of this.
Carers, often low on energy and self-esteem, find it hard to get information, advice and support, and I am advised that social workers often do not have much time to signpost them. However, local charities for carers can perform an important function in offering a great source of advice. Another function that they perform is by acting as a counselling service, providing counselling time—again, something that social workers cannot provide. There is a real need to recognise and support carers—for example, by giving them help in adapting to change, or to loss, or grief for a life once lived, or a life that might have been.
Caroline Hebblethwaite also told me about how much carers days have meant to those whom she has supported. Carers days in Cheshire have been held at local hotels, or even at a golf club. Carers are invited to come for special “feel good” days, where they are affirmed and told how much they are valued, and where high-level speakers talk to them, acknowledging the vital role that carers play. More of this is what we need as we move forward.
Local authorities could also ask professional advisers in carers charities to carry out more assessments of carers. This would not only be a valuable source of additional funding for carers’ charities, but also a likely cost-saver for local authorities. Incidentally, I am informed that assessments of carers’ needs are not made as frequently as they should be in many circumstances.
I would like now to deal with one or two other points. First, my constituent Barry Smith has written to me about higher attendance allowance:
“My parents-in-law are both 89, my father in law has advanced Alzheimer’s and my mother in law, in poor health herself, and lacking easy mobility after having broke both hips, is his primary care…We have spent the last few days trying to fill out the forms for…Higher Attendance Allowance and have come to the conclusion that the application itself constitutes a form of discrimination against the elderly. We had been warned…that the form is extremely difficult to fill in…and that the rate of success is only 60%,”
but it seems that
“for most elderly people it is simply impossible to complete…It is as though it has been carefully designed to ensure that the minimum number of applicants receive their entitlement”.
Hopefully that is something the Minister will look at.
I commend the proactive work of Cheshire East council, the local authority area in which my constituency lies, to support older people, as illustrated in its innovative “Ageing Well in Cheshire East” programme, 2012-17, which has just been launched. It focuses on how to support people from as early as 50 upwards—a little depressing for some of us at that age!—on the basis that the earlier we plan, the better those plans will be for later life, given that we all want to live well for as long as possible.
The aim of the programme is to ensure that older people live well and have access to the right levels of different services and support, including crisis support, at appropriate times in their lives. The programme aims to ensure also that they have a strong voice in influencing local policy and services; remain healthy, active and independent; receive help to plan their finances long-term; live in a safe environment, with appropriate housing; access appropriately constructed public transport; benefit from and contribute through employment, volunteering and learning; keep their links with family and friends; are actively involved in their communities; and maintain their roles as partners, carers and grandparents.
I commend in particular the wide-ranging network of relevant public, private and voluntary sector bodies which the Ageing Well programme has fostered, garnering a commitment to the programme that will be essential if we are to maximise our support and provide the effectively integrated care that has been talked about today. The programme has secured a commitment from agencies as wide-ranging as Cheshire fire and rescue, the police, clinical commissioning groups, local councils, the faith sector, housing providers, care charities and even the chambers of commerce.
The programme is already tackling older people’s concerns, such as those about disjointed services, the variable quality of care and social and economic isolation, and it is also improving volunteering opportunities. Such forward-thinking work is an essential component of our successfully rising to the challenge of caring for the elderly in the years ahead, and it is particularly important in an area such as Cheshire East, which has a rapidly ageing population and, in fact, the largest elderly population of any area, per head of population, in the north-west of England. The number of over-65s in the area will grow by 50%, and the number of over-85s is set to double, by 2025.
Cheshire East has funding challenges, however. The Government funding for the area is among the lowest of any in the country, despite the challenges that we are going to face and, indeed, already face in caring for such a large elderly population. We are given £191.62 per head, while Tower Hamlets, by way of comparison, is given £968.18, meaning that we can afford to spend per head £753.42, while Tower Hamlets has almost double, £1,428.16.
The funding context of each local authority area is an important influence on the services that can be provided, and in an area such as Cheshire East, with low funding but an increasingly elderly population, that is going to be a challenge, so I ask the Minister to consider it as we move forward.
I commend the Minister’s commitment to build on community capacity as the way forward, helping people to stay independent, healthy and well for as long as possible. Indeed, perhaps a better term for independent living would be inter-dependent living, recognising the importance of, and the need for, all of us to give and receive care at various stages of our lives. The more we can encourage caring within families, by friends and in communities, the healthier our society will be. We need to do all that we can to foster support and to encourage the sharing of caring, and we need to treat with gratitude and respect those who do care.
The words of the chief executive of Carers UK are apt:
“Our health and social care services could not function without the contribution of the unpaid care provided by families—which we estimate to be the equivalent of £119 billion a year.”
The basic building blocks of a healthy society are found in relationships—the networks of reciprocal responsibility that are found in the family, in friendships, in church, in community life, in work, and in schools. Through these basic building blocks, individuals meet the needs of their community. It is as much, if not more, the role of Government to help society to meet its needs through those relationships rather than seeking to take control and trying to meet those needs itself. As human beings, one of the ways we grow is through the challenge of meeting the needs of others in our relationships within our communities. Our national mindset needs to be increasingly directed towards that goal. Looking to the selfless example of our country’s 6 million carers would be a very good place to start.
Laura Sandys (South Thanet) (Con)
It is a great pleasure to follow my hon. Friend the Member for Congleton (Fiona Bruce).
My hon. Friend the Member for Truro and Falmouth (Sarah Newton) has been very important in instigating this debate about future policy on long-term care and ensuring that other such discussions are going on around the House. If it is the case that we come into Parliament because of certain issues, then reviewing and reforming long-term care would be one of the reasons that I find myself in this place. I am not sure that anything is more important for Government, Opposition and this House to resolve, and I give a huge amount of support to the cross-party debate that is going on.
However, we must realise that, unlike in other parts of NHS reform, there is not one person in the country who does not have a view on this subject and does not understand what long-term care means to them. They will look at it, and present it, through the prism of their parents or elderly relatives, and in their heart they will be thinking, “That is what my future will look like.” The shadow Secretary of State said that this debate needs to go beyond this House and to engage the public. I welcome that comment. As my hon. Friend the Member for Kingswood (Chris Skidmore) said, this is about a contract. We are entering into a discussion that will end up as a settlement between the country—the hon. Member for Luton North (Kelvin Hopkins) thinks that a little more funding might be needed—and the public, whose responsibility meets that of the state halfway, or perhaps more.
The public know that the system is broken. Its funding has been squeezed and there has been very little reform or innovation—other than in Torbay, which as we all know is the place to move to as one gets older. When people talk about care packages, it sometimes seems as though the patient is the package and it is hard to understand where the care kicks in. I believe that Dilnot has produced something useful and important, but perhaps it is a little pre-emptive. Until we can be explicit about what this care looks like and feels like, and what people’s experiences of it will be, it is difficult to talk to people about how we expect them to pay for it. I do not believe that the public are prepared to fund the current system, so we must first look at changing it.
I have been a carer myself. I cared for my father when he had a stroke when I was 17, and I saw my mother age by 15 years over a five-year period of caring for him. I have seen it first hand, and I understand some of the key issues that people face. I have also worked professionally in the areas of incontinence—not a charming subject, but one that is exceptionally important in this respect— epilepsy and motor neurone disease, so I have seen this from the end user’s perspective.
What could the new system look like? I believe that the system should be re-engineered around the principle of early intervention. The deceleration of the impact of ageing could be achieved by co-ordinating non-clinical services to keep people fitter and out of the care system. The things that social care delivers must change; it needs a total refit. I believe that that could be guided by four key principles. The first is about keeping the new old young. The second is about keeping people out of care, rather than talking about funding them in care. The third is about caring for carers; we need a whole stream of wraparound policy to support those people who are making that ultimate sacrifice—well, not the ultimate sacrifice, but a significant one. The fourth is about the need for top-quality care for those who do end up in residential care.
I hope that we will be able to keep the new old young. Members will be thrilled to hear that most of us have already started the process of ageing. Everything that we do now will have an impact on us in our 60s and 70s, and beyond. Why are we not introducing, through our GPs, human MOTs to look at any challenges to mobility? Owing to distributing far too many leaflets, both my arches have collapsed and I now have insoles in my shoes. That could have become a major problem as I got older. Why are we not looking at people in their 40s and 50s and taking steps to intervene and decelerate the ageing process?
Laura Sandys
I totally agree.
The acceleration of ageing starts to happen before we get old, and we must look at the public health opportunities to engage with and pre-empt some of the issues that we might face as we get older. That leads me on to keeping people out of care. The three biggest reasons for people going into care are dementia, incontinence and accidents, such as falls. Are we looking at those three factors in enough detail? This morning, on the radio, we heard about a drug that could help people to stay more able despite their dementia, and I hope that it will become more widely available.
I said earlier that I had worked in the area of incontinence. It is one of the most easily managed conditions, so why is it not properly supported? Why are so many people referring their family members to residential care for that reason, when the condition can be addressed easily and extremely cheaply? We are not addressing the condition, and we need to look at it in a lot more detail to ensure that more people can keep their relatives at home. I also mentioned falls. Why do we wait until someone breaks their pelvis before going into their house to see whether they have a handrail, whether their lights are working or whether the ramp is in the right place? None of this is rocket science, folks. It is perfectly straightforward, and I do not understand why such interventions are not being made much earlier.
We have a system that is broken, but we are not doing the necessary pre-emptive work. Instead, the system rewards acute services. It finds installing handrails or wet-rooms less thrilling than ambulances and broken hips. That makes no financial sense, and no human sense. The public know where the system is going wrong, and they can see that earlier intervention would make a difference to their loved ones. Many people have spoken about carers today, and we need to do as much as possible for them. They are at the heart of keeping people out of the care sector.
If we re-engineer our care system, making prevention and pre-emption the gold standard, we must look at a re-engineered funding mechanism, too. I believe that there is a policy framework that is a little like the green deal: for those who support people out of care, there is a bonus and an incentive, rather than the current financial model that rewards hospitalisation and pays far too little for those in home support.
I welcome the comments of hon. Members about how little care workers in homes are paid. My word, if we look at the value we get from that particular care intervention in comparison with extreme nurses in hospitals, we should start to understand that we have a very unbalanced system.
In conclusion, if we have a vision for decent and dignified care, the public will enter into a contract with the Government. They might even do so more than the Government think; they might even pay more than we are currently asking them to contribute. However, they will do that only if they see a re-engineered system that places the foremost priority on delivering care—quality care—that they can trust, rely on and understand.
Andrea Leadsom (South Northamptonshire) (Con)
My hon. Friends the Members for South Thanet (Laura Sandys) and for Congleton (Fiona Bruce) made interesting points specifically about caring for carers, which is the issue I want to address, too. I have one specific policy suggestion for the Minister, on which I would be interested to hear his thoughts: we should seriously consider introducing a post-retirement carer’s allowance.
It has always been the case in our society that no more than about a fifth of all the caring that goes on has been achieved by the state. In recent years, that fifth has expanded slightly to about a quarter, but if we were to try to pay via the state and taxation for all the caring in our society—whether it be for children, disabled relatives or the elderly—we would never raise enough in tax to be able to achieve it. For me, it has always seemed nonsense simply to look at the budgets and try to spend a bit more and a bit more. That will not be the solution in the longer term, particularly in an ageing society where the issue will crop up time and again.
I applaud my hon. Friends the Members for Congleton and for South Thanet for focusing instead on the carers—the people who carry out the caring. There are currently about 1 million people in England alone who are aged over 65 yet are caring for a relative. A constituent wrote to tell me that he was disabled, that his wife was his carer and that they also had a disabled adult child for whom his wife had been the carer since the child was born. He told me that his wife, who had retired at 62, was not eligible for any carer’s allowance because she was drawing a state pension. She is trying to care 24/7 for a disabled husband and travelling at her own expense to care for an adult disabled child. That is simply impossible, and he told me that it was inevitable that the family would have to go to the local council and call for help. His wife will give up that caring role because she will not be able to cope—financially, let alone physically—with the stress of having to care for two people in her own family.
If we turn that on its head and think about what happens with a carer’s allowance, we find that the carer gets £55.55 for 35 hours of care a week—£1.58 an hour in comparison with the national minimum wage of £5.59 an hour for an adult. Carers thus get an incredibly small sum of money. Looked at from the state’s perspective, it is an absolute bargain. If the person was not doing that caring for that kind of money, the state would be the default and have to pick up the pieces, as that is how things work in this country.
What we should be looking at is how we can continue to benefit from the love and cherishing of family members in order to give the people being cared for a quality of life that is so much better. We all know that £1 spent in the home saves £4 in the NHS. How much more is £1 spent on a carer who knows and loves the person they are caring for worth than £1 spent on a carer who, perhaps, comes in periodically through the day and who may frequently be replaced by another carer? The outcomes for the person being cared for are so much better if they are cared for by someone who genuinely loves them.
We should therefore seriously consider introducing a post-retirement carer's allowance that is available only to retired carers who continue to be the only carer for their loved one. That carer's allowance would cease on the day that they call on social care from social services or the local council. There will therefore be an incentive for people to continue to care for their loved ones, which is better for everybody. I absolutely take on board what my hon. Friend the Member for Congleton said about the need to provide a care package for the carers themselves, but the principle of enabling carers to continue to provide that support for as long as possible should not be overruled by the need to care for the carers.
The Department for Work and Pensions has estimated that this year the cost of simply retaining the carer's allowance alongside the state pension would be about £950 million. What it did not take into account was the fact that there would be a commensurate reduction in the pension credit, and also the enormous potential reduction in the cost of providing social care. We might be paying a family loved one £1.53 or £1.58 an hour, but we would be paying an official carer £10 or £20 an hour, perhaps, to go in and look after that person—and in a far less assiduous way.
The taxpayer, through Government aid, is simply not going to be able to foot the bill for all the care that will be needed in the future. We must find a way to support society, communities and carers, so that loved ones can continue to care for their own family members. I would be interested to hear the Minister’s thoughts on this idea.
Dr Sarah Wollaston (Totnes) (Con)
I have good news: people in their 40s and 50s are at the pinnacle of evolution, according to Dr Bainbridge writing in the New Scientist. I do not think my children would agree with that assessment, but they would agree that they feel rather outnumbered. This is a cause for celebration, however, and we should note it in this House: it is a good thing that we are all living longer—after all, the alternative is very unattractive indeed. A man who reaches the age of 65 can now expect on average to live a further 18 years, and a woman at 65 can expect to live even longer—to 85 and a half. We should welcome that on international women’s day. This is good news all round, therefore, but these extra years must be lived well. We should add to people’s years of life while also helping them live with independence and dignity.
I have the privilege of serving on the Health Committee, and I have also had the privilege of working for 24 years on the front line in the NHS. I have therefore met many carers, and also many people who, sadly, are suffering from dementia. Many Members have commented on that topic however, so I will not discuss it further now.
I want to focus on the Select Committee’s recommendations following our inquiry into social care. I acknowledge that, by 2014, an extra £2 billion a year will be spent on social care, and I welcome that investment. There is still an issue that needs to be addressed, however, and it transcends party politics.
As the King’s Fund and the Dilnot commission have made clear, demand is outstripping supply—by 9% over the past four years—and the Local Government Association and the Association of Directors of Adult Social Services have stated that this underfunding is a long-term problem. According to the King’s Fund, the funding gap could be as high as £1.2 billion by 2014. Also, about 890,000 older people in social care may have a need that is not being met. As the Select Committee heard, some councils are tightening their eligibility criteria, so that people who perhaps would have been classed as having “substantial” needs are now being classed as having “moderate” needs. Other councils are setting a different benchmark, so they are funding only “substantial” needs, rather than both, as they might have done in the past. Obviously, the problem goes beyond the total spend. Government Members are taking a realistic attitude to our national debt, knowing that there are no blank cheques. However, we need to continue to increase our social care funding slightly, so that we can achieve what we want to achieve for our older people: dignity and independence.
It will not matter how much we spend unless we change how we spend it. One thing the Dilnot commission examined well was how we divide our spending. We know that we spend £145 billion a year on older people in England, about half of which goes on benefits, such as pensions, housing-related benefits and pension credits. Some £50 billion is spent on the NHS but only £8 billion goes towards social care. That balance is not right. If we were designing the system from scratch, we would not set the funding in that way. That structural problem has been recognised for decades, but the White Paper and the changes in the Health and Social Care Bill give us an opportunity to address it. I therefore ask the Minister to rebalance things by examining the Select Committee’s key recommendation, which was to deliver integrated health and social care, with a single commissioner or a commissioning body, and to drive this joint working by also looking at pooling budgets.
Some wonderful examples of that approach are available, as we found when the Select Committee visited Blackburn with Darwen PCT and Torbay Care Trust. I am fortunate that the Torbay Care Trust covers much of my constituency, because it achieves real results: low average lengths of stay; rapid access to equipment, thus avoiding hospital admissions; and getting people out of hospital much quicker. The key to all that is recognising that keeping people independent in their own homes, rather than admitting them to expensive hospitals, saves money. As has been said, for every £1 we spend on integration, we save £2.65 for the health service—as is so often the case, the best care turns out to be the cheapest care.
I was disappointed to hear the Minister describe the care trust model as an experiment that never really got “out of the lab”. I urge him to get back into the laboratory with care trusts, because this is good practice. They bring a positive culture on joint working, pooled budgets and putting patients first. In Torbay, they have considered an imaginary patient, “Mrs Smith”, who has complex care needs and at every stage in the system they have designed everything around her, putting her needs first. That sometimes means sweeping away the silo working that we so often see. In many parts of the country, six different phone calls have to be made when dealing with a patient with complex care needs, and there are endless delays and frustrations, and repeated assessments, but Torbay has a care co-ordinator with a single number. We need to adopt that kind of working.
Paul Burstow
The hon. Lady is making an important set of contributions to this debate. That comment I made during the Health Committee’s evidence session was very much born out of frustration—it is frustration that my hon. Friend the Member for Southport (John Pugh) has echoed. How we spread best practice and get it adopted is one of the key challenges in delivering more integrated health and social care, and it is one of the things we are going to address in the White Paper. The Select Committee’s contribution to that process has been very helpful.
Dr Wollaston
I thank the Minister for that encouraging response. I am glad to hear him say that rolling out good practice is key to this. I ask him to consider the Select Committee’s recommendation that the way that we can best drive that is by having a single outcomes framework. We are currently going to have outcomes frameworks for housing, for social care and for elderly people in health. Bringing those together would drive proper integration. Having a single commissioner for all these services would bring people together. If we do not have that, we risk carrying on as we are. When budgets are stretched, as we all accept they are, there is more of a tendency for organisations to say, “This money is for social care”; where spending the money would perhaps improve only health outcomes, there is less of an incentive to spend it. We should consider pooling the budgets, and having a single commissioner and a single outcomes framework. I am not saying that we should be too rigid in imposing how that is done, but we should set out what we expect. In addition, we should recognise how important housing is in this area. We should not leave it out of the equation when we consider how we help older people to continue to live independently.
Damian Collins (Folkestone and Hythe) (Con)
Would my hon. Friend include more informal forms of care, such as referring patients who are socially excluded to local walking or singing groups where they can participate and be with other people? There are some good models of that in my constituency.
Dr Wollaston
I thank my hon. Friend for that intervention and agree with him absolutely. In the past couple of weeks, I have visited an organisation called Brixham Does Care in my constituency as well as another, Saltstone Caring, and I am sure that we all have wonderful examples in our constituencies, sometimes involving social enterprises and sometimes charities.
I feel that one of the most encouraging things about the Health and Social Care Bill is that it will give commissioners the flexibility to draw in partners, because there is sometimes an assumption that only the NHS can deliver good care. The NHS remains at the core of good care and I trust that GPs will have the sense to commission integrated care pathways that do not fragment local services. I do not know a single GP who wants to privatise the health service or social care; GPs want the flexibility to bring all these elements together while having the good sense to protect their much valued local NHS services. I am very encouraged to see that there will now be a focus on integration, but I ask the Minister specifically to consider integrated care with a single commissioner, because the Committee felt that that would be the most encouraging way forward.
In conclusion, let me return to Dr Bainbridge in the New Scientist, who describes middle-aged people as
“the most impressive things yet produced by natural selection.”
The Minister fits that bill perfectly and has a fantastic opportunity to achieve what we have been trying to achieve for 50 years: an integrated health and social care model. It can be done and I hope that he will look at the Health Committee’s report and make it a reality.
Guy Opperman (Hexham) (Con)
Well, they make them out of strong stuff in the west country. It is a joy to follow my hon. Friend the Member for Totnes (Dr Wollaston), who brings great medical and intellectual wisdom to the debate, and I am honoured to be speaking in a debate introduced by my hon. Friend the Member for Truro and Falmouth (Sarah Newton).
I would be humble in my approach to this matter, but I would like to think we are united in the sense that Members from all parties have a common desire to tackle what is probably the most intractable problem we face. There is in effect no dispute about what we want from social care: we want independence, dignity and privacy for those who are being cared for, and the people who provide the care need patience and humour and to know their individual clients and their family members. The question is how we develop a social care network that treats people as people within the confines of a budget that is ever changing and ever more difficult to reconcile.
How a society treats the vulnerable is surely the best definition of that society. I came into this House in my 40s, I am delighted to say, and I thought I was in the prime of my life, until last year when I became unwell. I am probably the only person in the Chamber at this moment who has needed social care. It was a great effort to become better researched in preparing for this debate, obviously, but becoming ill last April gave me a great deal of knowledge and insight from a personal standpoint about the degree to which such care is necessary and about the great service that is provided. Today’s debate is a wonderful opportunity to celebrate the great work done by individual carers in the public and private sectors and, not least, the work done by families.
I speak as an MP for the north-east, and there are shining examples of how the north-east leads the way in the provision of care to individuals. There is outstanding palliative care in my constituency through the Charlotte Straker palliative care teams in Corbridge. If I need to make a declaration it is that last summer I raised in excess of £3,000 for the charity Tynedale Hospice at Home, which provides care in Hexham. All of us as MPs will go around individual care homes in our constituency. The Helen McArdle organisation does an amazing job across the north-east, including at its Acomb Court service in Hexham. I was lucky enough to be asked to present some prizes at Wentworth Grange in Riding Mill and it was noticeable that more than 35 awards were made to individual staff members because there was a great deal of ongoing training to improve the quality of individuals’ care. I could name many others throughout the constituency, including Wellburn House in Ovingham, but I will move on, given all the support there has been across the House, to talk about the White Paper.
The White Paper on social care is coming this spring. I know that spring is drifting on, that there are pressures and that people are calculating what kind of spring it is going to be, but let me reassure the Minister. Last year, we all celebrated the Arab spring across the near and far east, which changed things. That Arab spring lasted quite a long time—virtually the entirety of last year—so we will not necessarily be critical of the Minister if the White Paper does not come within the technical confines of spring. Surely—I make a serious point—it is more important to get this right than to rush it. I accept that there have been a plethora of consultations and assessments over the past few years, but there is no doubt that the way we have approached this issue, on a cross-party basis with constructive attention to detail, is much more important than rushing something out that is not the right way forward. I welcome the fact that the White Paper is coming and I urge that we get it right and work on a cross-party basis.
This issue, I regret to say, is not about funding. There will always be small issues about the way that individual local schemes and individual approaches are funded, but the issue we will decide in the House this year is not about funding from the state: it is far more about outcomes. How do we reform the system such that we have an outcomes framework that integrates all the services for particular individuals? I endorse entirely what my hon. Friends the Members for Truro and Falmouth and for Totnes said about this. I hope that health and wellbeing boards can deliver a single commissioning process with a single outcomes framework whereby older people’s health, care and housing services in a particular area are integrated. That has never happened in the entire existence of the NHS or previously; it is a genuine aspiration. Less important than funding is attention to that detail because at the moment we have a patchwork of care.
I am conscious of the time and eager for my hon. Friend the Member for South Swindon (Mr Buckland) to get in. We speak so much in the House that we are now the rear gunners of every debate—of democracy. It is a shame because we feel that we have much to contribute but we contribute so much that we are always the last to speak. I must not dispel any chance for the House to hear from the great man from South Swindon so I shall try to abbreviate my comments.
I agree that the Dilnot proposals are correct but there has to be genuine understanding and we all need the ability to sell to our constituents what Dilnot means. The idea that Dilnot will not—I will not try that again—cost us in any way whatever is hard to grasp and hard to convey to our constituents. There are nettles that need grasping. Funding will be an issue, and a contribution from individuals will be unavoidable. If we do not accept that, there will be grave difficulties ahead.
I welcome the fact the NHS budget is protected at present. Given all the difficulties, we should celebrate the choices that are being made and that extra money is being spent on social care. It concerns me, for example, that the Government spend eight times as much on cancer research as on dementia research. I welcome the extra money going to dementia patients, but more needs to be done, as many groups have made clear.
I want to put one point to the Minister that I hope will assist. I tabled a question to the Department of Health and received the answer on 7 February. It was:
“To ask the Secretary of State for Health if he will make it his policy that the influenza vaccine should be compulsory for all public and private sector care workers.”—[Official Report, 7 February 2012; Vol. 540, c. 199W.]
I accept that certain people will want to retain the choice not to have the vaccination, which would be given only on the basis of informed consent, but it would be of great assistance to the vast majority of care workers. Vaccination would clearly cut the prevalence of infection and other problems, and the Government should lead the way. Some, for religious or other reasons, would not to want be vaccinated, and they should be exempted, but it would be a good move for the Department of Health in addressing what is clearly a problem of infection and of staffing when staff become ill themselves.
I support public sector carers, who need to be valued just as much as any other public sector workers. They do a difficult, messy and not always entertaining job. They are the unsung heroes. We also need to support our family carers and recognise the services that they provide. We must ensure, as many have said, that there is a decent system of respite care because if the family carer cannot care there will be huge problems for the Department of Health and the NHS.
With that, and allowing sufficient time for the sage of Swindon, I will sit down.
Mr Robert Buckland (South Swindon) (Con)
I do not know whether I should thank my hon. Friend the Member for Hexham (Guy Opperman) for that warm-up act. I know my place, and I am more than happy to take part in this interesting and varied debate.
There is no doubt that the facts that face us all as parliamentarians are pretty stark. We know that 11 million people alive today will live to be 100 and that the population who are over 65 is projected to grow by 50% over the next 20 years. The expected number of working age adults with a learning disability will rise by about 30% over the same period. My hon. Friend the Member for Totnes (Dr Wollaston) reminded us that we should celebrate the fact that we are all living longer rather than being a permanent Jeremiah figure when it comes to these statistics. However, they do pose us quite a stark challenge.
Much has rightly been said today about the army of carers. I add my voice to that chorus of opinion about the invaluable work they do. My hon. Friend the Member for Congleton (Fiona Bruce) estimated that their work saves our economy £119 billion a year. I support the arguments made by my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) in respect of carer’s allowance for people post retirement. It is a sensible and thoroughly appropriate point to make in this debate, bearing in mind the need to create an incentive to care for people at home.
Many hon. Members have mentioned local carers centres. I pray in aid my local centre, the Swindon carers centre, which provides an excellent support service for carers, many of whom are young people still at school caring for an adult relative. It provides a focus and brings people together in the way that has been described and organises carers days in my constituency in which I and others take part. The messages we get from those events are messages not just of emotion, but of hard facts about the reality of life for carers on the ground. Frankly, they are the greatest experts on the people they care for, which is why they must be involved as service users in developing the services on which they rely. Carers are a huge resource, as we have heard, and must be an important part of the service.
Two key principles underlie the reform of social care: first, transparency—I have already mentioned the need for carers to have knowledge of and access to local services—and the way we track national funding and how it is spent locally; and secondly, predictability and reliability for those who need care and their families. They need to know that they can work within the system and rely upon it in the long term.
We have heard a lot today about care for the elderly, and I support the observations made by hon. Friends and Opposition Members. Rather like the hon. Member for Mansfield (Sir Alan Meale), I want to focus on those with learning disabilities. I am grateful to him for raising the issue of autism, which is rather close to my heart, as I think most Members will know, as I chair the all-party group on autism. Before dealing with the issue, it is right that I emphasise the importance of advocacy for people with learning disabilities.
There are many independent charities and voluntary organisations across the country that provide a voice for adults with learning disabilities. In my constituency the Swindon Advocacy Movement, which receives sustainable funding from the local authority, works hard on that philosophy. It draws in people in with learning disabilities so that they can be part of the planning for the service, which enables them to speak for themselves, because advocacy is not just about people like us talking for people like them; it is about enabling those people to do it themselves. I know that the hon. Member for Mansfield and I agree on that point, because I raised it when I intervened on him earlier. What we want to see is a service that enables people with learning disabilities to stand on their own two feet as much as possible and to play a full and active part in our society. That is why I believe passionately in local advocacy, which will help us see an end to the Winterbourne Views of our society and the betrayal of all the principles we believe in become very much a thing of the past.
We also heard about overarching frameworks within which care services should be developed, and I want to thank my hon. Friend the Minister publicly for following my advice, and that of many others, by referring the quality standard for care of adults with autism to the National Institute for Health and Clinical Excellence. He knows that I and others have been working on that issue for some time. It was the subject of a 10-minute rule Bill I introduced last year. As an aside, I urge him to look at a quality standard for care for children with autism, because I strongly believe that it is the transition from childhood to adulthood that we are still getting so badly wrong in this country.
I will pause for a moment and deal with the threshold into adult social care and how we need to plan adequately for that while the person is still young so that adult social services are working hand in glove with children’s services. In particular, when we develop our policy on special educational needs—I know that this is not the responsibility of the Minister’s Department, but it is a point that should be made—we must ensure that the new care, health and education plans go up to the age of 25. It is absolutely vital that we stick to that proposal, which was set out so helpfully in the special educational needs Green Paper, so that the threshold issue can be dealt with properly and there can be proper and adequate further education provision for young adults. There is a dearth of provision for young adults between the ages of 18 and 25, particularly those with autism and related conditions. It is in those seven key years of life that adult social care often fails and when we do not address issues of education for young adults with autism. Ambitious about Autism’s “Finished at School” campaign, which I had the privilege of launching in Parliament a few months ago, calls for that extension of provision.
I have referred to the key principles that underlie the Law Commission’s report on adult social care that was published last year, which we all know about. There needs to be a single duty on authorities to meet eligible needs, a duty for carers assessments to be undertaken and—something that we have perhaps not touched on in this debate—a duty for adult protection cases to be investigated by local authorities or other agencies. We are getting child protection largely right, but let us not forget vulnerable adults, whether they be elderly people or people with learning disabilities. To return to the Winterbourne View scenario, there needs to be a proper mechanism by which we investigate cases in which the welfare and safety of vulnerable adults has been called into question.
It has been a pleasure to take part in this debate. It was particularly reassuring to receive a clean bill of health from my hon. Friend the Member for Totnes. Dare I say that I am in the same age group as her? I will leave the Chamber thoroughly reassured. Finally, if we do not address these issues, we will fail not only current generations, but the generations to come.
Sarah Newton
This has been an excellent debate in the breadth and depth of its contributions. We have seen the experience, passion and commitment of Members from all parts of the House.
In particular, I thank the hon. Member for Worsley and Eccles South (Barbara Keeley), with whom I work in the all-party parliamentary group on social care. The contributions have been wide-ranging. We have heard from my hon. Friend the Member for South Derbyshire (Heather Wheeler), the hon. Member for Blaenau Gwent (Nick Smith), my hon. Friend the Member for Kingswood (Chris Skidmore), the hon. Member for Mansfield (Sir Alan Meale), my hon. Friends the Members for Southport (John Pugh) and for Banbury (Tony Baldry), the hon. Member for Luton North (Kelvin Hopkins), my hon. Friends the Members for Congleton (Fiona Bruce), for South Thanet (Laura Sandys), for South Northamptonshire (Andrea Leadsom) and for Totnes (Dr Wollaston), and our famous rear gunners, my hon. Friends the Members for Hexham (Guy Opperman) and for South Swindon (Mr Buckland).
There can be no doubt from this debate about the cross-party support for delivering a re-engineered care system for the people who need care and for our vital carers. The system needs to be shaped around the person who needs care and their carers. I wish the Government and Opposition teams good fortune in their vital work to negotiate a new system for providing and funding care, so that we can all be proud to have created a society that we all want to grow old in.
Question put and agreed to.
Resolved,
That this House believes there is an urgent need to reform the current system of providing and paying for the care of adults in England and Wales; recognises that social care, unlike the NHS, has never been free at the point of need irrespective of income; notes the central role of informal carers in the provision of care; welcomes the Coalition Agreement pledge of reform and legislation; further welcomes the plans for better integration between adult social care services and the NHS; welcomes the extension of personal budgets; urges the Government to ensure that fairness is central to reform, including access to advice, advocacy, assessment of need, care services as well as funding options; recognises the need to break down the barriers to portability; and further urges the Government to publish its White Paper as soon as possible, and to bring forward legislation.
Mauritania (Fishing Agreement)
(12 years, 9 months ago)
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Sheryll Murray
There will be €1 million a year to support the parc national du banc d’Arguin, a national park. Licence fees costing an estimated €15 million are paid by ship owners to Brussels. The agreement with Mauritania is by far the most expensive and important for member states such as Spain, which is already moving to negotiate a bilateral agreement if the EU negotiations fail.
The fleet can be broken down into two sections, the industrial and the artisanal. The industrial fleet is made up of a variety of vessels targeting various stocks. A few Scottish and Irish vessels catch pelagic stocks—mackerel, horse mackerel, sardine and sardinella. Sardinella are bonier and larger than sardines, and are mainly sold to the African market. Those vessels pair trawl, and they are fitted with saltwater tanks to store the fish, similar to a vivier tank in a crabber. The catch is trans-shipped to factory ships, and one Norwegian factory ship in the area is called the Ocean Fresh.
Factory ships and pair trawls are permitted by derogation from Mauritanian fisheries law. The sector is permitted a catch of 15,000 gross tonnes a month, to be averaged over the year. Dutch freezer trawlers catch pelagic stocks, and the catch is frozen on board. There are 17 licences, for a reference tonnage of 250,000 tonnes. There are 32 licences for 13,950 gross tonnes of cephalopods—species such as octopus and squid. Spain holds 24 of those licences and also catches tropical round fish and white fish, working in competition with the artisanal sector. Other licences are issued, mainly to Spain, for different fishing methods and species.
The artisanal fleet comprises mainly pirogues, constructed sometimes from laid wooden planks but increasingly from aluminium. Those boats operate with an outboard motor, and many are crewed by Senegalese fishermen. The crews operate with only a satellite or mobile telephone for communication, and they often have no navigation lights on their vessel and no VHF radio.
The Mauritanian Government have drawn up a development plan for the artisanal fisheries. The pirogues fish for cephalopods using pots or traps, and when shoals of tropical round fish, white fish and sardinella come close to the shore, the pirogues fish for them with nets. Most of the artisanal catch is landed locally in the port of Nouadhibou, where there is a quay.
As was pointed out in the report produced following the visit by my right hon. Friend the Member for Shrewsbury and Atcham—
Daniel Kawczynski (Shrewsbury and Atcham) (Con)
Just honourable, not right honourable.
Sheryll Murray
My hon. Friend's report pointed out that landing facilities are sparse, with just one small factory that can take 100 tonnes of mixed pelagic fish. I know that he would be pleased to confirm that, but he is prevented from speaking on the matter owing to his position as Parliamentary Private Secretary to the Minister. His report makes the following observations:
“The fish are either auctioned in open air for the local market or auctioned in the purpose built facility with chilled storage units to buyers that deal with European fish and seafood firms. The operation here was of a reasonably efficient standard, however there was no large scale refrigeration available, meaning the fish were left out in the 30 plus degree heat.
There was one small room where a refrigerator from above was creating ice for use with some of the fish stocks, however the scale was not sufficient to deal with the volume of catches of different fish species, which were as a result liable to lose freshness and therefore value as a consequence.
In addition to the lack of refrigeration, there was also an absence of any other automated processing of any kind.
The port was littered with rudimentary stalls that ranged from people gutting and de-scaling fish, to making various broths and dishes with the catches. There were also basic sheds which sold various supplementary goods for the fish, as well as maintenance sheds for the boats and port workers.”
The current EU fisheries partnership agreement contains several promises. Some have been honoured, but others have not. Annex IV of the current protocol makes specific promises for port facility improvements. First, on progress on the refurbishment of the port of Nouadhibou, I understand that some work is being carried out, with the contract awarded to a Spanish contractor. Secondly, progress was to be made on refurbishing and extending the non-industrial fishing port of Nouadhibou. Thirdly, a number of measures were to be carried out to bring the fish market into line with standards. Fourthly, progress on the creation of landing stages for non-industrial fisheries was promised. Finally, a number of wrecks were to be removed from the Nouadhibou area.
Many shipwrecks have been removed, financed by the EU, and the contract was awarded to a Dutch contractor. However, I understand that there has been no progress on improving the artisanal side of the ports of Nouadhibou or Nouakchott. The three other landing piers to spread the artisanal sector more evenly along the coast have not been provided.
The joint motion for a resolution by the European Parliament of 10 May 2011 confirms that. The preamble states:
“owing to the scant development of the fisheries sector in Mauritania, including the lack of significant landing ports outside Nouadhibou, the country is being deprived of the added value it would obtain, if it were exploiting its fishery resources itself (including processing and sales)”.
The resolution continues:
“as envisaged in Article 6(3) of the current protocol, the EU should support the fastest possible construction of adequate facilities for landing fish along Mauritania’s central and southern coastlines, including—but not limited to—Nouakchott, so that fish caught in Mauritanian waters can be landed at national ports rather than outside the country, as is often the case at present; this will increase local fish consumption and support local employment”.
Talks between the EU and Mauritania collapsed last December according to Euronews, which reports that a negotiator from the west African country said that the two sides failed to make an arrangement regarding money. For far too long, EU bilateral agreements and the successor fisheries partnership agreements have failed both conservation and the local fisheries sector of the host nation.
I urge my hon. Friend the Under-Secretary to make representations to the European Commission and fisheries Ministers from other member states, calling for the inclusion of the European Parliament’s recommendation in any future FPA with Mauritania. That should include: delivery of all promised port facilities; a requirement to land all catches from EU vessels, including pelagic and cephalopod, in Mauritania; and support for the artisanal fleet, including education about fishing practice, management, safety equipment and marketing advice.
Will my hon. Friend also investigate, with all parties at UK, EU and Mauritanian Government level, the possibility of helping create a sustainable, self-supporting fishing industry in Mauritania? That could be through the formation of a fish producer organisation or a non-governmental organisation similar to the Sea Fish Industry Authority. In the UK, both those organisations are funded by a levy. Such a levy would be easy to apply if all catches were landed in Mauritania. It would provide the financial means for marketing, management and safety training to the local industry among other things, and could allow Mauritanian fisheries to become self-supporting and sustainable, thereby eradicating the need to rely on handouts of aid from the EU or Government sources, and boosting the Mauritanian economy. Most importantly, it could provide the means for scientific data collection and ensure that those rich waters are not plundered by large third country vessels to a level where the fish stocks they contain fall below the safe biological limits. The EU has a responsibility to ensure that fisheries agreements do not harm nations such as Mauritania.
In conclusion, I should like to describe disgraceful behaviour that has taken place off west Africa, as highlighted by the European Environmental Justice Foundation. Fish caught by pirate vessels were trans-shipped to a larger factory ship—the Seta—before being landed in Las Palmas. The EU confiscated the catch under the recent regulation concerning illegal, unregulated and unreported fishing. Some four months later, claiming a discrepancy in translation, the Spanish Government released the catch, allowing the pirates to sell it and receive the income. Will my hon. Friend the Minister investigate that matter with both the Commission and the Spanish Government?
Neil Parish (Tiverton and Honiton) (Con)
I thank my hon. Friend the Member for South East Cornwall (Sheryll Murray) for allowing me to contribute to her Adjournment debate. I also thank my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) for his report highlighting the problems in Mauritania.
I want to talk not only about what is happening in Mauritania, but about the agreements in principle. I spent 10 years in the European Parliament from 1999 to 2009 and voted against every agreement, because—quite simply—the EU should not be buying up the resources of west Africa or anywhere else, and taking fish from the mouths of those fishermen and families. Boats often run down and destroy local fishing boats. If we are to help those countries, we should buy fish from them and help them to build up their fishing and port industries.
The agreements are absolutely morally wrong, and we should not use our taxpayers’ money or European taxpayers’ money for them. That money very often goes not to the people of west African countries, but to their various Governments of various types. I shall be reasonably diplomatic—for me—and say that not much of that money gets to the indigenous population. It more likely lands up in Swiss bank accounts. I am blunt about that, because we know how governance in such countries often takes place.
The Minister is a great warrior, and I know he will go to Brussels and raise those points. It is time we stood up to be counted as a country within the EU and said enough is enough. One has only to go to Spain and see the amount of fish eaten there to see why they are so hungry for fish, but if Spain wants fish, it should buy them from those African countries, not plunder their waters at European taxpayers’ expense, which destroys the livelihoods of the fishermen and communities in those countries.
I urge the Minister to take strong action. I am delighted that my hon. Friend the Member for South East Cornwall is an expert on fishing and was able to describe the species and types of fish being caught. Hundreds of thousands of tonnes of fish are being taken from Mauritania. It is completely and utterly indefensible.
The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Richard Benyon)
I congratulate my hon. Friend the Member for South East Cornwall (Sheryll Murray) both on requesting and on securing the debate, building on the expertise of my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski). I should also acknowledge the powerful contribution of my hon. Friend the Member for Tiverton and Honiton (Neil Parish). I shall explain shortly why this debate comes at an opportune moment. It is important that we debate such issues not only in the House, but where it counts, in the European Union. I shall go on to explain the Government’s policy on the external dimension of the common fisheries policy.
The future of the fisheries partnership agreement with Mauritania is important, as is the future of all EU fisheries partnership agreements with other countries. The EU spends around €120 million each year on fisheries partnership agreements with countries outside the EU in exchange for EU vessels being permitted to fish in their waters. That is a large amount of money, representing 15% of the total EU fisheries budget. I am determined that these agreements should provide value for money, support good governance and apply only where the exploitation of fish resources is sustainable.
Over the past four years, the EU has paid €305 million to the Government of Mauritania so that its vessels can fish there. In total, the EU catch is about 300,000 tonnes of fish each year. Rather than it all being landed into the EU or Mauritania, much of it finds its way to other African countries, as my hon. Friend the Member for South East Cornwall said. In fact, very little of the fish caught in Mauritanian waters by EU vessels is actually landed into Mauritania. In 2006, only 8% of the EU’s catch was landed in Mauritanian ports. In response, Mauritania insisted on the inclusion of a clause in the latest protocol stipulating that, if vessels did not land into Mauritania, they had to pay higher licence fees. That has encouraged some additional landings but even now they are only around 12% of the total.
Vessel operators claim that they are unable to land into Mauritania because the conditions are simply not adequate for them to do so. In some cases, they say that to land into Mauritania could put the safety of the crew at risk, cause significant damage to the vessel and risk damage to the wider marine environment through oil spills. In 2011, the European Parliament issued a declaration that called on the EU to support the rapid construction of adequate facilities for landing fish into Mauritania. That would increase local consumption and support local employment—the kind of aims that a real partnership agreement should seek to achieve and, indeed, aims that are supposed to have been fulfilled in this agreement. The European Parliament also considers that more effective mechanisms must be in place to ensure that funds earmarked for development, and in particular for infrastructure improvements in the fisheries sector, are used properly. I entirely agree. We must be able to demonstrate that these public funds are being used for the purpose for which they were provided.
An independent evaluation of the Mauritania agreement indicated that, although it was better than previous agreements, there were still substantial deficiencies. For example, it concluded that most stocks offered to the EU by Mauritania were either fully exploited or over-exploited. If the EU wishes to be regarded as a responsible fishing entity, it must only fish against stocks considered sustainable. The scientific advice must be more robust and then adhered to by both parties to the agreement. The EU should not be contributing to overfishing in the waters of other countries by vessels that are, to all intents and purposes, subsidised by our taxpayers.
I am pleased to report that we are making progress. For example, all agreements now have to contain a clause allowing the EU to terminate them in the event of serious human rights concerns in the countries with which the agreements have been negotiated. I have also noted that the European Parliament has recently added its weight to the debate and called for money paid as compensation for access to fish stocks in Mauritania waters to be decoupled from financial support, so that reductions in fishing opportunities do not necessarily lead to reductions in financial aid.
I want the proportion of funding for fisheries agreements that is paid for by vessel operators to be increased significantly so that public money is not used to subsidise EU vessels fishing in developing countries. In 2012, only 20% of the money given to Mauritania was contributed by vessel operators themselves. We must ensure that these agreements represent value for money to the EU taxpayer and the local populations, and that these subsidies do not work against precisely what we seek to achieve on the development of sustainable fisheries.
We have been criticised for allowing vessels to operate around the globe that are no longer economically viable for fishing in EU waters. That criticism is well founded and we now need to take action to address it properly. I also want to ensure that, when these vessels fish under these agreements, they are subject to the same standards of control that apply to vessels fishing in EU waters. That means ensuring that a sufficient proportion of the funds under the agreements is spent on strengthening inspection and enforcement capability.
In that regard, I note what my hon. Friend the Member for South East Cornwall said about a factory ship landing in Las Palmas. We will certainly make inquiries with the appropriate authority to investigate that. What she described is a disgraceful situation—if it can be proved—and we will work hard to ensure that, where possible, such matters are decided.
I should also report to the House that my discussions with other Fisheries Ministers from west African countries have shown me that what they require is a single point of contact with the Commission, so that if an EU-registered vessel is held and those concerned are arrested for malpractice of any kind, that information can be transferred to the Commission and appropriate licensing action can be taken by the EU. At the moment, that does not happen. We currently have a crazy situation, where a vessel can leave a port and just go out to sea, perhaps carrying on fishing illegally without the kind of sanction that should be applied by us, as the EU, from where it is licensed.
I have already been pressing those points in a number of forums. Over the coming months, we will have a number of opportunities to tackle the issues and bring about real change that will improve the governance of the agreements, ultimately benefiting both the EU and—more importantly for this debate—the countries with which we have those agreements. That is why this debate is so timely. The first such opportunity falls in about 10 days or so, at the March Fisheries Council, where I will be discussing with fellow EU Fisheries Ministers the external dimension of the common fisheries policy, as part of the reform of the common fisheries policy to deal with fisheries partnership agreements. I can assure hon. Members that I will be maintaining the pressure and reflecting the mood of the House this evening.
The UK’s position is clear. We want a common fisheries policy that promotes the genuinely sustainable use of fish stocks, wherever they are. We are seeking to ensure that fisheries partnership agreements are based on robust science, allowing EU vessels to fish only for stocks where a genuine surplus exists and providing value for money to the EU taxpayer. I want fisheries partnership agreements to place a greater financial burden on the vessel operators who benefit from them, and I want to see the same standards of control and enforcement as are currently applied in EU waters. I also want a mechanism that separates the money paid for access to fishing grounds from development aid, and provides a real benefit to the indigenous populations and fishing communities of the countries with which we have such agreements. Critically, any agreement must be subject to a rigorous assessment, to ensure that its sustainability is assured before, during and after its life cycle.
I end by offering this assurance to my hon. Friend and the House. I will continue to argue strongly for improvements to both fisheries partnerships agreements under the current CFP and the future policy frameworks under a reformed CFP, for the benefit of taxpayers, developing countries and the fish stocks themselves. I would also say this to my hon. Friend the Member for Tiverton and Honiton. He may not share the view that not all fisheries partnership agreements are wrong. However, if we can get this right and develop a sustainable fishery off a country’s coastline, so that the fish are caught sustainably and landed there, with value added to them by local fish processing businesses—perhaps with the support of aid from countries such as ours—and if those fish can then be sold on the world market, all that can benefit both the indigenous populations along those coastlines and the economic development of that country as a going concern, as well as helping with better governance and greater scientific understanding of what is happening in the seas around those coasts. That is what I am trying to achieve, by making a virtue out of what is, really, a black mark, in what has been the sorry history of the common fisheries policy, both at home and in its external dimension. I can assure the House that I am working hard with all those with an interest in the agreements, to ensure that we achieve real and meaningful improvements to the current framework of fisheries partnership agreements.
Question put and agreed to.
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UK Aid
Westminster Hall
(12 years, 9 months ago)
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Common Agricultural Policy
(12 years, 9 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Miss Anne McIntosh (Thirsk and Malton) (Con)
It is a great privilege to serve under your chairmanship this afternoon, Mr Weir. The Select Committee on Environment, Food and Rural Affairs is delighted to have secured this debate, which is welcome and timely.
The common agricultural policy has been on a long journey since it was first established, moving from a time of rationing through a time of plenty to a time of increasing fluctuation. Previously, the CAP took the lion’s share of the European Union budget. Now it accounts for approximately 40% of total EU spending. We are mindful of the fact that negotiations on the CAP reforms are continuing in parallel with the negotiations on the financial framework 2014-2020 for the European Union.
The CAP is at a crossroads. Decisions made now will determine our future food prices and availability and shape Europe’s countryside and rural communities. I want to thank all those who participated in the preparation of this report. I am also grateful to those who have contributed to our subsequent inquiry into the greening proposals contained in the communication. We have not yet had the opportunity to agree that and publish a report. I pay tribute to those who farm not only in Thirsk, Malton, Filey and the rest of north Yorkshire, but across the United Kingdom. They have the perils of the landscape and also the elements to contend with. They are not just feeding the nation, but are increasingly being called on to feed a hungry world.
The current round of CAP reform is being played out against a very different background to farm reforms. Food security is rising up the political agenda, placing a renewed emphasis on agricultural policy. I submit that there is a potential inconsistency at the heart of Government policy between food production and sustainability. We await the Minister’s response to hear where exactly the Department for Environment, Food and Rural Affairs is taking us in its negotiations.
We should not underestimate the challenge facing agriculture globally. We need to increase production significantly, but we cannot do that simply by using more land, more chemicals and more water. We already have problems in the UK food system. Prices are rising. We have food inflation running at about 4%, but farm incomes are falling for many farms. Grazing and livestock income is predicted to fall nearly 50% over the coming year.
Paul Flynn (Newport West) (Lab)
In view of the change in farmers’ prosperity—there have been better times recently, particularly in the value of agricultural land—does the hon. Lady think it might be a good time to call on the farming community to take their share of the cutbacks suffered by the rest of the country? Would she suggest that a cap of £26,000 be placed on subsidies?
Miss McIntosh
I am sure the Minister will have heard that. That proposition was not put before the Committee and we have not reached a conclusion on that. The farmers are making a huge effort—unpaid—in areas such as retaining and storing water, for which it may be possible to use funds from the CAP in future.
The CAP needs to provide a clear plan for growth and sustainability. As a Committee, we were not convinced that either the European Commission or indeed the Department have faced up to the challenges ahead. In our approach in the report before us this afternoon, we are perhaps less reformist than DEFRA. We express some reservations about the prospect of capping. The hon. Member for Newport West made an interesting intervention, but we will resist any attempt—it would not be the first attempt—to seek to discriminate against some of the larger units that we have. Farming units tend to be larger in the UK. That is partly historic and partly because they are more productive. We would resist any attempt to discriminate on the grounds of size, and we would also resist the greening of pillar one through compulsory measures.
We recognise that our farmers are already subscribing in larger part to agri-environmental measures than many other farmers in the EU. We believe that successive Governments have done absolutely the right thing in pursuing that policy. We do not want to see our farmers, who are in agri-environmental agreements, discriminated against by having to go possibly at short notice down a different path, or be discriminated against by facing a penalty when they leave agri-environmental agreements to look at new agreements. We want reassurance on that from the Minister today.
Glyn Davies (Montgomeryshire) (Con)
Even though I am making an intervention, I should declare an interest as a farmer. Does the hon. Lady agree that we must resist the principle of greening the CAP, which, I must admit, most people in this country support? It must not happen in a way that increases bureaucracy and the difficulty of operating within it to the extent that it discriminates against the British farmer.
Miss McIntosh
For the sake of clarity, I am addressing the House as Chair of the Environment, Food and Rural Affairs Committee. I will leave it to my right hon. Friend the Minister to respond to the debate, and I commend the work that he does. Having been a shadow Minister, I am delighted to participate in this debate.
I will deal some of the points that my hon. Friend has made. On food security, the EU must have a significant degree of self-sufficiency. Speaking personally, I am concerned that we are less self-sufficient in this country than we have been historically. That is a comparatively recent development over the past five years. I hope that we can stop such a development in its tracks and that we can become not only increasingly self-sufficient but a major exporter, following the Foresight report in particular and some of the invitations to farmers in that report.
Julian Sturdy (York Outer) (Con)
I refer to my entry in the Register of Members’ Financial Interests. My hon. Friend is making a key point about food security and the importance that it will have not only in the UK but across the world, and also to the impact on food prices. Does she therefore agree that it would be dangerous to take all arable land out of production in the name of greening?
Miss McIntosh
We will return to greening measures in our further report. The greening measures are the most controversial part of the reform. We believe that the CAP should enhance food production capacity—not necessarily increasing production now—by keeping land in agricultural use and in good environmental condition so that the land is usable when we need it. We need a competitive and viable agricultural sector. We need to redress the imbalances, because farmers cannot get a fair return from the market.
Kelvin Hopkins (Luton North) (Lab)
The hon. Lady makes a point about the importance of food security for the long-term future and for maximising our self-sufficiency, with which I totally agree. Does she agree that the logic of such an argument is that agricultural policy and agricultural subsidy should be managed nationally, not internationally?
Miss McIntosh
The evidence we received was very clear in that regard: as long as there is a level of farm support across the European Union—and in other parts of the international community—farmers subscribe to decisions being taken within the European Union, so that there is a proverbial level playing field. That is something I have sought most of my professional life. I do not know if we have reached it yet.
I want to say a few words about direct payments. In the Committee’s view, direct payments should be retained—the evidence was very powerful in this regard—up to 2020. They should not be abolished until business conditions in agriculture improve, because UK farms are highly dependent on direct payments—currently the single farm payment as introduced in 2005. Without them, more than 50% of farmers would be unprofitable. I dare say that many of those would probably be in my uplands in Thirsk, Malton and Filey. The evidence we received indicated that UK livestock production would fall significantly as a result of such an approach although, interestingly, it would have only a negligible effect on crop production. The Committee is concerned about the implications for food security and for landscapes, and the rural livelihoods that depend on farming.
Ian Paisley (North Antrim) (DUP)
I thank the hon. Lady for giving way in this very important debate. Does she accept—and has the Committee reflected on—the issue regarding the fair distribution of the amounts between pillar one and pillar two? Does the Committee recognise that there must be a fair distribution, which should not be at the expense of one pillar over the other?
Miss McIntosh
That is an excellent intervention. If the hon. Gentleman bears with me, I shall come on to those very concerns.
Under successive Governments, UK farmers have been expected to meet higher standards on animal welfare than farmers elsewhere. We have unilaterally applied the sow stalls and tether ban, which only comes into play in 2013 across the rest of the European Union. Those standards impose extra costs on our producers and make them less competitive globally. Direct payments provide a means to pay for those higher standards. Without them, society—the community—runs the risk of EU farmers going out of business while exporting the social and environmental impacts elsewhere. In the longer term, the European Union must argue more strongly for a recognition of production standards in trade agreements. We conclude that DEFRA must set out more clearly how it will reduce reliance on direct payments, including the policy tools needed.
Andrew George (St Ives) (LD)
On direct payments, the hon. Lady will know—I know that the Select Committee has considered this issue—the definition of what an active farmer is. The Government entirely support the principle of that. Does she not also agree with the Government’s approach, which is that the definition of what is and is not an active farmer surely must be decided at a member state level?
Miss McIntosh
I will come on to say a bit about that if time permits. I have personal reasons that relate to constituency interests—apologies for not mentioning it earlier but, as declared in the register, I farm two fields in partnership with my brother—for believing that tenant farmers in this country risk being in a very difficult position. I am very grateful to the Minister for having heard me out on my personal concerns in that regard.
During the course of compiling the report, the Minister told us that DEFRA would like direct payments to be phased out over the next financial period—in other words by 2020—and to end shortly thereafter. If DEFRA wishes to achieve that, we would like to see a plan to make farming in the European Union more competitive and less dependent on subsidy, otherwise the Department’s position does not seem credible and risks alienating farmers and weakening DEFRA’s influence in Brussels. From the evidence the Minister gave us, there seemed to be no new ideas on how to make UK farming more competitive. The Committee is not convinced by the Department’s arguments that rising prices for some commodities will necessarily deliver long-term improvements in farm incomes, for example, because of pressure from supermarkets on farmers.
Barry Gardiner (Brent North) (Lab)
I am grateful to the hon. Lady for setting out the Committee’s report so clearly and for initiating the debate. She will have heard the Minister say from a sedentary position, “That’s nonsense. It’s piffle.” It is important that she sets out how the Committee arrived at that conclusion and the basis of the witness statements that we took from the Minister and others.
Miss McIntosh
I am grateful to the hon. Gentleman and distinguished member of the Select Committee for those remarks. I could go through the witness statements at some length, but the record speaks for itself. For the record, the Government response states:
“The UK Government accepts that there is more for us to do in this area and are continuing to develop our ideas for reform. A UK Government priority will be to continue the good work undertaken in previous reforms, such as phasing out the remaining coupled subsidies and continuing the market orientation of the CAP.”
I am sure that the Minister would like to stand by the evidence that he gave to the Committee in an oral session.
The Minister of State, Department for Environment, Food and Rural Affairs (Mr James Paice)
I need to point out to my hon. Friend and, indeed, to the hon. Member for Brent North (Barry Gardiner) that if she read her speech as I believe she did, she said that I had stated in witness evidence that the policy was to phase out the single farm payment over the next seven years and end it shortly thereafter. That in itself is a contradiction. That is not our policy. Our policy is, yes, to seek a phasing out of the single farm payment. However, she implied that I had said that it was to be extinguished by the end of that seven year period. That is not the policy.
Miss McIntosh
I am grateful for that clarification because the Committee was led to believe that that was the desire of the Department and the Minister. Certainly, that was the understanding of the witnesses—both the witness statements—from the farming community as well. I am sure that hon. Members will want to return to that matter.
We have already moved away from the historic basis of payments, and it would be anachronistic to continue to pay farmers on the basis of what they produced a decade ago. However, a flat rate per area would result in considerable redistribution within the UK, suggesting that national flexibility will be needed.
Turning to greening the CAP, the Committee agrees with the principle that the future CAP should reward and encourage sustainable farming. The Foresight report, “The Future of Food and Farming: Challenges and choices for global sustainability”, says that we will need to produce more food but use fewer inputs. We conclude that greening measures should not come at the expense of productive successful agriculture, but we need to find win-wins for sustainability and competitiveness. I repeat: we applaud the fact that, in this country, our farmers are already greening through agri-environmental schemes to a much greater extent than elsewhere in the European Union.
Paul Flynn
Moving away from the principle of subsidising food production to subsidising the ownership of land, a recent claim was made that nearly 1,000 landowners in this country, some of whom are not farming their land at all, receive very large grants of more than £250,000. Does the hon. Lady think that the pubic will accept not only that such farmers should receive those large amounts, but that those large amounts should increase at a time when cuts are being made everywhere else in the economy?
Miss McIntosh
With the greatest respect, I have addressed capping, having a CAP and the historic reasons why we are more productive and have larger units. I personally oppose any move to discriminate against our productive farmers on those bases.
The European Commission seems to be proposing a return to compulsory set-aside. We on the Committee think that that runs counter to the prevailing message that we should produce more food. The Commission needs to focus on ways to help farmers to produce more using fewer inputs for the reasons that I have given.
The Commission’s proposals to add more conditions into pillar one would tie farmers up in environmental red tape without delivering tangible environmental benefits. The Committee was persuaded that we need more simplification and less complication, which is why we are hesitant about the proposals. Also, farmers need to be involved in the process, so voluntary measures and incentives are preferable to more regulation.
The evidence that we have received shows that UK agri-environmental schemes are a European success story. CAP reform should build on that success by encouraging a broader uptake of agri-environmental schemes across Europe, not by creating a whole new system that requires more auditing and more expensive computer systems.
We reject DEFRA’s alternative proposal, which, as we understand it, would shift most of the CAP budget into pillar two and make it more flexible with fewer controls over how much member states spend on different objectives, because pillar two is co-financed—both the EU and the member state contribute funds. The Committee is concerned that cash-strapped member states, not least our own, will not want to take up more co-financed measures, and UK farmers will end up being disadvantaged. A common approach and common funding are needed across the EU.
The briefing prepared by the National Farmers Union for today’s debate contains a useful graph that shows that we are at the absolute bottom: the UK receives the lowest per hectare allocation of pillar two funds of all member states. That is reflected in the fact that pillar two payments for England are low, owing to the reluctance of successive Governments to draw down discretionary European funds. It would therefore be nonsensical to pile more funds into pillar two away from pillar one.
On the idea of ceilings and capping, the Committee disagrees with a payment ceiling, whereby the maximum direct payment cannot go above a certain level—probably €300,000—irrespective of the size of the farm. Direct payments should mostly reward farmers for their provision of a public good, so larger farmers deserve larger payments. The evidence that we have received suggests that capping direct payments would discourage farm rationalisation and generate more business costs.
Regarding tenants and landowners, we invite DEFRA to ensure that a new definition of an active farmer will not disadvantage UK tenant farmers and commoners, some of whom are found in my constituency. The UK has a unique system of tenanted and common land, of which I am extremely proud. The Commission proposes a new definition for eligible CAP recipients, and it is essential to ensure that tenants and commoners are not left out.
Tenant farmers can currently claim direct payments, provided that they meet the usual scheme rules. We agree that it is important that they continue not only to do so following CAP reform, but to be eligible, where they meet the rules, for agri-environmental schemes. We are working with representative commoners and other interests in the management and protection of common land to identify options for the delivery of direct payments on common land. I warmly welcome the fact that that is the Government’s response, and I pay tribute to the Minister for his personal involvement. We concluded that there is a need to look at European rules to protect tenant farmers, and we urge the Minister to lead, as he is doing, in that regard.
In our view, the CAP should in the future include optional coupled payments within strict limits. The Committee agrees that most payments should be decoupled from production, as with the single farm payment, because that allows farmers to respond to the market, is less distorting to world trade and does not lead to over-production. However, in the uplands, keeping livestock is central to the delivery of other public benefits, such as landscapes, but it is unprofitable. Payments per head within strict limits would be a fair and transparent way to reward farmers for the public benefits that they provide. We recognise that DEFRA opposes such payments, but we hope that the Minister is open to persuasion.
We have not taken a strong position on the budget. We agree that some savings need to be made, but they should be balanced against their effect on farmers’ incomes and the ability to fund agri-environmental schemes. EU money is the main funding for the agricultural environment and the environment in the UK, and the Department should be mindful of the consequences that will follow in stripping it away.
The evidence that we received did not support a return to greater price support, but said that measures such as intervention buying would be needed in the future to prevent a collapse in production if prices fall.
Our bottom line is that simplification of administering the CAP is desirable and that elements of the Commission’s proposals risk making the CAP more complicated—for example, by using a new definition of an active farmer that might have heavy audit requirements, a more complex new system of allocating direct payments or more green conditions.
Today’s debate is timely; the negotiations are at an early stage. We believe that the Commission’s proposals lack both vision and detail on how to increase the competitiveness of UK agriculture. Elements of the Commission’s proposals, such as payment ceilings and additional support for small farmers, risk making UK businesses less supported. The proposals should give greater consideration to rectifying imbalances in the food supply chain and strengthening farm extension services. Any new definition of an eligible recipient of CAP payments must not, as I said earlier, disadvantage the UK’s tenant farmers and commoners. Currently, the CAP is in a fairly good place in this country, but there is some way to go before we can best deliver a food policy that meets all requirements and delivers for the environment in this country and beyond, in the wider European Union.
Dr Eilidh Whiteford (Banff and Buchan) (SNP)
I congratulate the Environment, Food and Rural Affairs Committee and its Chair on the report and their important work in scrutinising the CAP reform process.
I want to pick up on a few key issues in the Commission’s proposals that will be of great significance to farmers in Scotland, not least in the parts of Banffshire and Buchan that I represent, where farming has been a way of life for many generations and where food production is still absolutely the mainstay of the local economy.
I suspect that there is a good deal of consensus across the House on a couple of critical issues in today’s debate, the first of which is the need to cut red tape and reduce the administrative burden on farmers. In many respects, that is about fixing a major problem with the current CAP regime and is linked to the need for effective regionalisation and flexibility for member states. I hope that the Minister will consider in his comments at the end how we can start making decisions much closer to home and in the interests of our farming communities.
Roger Williams (Brecon and Radnorshire) (LD)
The hon. Lady touches on an important point. A common agricultural policy is needed, but considering the difference between farming in Finland and farming in Greece, we need to ensure that local decisions are taken on local matters within the umbrella of the CAP.
Dr Whiteford
I agree entirely with the hon. Gentleman. Clearly, we have different climates and landscapes, diverse methods of farming and different ways of doing business in farming. Without prejudice to the common market, it is important that decisions are made in a practical way by the people best able to make them.
Member states will need flexibility in the process to tailor implementation to their own needs. Within the UK, all three devolved Administrations must be able to work around the challenges that they face in delivering sustainable agricultural development in some least favoured areas. About 85% of Scotland is classified as least favoured areas. That compares with much lower proportions in some other parts of the UK. I hope the Minister will offer assurances that he will press for greater regionalisation as the negotiations intensify and that the issue will not fall off the agenda.
The hon. Member for Thirsk and Malton (Miss McIntosh), the Chair of the Environment, Food and Rural Affairs Committee, quite rightly concentrated on direct payments in her remarks. I welcome the fact that the Government have moved away from the more rigid position of the previous Government, but I am still concerned about their direction of travel. I welcome the Minister’s remarks earlier on clarifying the Government’s position. I hope that he will listen carefully to the Governments of Scotland, Wales and Northern Ireland on direct payments and pursue a negotiating stance in Europe that reflects the needs and wishes of the whole UK.
It is worth remembering, as the hon. Lady pointed out, that direct payments are there primarily to compensate producers for the increased costs of operating in a highly regulated market and to enable them to meet the high animal welfare and food safety standards that we all expect. We need to acknowledge that that does not come for free. We need to accept the reality that, in the past few decades, farming has not been particularly viable as a commercial enterprise. If we did not support agriculture with direct payments, food production and land management simply would not be happening in large areas of the UK. Farming, especially in the least favoured areas, would have ceased a long time ago.
We cannot consider this in purely economic terms. The hon. Lady hit the nail on the head when she put food security at the heart of the debate. Brian Pack’s 2010 report, which was produced for the Scottish Government, highlighted not just the food security challenge, but the challenges of climate change, water supply, energy use and biodiversity as the starting points for CAP reform. In a global context of rapidly increasing demand for food and the need to manage our natural environment much more sustainably, the case for direct support for farmers is actually much stronger now than it ever has been in the past.
We also need to consider the future of direct payments against the historical backdrop of Scottish farmers receiving a disproportionately low share of pillar one support—a pressing issue for those Scottish farmers who want to export their produce. At present, pillar one rates in Scotland are only €130 per hectare, which is less than half the EU average, and well below the UK average of €229 per hectare. The UK needs to argue for its proper share of pillar one, not least so that it can provide a fairer allocation to Scottish farmers.
Glyn Davies
I want to return to the point that I made when I intervened earlier. I think that there is general agreement that pillar one is crucial. In Wales, where we have more than 80% of least favoured areas, it is absolutely crucial. Farmers who approach me are concerned that a significant part of pillar one will be subject to greening policies that are so bureaucratic that they will not be able to comply with them. The biggest threat is that the greening proposals on pillar one will probably make that part almost inaccessible.
Dr Whiteford
The hon. Gentleman raises a valid point. In their current form, the greening proposals are probably unworkable. They are inherently bureaucratic, which is exactly what we should be trying to move away from. I am afraid that they will have unintended consequences and that the one size will simply not fit everyone in exactly the same way as we have seen in previous incarnations.
One priority for farmers in my constituency, as well as other parts of Scotland, is the need to retain the option for coupled support for the beef sector. The hon. Member for Thirsk and Malton mentioned that in relation to upland farmers. The Minister will know that Aberdeenshire is famed for its beef, but we face challenges in least favoured areas. A lot of the land used for livestock grazing in Scotland is not suitable for arable farming. Grazing livestock is the most sustainable and environmentally friendly way to manage that land. I hope that the Minister listened to the concerns of Scottish farmers when he met representatives of the National Farmers Union earlier this week. I am sure they made their views known; I hope that he will take their concerns on board and respond to that issue.
Another issue that relates to the point about greening is the three crop rule, which will not work in those least favoured areas where only grass can grow—a lot of those areas are permanent pasture. I hope that the Minister can find a workable solution to that, too.
CAP reform gives us an opportunity to clear up some of the problems with the current approach, including the opportunity to target support at those who are actively farming the land. There has been recent controversy about so-called slipper farmers. It is worth making the point that, certainly in Scotland, more than 98% of those in receipt of farm subsidies are actively farming. It is important to keep that in proportion, notwithstanding the need to tighten up and close that gap.
This is a time of austerity throughout Europe, and everyone is feeling the spending squeeze. We need to justify the support that we give to farmers through direct payments if we want to keep public confidence in the benefits that they accrue. A very strong case can be made for our food producers and land managers, but it is hard to justify large handouts to those who are not actually involved in farming.
It is important that any active farming test is based on how the land is managed, not on an arbitrary accounting measure, because many small crofters in Scotland are part-time farmers—they either run other businesses or have other employment—and they could be adversely affected. Increasingly, perhaps more in my own area than in some others, farmers are trying to diversify their farm businesses. Renewable energy is probably the most obvious example, but they are moving into areas that are sometimes considerably more lucrative that their farming businesses. Farmers who are actively managing land sustainably should not be penalised because of their other business interests.
Simon Hart (Carmarthen West and South Pembrokeshire) (Con)
I imagine that the hon. Lady has similar examples to ours in Wales. Farm businesses that have traditionally formed the bulk of a family operation have been overtaken by, for example, a tourism diversification scheme. In our case, that is every bit as important. She makes a good point, but I hope that she recognises that that applies, particularly to coastal areas.
Dr Whiteford
The hon. Gentleman makes a good point about his constituency. The picture in Scotland is more mixed. There are some areas with a tourist dimension, but there are other areas where farming and food production is much more the core business. Again, even in the UK, we cannot say that one size fits all. Even within regions in parts of the UK, there is diversity.
Mr Alan Reid (Argyll and Bute) (LD)
The hon. Lady rightly said that that direct payment should be linked to active farming. Does she agree that the system needs to be improved, so that new entrants will be attracted into farming? The present system with a fixed point in the past discourages new entrants.
Dr Whiteford
Absolutely. That has been an historic problem, and this is an opportunity to address it. The Commission’s proposals to support young farmers are probably a step in the right direction. It has been very difficult in recent decades, as the hon. Gentleman is aware, for new entrants to get a start in farming unless they inherit a family business. I am concerned that the proposed scheme will apply only to those who are already entitled to basic payments. That will not help new entrants aged over 40, or those who enter farming after 2014.
I should like the scheme to be open to all genuine new entrants to farming. I should also like member states to have the option to implement that policy, so that it can be tailored as necessary to address the real issues that we face. Likewise, a simplified scheme for small farmers could be a useful step in Scotland, where 13% of pillar one support is for less than €1,000. Crofters would be prime beneficiaries of such a move, and I hope that we will find a suitable way forward on that proposal.
Barry Gardiner
I agree with the hon. Lady on the importance of local understanding in the distribution of funds; they should be managed locally. However, has she considered that perhaps in other parts of the EU—not within the UK—there might be countries that could abuse or rig such a system to ensure more finances for their own farmers? That would not be good for farming in general or for the CAP’s objectives as a whole. Indeed, it would not be good for the environment.
Dr Whiteford
The hon. Gentleman makes a valid point, which touches on one of the key struggles that I mentioned at the outset: the problem of regulation and bureaucracy. We need to strike a balance between bureaucracy and regulation, with all the problems of compliance in recent times, and have an effective and workable system. There is no easy solution. Nevertheless, those who comply with the system should not be the ones who are punished by it. I have lost count of the number of farmers in my constituency who have complained about the amount of paperwork that they have to deal with to access CAP funding. Even though that burden of regulation has eased a little in the past few years, the single, biggest complaint that I hear from local farmers is about the very stringent and absolutely bureaucratic compliance rules.
The financial penalties for even a minor infringement or an administrative error can run into thousands of pounds, which is out of all proportion to the seriousness of the infringement. I have raised that with the Minister on more than one occasion, and he is well aware of farmers’ concerns. What prospects are there in this CAP reform round of addressing that serious issue, which has caused more problems than any other?
I hope that the Minister will respond to those concerns and to those that, I am sure, other Members will raise. There is a future for farming. It supports nearly 500,000 jobs in Scotland, either directly through agriculture or indirectly through the food and drink supply chain. Farming is a critical part of our economy and our culture, and the money that we invest in it is repaid many times over through the management of our rural communities.
George Eustice (Camborne and Redruth) (Con)
It is a pleasure to follow the previous speakers.
I am a member of the EFRA Committee, and I agree very much with many of the points made by its Chair, my hon. Friend the Member for Thirsk and Malton (Miss McIntosh). In particular, I agree with her criticism of the current direction of the reforms. The Committee is a broad Church, however, and it would probably be fair to say that I am less critical of the stance the Government have adopted, for the simple reason that all British Governments face the same problem on the CAP: ultimately, the policy is not their decision.
There are complicated negotiations between 27 member states, so our negotiating stance constantly comes up against opposition from other countries. That makes it quite difficult to set out a clear view of what we want to do; indeed, the previous Select Committee criticised the Labour Government for wanting to see everything in the long term done in pillar two, and for wanting pillar one to be phased out. The Committee said that it was unrealistic to suggest that in negotiations and that it was wrong for the Government even to have a vision of where they wanted to end up.
I disagree, and farm policy is a good example of what happens when we stop making decisions at a national level and subject ourselves to the spirit-crushing process of endless negotiations with 26 other countries. We end up with a poverty of vision right across Europe about what a good agricultural policy should look like, and I will say more about that in a moment.
Roger Williams
I thank the hon. Gentleman for making that point, but does he not agree that if we are to have a common market and a trade in food between our nations, we need commonality and a common agricultural policy?
George Eustice
As I will say later, we need common objectives, but not necessarily a common policy. We also need clear state aid rules, as we have in other sectors. In that way, we can have a proper functioning single market and protect it, even though we do not have a common uniform policy across Europe.
The most important point about the proposals on the table is that they are a backward step for the CAP. The aim was to simplify it, and simplification has been the buzz word for many years, but the proposals will make it more complicated. As the Chair of the Committee said, we are effectively seeing a return to set-aside, with suggestions that 7% of people’s land should be set aside. At a time when food security, which should be a key objective of a common agricultural policy, is a growing issue, that is a step backwards.
I also object to the cap proposed on payments to farmers. If we want to encourage farmers to become less dependent on subsidies in the long term, we need to support consolidation and more efficient farms. A cap on payments would force farmers to break up holdings into collections of smaller holdings so that they still qualify for the subsidy, but that makes no sense. If we want a more efficient agricultural industry, why penalise the larger, more efficient farms?
There are some ludicrous things in the proposals. For instance, in an attempt to achieve crop rotation, there is some suggestion that farmers grow at least three crops to qualify for a subsidy. We can tell that the proposal was written by people who do not understand farming, because insisting on growing three separate crops will not necessarily bring the benefits we seek from crop rotation. For instance, somebody might grow cabbages, cauliflowers and oilseed rape to ensure they have their three crops, but those crops all come from the same brassica family, and are all subject to similar diseases, so a farmer who grew them would soon run into serious problems on their land.
What should a new CAP look like? We should start moving towards something that is about common objectives, rather than a unified common policy. The CAP should have key objectives, such as enhancing biodiversity, improving animal welfare and delivering food security. However, we should then give national Governments much more freedom to innovate, try new policies and adopt approaches that work in their countryside, rather than trying to have a uniform approach that works from Scotland all the way down to Greece, which is clearly difficult to achieve.
Allied to that, we would have a clear set of state aid rules that were specific to the agricultural sector, just as we have clear state aid rules for the single market in every other sector. Such rules would prevent, say, France from subsidising its farmers more than the UK Government and thereby putting our farmers at a disadvantage. Provided that we got those rules right, we could protect a single market in agricultural produce.
The key benefit of such an approach is that it would be more fluid. We would be able to hold the UK Government to account and say, “Why aren’t you trying this great new idea that is working so well in France? Surely, it would work here.” Instead, the best we can do now is to say, “How many meetings have you had with Poland to try to outmanoeuvre France?” That is not a good way forward.
When we make such proposals, people immediately think, “That’s a good idea, but it’s not realistic in the current time horizon.” I have heard that, too. Indeed, when I put these ideas to the Secretary of State last week, the answer was that they were ahead of their time, which is a flattering way of saying, “No, we’re not going to do that.”
Huw Irranca-Davies (Ogmore) (Lab)
The hon. Gentleman has great experience in the European Parliament, and I want to put one point to him. What he describes is already the direction of travel in the common fisheries policy, where there is a strong push from the UK Government, as there was under the previous Government, to move towards a more dynamic, regional-management approach, with much greater subsidiarity and local decision making, albeit in an overall framework. The hon. Gentleman may be ahead of his time on this issue, but practice in other areas is catching up with him.
George Eustice
The hon. Gentleman is right, except that I was not actually in the European Parliament. I was a candidate in the 1999 European elections, although unsuccessfully—and for a different party, I should add. However, I have followed these issues closely, and the hon. Gentleman is right. The EFRA Committee has, separately, been looking at the common fisheries policy, and there are proposals on the table not only to have a common framework and common objectives, but to give much more devolved power to groups of national Governments so that they can manage their own waters. It remains to be seen whether we get those reforms through, but the Government have been quite successful in getting the Commission to adopt them. That also shows the difference a different Commissioner can make. In Commissioner Damanaki, we have someone who is much more open to such proposals in relation to the common fisheries policy.
I want to question the idea that it is impossible to do what I am talking about. Alongside taking evidence on the CAP, the Committee has been looking at the natural environment White Paper. The striking thing about the CAP is that we hear people say, “We want to green pillar one in a flexible way. All this money is going into it; we need to get some public good out of it and green it.” However, they do not really know where to start, and the current proposals have run into a bit of a muddle.
On the other hand, we have the natural environment White Paper, which everybody says is very coherent and really well thought through, as well as having lots of interesting proposals about valuing natural capital and creating markets in which we can mitigate and offset environmental damage in some areas through improvements in others. The problem is that there is not enough money to bring life to those ideas.
Is it really beyond the wit of man to connect the two? Let us take some of the principles from the natural environment White Paper, link them to the funding in pillar one and see if we can make that work. What would that look like? It would mean replacing the single farm payment with some kind of market in transferable environmental obligations. A farmer on the fens who grows lettuces, and who does not really require the single farm payment for his business model to work, might say, “I don’t want to set aside 7% of my land. I don’t want to get into that. I just grow lettuces, and that’s my business model.”
In contrast, a farmer on marginal land in Wales, for instance—I have nothing against Wales, and there are patches of good soil there—may decide to opt into environmental obligations on a larger scale. That can bring benefit, with the establishment of wildlife corridors, and with critical mass in some areas for improved wildlife habitats. That might actually work, rather than a piecemeal approach with 7% of every farm’s land set aside.
Such a transferable obligations system could also be extended to issues such as animal welfare. For instance, in the case of livestock farmers who pursue less intensive systems that are better for animal welfare, rather than having to fight in the market for recognition for their extra work to improve animal welfare, they could be given that recognition by the Government; we could make them eligible for payments for which those who pursue intensive systems would not be eligible. There are lots of interesting things that could be done with such a system of transferable obligations.
As for pillar two, the Select Committee Chair mentioned the problem of its needing to be co-financed; sometimes the Government have been reluctant to buy into those things. To my mind, the answer is perhaps to bring back even greater control of pillar two, so that it does not become co-financed, but we do not send the money to the EU in the first place, and then have it come back with strings attached: in fact, we try to finance that as an agricultural fund that focuses on several key areas. Developing farm competitiveness is an important one that we should try for.
I also agree with the point that was made earlier about encouraging new entrants into farming. There was an interesting project, piloted in Cornwall, called the Fresh Start project, which aimed to encourage new entrants to the industry. The average age of farmers is incredibly high. I think that two thirds of farmers in Europe are over 60, which is a shocking figure. We need new entrants. The Welsh Government have also started interesting schemes to encourage new entrants to the industry. Pillar two could focus on improving competitiveness and encouraging new entrants, as well as keeping going with schemes such as the entry level and higher level stewardship schemes.
Those two policies, to return to what I said at the outset, prove the point that if a national Government are given the scope, freedom and head room to think through what a good policy looks like, they can get it right. The ELS and HLS are good examples of that. Britain is a trailblazer in that respect, because we have been able just to do the right thing. We have not had to go behind closed doors and haggle about it with 27 other countries. If we could do that in more areas of agricultural policy, our farming would be stronger.
Ian Paisley (North Antrim) (DUP)
At the outset, I thank the hon. Member for Thirsk and Malton (Miss McIntosh) for the way in which she introduced what is one of the most important subjects Parliament deals with—the production of food. It is one of the nation’s most important industries. It has been taken for granted too often, and for too long, and cast as a secondary issue, but it is crucial, and it is right and proper for the House to have the opportunity to debate it.
I think that we are all on a common page, if not a common agricultural policy, and that page is headed “The system doesn’t work.” As the Irishman said: “But you wouldn’t start from here”; but the trouble is, we are here. We are at this point after years of implementation of a policy that was initially flawed anyway, and which created huge butter mountains and a waste of food. There is virtually nothing we can do about where we are now. Those who suggest that we can suddenly end this, and everything will be all right for the industry, are just barmy. That is just silly. If anyone were to say that about any other sector of the economy, they would realise how daft it sounds. From time to time, people cry out, “What about New Zealand? It did it.” It took New Zealand nearly 20 years to get things right, and there was a lot of pain in the process. Those who advocate moving away from subsidised agricultural production need to get a grip, and to make comments relevant to the needs of the sector.
George Eustice
Does the hon. Gentleman recognise that when New Zealand abandoned its subsidies it substantially devalued its currency at the same time, so that farmers lost subsidies but gained a dramatic increase in price for their produce?
Ian Paisley
That is an interesting debate in its own right; there could be a good examination of what has happened in countries that have tried to reform their agri-food sector. The New Zealand question is not a debate for today, but we should always have it at the back of our mind.
No matter what we try to do, it will be pain for someone. Most importantly and obviously, it will be pain for the farming community. We must ask ourselves whether we want to put that community through pain. Let us put the matter in perspective: agri-food production in this nation is a £20 billion industry. Milk production alone represents more than £8 billion in the industry. Good, clean, traceable food, that the consumer wants to put into their body, is a positive and beneficial product. If we start to mess about with it and ruin the stability of the industry, we must be careful to understand the consequences. The production of food that the public do not feel comfortable with, or about whose production they do not feel confident, will destroy a positive and powerful economic factor for our nation. We always need to bear that in mind when we deal with agriculture; because it goes by the way, which sickens me. We need to get a grip on the fact that agri-food production is, as I said, one of the most important industries, if not the most important, in which this nation is involved.
In Northern Ireland, agriculture is a key driver in our economy. Indeed, the agri-food sector represents approximately 20% of the total private sector employment in Northern Ireland. The food and drink sector contributes £3.2 billion to our little country’s national turnover. At a time of economic difficulty, agri-food production is in a state of growth, whereas other sectors of the industry are either stagnant or in minus figures. The sector is positively growing. Agri-food production will be a crucial factor in rebalancing our local economy away from total reliance on the public sector. The key to achieving those goals is driving an export-led growth in the agri-food sector in Northern Ireland.
Given the importance of the common agricultural policy to the Northern Ireland economy, and its cross-cutting nature across the majority of Government Departments, including not only Agriculture and Rural and Development, but Enterprise, Trade and Investment, and Environment, a formal agreement should be reached at Northern Ireland Executive level on how the reformed common agricultural policy will be implemented in Northern Ireland. The implementation of the reformed policy must deliver the objectives of the draft Northern Ireland Executive programme for Government. In bringing that about, it is vital that our Minister, locally in Northern Ireland, should up the game and engage directly with the ministerial team here, nationally.
Let us face it, the Minister present today, and his team, will negotiate the CAP package, no matter what form it takes. I want him to be on my side, and to argue the case for Northern Ireland. He will know that case, and how it affects the part of the United Kingdom I come from, if our Minister in Northern Ireland ups the game and engages more directly with him. I hope that that happens. The challenge is a serious one, because time is against us. The clock is ticking. The Minister needs to know all the permutations and ramifications of each decision that he will take at the CAP reform meetings, and how they will affect my part of the United Kingdom. There is a duty on politicians now to lobby hard, and that is why I welcome the debate. It sets some pretty important touchstones, which need to be recognised, and I think are being recognised, to a greater or lesser degree.
We also need to ensure that Northern Ireland gets its fair share of the UK CAP budget. It is a point that we need to negotiate directly. I do not want to do that against Scotland’s interest. Scotland has every right to make its case too—as does, of course, the great Welsh Principality, which has to be saluted at every opportunity in this place. We must ensure that there is regional flexibility within the United Kingdom. I understand that there could be a degree of flexibility across the regions of Europe. I want flexibility in the UK, so that the Department can ensure that it shares—parcels out—the money fairly and appropriately, understanding the unique circumstances in all parts of the UK. As a politician, I believe that the draft reform proposals outlined by the European Commission are deeply flawed, because they fail to address those peculiar, necessary needs and could have a major negative impact on our major industry in Northern Ireland, which would be proportionately much more significant than in any other part of the UK.
People should stop for a moment, pinch themselves and imagine a United Kingdom economy that does not have an agri-sector. If they do that, they will realise that without that sector we would be bereft of a culture and a way of life for many people and bereft of a powerful, important industry which, as I have mentioned, contributes a £20 billion value. We need to do that to recognise what is at stake and to ensure that we go out there and campaign, lobby for and achieve a settlement under the CAP that is beneficial for the whole kingdom.
The Commission’s CAP proposals will cause a huge redistribution of moneys within Northern Ireland, from lowland to hill farmers—similar to the constituency of the hon. Member for Thirsk and Malton. That will impact greatly on those who are able to make food production sustain a community and sustain a way of life. Under those proposals, they will lose out and will be disincentivised from becoming competitive. We have to put the finger on that and recognise that the policy drivers that Europe is pursuing are upside down. The speed of transition is too fast and will not allow adequate time for the industry to adjust from a 30% flat-rate payment to a 40% transition in direct payments in one year. That is too much. A slow, proportionate transition period is ultimately required.
There should be regional flexibility within the 27 regions that comprise Europe, and internal flexibility. At regional level, it is important that Northern Ireland receives its fair percentage. I mentioned earlier fair distribution between pillar one and pillar two. It will be difficult for us to argue for fair distribution when the Government’s policy appears to be a reduction in CAP money anyway, but the money that we get must be fairly distributed, when we get it, between the two pillars. I will not go into detail in respect of my views on the active farmer, but I agree with the points made by the hon. Member for Banff and Buchan (Dr Whiteford), who made that case exceptionally well.
The 7% set-aside rule is nonsense in light of the increasing global population and the increase that we have witnessed in westernised eating habits. In that regard, I should like to reflect particularly on the dairy sector, which is worth more than £8 billion to the UK economy and employs more than 80,000. We are the third largest milk producer in the European Community and the ninth largest in the world. Our products can be found in 98% of UK households.
Jim Begg, the director general of Dairy UK, wrote a pamphlet that has been distributed called “Action for growth”, in which he deals with how the CAP should address the needs of the milk producers:
“A requirement for ecological set aside of 7% of arable land will reduce the area available to dairy farmers for feed crops. Maintenance of permanent grassland will also restrict the ability to increase the production of home grown feed. The termination of historic payment calculation method will disadvantage dairy farmers in particular.
It is imperative that the UK ensures the distribution of payments in the EU and the UK does not discriminate against UK farmers or undermine their productive potential.”
A hearty “Hear, hear!” to that. The milk industry needs that security of tenure. We should not be doing something that upsets an already difficult market, in which prices can be difficult.
I make my comments as a representative of my constituency, in which the single largest employer is the poultry sector. One factory alone employs 1,100 people. Unfortunately, today it announced 19 redundancies, but in the scale of things—in the current economic climate—that could, of course, have been an awful lot worse. Poultry production is incredibly successful in Northern Ireland, but the fact that it, too, is feeling the squeeze at present and is having to announce re-jigs and evaluate job-shares makes it clear that even the most successful parts of our industries face a crisis at present. Heaping CAP reforms on such businesses does not address their real, genuine needs and is a flawed way for us to proceed.
Neil Parish (Tiverton and Honiton) (Con)
I thank the Chairman of the Select Committee for securing this debate, because it is important that we debate in this Chamber the future of agriculture, farming and the countryside.
I thank the Minister for being here. He has a difficult job ahead of him. I do not blame him for all our ills; the European Commission has got it entirely wrong. I have had some slight experience of the European Commission over 10 years. The Agriculture and Rural Development Commissioner has got it absolutely wrong; we have to move to more competitive agriculture, and we must look after and manage the countryside well, but the policy that he is producing does not go in the right direction on either of those issues. I agree with my hon. Friend the Member for Camborne and Redruth (George Eustice) that one size does not fit all.
Let me provide a brief history of the common agricultural policy. It arrived at the beginning of Europe, when the Common Market was made up of six countries, France and Germany being the dominant ones. This was after the second world war, when food was hugely important. For those five or six countries in the middle of Europe, it was much easier, given the type of crops they grew and their type of farming, to devise some sort of common agricultural policy. However, now there are 27 countries, covering from the north of Finland to the south of Greece, and including Poland, Romania and Bulgaria. There are hugely different types of farms—very small farms and very large state farms left over from previous communist systems, and private farms of various sizes throughout the rest of the European Union. If we also consider the different types of crops grown, and all the complicated subsidies introduced over the years—for cotton, olive oil, sugar and everything else—we begin to see the complexity of the matter. I agree that we need to ensure that we have an agricultural policy that suits this country. I know that the Minister is trying to work on that.
The shadow Minister, the hon. Member for Ogmore (Huw Irranca-Davies), mentioned fisheries, and he has a point. The Commission is offering more regional powers; whether it is giving those powers in reality is a matter for another debate, but it certainly needs to move in that direction.
Let me turn to the need for agriculture. There are now more than 7 billion people in the world. There is a moral duty to produce food, and for this country to do so. As global warming and climate change alter the growth that can take place in many other parts of the world, it becomes up to us to produce good food when we can. Also, we would otherwise have to import food. There is also the issue of the water used to grow food; many countries can ill afford to lose water. Whatever economic difficulties our nation has, we can afford to feed ourselves and buy food, but in many parts of the world, that cannot be done. We need to be conscious of that.
We must face up to the reality of where agriculture and farming are going in future; I hope that the Minister agrees with me. I think he does not want to do away with the single farm payment and support for agriculture overnight, but he does want agriculture to be weaned off public support, because we cannot accept, year after year, ever more public support for agriculture. We need competitive agriculture, and we can have it.
The hon. Member for North Antrim (Ian Paisley) talked about the poultry industry; the thing to remember about it is that it is competitive even though it is unsupported. It is not supported by the common agricultural policy, so it competes well. We have a successful poultry industry in this country.
Dr Whiteford
In recent months, the poultry industry has had to compete on an unfair basis, thanks to EU rules that have pulled the rug out from under it after it has invested heavily. While we are in the common market, the rules must be the same for everyone.
Neil Parish
The hon. Lady is absolutely right. It is a travesty of justice that the rest of Europe has not complied with the requirements for enriched cages for producing eggs, but that is the fault not of this Government but of a weak European Commission that has not taken proper action against those member states that have not complied. No matter what the policy, it must be properly applied across member states, and not just by our country.
Barry Gardiner
I absolutely agree with the points that the hon. Gentleman makes. He may be sympathetic to this suggestion: if we were to see the withdrawal of the direct payment subsidy, UK farms would do rather well, because they are better managed and more competitive than many in Europe. That would help our industry, as long as there were common standards with which everyone had to comply—a point made by the hon. Member for Banff and Buchan (Dr Whiteford).
Neil Parish
The hon. Gentleman is right. We have very competitive agriculture, and our country can compete well. As we move on with agriculture, we will have to decide where to put what public support we have. There is an argument for some support in upland and difficult-to-farm areas, not only for agricultural production but in relation to the landscape; that is essential. We have to look at where we can create competitive agriculture.
That brings me on to regulation. I praise the Minister for bringing in Richard Macdonald to look at the regulation and to try to remove it from agriculture, so that the industry can be more competitive. However, although the Minister is busy removing regulation, the European Commission is busy applying more, even though the commissioners talk about wanting to get rid of regulation. All the reform will do is add more complication. We have talked about the 7% set-aside, the three or four crops and all the rubbish coming out of the Commission; we need to oppose that, and I know that the Minister intends to.
Huw Irranca-Davies
I make one point in defence of regulation, which is that there is good and bad regulation. There is over-regulation and over-complexity, but an area where the farming community has worked well—although we still need to do more—is on the water framework directive. When it comes to our rivers, the quality of the natural environment—something to which the Select Committee and its Chair must have turned their attention—has improved more than we could have imagined 10 years ago. There is good regulation as well as bad. We need to fear the bad, praise the good, and get on with delivering for this country.
Neil Parish
The shadow Minister is right that there is good regulation, but he must also admit that there is far too much regulation. It is not that regulation is good or bad, but that there is too much of it. The coalition Government are looking through regulation to weed out the unnecessary and keep the necessary. Over the years, we have built regulation on regulation; that has been the problem. Take farm inspections and other requirements, many of which we must comply with because of European regulation. We often have many different people on farms to inspect, so we are trying to bring in one inspectorate and not have as much duplication.
We ought to move towards a strong market in agriculture and agricultural products, which is why, as we can all agree, the groceries code adjudicator is so important. That may not be a European or CAP issue, but it is very much about ensuring that agriculture can compete in the market and get a fair deal from the marketplace. The crux of my argument is that if we are to wean farmers off subsidies over the years, we have to enable them to compete in that strong market.
Agriculture is important in itself—it is a huge part of the economy—but there are also 500,000 jobs in the food processing industry, and much of the food being processed comes from this country, as it should. Again, I am not exactly on the subject of the CAP, but I urge the Minister to look at how we procure food, and to ensure that all the food that we eat in this place—and everywhere else, including in Departments and in Westminster generally—is from this country. I assure the Chamber that in France people would not be eating British beef, so the last thing that we want to do here is eat French beef. That, however, is a particular pet subject of mine, so the Minister might not necessarily want to comment.
In my constituency, there is a lot of grassland and livestock, both sheep and cattle, including dairy cattle. Much of the livestock is fed on grass, a lot of which is on permanent grassland, but some is on semi-permanent grassland. What I fear most about Commission proposals is that we will see agricultural grassland ploughed up unnecessarily, because of worry about the reforms. The Minister is reassuring farmers and trying to obtain the best reassurances possible from the European Commission, because such a development would be almost criminal. We need to deal with it quickly, to ensure that the Commission does not drive agriculture in the wrong direction.
In the future, I want agriculture to stand much more on its own two feet. That has to be. Public support for agriculture should not distort trade between member states or with those in other parts of the world. We must not forget that one of the reasons for reforming the CAP has always been that previous policies promoted high production levels in Europe, and those products were then dumped on the open market, destroying much of the agriculture in developing countries. We have at least moved away from that, and we do not want to move back in that direction.
I wish the Minister well in his negotiations with the rest of the European Union. As a Government and as a country, we must seek greater independence when it comes to how we develop our agricultural policy. The European Union must recognise that as it has grown, and will probably grow further, it must have much more flexibility when it comes to agriculture, because one size will not fit all, especially as the EU grows bigger and bigger.
Barry Gardiner (Brent North) (Lab)
It is a pleasure to speak in the debate, Mr Weir, particularly under your knowledgeable chairmanship on this subject. I pay tribute to the Chair of the Select Committee, the hon. Member for Thirsk and Malton (Miss McIntosh), for obtaining the debate.
I do not wish to go over ground already outlined by hon. Members this afternoon. They have made many serious and important points, most of which I agree with. I want to restate a few basic facts, however, and €57 billion is one of them—40% of the entire European Union budget. This is a fix such as no heroin junkie has ever been on, and it is difficult, in the words of the hon. Member for Tiverton and Honiton (Neil Parish), to wean farmers off it, sometimes for the good reasons that he outlined.
The CAP provides support in three distinct elements to agricultural producers and rural areas. We should not forget that we are talking about not just farmers, but other land managers and the whole rural community. The three elements are direct income support, market measures and the rural development programme. As we have found, the key point is that the RDP must be co-financed, and we will return to that bugbear.
Given the enormous subsidy, is it not appropriate to consider what the CAP’s objectives are? Our Committee heard five objectives, the first of which should be
“to maintain or enhance the EU capacity to produce safe and high-quality food.”
The second objective should be to enhance
“the competitiveness and viability of the EU agricultural sector”
because a
“competitive and viable EU agricultural sector is the key to producing more while having less impact”—
detrimental impact—
“on the environment and to reducing farmers’ reliance on income support from taxpayers in the long-term.”
The third objective should be
“to ensure the sustainable management of the EU’s natural resources, biodiversity and landscapes, recognising that farmers are the managers of over half of the…land area”
of Europe. The fourth objective
“should be to help to maintain agricultural activity in areas where it delivers significant public benefits, such as the maintenance of biodiversity and cultural landscapes”
such as those that were mentioned earlier. However,
“the CAP should not aim to deliver an acceptable standard of living to every farmer in the EU through income support alone”—
that was a key finding by the Committee and is in the report—and
“farmers should be encouraged to look to the market for their”
fundamental returns.
The aim of this CAP reform should be to enable farmers to achieve the sustainable intensification that is required to meet the global challenge of feeding a world population that will rise from the 7 billion that it reached just a month ago to the 9 billion that it will reach in 2050, but to do so without destroying the very things that it is predicated upon: our biodiversity and our natural landscapes. The Government’s position on CAP reform must be coherent in its strategy for ensuring food security, and DEFRA must decide—I am keen to hear from the Minister on this point—whether and, if so, how it intends to implement the previous Government’s “Food 2030” strategy, taking into account the recommendations from the Foresight report on “The Future of Food and Farming” by John Beddington and co. and the UK’s position on the future of the common agricultural policy.
In the interests of fair trade and the long term, the EU should argue more strongly for a recognition of standards of production in trade agreements, including animal welfare, the use of water and greenhouse gas emissions. That is essential to achieve the global shift towards sustainable intensification that “The Future of Food and Farming” report recommended.
The Commission’s proposals to green pillar one have been at the heart of the discussion throughout Europe and our debate today. There is a suspicion that that was a sop and a way to try to justify the subsidy and support. The proposals did not receive strong support from any of our witnesses. There was concern that they would make the CAP more complicated to administer, as other hon. Members have said, and that they would confuse the logic of the two-pillar structure.
[Jim Sheridan in the Chair]
Several witnesses expressed concern about expanding pillar two, and that is DEFRA’s alternative to the expansion of pillar one. The central issue seems to be the difficulty of achieving political support in Europe, and I want to tell a story about what happened when I was in Europe just last week. I had gone over there, as had the hon. Member for Thirsk and Malton, to join in the parliamentary debate that the Commissioner with responsibility for reform of the common fisheries policy had called. I spoke to several members from throughout Europe and tried to persuade them of the UK’s good ideas on CFP and CAP reform. I was told universally that although some of those ideas were good, for God’s sake, I should not let the British Government suggest them because they are the most toxic brand in Europe at the moment and suggestions will not garner political support if they come from the UK.
We must consider seriously how the Government have engaged in Europe, and how they have got themselves into a position when even good ideas will not be accepted because we suggest them. Perhaps we should get other people to suggest our good ideas, and then take a back seat.
George Eustice
If the UK is putting forward good ideas and they are ignored because they come from us, the failure is on the part of those countries that adopt that stance. Clearly, if an idea is good, they should adopt it.
Barry Gardiner
Of course, in principle, we should all work from a basis of fact, science and what is rational and reasonable. The hon. Gentleman and I are totally at one on that, but we are both politicians as well, and we know that alliances are important in politics. We know that sometimes the issue is not having the right idea or the best idea; it is stacking up the votes to get that idea not only on the table, but accepted. That is what the Government have singularly failed to do. They have singularly isolated themselves in Europe, and that is a real problem for our farmers, because many of the ideas are good.
Another aspect is how, as the hon. Member for Tiverton and Honiton said, we go about weaning farmers off the subsidies of pillar one. If we are to do that by 2020, or shortly thereafter—perhaps the Minister will clarify when—it sounds a bit like saying, “Make me virtuous Lord, but not yet.” In this round of CAP reform, we should try to get the Commission to set a date for when it will happen. Without a deadline, hon. Members know as well as I do what will happen. Come 2020, we will all be in the same position, saying, “Yes, make me virtuous Lord. Let us wean ourselves off the subsidy, but in 2027, or 2032.” We must bite the bullet. We cannot continue with this junkie habit, because it is damaging the prosperity of Europe as a whole.
It was interesting that one witness told us that the problem with shifting the policy to pillar two was that, when the opportunity was offered to member states with voluntary modulation, all but the UK ignored it, because they did not want to put additional money into match funding and co-financing. In principle, we may be in favour of co-finance in pillar two and putting more into it, but the political reality is that many do not have the money to do so. Another witness told us that expanding pillar two risked creating a very uncommon market. New member states cannot afford their share of the finance, so they cannot draw down European money.
I think we have the right nostrums. We should move away from pillar one and into pillar two, for all the reasons that hon. Members have outlined. However, regional flexibility is a problem. With pillar two, as Members have said, there is a problem of how to ensure, from Finland to Greece and Romania to Ireland, that the measures adopted are appropriate. Inevitably, as we all know, countries try to fix things in their own favour. If it is simply a smorgasbord created by an individual country, that smorgasbord will be arranged to give maximum benefit, advantage and subsidy to the country’s own farmers. Therefore, what is needed within Europe is recognition that although a regionalised, smorgasbord approach is the right one, parity must be ensured through something that we seem to have left out of this debate: sound science.
We believe in evidence-based and science-based policy. We must ensure that the benefits to the environment and the benefits that each country would bring to that regional smorgasbord are established on some sort of points system to show that they are equivalent to what other countries are offering, and therefore that the financial reward that follows from them is likewise rewarded. That is not new to DEFRA. It is already doing that in the UK national biodiversity strategy. It is considering different points for different elements of biodiversity. Why can we not propose that in Europe for adoption there? It is right to move towards a more regional approach and from pillar one to pillar two, but we must do so on the basis of sound science and public good, which must be assessed independently to ensure genuine parity.
Kelvin Hopkins (Luton North) (Lab)
I apologise, Mr Sheridan, for not being here for some of the debate. I have been trying to speak in the debate in the main Chamber. Being in two places at once is rather difficult. I wanted to have a say on the common agricultural policy, on which I have commented many times in the Chamber, and to take a rather more radical position than the Select Committee on Environment, Food and Rural Affairs or the Government.
I was somewhat disappointed by the Select Committee report. It was written by well-intentioned and good people, but I am disappointed that it does not take a radical position. In some respects, I support the Government’s position more strongly than the Committee’s. The report says that the CAP no longer takes the lion’s share of the budget, but it is still 40%. What is a lion’s share? I think that 40% is pretty much a lion’s share.
The CAP is still a net cost to the UK, although not as high as it was, and food prices have been consistently higher for UK consumers ever since we joined the European Union, or the Common Market, as it was. Higher food prices are regressive, in that they bear more heavily on those who spend a higher proportion of their income on food, namely ordinary working people and the poor. In that respect, it has always been negative, certainly in terms of the people in Luton North whom I represent.
Access to cheaper food from elsewhere in the world has been restricted. Before the CAP, UK prices and national subsidies were related to lower world food prices, not to the higher prices demanded inside the CAP area. UK membership of the European Union has resulted in an excessive cumulative cost in both budget and taxpayer terms and in food prices, but it has also had a knock-on effect on economic growth. If one spends more of one’s wealth on subsidising agriculture, clearly less of one’s wealth can be used in other parts of the economy, and we have had lower growth overall as a result.
On numerous occasions, I have called for the abolition of the CAP. I keep pressing that point, because I believe that within the European Union, or whatever it might be called, national subsidies would be more appropriate. They would be better judged, because nation states know better what it is appropriate to subsidise within their own economies; their agricultural sectors are different and they would be much more likely to husband their resources carefully if it bore directly on their own taxpayers rather than coming from some great gift in the sky, namely a CAP budget contributed to disproportionately by countries such as Britain.
That would be more targeted and efficient. It would also cause countries to decide to what extent they want to keep their agriculture at the same level or increase its size for security reasons. The report makes the point well about food security for the future. If we as nation states were concerned about it, our food production would be better than it is under the CAP arrangement, which makes us casual about it all.
Britain in particular would do well to maximise its food production—not absolutely, but in order to ensure secure supplies for the future. I am possibly the only person here born during the second world war. I survived only because we managed to import food, mainly across the Atlantic. Many people died bringing that food. We learned that producing a higher proportion of our food domestically is important for reasons of long-term security. With the world’s population growing and food shortages likely, we cannot guarantee that that will not be necessary in future. Food security is important.
Britain is an efficient agricultural producer. Other countries are very inefficient. Increasing their efficiency would make their agriculture more profitable, and they would be able to sell it. In some cases, their wage costs are much lower. They could sell more to countries such as Britain as and when we decide to purchase. A national approach to agricultural subsidies is the way forward. The CAP is outdated and was never a good idea in the first place.
From time to time we have called for reform of the CAP, and some reforms have been made. I called for its abolition, but our leaders during the previous Parliament decided that they would seek serious reform. I remember that at the end of Britain’s last presidency of the European Union, Tony Blair went to the very last meeting in December, in theory to call for CAP reform. He was then beaten all around the room by President Chirac, coming back with no reform and a cut in our rebate. At the time, The Economist, hardly a magazine of the left, said that the deal was so bad that no deal would have been better. So much for reform. We must put pressure on the European Union. That is the only thing it reacts to.
Neil Parish
I think the mistake made by Prime Minister Tony Blair at the time was that he gave away the rebate without getting the reform. What he should have done, if he was going to give away the rebate, is get the CAP reform first. That was his mistake.
Kelvin Hopkins
Indeed. Had I been at his side, I would perhaps have advised him rather differently, but I was never at Tony Blair’s side, and he never consulted me on my views.
Kelvin Hopkins
Indeed. I do not flatter myself, but a bit of advice here and there might have been helpful.
The Government’s response makes important points, including a call for greater emphasis on subsidiarity. If subsidiarity means that more decisions will be made at national level within the European Union, it is a good thing. We had a debate about it in the Chamber the other day. I think that the rest of the European Union regards it as a decoration, but we take it seriously, and we want more things decided at national level. The Government urge more regional flexibility. The ultimate regional flexibility is for agricultural subsidy and policy to be decided at national level. That is a sensible way forward too.
The report mentions room for savings. The Government say that CAP expenditure should be cut substantially, and I tend to take the Government’s side. I hope that we will not take a “softly, softly” approach to the CAP, that the Government will continue to take a strong line and that ultimately, the CAP will be abolished and replaced by more sensible arrangements based at national level.
Earlier in the debate, a point was raised about genuine farmers. Quite a high proportion of farmers in continental Europe, particularly in wealthy countries such as Germany, use farming as a secondary source of income. They are solicitors, doctors, factory workers or whatever, but they have a small market garden and receive subsidies to buy tractors and so on, and that has been going on for decades. Such people are not genuine farmers, but they get a bit of extra cash from growing a few vegetables and receiving a subsidy from the European Union. That is not farming and we ought to take such matters seriously.
There is, of course, still a degree of corruption although it is perhaps not as bad as it was. I remember hearing about a beef producer who lived in a tower block in Turin, although I do not know how many cows would have fitted on the grass outside. That was some years ago, but there is scope for corruption and if national Governments have to subsidise the system, they will take such matters more seriously. They will ensure that people are genuine farmers and they will try to eliminate corruption so that every penny, cent, or euro is spent more sensibly and is better targeted. In that way, the agricultural industry across Europe will be better for everyone at both nation state level, and collectively.
Huw Irranca-Davies (Ogmore) (Lab)
It is a delight to attend this debate on the reform of the common agricultural policy; only three or four weeks ago, the Minister and I were debating the same subject in a European Committee. This is a welcome opportunity for further debate, and I congratulate the hon. Member for Thirsk and Malton (Miss McIntosh) because we need frequent opportunities such as this in order to keep track on progress and on the European negotiations of the Minister and his team. We must also watch the changes as they take place. This is a live and dynamic issue, and we hope that the leadership on reform that has been shown by the UK, both now and previously, will continue, and that we will push as hard as we can.
I would not go quite as far as my hon. Friend the Member for Luton North (Kelvin Hopkins), although I will return to his points in a moment. I hope, however, that the UK vision for CAP reform will deliver food security and viable farming livelihoods, as well as biodiversity, environmental gains and other public goods. My hon. Friend the Member for Brent North (Barry Gardiner) wisely widened out the debate, and we must also ensure that such benefits are delivered across the EU.
A common theme of this debate has been more regional autonomy and management, and how not to lose gains that the UK has made such as the uplands entry level stewardship scheme and so on. We must also, however, be ardently fixated on the need for environmental and animal welfare standards to be driven up across the EU. As a pro-European, I believe that one benefit of the EU is that it allows us to level the playing field up, rather than down. During negotiations it is important not only to look at ourselves—vital though that is—but also to look externally at the benefits for UK farmers if we level up the playing field. Not only will we have great standards of environmental and animal welfare, but the costs of agricultural food production and farming will be more uniform across the EU.
I genuinely congratulate the hon. Member for Thirsk and Malton and her Committee on initiating this debate and on the report. Early in her contribution, the hon. Lady made a commitment that the Committee will return to consider the topic, and I welcome that. She focused on what can appear to be a dichotomy between food production and food security, and environmental sustainability. That is the greatest challenge that we face, because it concerns not only environmental sustainability and biodiversity in individual fields and regions, but the challenge of climate change, and what that means for food production and the land use that was referred to so well in the Foresight report. How does the Minister square that circle, both in the UK and elsewhere?
To inject a note of optimism, I believe that we can face that challenge with strong leadership and vision, although we must recognise that there will be many a slip. My hon. Friend the Member for Brent North mentioned the previous Government’s “Food 2030” strategy, and I urge the Minister to return to that and perhaps address it in his closing remarks. Perhaps he could take the report off some dusty shelf in his Department and look at it again. One observation that is made frequently, not only by environmental or international development NGOs but by farmers and others in the farming community, is that although the “Food 2030” strategy is integral to CAP reform, it goes beyond that. It sets out a compelling, large-scale narrative, and a coherent vision of what we should be doing across the food chain, in terms of the environment and land management. I know that the Minister has such matters firmly at the front of his mind, but—I hope he will take this as constructive criticism—it does not matter how many narrow, discrete pathways of good work there are in his Department, those outside the political sphere tell me that the overarching, compelling vision is deficient. If we do not have the “Food 2030” programme, we need something that looks very much like it. An enormous amount of work went into that report, and I urge the Minister to look at it again as a basis for the overall framework.
The hon. Member for Thirsk and Malton mentioned the importance of self-sufficiency in food production, not only in the UK but in Europe. That provides a similar paradigm to our experiences of energy markets. We want the UK to be as self-sufficient as possible, but we also want to export as much as we possibly can. On St David’s day, my colleagues from the Welsh Assembly Government were in Brussels lauding the fact that the first 11 months of the past year saw a 22% increase in exports of Welsh lamb and beef. For the UK, the figures were 14% overall—the Minister will correct me if I am wrong. We are doing well across the UK, but Wales is doing exceptionally well. It still trades significantly with the EU as a trading block, but also well beyond Europe with countries such as China, India, Brazil and elsewhere. We must ensure that as well as UK self-sufficiency, we work with European colleagues to ensure a large degree of collaboration on EU sustainability. Britain is an island, although not in every respect, and we need to work together on many issues of food production and food security.
The hon. Member for Thirsk and Malton went into forensic detail on many other issues, and I will return to those during my remarks. She rightly pointed out the challenges faced by tenant farmers, and others, due to the current active farmer definition. That point was well made, and I am sure that the Minister will return to it. I agree with many of the hon. Lady’s points, and although I may not agree on some other issues, one benefit of the Committee’s report, and today’s discussion, is that it stimulates intelligent and well-informed debate. I hope that the Minister will accept that the comments that I and other hon. Members make are genuinely intended to help and to engage with him constructively so that he can take those thoughts into his discussions with the Commission, Members of the European Parliament and others.
All today’s contributions have been good in their own ways. The hon. Member for Banff and Buchan (Dr Whiteford) —as a Welshman, I can pronounce Buchan because I suspect that it has similar Gaelic roots—mentioned a theme found in several contributions about the need for an appropriate level of subsidiarity in decision making. There has been much talk about regionalisation and making decisions closer to home. I agree with that in principle although I do not know how far we will get; there is a similar debate on reform of the common fisheries policy. Regionalisation must be balanced against my earlier point about having more informed, intelligent decision making closer to home. We can say that with some confidence in a UK context, because although there is always the criticism that we could do more, our achievements probably set some of the highest standards in the EU. However, that regionalisation must be balanced against ensuring that we can monitor and evaluate what is happening in the rest of the EU. That is where the balance lies. We must ensure that other member states are equally good not only on food security, but on the environmental benefits and public goods.
The hon. Lady raised, as other hon. Members did, the spectre of over-complication in the CAP reform proposals. We, too, have that worry. We do not want to make some construct whereby farmers and their advisers spend inordinate amounts of time working around and through the proposals in order to avoid some of the complexities. That would be a self-defeating proposal. I hope that the Commission is aware of that. Certainly in my discussions with it, it has not wanted that to happen, but I think that it needs to look carefully while it is in these stages of finessing the proposals—this will require the Minister’s engagement as well—to try to strip out some of the complication and not get to the point at which very well paid advisers are advising some of the larger farmers at great expense on how to avoid and work around some of the complexities. The worst situation would be smaller farmers having immense difficulty in doing that.
The hon. Member for Banff and Buchan spoke out on something that has received a fair bit of publicity recently—the concept of slipper farmers. This is an interesting one. Even if they are a marginal element, it is important to deal with the issue. I do recognise the points made by others. Clearly, in terms of units of production, some of the larger farms will be not only highly productive, but highly efficient in terms of the cost of food production; and that rattles through to the supermarket shelves. Let us say, however, that someone does not look anything like an active farmer. We might be talking about an investor community or someone who has no interest whatever in an active role on the farm or in an active role in biodiversity and landscape management.
I would be interested in the Minister’s comments. Some people have argued that we do not need additional rules to deal with it—that each member state already has competences that could tighten up the situation. However, keeping public trust is vital. Even if what I am describing is a marginal issue, there is a danger that it will tear down public trust in where subsidy is going. Even if we make the argument that subsidy is not going simply into traditional food production, but into all those wider public goods, we must ensure that there are not exceptions that tear down public trust. As I said, I would be interested in the Minister’s comments on that, in quite a rational way. Are there examples? What is his assessment of whether agricultural subsidy is being used in a way that was not intended, and what we can do to tighten up the situation before the issue becomes one of wider public concern?
The hon. Member for Camborne and Redruth (George Eustice) recognised the need for a clear and powerful vision as part of negotiating strategy—this is where we are; we are dealing with CAP reform. Regardless of other ways forward, we need that powerful vision underpinning the strategy. The hon. Gentleman pointed out some ideas for greater regional decision making, which he described as ahead of their time. We have no difficulty with that. Those ideas need to be put forward, because eventually their time does come. I apologise for giving him membership of the European Parliament and for raising by accident past membership of other parties. He will not be the only one here today in that position. I am not making a confession of that nature, I hasten to add, in case my constituency Labour party is listening, but I will make my own confession. I have attended a Conservative club in my constituency on a regular basis. [Interruption.] Indeed. It is at the club’s invitation; we hold our branch meetings at a Conservative club.
The hon. Member for North Antrim (Ian Paisley) regularly speaks in debates on this issue. He is no longer in the Chamber, but he talked about the importance of export growth and engagement with the devolved Administrations. The Minister and I have talked about that matter before, and I certainly know that from the Scottish perspective and from the Welsh perspective, there is very strong engagement. The flipside, of course, is that there needs to be one coherent voice speaking on the issue once all the different elements have been pulled together. We need to avoid the dilution of an effective UK voice when three or four different voices are speaking. We must bring in those voices—that engagement is critical—but ensuring that there is one coherent voice at the end is also critical. The hon. Gentleman made powerful points of detail on behalf of his farmers. I know that the Minister will have heard those points and will respond to them.
The hon. Member for Tiverton and Honiton (Neil Parish) talked about the moral duty to produce food. I agree, not least because of the challenges that we face currently. I am thinking not only of food poverty, but of growing populations. It is a moral duty in this country and globally. However, I would argue that we also have a moral duty—to pick up the comments made by my hon. Friend the Member for Brent North—to protect and enhance the environment, to tackle climate change and to improve animal welfare. I know that the hon. Member for Tiverton and Honiton would agree with those as moral duties as well. I made a point to him about good regulation. Mention was made of one of the best examples, although it brought costs with it—the regulation on enriched cages. It is a tremendous tribute to our farming community that it stepped up to the mark and invested heavily in them. It now needs to be rewarded. I have made this point to the Minister before: he, in concert with the Commission, must strongly pursue enforcement action against states that are not complying, because otherwise we are disadvantaged. We have made all the investment and done our moral duty on animal welfare, but others are not doing that. From that moral high ground, we should not hold back in pursuing enforcement action against other countries.
My hon. Friend the Member for Luton North, who has just left his place, introduced a welcome diversity into the ecology of the debate by calling for abolition of the CAP. All contributions are welcome; there are different views on the matter. He also reminded us, not too diplomatically, of the failure of past EU negotiations under former Labour Prime Ministers and called for the Minister to heed his advice. I will move on swiftly at this point.
My hon. Friend the Member for Brent North regularly takes part in these debates, and with a fair degree of expertise. I think that he made the first mention of sustainable intensification today. My apologies to other hon. Members if they used that phrase. My hon. Friend is gesticulating towards the Chairman of the Select Committee, the hon. Member for Thirsk and Malton, so I apologise if she used it too. It is a critical issue. I am referring to challenges of how we raise food productivity—by that, I do not mean production; I mean productivity—while at the same time not damaging the environment, but improving it. That may relate to soil quality, river quality or biodiversity. It is a huge challenge and it means that part of the EU reform needs to involve the driving forward of research and innovation in those areas, so that we have much more productive and much more efficient farming, both in the UK and throughout the EU. In that context, I have mentioned “Food 2030,” which could be a very helpful contributor to that debate.
My hon. Friend the Member for Brent North also raised the spectre of the UK’s isolation. The Minister and I talked about that only a few weeks ago, and he gave me assurances that it had no impacts, or certainly no long-term impacts. I am not making an easy political point on this issue; the matter has been raised by the farming community. It has been raised directly by the National Farmers Union in documents, directly by the Farmers Union of Wales, and by the leader of the Liberal Democrats in Wales. I will not cite what they said, but their clear concern was that the matter could have damaged what was, I think, a good negotiating position on CAP reform and other issues. Today, I again seek the Minister’s assurance that he has bypassed those problems—that the matter is not causing him problems—because we need that reassurance for the farming community. I am sure that he is doing a tremendous job out there of engaging with like-minded countries on various issues, but we need to know that we have not taken a step back because of wider political issues.
My hon. Friend the Member for Brent North reminded us of the importance of sound science and the evidence that underpins it. Curiously, as we understandably focus on the farming community and food production in these debates, we sometimes forget that our overall approach to what we are doing—squaring this circle—needs sound evidence at every step of the way. That is probably one of the lessons that we should have learned from past CAP reform and past common fisheries policy negotiations. I am sure that the Minister will have heard my hon. Friend’s powerful contribution.
Let me refer Members to the recent debate that we had in the European Committee if for no other reason than that I am losing my voice and I do not want to repeat everything that I said then. I want to raise a couple of broad points. First, let me make one remark in praise of the CAP. We must remember why it was originally set up as we—the collective we—celebrate its 50th birthday. Over the years, it has been a constant source of controversy, but it has none the less stabilised farm prices so that farmers can innovate, invest and modernise agricultural production. In recent iterations of CAP reform, there has been a move towards recognising public goods, which is a welcome development. We should not forget—I want to put this on record today as I did in the European Committee—that despite the still huge sums of public money going into the CAP and then being returned not just to the farming community but to rural development and so on, European support for farm incomes has fallen markedly over the past 20 years, thanks to a series of reforms. In 1986 to 1988, nearly 40% of farm income was derived from European support, but by 2008 to 2010, that figure was down to 22%. I accept that we need to get to a position where our farming is competitive across the EU and where that support diminishes again, or at least is focused on where the public benefits are clearly seen and evident. At least the trend is going in the right direction. Many people would want it to go faster, but we are going in the right direction.
We must recognise that additional work needs to be done. In the previous European debate, I referred to the OECD report, which considered CAP reform and identified the need to remove the remaining impediments to the functioning of markets, to increase the investment in agricultural innovation and to target more effectively environmental performance of agriculture, including direct payments to farmers for environmental goods and public services.
It is fair to say—the OECD notes this, but so, too, have many others—that the more detailed proposals, which were made late last year, did not receive a universal and magnanimous welcome. Many people in the farming and environmental communities, the Minister and I criticised those proposals as potentially a missed opportunity. I say “potentially” because there is still time to work on them, save them and make them good after negotiations with the European Commission. They are potentially bad because they risk failing not only our farmers but the natural environment as well. I know that the Minister will be working hard to turn the situation around.
Devolved engagement was mentioned by many Members, and it is critical. Rather than repeat the whole of the European debate, let me just touch on the greening proposals which, significantly, are designed to avoid a situation in which we undermine the environmental benefits that we have already created here within the UK. The proposals operate differently within different devolved regions. It is certainly the case that while many called on us to go further and to go faster, we have none the less managed to put in place some very good examples in partnership with farmers, especially compared with other member nations. Schemes such as the entry level stewardship and the uplands ELS were worked on into the midnight hours and beyond on successive nights with large cups of coffee, if not bottles of whisky.
In addition, there is potential for voluntary schemes such as the Campaign for the Farmed Environment. Those are highly innovative ideas and we need to ensure that whatever is introduced, we do not undermine them in any way. The Minister will be acutely aware of the concerns that exist in the run-up to the CAP reform. I am sure that the farming community frequently says to him, “Do we continue with the way we are? Do we continue with reapplying into the existing schemes, or do we drop out and keep our fingers crossed and hope?” I hope that the Minister will give clear guidance to the farming community about what it should be doing. Farmers should not lose out if they continue under the current systems until everything is decided.
The CAP’s well-intentioned greening proposals have received a fair bit of criticism because of some of the apparently negative consequences. We have talked about crop rotation and the rule that stipulates that 7% of land should be set aside for environmental gains. In previous debates, the one thing that we have learned is that when land is set apart, some of it can be of negligible biodiversity value. What we need to look at, based on what we have done in the UK and in other countries, is the best way to identify and manage those corridors or areas of ecology. I say to the Minister that what we do not want is for these well-intentioned greening proposals, which have faced some criticism from the environmental lobby as well, to undermine what is already there. On the flipside, some farmers have said to me, “That’s okay, we’ll find a way to work round it. We’ll identify the land that we can put within that 7%, and it will be no good for biodiversity, but we can do that. Or we can take what we are currently doing.” We do not want people to find ways around the proposal; we want this to be a positive measure in which the Minister can come back and say, “The way I will interpret this in the UK is for us to take this approach.” That will be much more positive, and will lead to the enhancement of our environment.
How has the Minister presented these proposals not only to the farming community but to environmental organisations? He needs to work with both groups together rather than separately. Our experience in government was always that the best way forward was to sit everyone down together and get an agreement. Some will want to pull in one direction and others in another direction. I talked about having a common UK position among the devolved Administrations. Equally, it is great to have a common position among green organisations, farmers and the agricultural community.
The proposals around the active farmer concept have received a lot of debate and discussion. I reiterate to the Minister our concerns about the businesses that have diversified—we encouraged diversification over successive decades—so that they do not look like they are spending 100% of their time on food production or farming. They may well be tested by this definition of active farmers, not least when we see the annual amount of direct payment being 5% or more of the total receipts obtained from non-agricultural activities in the most recent financial year.
As I have mentioned to the Minister before, agricultural firms can have very high turnovers but low or negative profit margins, and they can then be excluded from pillar one payments despite the fact that their business provides no real alternative income. I have also mentioned to the Minister large commercial organisations, such as the largest farming organisation that employs tenant farmers in the UK—the Co-operative Group. Co-operative Farms is a separate business, but it is a wholly owned subsidiary of the Co-operative Group, which operates in retail and banking. However, one cannot deny that the Co-operative Group is also farming actively in the UK, so we need to be very careful about how the EU proposals affect those companies and others.
The Chair of the Select Committee, the hon. Member for Thirsk and Malton and other hon. Members have asked how the concept of the active farmer affects organisations such as the Royal Society for the Protection of Birds, the National Trust and others that farm but do so in order to deliver environmental benefits. Very often, they provide good lessons in how to take the environmental agenda forward, but they are membership-based organisations and they have a wider core business than just farming. We need to ensure that the proposals do not impact on them.
There has been much debate about capping. Many financial analysts, including analysts outside farming, argue that because the proposed 30% environmental element of the single payment will be excluded anyway and because farm labour costs can be extracted under these proposals, the impact of the capping element could actually be negligible, with virtually no risk of subsidy capping or reduction in practice. However, to get to that point there will be Houdini-style contortions by many farmers and that is what we need to avoid. If it is simply an exercise in avoiding the impact of the capping element, perhaps we should argue to the Commission that it ought to just streamline or simplify it, and allow member nations subsidiarity to deal with how it works on the ground.
I just want to make a few more points to the Minister. The Commission’s CAP reform proposals allow a transfer of up to 10% of a member state’s pillar one national envelope to pillar two from 2014. However, I understand that there is no provision available for 2013, which will leave the UK with a significant gap in funding from 2013 to 2014. Perhaps the Minister could confirm that and, if it is the case, say what the Government intend to do about it. Will the Minister comment on the views of the RSPB and other NGOs that feel quite strongly that the agri-environment schemes should receive a larger share of the rural development budget in pillar two. How does he respond to that view? What are his thoughts?
The sugar industry in the UK has been in the press a lot recently because of its difficulties. What consideration has the Minister given to ending, within CAP reform, the sugar import barriers, so that British farmers such as Tate & Lyle, which rely on cane sugar supplies, can compete on an equal footing? What efforts is the Minister making to help young farmers to overcome the problems with the profitability of farming, and the problems of gaining access to capital? Gaining access to capital is not directly addressed in the CAP reform proposals, although there are some good proposals on young farmers. On a UK basis, however, I am repeatedly told about the difficulty that farmers experience in accessing capital, especially new entrants into farming.
I shall make two final points. First, will the Minister explain why these proposed reforms will continue to provide export refunds? That is a concern, not least because the EU itself made a commitment at the World Trade Organisation ministerial meeting in 2005 to phase out all those export subsidies by 2013. Secondly, as the Minister is aware, to improve farmers’ negotiating position in the food chain, producer organisations—the POs—and inter-branch organisations will now be expanded to cover all sectors. That is the trend, but the proposals do not appear in my reading of them to offer significant incentives for people to form those POs. Perhaps the Minister will explain how the proposals will work and how they can be improved, so that we get those incentives in place.
This has been a very good debate and a very good chance for many Members to air their thoughts to the Minister in a very constructive way. There have been lots of different ideas. We have time to improve these CAP proposals, but not a lot. I assure the Minister, as I have done before, that he will have Labour’s support to drive forward the right changes within the CAP proposals, so that they are good for the UK in so many ways—good for UK farmers, good for the sustainability of their livelihoods, good for food production and good for the environment—as well as being good for the EU as a whole and good in relation to our international obligations, not only in terms of food security but in terms of biodiversity, the environment and climate change. The Minister will have our support in that process, and once again I wish him the very best in his continuing negotiations.
Jim Sheridan (in the Chair)
I think the hon. Gentleman’s voice held out well there. In fact, it got stronger as he went on.
The Minister of State, Department for Environment, Food and Rural Affairs (Mr James Paice)
Good afternoon, Mr Sheridan. I thank the hon. Member for Ogmore (Huw Irranca-Davies) for that expression of support. I will start by reminding hon. Members of my own interests, as already declared, and thanking them for the way that they have contributed to this debate on what everyone agrees is an extremely important issue that probably does not get enough debating time in the House when compared with many other issues. That probably reflects people’s concerns and the fact that the country has become more urbanised in the past few decades.
As my agenda for my remarks, I want to use the proposals about CAP reform. As Members will know, although the subject of the debate is the Select Committee’s report and the Government’s response, both documents are basically obsolete, given that the report was produced last summer, since when we have had the Commission’s detailed proposals. Indeed, we have been able to explore those proposals. Negotiations have started and the Government have obviously been able to develop our own ideas. So I think that it will be more helpful to use the Commission’s main proposals, most of which have already been referred to during the debate, as a framework, and in doing so I will try to pick up on all the comments that colleagues have made about the proposals and some issues that arise from them.
First, we need to reflect, as one or two of my hon. Friends and other hon. Members have done, on the background against which—uniquely, or certainly for the first time in many decades—this round of CAP reform is taking place. In my view, which I think is shared by the hon. Member for Ogmore, that background is one of optimism.
As was mentioned right at the start of the debate, also in the background is the Foresight report, which demonstrated that global demand for food will be somewhere between 70% and 100% greater—different figures are used—in the next 40 years than it is today. That rise in demand will be brought about not only by the population increase that Members have referred to, but by the fact that a large part of that population increase will happen in the two most populous countries—India and China—both of which have a rising middle class and a rising demand for higher quality and better diets. That is part and parcel of this change; it is not just about the rising number of people.
It is also worth making the point that 1 billion of those extra people in the years ahead will live in Africa—a continent that has immense potential for agricultural production, but a potential that is woefully underused for a whole raft of reasons, many of which were mentioned by hon. Members.
Furthermore, all of those changes are set against the background of climate change, which will render parts of the world almost impossible to farm but which perversely appears to make northern Europe one of the best places to farm.
The background is crucial in assessing not only the Commission’s proposals, but where we go with agriculture in the coming years. It creates great opportunities, and the Government are disappointed that the Commission’s proposals do not really meet the opportunities that that background provides. At their worst, they could take us backwards—I do not believe that they will, but they could—so I should like to spend some time analysing them. I accept—the hon. Member for Ogmore is right—that some of what I will say is a repetition of what we discussed in a European Committee, but it was so good that I will say it all again.
The most important issue to start with is the future of the single farm payment. I am disappointed with the views of my hon. Friend the Member for Thirsk and Malton (Miss McIntosh) on the single farm payment. I know a lot of farmers—farming has been my life—but I do not know a farmer who would not like to do away with subsidies. Of course, there are issues around that, but they would far rather not have a subsidy and not be dependent on public money. They would prefer not to have to be apologetic sometimes or to justify themselves. That in itself is an important point, and we should therefore set our sights on achieving that.
I want to put the record straight on the issue that we touched on earlier and say exactly what the Government’s position is. When I gave evidence to the Environment, Food and Rural Affairs Committee, I said:
“I have always believed…that direct payment support…will end eventually… We are not going to see it happen in this financial perspective, but I think it will happen and I think the challenge is to help the farming industry face up to that day whenever it comes.”
That was my view, and it remains my view. It has been my view for the 25 years that I have been a Member. To confirm the official position, as opposed to merely what I have said, I refer hon. Members to the official Government response to the report. It states:
“we have made it clear that phasing out such payments”—
single farm payments—
“by 2020 is unrealistic, in both practical and negotiating terms.”
That is, as the hon. Member for Banff and Buchan (Dr Whiteford) said, a significant change from the previous Government’s position. I therefore hope that there can be no debate about what we are suggesting.
The hon. Member for Brent North (Barry Gardiner) said that a date needs to be fixed. In an ideal world, one would be, but the first argument to win is that we should set a trajectory. It is clear that the Select Committee does not agree. It is perfectly true that many member states and the commissioner do not believe that we should be ending, or even considering ending, single payments. We should recognise what I think will be an inevitable event at some time in the not-too-distant future but beyond this financial perspective.
We can look at what is going to happen, even though the crystal ball is extremely murky about the outcome of the negotiations. Even if the Commission’s own budget proposals for the CAP go through, that will mean a reduction in the single farm payment. That is clear. There is a cash freeze over the whole financial perspective for the CAP. Excluding one or two movements such as convergence between the highest and lowest paid member states, the single farm payment will reduce, certainly in the UK, so let us not pretend that we can somehow protect it and live on it for ever. That is not going to happen, so it is important that we spend a lot of our time and effort focusing on the CAP and trying to ensure that the industry can accommodate that and, as has been said, become more competitive.
Dr Whiteford
Will the Minister press for a fairer deal for Scottish farmers in the pillar one support, because we are currently well below the average in the UK and less than half the average in the EU?
Mr Paice
I was going to come to that point. The hon. Lady referred in her speech to the fact that I was in Scotland yesterday. I met the Scottish NFU, and I gave evidence to the Rural Affairs, Climate Change and Environment Committee in the Scottish Parliament. I was asked the same question. I cannot give clear commitments, because we do not know what the outcome will be. We do not know what the total CAP budget will be. We know what the Commission is proposing. We certainly do not know how much there will be in pillar one or pillar two. We do not know what the convergence debate will lead to and whether that will be reflected in how we divide up the UK’s share of the cake, whatever it may be.
I will make the point that I made yesterday. It is a blunt instrument simply to take the total payment—to Scotland in this case—and divide it by the number of acres, because the acres are not all equal. As the hon. Lady rightly said, 85% of Scotland is in less favoured areas. Some of the land in the highlands is of little, if any, agricultural use. That bald statistic is a blunt way to compare resources. In any case, as she will be aware, the resources are simply based on the historical payments before the advent of the single farm payment. That is fact. As for the future, I made it clear yesterday that we will sit down with all the devolved legislatures to consider how to split the cake once we know how it has been arrived at and how big it is. We cannot prejudge the outcome.
I will say, because the hon. Lady intervened, that the point about the less favoured areas is crucial. The British Government fully support the need for Scotland, Wales, Northern Ireland and England to target support at such areas, which will be renamed under the CAP. I have forgotten the phrase, but it will come back to me. Those areas will get a new title, but little else will change. I am told that they will be called areas of natural constraint. In an ideal world—I will come back to the wider aspects—the targeted payment is best made from pillar two. The hon. Member for Ogmore referred to the uplands entry level scheme, which is what we have in England. Pillar two targeted payments for those areas with natural constraints could be just as effective as a blanket per acre, or per hectare, payment.
Miss McIntosh
We are benefiting from the fact that the Government’s thinking has moved on. If the Government are eventually moving away from direct payments, what tools does the Minister hope to use to make UK farming more competitive? I do not think that agri-environment schemes make British farming more competitive. They deliver sustainable farming, but we are looking to develop more competitiveness across the EU.
Huw Irranca-Davies
When the Minister enters the final stages of the negotiations, he will draw up a list of priorities with colleagues in the devolved Administrations —a top three, a top five, a top 10. If there is a feeling, as seems to be emerging from the devolved Administrations, that the transition from historic payments to more flat payments is a top priority, will he be mindful of that and ensure, if necessary, that it is one of the red line negotiating positions with the EU?
Mr Paice
I am very happy to address that. Indeed, I addressed it yesterday in the Scottish Parliament. I am not sure about red line issues. As the hon. Gentleman knows, there is no requirement for unanimity, so we can have a red line issue that stays a red line issue and not get our way. On key negotiations, I can assure him and the hon. Member for Banff and Buchan that we have made it absolutely clear that we think the Commission’s proposals for the shift to an area basis is too draconian. The 40% first-year drop is far too dramatic, and we will support the proposition that there should be a more gradual transition.
I shall move on to the greening issue. As other hon. Members have said, that is perhaps the most important subject—it has certainly grabbed the most headlines in the farming press and in debates. As the hon. Member for Ogmore said, to put it mildly, the greening situation requires a lot of improvement. There are three components. First, farmers with permanent pasture must keep it as such and must not be allowed to plough it. There has been grave concern—and, indeed, anecdotal stories—that some farmers have started ploughing such land because they do not want to be stuck with that obligation. I urge them not to do that because we can negotiate around it. Indeed, at the NFU annual general meeting three weeks ago, the commissioner said that he did not see a problem with farmers who wanted to reseed such land every 10 years. As long as we can get that commitment in writing, we have largely resolved the issue. So there is no justification for farmers to consider ploughing up permanent pasture.
The second issue that has been debated is the requirement for a three crop rotation. My hon. Friend the Member for Camborne and Redruth (George Eustice) properly identified one of the nonsensical issues with that. A further issue with a three crop rotation is that very large numbers of dairy farmers, particularly those with outdoor stock farms in the hills, will grow a field of turnips, maize or barley to feed their own stock. It is clearly nonsensical for them to have a three crop rotation. We have made that point to the Commission repeatedly. I hope that we can get somewhere, but we will have to wait and see. I assure hon. Members that we have pressed very hard on that subject.
The third part of the greening proposal is, of course, the 7% ecological focus area. The commissioner has said repeatedly in Council meetings that he is not trying to reintroduce set-aside. However, one has only to listen to the language of this debate to realise that that is how the matter is perceived. The commissioner has said that someone will be able to count their hedges, ditches and I think that I even heard him say tracks—in other words, what someone has not got in production—and take out some land to get to the 7% if they have not got enough out already, as will be the case with most farmers. If farmers are fortunate enough to have perhaps a piece of woodland, they may well already be up to their 7%.
The Government consider that taking land out of agriculture, when, as hon. Members have all said, we need to increase production, is clearly wrong. However, there is a more fundamental problem with ecological focus areas. I have used the phrase that this is about trying to reach down to the lowest common denominator—the thing that most farmers will be able to meet without having to do anything—and that if they really have to, they might have to take a little bit more land out of farming.
The British Government take the view that we need to be far more active. Several hon. Members have rightly referred to our stewardship schemes. Such active management is far more important. There is plenty of science to demonstrate that, in terms of environmental care, biodiversity, water retention or whatever, active management of a small area of ground can deliver far better results overall than simply watching—for want of a better word—the 7%.
I will come back to the comments made by the hon. Member for Brent North in a moment before he leaves because I want to talk about his remarks on engagement. We are working very closely with a number of other member states to develop a proposal of what we might call equivalence measures: a menu of different options that member states can choose from, all of which have an environmental equivalence in quality terms. The commissioner has already made some good noises about appreciating the concept of equivalence, but he still seems to equate it with quantity rather than quality. That still concerns us.
Mr Paice
Give me a minute. I see that the hon. Gentleman is anxious to leave. I am sorry if I have bored him already. Frankly, what he was saying about engagement is, I am afraid, nonsense. He obviously has a very selective group of people to whom he speaks in the European Parliament, because the Secretary of State for Environment, Food and Rural Affairs and I have spent a great deal of effort over nearly the past two years developing relationships through the European Council, the Commission and the Parliament.
As I said to the hon. Member for Ogmore in our earlier debate, nowhere is there a better example of that than fishing, which has been mentioned. The Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Newbury (Richard Benyon), who has responsibility for fishing, visited Brussels four days after the Prime Minister executed—I mean exercised—his veto. He executed the issue, but exercised his veto. Yet my hon. Friend the Under-Secretary came away from that Fisheries Council having made a superb step forward in terms of the overall EU fisheries policy, which demonstrates that the British voice is still being listened to. Frankly, as the hon. Member for Luton North (Kelvin Hopkins), who has left his place, said, the previous Government’s attempt to renegotiate the CAP did not exactly put them in a good position from which to criticise others.
Barry Gardiner
Not at all. I apologise that I have to leave, Mr Sheridan. I am delighted to hear what the Minister has said, but, of course, the proof of the pudding will be in the eating.
Mr Paice
I am grateful to the hon. Gentleman.
I have two further short points to make about greening. First, it is a good example of something where one size does not fit all. Others have used the same phrase; we have used it regularly in Brussels. We have tried to persuade Commissioner Ciolos that he needs to accept that, as my hon. Friend the Member for Tiverton and Honiton (Neil Parish) said, there are a vast range of farm sizes, types, soils, topographies and so on across the EU. The rigid three-legged stool that the commissioner has invented for greening the CAP is too inflexible to meet all those needs. I fear that, as I suggested earlier, he is simply trying to deliver something that most farmers could achieve.
Huw Irranca-Davies
Equivalence is a welcome development. Although, understandably, the focus of the UK negotiating team will be very much on how it will apply here, what work are they doing about ensuring that equivalence is not used as an excuse in other member nations for avoiding delivering those environmental goods? We must refer to that moral duty to try to raise the level throughout the EU, which is where the greening measures are probably intended to impact most heavily. What work is the Minister doing to ensure that equivalence raises the floor and is not used as an excuse for abdicating any responsibility for the measures?
Mr Paice
The best answer I can give the hon. Gentleman is to point to what the Commissioner said at the NFU conference a few weeks ago, which I have already mentioned. He said that people in Britain are the “champions”—that was his word—of environmental conservation, stewardship and so on, and he did not want to penalise us. Therefore, we are using our own experience as the benchmark. We will be pressing the fact that standards need to be raised, rather than reaching down to the lowest common denominator, as I have suggested. My phrase “equivalence” is not about whatever is down at that level; it is about what is at a higher level and trying to raise concern for the environment and so on across the whole of the EU, including in those member states where lip service is barely paid to the matter.
I shall make a final point on greening. I should have mentioned this earlier as it was raised by several hon. Members. I have said publicly in writing in many places that any British—sorry, I meant English farmer in this context, although there will be similarities in the rest of the UK. Any English farmer who is either in a stewardship scheme or who is considering renewing or entering one need not be concerned about any changes that may come. I have said clearly that if—we hope that this will not happen—the outcome of the negotiations are to someone’s detriment, we will allow them to opt out at that stage with no penalty. I cannot be clearer than that; that is absolutely the case.
A number of Members referred to capping. Capping is, first of all, anti-competitive and does not stimulate businesses to grow. It will give the wrong message to the industry, which we want to be competitive. Secondly, in its proposed form, we think that the capping is quite bureaucratic. Bringing labour costs into it will complicate the process, which is completely opposite to the direction in which we wish to go. Thirdly, as the hon. Member for Ogmore said, there will be a great deal of business for lawyers in trying to find ways around it. When the hon. Gentleman referred to the Co-op, he also inadvertently put his finger on the fourth point to consider—corporate structures. Many of our largest farms operate under a corporate structure, which means that the issue of whether we break them down then comes into play.
That leads me to the closely linked issue of active farmers. The Commission’s proposals for active farmers are twofold. First, farmers should be actively farming—doing the job—and I will come back to that. The second aspect, which has caused the most concern, is the idea that the classification should be based on a proportion of farmers’ total income that subsidy comprises. That again falls foul of the corporate structure argument, because farmers may have businesses in a number of different corporate structures. Secondly, it prompts the scenario—the nightmare, almost—of having the Rural Payments Agency’s computer talk to Inland Revenue’s computer to establish whether someone’s non-farm income is at a specific level. Again, that is a non-runner in terms of implementation.
However, we have great sympathy with those who believe that the money should go to the people who farm the land. That touches on the question asked by the hon. Member for Ogmore. If they are tenants, the money should go to them. Under whatever form of tenancy, management or contract farming arrangement, the money should go to the business that controls the land. That is the way in which the system should operate.
That brings me back to the point made by the hon. Member for Banff and Buchan about the issue of slipper farmers in Scotland. Again, we understand that problem entirely, and we will do our best to find a way through it. It will not be easy, but it is important to ensure that people are doing something on their land before they receive any money. Whether the solution to the problem is that proposed by the Scottish National Farmers Union, namely, a minimum stocking rate—the problem tends to be associated with that sort of land—or another mechanism, I assure hon. Members that we will try to find a way forward.
A few Members spoke about the young farmers’ proposals, but, again, this is another example where one size does not fit all. The Commission’s proposal is simply that if young farmers—I say “young”, but new entrant young farmers can be up to 40 years old—have some entitlements, they will be able to get a 50% premium on them for a certain number of years. That would represent a small increase in their income, but it would bear no relevance to the size of the business and, as the hon. Member for Banff and Buchan pointed out, it would ignore the fact that they probably would not have any entitlements anyway, because of how the system operates. Virtually every Minister at Council agrees that we should help young farmers; there is no debate about that. However, it should be left to individual member states to decide the best way forward, which is how we address the issue of access to capital.
No one mentioned this afternoon the Commission’s proposals for small farmers. The only reason why I want to mention them is that the Commission is proposing that small farmers could opt for a small farmers scheme, in which they fill in a form and get the money with no questions—I will not go quite so far, but that is the impression as to the proposal. The key thing about the Commission’s proposal is that small farmers will be exempt from the greening requirement, which we oppose. We are quite happy with the idea of a simplified scheme for small farmers, as that makes sense, but to exempt them—and we are talking about a massive swathe of farmers across Europe— from the fundamental greening obligations facing other farmers would be wrong.
There was a lot of discussion about pillar two. The Government’s position, which has not changed since we took office, is that we would like to see a bigger share of CAP funds put into pillar two, and that any reduction in the funding should primarily be at the expense of pillar one. We believe that, because through pillar two it is possible to make targeted payments for public goods, whether they are existing ones or new ones that we can develop under the ecological assessment that DEFRA published last year. For example, we could start to fund farmers in the hills for what they do for water or carbon retention. That is how one could target payments through pillar two.
The hon. Member for Ogmore asked me about agri-environment taking a bigger share of pillar two, but given that it takes more than 80% now, I am not sure that it should take an even bigger share, because—I come back to answer the question asked by my hon. Friend the Member for Thirsk and Malton—of competitiveness. We believe that pillar two is the best way of enhancing competitiveness, and we have already started to do that. In the past few months we have launched three different schemes in the existing rural development programme for England to fund, grant-aid and help farmers and other rural businesses to invest for the future. That investment may be in plant. For example, there will be £20 million, which I announced—I hope I have announced that; I think I have just announced it; I just have, if I had not.
Mr Paice
Yes.
We will have a £20 million scheme for skills and training. My right hon. Friend the Secretary of State for Environment, Food and Rural Affairs announced last week £60 million for large schemes, and I have previously announced another £20 million for smaller schemes of up to £25,000. That is how one can help farmers to become more productive and competitive, to work together, develop new skills through the training funding and face the big challenge lying ahead.
As for the Commission’s other proposals that have not been discussed much, we are quite happy to see market support remain as an instrument, whether it is intervention or private storage. However, it has to be right down at safety net level; it must never again become part and parcel of the marketing structure, which is what it became in the ’70s, ’80s and ’90s, when people were openly producing just to go into intervention. It was madness, and those days must never return.
Linked to that, the Commission is proposing a global crisis fund, about which we have some reservations. Our biggest concern is that the Commission is proposing that it should be outside the budget. We do not support off-budget measures, and if the Commission is to have such a fund, the fund must come within the budget. That applies equally to the proposals on risk management.
We believe that research is central to the issue of competiveness and improving the industry’s ability to compete and become more sustainable, a key point highlighted this afternoon. We therefore support in principle the Commission’s doubling of the money for research and the development of the European integration partnership, although we need to see more about that.
I will now try to pick up points raised in the debate. Several hon. Members, including the hon. Member for Banff and Buchan, talked about regulation, and my hon. Friend the Member for Tiverton and Honiton kindly referred to the work that we have already done on that. The hon. Member for Ogmore is right to say that not every regulation is bad. What we have tried to do through the Macdonald process—we have discussed this and Richard Macdonald has been to the Commission to promote his proposals—is not to say, “We just have to get rid of regulations”, but to look at how we implement and enforce them in a way that causes minimum burden on business while achieving the standards that we are trying to achieve. We will continue to press that approach.
We have said over and over again that the groceries code adjudicator is the responsibility of the Department for Business, Innovation and Skills, but I am hopeful that the relevant Bill will be introduced shortly.
Huw Irranca-Davies
The Minister has expanded on many points, for which we are grateful.
One of the things that we and successive Governments often struggled with was the complexity of the EU and its machine. Regulations will come from the least expected direction. They may not come from the Agriculture Committee. They may come from the Environmental Committee, from somewhere else, or, nowadays, from other parts of the institution entirely. In light of the MacDonald proposals, has the Minister or the Department developed anything about that early warning system where, at the earliest possible moment, it is flagged up that it might arrive on the Minister’s desk in five or six years’ time from the least-expected direction?
Jim Sheridan (in the Chair)
Before I call the Minister, may I remind hon. Members that I wish to leave five minutes for the Chair of the Select Committee to conclude?
Mr Paice
Thank you for reminding me, Mr Sheridan.
I will not say that we have developed a rigid blueprint system, but if the hon. Gentleman reads the response to the MacDonald report, it is clear that we understand fully the point he rightly makes; indeed, it is a point that I made when I was in his shoes in opposition. We need that early warning. The general thrust is that the whole industry—DEFRA officials, and other Departments’ officials for that matter, which is something that we are discussing in government, or other arms of the industry, all of whom who have their Brussels people working out there—feeds this back and knows, together, the moment that some official has what they think is a bright idea.
The hon. Gentleman and others mentioned Food 2030. It is fine—a good document. However, I think he would be honest and agree that it was pretty vague on how to deliver. That is why we have set up the green food project, which we announced in the “Natural Environment” White Paper last year. The green food project is bringing together all the different interests to try to see how we meet that big challenge of increasing food production and productivity, while doing so sustainably. It is about producing more and impacting less, and sustainable intensification. Whatever phrases we have been using, the green food project will produce its first report in the middle of this year. It has set up a number of working parties and is working through different themes and food products. I am hopeful that we can build on the Food 2030 document.
The hon. Gentleman asked about moving from pillar one to pillar two. For the life of me, I cannot remember why he asked me that. However, it is currently 10% in the proposals. He asked why export refunds are still there. I agree with him. As he rightly said, the EU had agreed to phase out refunds as part of the offer on the table for the Doha talks. We agree with that, which brings me on to sugar, an issue he also raised. We have made it clear that, while we support the Commission’s proposals to do away with sugar quotas, we do not agree with its idea that we should retain all the barriers around the EU. The issue of Tate & Lyle and raw cane sugar imports is very important for the whole country, not just for the 1,000-odd people who work in the refinery. We are determined to continue to press forward on that.
The hon. Gentleman’s final point was about producer organisations. He is entirely right. There is a great deal of noise about their importance, and we share that view. We would like to see many more farmers working together in producer organisations. Britain has a chequered history of producer organisations, co-operatives, farmer-controlled businesses, or whatever we call them. The only carrot being held out by the Commission is that of being exempt from competition law. That prompts two questions. Is it a carrot? For most producer organisations, it is not. The idea of having 20% of their market—where most competition law clicks in, or even higher—is pie-in-the-sky wishful thinking. It also prompts the question: is it actually right to exempt farmers, co-operatives or producer organisations from competition law? The most reasonable answer to that is no. Why should they be any more exempt than any other? Why should they not comply with competition law?
The EU’s proposals have a long way to go. We think that it will be at least a year, probably more, before we secure a final outcome. As several hon. Members have said, there will be a lot more discussion. The proposals will evolve through the European Parliament and the European Council. We have already made our commitment to keep the House informed as much as possible as that goes forward. I, for one, foolishly—I will regret saying this—will welcome further debates, as we go forward, to keep the House informed and to help the Government decide on new positions. I hope that is helpful.
Miss McIntosh
I thank everyone for contributing to the debate. I thank the Minister for being so generous in updating the Chamber this afternoon. I particularly thank my colleagues on the Select Committee—we work very hard. The saying is, “You wait for a bus and then they all come along at once.” We, as has the Department, have been occupying ourselves with reform both to the common agricultural policy and to the common fisheries policy.
The hon. Member for Banff and Buchan (Dr Whiteford) brought with her the experience north of the border. I am sure there are many similarities between her constituency and mine. I am sure she will have received some comfort from the Minister’s remarks this afternoon.
My hon. Friend the Member for Camborne and Redruth (George Eustice) came through with some novel ideas about dismantling the CAP in its existing format. The difficulty always is that if we move away from direct payments, or, eventually, any support for farming, it will be too attractive for whichever party is in power to dismantle support, for the reasons given by the Minister. The farmers in my constituency would like to be less dependent on farm subsidies, and be allowed to go out there and do the job. Whether state aid rules on their own would be sufficient to achieve a level playing field, I am not sure.
We have benefited greatly from the contribution by the shadow Minister, the hon. Member for Ogmore (Huw Irranca-Davies), who has had the opportunity to participate in previous debates as a Minister. I hope that the Minister of State welcomed the opportunity—he was gracious enough to say so this afternoon—to participate. It is some time since he has responded to a debate, but this afternoon he has had the opportunity to reach a wider audience.
A lot of ideas have coalesced around the need to simplify and reduce regulation. I add my congratulations to those that have been expressed. I think the Department is the first to have embarked on something on the scale of the MacDonald report. That is very welcome indeed and I hope that other Departments will take courage from the work that the Department has done in that regard. I hope that we will perhaps be a little more ambitious. While we welcome the “one in, one out” rule that seems to apply at the moment, where there are opportunities to dismantle more than one regulation, I hope that we will seize the opportunity to do so.
The arguments for subsidiarity and regionalisation are well made, for both CAP and common fisheries reform. I hope that we have given the Minister some arguments to deploy. The previous Committee had the opportunity to consider the Food 2030 report, which was published right at the end of the previous Parliament and the tenure of the outgoing Government. I applaud and welcome many of the announcements and policies that the present Government have rolled out. I particularly welcome the announcement from the Minister this afternoon—I do not know if it is new or recycled. He graciously met some of those who have benefited from the previous rural grants and funding. My own area will welcome the announcement of the investment of the additional money in training and skills. He will be aware of the ONE scheme in my constituency, which gained support from the Churches, as well as others in the wider community. I hope that there will not be any loss of continuity. I thank all of those who have participated in the debate, and all of those who have contributed to the report and helped to put it together.
Question put and agreed to.
Written Ministerial Statements
(12 years, 9 months ago)
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Green Investment Bank
(12 years, 9 months ago)
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The Secretary of State for Business, Innovation and Skills (Vince Cable)
On 12 December 2011, I published details of the criteria I would take into account in reaching decisions about the location of the Green investment bank (GIB). The two primary criteria were concerned with (i) the ability to recruit and retain the necessary specialist staff and (ii) the ability to engage effectively with the “ecosystem” for originating and negotiating transactions. A further consideration related to how the choice of location would affect the overall costs of operating the GIB.
Interested parties were invited to make representations about the merits of particular proposed locations by 30 January. We received 32 such representations and these have been reviewed carefully. I have now reached conclusions on this matter and am today publishing a decision document with reasons. A copy of this and other supporting documents have been placed in the Library of the House and these may also be found on the GIB page of the Department of Business, Innovation and Skills website.
Our assessment concluded that London and Edinburgh were the two leading candidates of the proposed locations. In light of the strengths that these two cities offer, I have decided that the headquarters of the GIB should be in Edinburgh, with the GIB’s transaction team and project financing team based, initially, in a London office.
Edinburgh is an established centre for financial services, coupled with a thriving green sector. It has the excellent transport and communications links that will enable GIB staff to engage with partner organisations as necessary. As the GIB develops into one of the UK’s leading investors in green infrastructure, it will benefit from the asset management skills for which Edinburgh is well known.
The assessment also underlined the strength of London in large-scale project and structured finance transactions. To be effective in originating transactions and participating fully alongside other commercial investors, it is clear to me that the GIB’s major transaction team must be located, at least initially, in London, though capacity may be developed over time in Edinburgh. In coming to this decision, I have concluded that the challenge of recruiting teams of project financiers of the necessary skill and experience outside London would represent a significant risk to the successful operation of the GIB in its early stages.
I believe this decision will ensure the GIB is able to operate effectively and achieve its mission of mobilising the additional investment needed to accelerate the UK’s transition to a green economy. Meeting the Government’s ambitious environmental and carbon reduction goals will require sustained investment over many decades, developing a whole new financial sub-sector. It is with that vision in mind that I have taken the strategic decision to ensure a commercial reach throughout the country, initially through significant presence in both Edinburgh and London. Over time I would envisage further offices being opened as the bank develops its activities, though this will be a decision for the GIB board to make. I would also expect that as the GIB stimulates the national green financial services sector, it would move some functions out of London over time, helping to contribute towards the Government’s goal of rebalancing the UK’s economy.
It is unusual for Government to decide the location of a new company. However in this case, the importance of the role of the GIB and the widespread national interest in the bank’s location has justified a thorough and open process. The Edinburgh headquarters will be specified in the company’s constitutional documents. The GIB will operate at arm’s length from Government, with the Government acting as its sole shareholder. As such, further detailed decisions about its structure and organisational arrangements will be a matter solely for the GIB’s senior management.
My principal aim, which I know is widely shared, is to ensure the GIB is successful and has a real impact in the green economy as soon as possible. I believe that this location decision will deliver that aim. We are now pressing ahead with the recruitment of the GIB’s chair and senior independent director, so that the bank will be in a position to be fully operational this autumn, subject to obtaining the necessary state aid approval.
Higher Education Student Finance (2013-14)
(12 years, 9 months ago)
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The Minister for Universities and Science (Mr David Willetts)
I am today confirming the student finance package for higher education students undertaking a course of study in the academic year beginning September 2013.
For all new and continuing full-time students in 2013-14, maximum tuition charges and maximum tuition loans will be maintained at 2012-13 levels.
For all new part-time students in 2013-14, and all continuing part-time students who started their courses on or after 1 September 2012, maximum tuition charges and maximum tuition loans will be maintained at 2012-13 levels.
The maximum maintenance grant for students attending full-time courses in 2013-14 will be uprated in line with inflation. For new students and continuing students who started their courses on or after 1 September 2012, the maximum grant in 2013-14 will be increased to £3,354. For continuing students who started their courses before 1 September 2012, the maximum grant in 2013-14 will be increased to £3,080.
For all new and continuing full-time students attending their courses in 2013-14, loans for living costs will be maintained at 2012-13 levels.
For those students who started part-time and full-time distance learning courses before 1 September 2012 and who are continuing their courses in 2013-14, maximum fee and course grants will be uprated in line with inflation. Maximum fee grants will be increased to £1,270, depending on the intensity of study of the course. Maximum course grants will be increased to £275.
Maximum grants for students with dependants and those with disabilities will also be maintained at 2012-13 levels in 2013-14.
Household income thresholds for grants for tuition and living costs, and loans for living costs, will be maintained at 2012-13 levels for 2013-14.
I expect to lay regulations implementing changes to student support for 2013-14 before both Houses in the summer 2012.
Teachers' Pension Regulations
(12 years, 9 months ago)
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The Minister of State, Department for Education (Mr Nick Gibb)
At the spending review 2010 the Government proposed increases to member contribution rates that would lead to savings of £2.8 billion a year by 2014-15, to be phased in from April 2012. The increases were to be progressive, affording protection to those on lower salaries and reducing the potential for members opting out of the scheme.
My Department consulted on a system of tiered contribution rates that would secure the savings and offer protection to those with lower incomes. The consultation opened on 28 July 2011 and closed on 20 October 2011. Over 1,700 responses were received to the consultation.
These regulations bring the tiered contribution rates into force. They will apply for service from 1 April 2012 and continue throughout the financial year. The Government remain committed to meeting their spending review commitments in 2013-14 and 2014-15 by increasing member contributions in public service pension schemes. The Department will be discussing potential contribution rate structures for 2013-14 and 2014-15 with unions and employers before starting a formal consultation process.
These regulations also provide a number of minor amendments required to ensure the TPS aligns with the Finance Act 2011 and to clarify administration procedures.
Taylor Report on Alternative Provision
(12 years, 9 months ago)
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The Secretary of State for Education (Michael Gove)
On 1 September last year, I asked the Government’s expert adviser on behaviour, Charlie Taylor, to review and report on school attendance and alternative provision.
He has now published his report on alternative provision, and I am writing to him to accept his recommendations.
Children who are in alternative provision are among the most vulnerable. When they receive poor quality provision they are being let down by those who should be looking after their interests. Their outcomes are well below those of their peers, and they may leave education ill-equipped to become productive members of society.
The recommendations in the report should raise standards in the alternative provision sector so that pupils achieve better academic outcomes and are motivated to remain in education.
We will therefore take steps to implement the recommendations in his report as early as we can.
Copies of Charlie Taylor’s report, and my response to him, are being placed in the Libraries of both Houses.
Reviewing and Strengthening the NHS Constitution
(12 years, 9 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
As Secretary of State for Health, I have a duty, under the Health Act 2009, to publish a report on how the NHS constitution has affected patients, staff, carers and the public by 5 July 2012.
The Government are committed to the common set of principles and values established by the NHS constitution, and have made a number of amendments to the Health and Social Care Bill to strengthen its influence on the NHS.
The statutory requirement for a report on the impact of the NHS constitution provides an excellent opportunity to assess the contribution it has made to reinforcing the principles and values of the NHS, supporting high quality patient care and ensuring that patients, the public and staff are aware of their rights, as well as what they can contribute. The report will help to inform efforts to fully embed the constitution in the everyday work of the NHS, including the plans of the NHS Commissioning Board (NHSCB) and clinical commissioning groups (CCGs) to fulfil their duties to promote the NHS constitution.
In order to make the most of this opportunity, I am keen to have a wide range of advice and I have therefore asked Professor Steve Field to chair an independent Future Forum working group to advise me on the NHS constitution. The Future Forum group will use a wide variety of information, including surveys, workshops, performance data, and patient experience reports to examine what effect the constitution has had on the NHS and will then advise me on how best to reflect this in my report.
Following the report, I have also asked the new Future Forum group to advise me whether there is any scope for strengthening the NHS constitution to support the fair and effective operation of the NHS. Both the group and the Government will engage with key NHS, professional and patient organisations in considering the potential for changes, before a full public consultation in autumn 2012. Any amendments to the NHS constitution would then come into effect by April 2013.
Between them, this work and the new duties on the NHS constitution contained in the Health and Social Care Bill, which will require NHS bodies to have regard to the constitution and for the NHSCB and CCGs to promote the constitution, will strengthen both the contents of the NHS constitution and the role it plays in the NHS.
Whistleblowing and the NHS Constitution
(12 years, 9 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
On 9 June 2010, I announced a full inquiry into the failings at Mid Staffordshire NHS Foundation Trust and gave a commitment to
“Reinforce the NHS constitution to make clear the rights and responsibilities of NHS staff and their employers in respect of whistleblowing”.
The Department of Health ran a full public consultation on a set of proposals for changes to the NHS constitution in respect of whistleblowing and published the Government’s response to that consultation, on 18 October 2011, setting out a commitment to making the changes in early 2012.
I have today published a revised NHS constitution which highlights the existing rights of NHS staff to raise concerns without fear of detriment and makes it clear that it is the right and duty of all NHS workers to report bad practice or any mistreatment of patients receiving care from the health service at the earliest opportunity.
Changes to the constitution add:
an expectation that staff should raise concerns at the earliest opportunity;
a pledge that NHS organisations should support staff when raising concerns by ensuring their concerns are fully investigated and that there is someone independent, outside of their team, to speak to; and
clarity around the existing legal right for staff to raise concerns about safety, malpractice or other wrongdoing without suffering any detriment.
These changes are part of a series of measures intended to highlight the importance of whistleblowing in the NHS. This Government have already issued unequivocal guidance to NHS organisations that all their contracts of employment should cover staff whistleblowing rights and amended the NHS staff terms and conditions of service handbook for those staff on Agenda for Change terms and conditions to include a contractual right to raise concerns. We have also issued guidance to the NHS on supporting and taking action on concerns raised by staff.
Enshrining whistleblowing in the constitution will contribute to further raising the profile of whistleblowing and play an important role in creating a culture where staff will be able to raise genuine concerns in good faith, without fear of reprisal.
I recently announced that the Department of Health has put in place a new and improved contract for the provision of a confidential whistleblowing helpline for NHS staff to provide them with advice on how to raise concerns and what legal protections are available to them when they do. The new contract provides for a free phone service and extends the provision of the contract to staff working in social care.
The revised NHS constitution has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
Violence Against Women and Girls
(12 years, 9 months ago)
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The Secretary of State for the Home Department (Mrs Theresa May)
Today, on international women’s day, we are publishing an updated violence against women and girls action plan. A copy will be placed in the House Library.
Each year, over 1 million women suffer domestic abuse, over 300,000 women are sexually assaulted and 60,000 women are raped. This is wholly unacceptable in modern-day Britain.
Soon after coming to office we set out a new strategy to end violence against women and girls, placing prevention at the heart of our approach. This document updates the actions underpinning that strategy, and details the progress made. Our key themes of prevention, provision of good quality services, improved partnership working, better justice outcomes and risk reduction remain so this revised document builds on the previous plan and makes it clear what we expect from local areas and local partners.
The previous action plan set out 88 specific actions. More than half of them have been completed, including the provision of almost £40 million of earmarked funding for specialist support services over the spending review period; the implementation of new laws to make all local areas hold a domestic homicide review after every domestic violence death; and the piloting of domestic violence protection orders. We are making good progress on almost all of the remaining actions.
This updated plan includes new actions to help keep women safe. For the first time, we will pilot a process for the police to give women access to information about the past actions of a new partner where that may help keep them safe. We will also create two new specific criminal offences of stalking and we are today tabling amendments to the Protection of Freedoms Bill so that these new offences can be enacted as soon as possible. And we will work to reduce the harm suffered by the vulnerable women working in prostitution.
We are proud of the progress this Government have made in protecting the lives of women and girls and remain committed to ending the violence and abuse which continues to blight the lives of too many of them.
Judicial Pension Schemes
(12 years, 9 months ago)
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The Lord Chancellor and Secretary of State for Justice (Mr Kenneth Clarke)
At the spending review 2010 the Government announced increases to member contribution rates in public service pension schemes saving £2.8 billion a year by 2014-15, to be phased in from April 2012.
The Judicial Pensions (Contributions) Regulations 2012, laid today, will introduce from April new net personal contributions of 1.28% of salary for the members of the judicial pension schemes who have not accrued full pensions benefits. The regulations also set out when no contributions are due and ensure that the payment of personal judicial pensions contributions will have no impact on the maximum additional voluntary contributions that an individual may make.
The Government remain committed to securing in full the spending review savings in 2013-14 and 2014-15 from further increases to member contributions to public service pension schemes.
The associated Judicial Pensions (European Court of Human Rights) (Amendment) Order 2012, also laid today, will enable contributions towards the costs of providing personal benefits to be taken other than from salary, from the UK judge of the European Court of Human Rights if that judge continues to be a member of a judicial pensions scheme in line with the process already in place for collecting contributions towards dependants’ benefits.
Rail Reform
(12 years, 9 months ago)
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The Secretary of State for Transport (Justine Greening)
I am today publishing “Reforming our Railways: Putting the Customer First”, which sets out the Government’s vision for the railways, alongside the policies that are needed to realise that vision. I am also announcing consultations on how we might move to a more transparent, modern and flexible approach to fares and ticketing; and on the opportunity to devolve power and responsibility away from Whitehall’s traditional command and control structure to the appropriate local level. I am making an oral statement to the House today to explain our approach.
Commission on Devolution in Wales
(12 years, 9 months ago)
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The Secretary of State for Wales (Mrs Cheryl Gillan)
I informed the House on 11 October 2011 that the Commission on Devolution in Wales would conduct its work in two parts: in part I, which is currently under way, the commission is reviewing the case for devolution of any fiscal powers to the National Assembly for Wales and if so what areas those could cover. The commission has confirmed that it currently intends to report on its findings on part I in late autumn 2012.
Part II of the commission will examine the powers of the National Assembly and consider whether to recommend any modifications that it considers could improve the current arrangements. The commission has requested an extension to the time by when it will report on its recommendations in relation to part II. I have agreed to this request and the commission will therefore publish its part II findings by spring 2014, rather than during 2013, enabling it to give more thorough consideration to the Welsh devolution settlement.
House of Lords
Royal Assent
Schools: Campaigns
(12 years, 9 months ago)
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Baroness Gale
To ask Her Majesty’s Government what action they are taking to ensure that every school is aware of forthcoming campaigns focusing on sexual consent and forced marriage, and that schools and colleges know where to refer young people for specialist support.
Baroness Warsi
My Lords, today, on this 101st anniversary of International Women’s Day, when women, and men, around the world are celebrating the progress that has been made on the rights and protection of women, the noble Baroness, Lady Gale, asks an important and timely Question. It is tragic that violence against women and forced marriage are still issues in this country. Sexual health is taught in personal, social and health education—PSHE—and is currently under review. The consultation phase closed three months ago, and the Department for Education is in the process of drafting a response.
On forced marriage, the Forced Marriage Unit conducts outreach work domestically and internationally and produces a wide range of resources that are available to schools.
Baroness Gale
I thank the Minister for her reply. I congratulate the Government on their excellent campaign “This is ABUSE”. Is the Minister aware that research has shown that the highest proportion of sexual abuse experienced by teenagers is perpetrated by those under 18 and that one in three teenage girls experiences unwanted sexual contact at school? It is essential that teenagers get as much information as possible, especially from this campaign. Will the Minister say why the Department for Education is not promoting the campaign, as that is where most teenagers are? I hope that she will not say, as the Minister for Children said the other day, that it is to reduce burdens on schools.
Baroness Warsi
My Lords, the noble Baroness is correct that the National Society for the Prevention of Cruelty to Children recently produced a report that stated that 16 per cent of teenage boys and, tragically, 33 per cent of teenage girls had experienced some form of sexual violence or abuse, predominantly from a partner. The teenage rape prevention campaign, which was launched earlier this week by the Deputy Prime Minister, will build on the recent teenage relationship abuse campaign. All partners and front-line practitioners with whom the Home Office has been working, which include teachers and schools, will have access to this further information and resource material. It will also be featured on the Times Educational Supplement Connect website and on the Department for Education’s corporate Facebook page. Before I came into the Chamber, I typed in “teenage abuse”, and the Home Office-funded website “This is ABUSE” and information about the new campaign, including a very hard-hitting video, are immediately available as the top click.
Baroness Hussein-Ece
My Lords, many of us will agree that forced marriages have no place in any civilised society and are also against the teachings of any religion that we are aware of. I am aware that the consultation ends on 30 March. However, most people are unaware that forced marriages are not illegal. Does my noble friend the Minister agree that making this a criminal offence would act as a deterrent, would support victims and would send out a very strong message that it is simply illegal to force any young girl to marry against her will?
Baroness Warsi
My Lords, I agree with my noble friend’s comments, and I completely agree that this issue is not confined to any specific culture or religion. Indeed, no religion condones this kind of behaviour. The forced marriage consultation, which started in December last year, is looking specifically at moving from a civil remedy to a criminal sanction. That consultation concludes at the end of March. During the consultation we are speaking to victims’ groups, lawyers and specialists who have been involved in this area for many years. There are arguments on both sides as to whether this should be a criminal offence. I have made it clear in both opposition and government that the time has now come to make it a criminal offence, but of course the Government will have to consider all responses to the consultation before we come to a final decision.
Baroness Massey of Darwen
Does the Minister agree and sympathise with my concern and frustration about the slowness of the implementation of personal, social and health education in schools? Can she also say who will be responsible in the mean time for carrying out education on things such as sexual consent and forced marriage, in which part of the curriculum it will be done, and how schools will get the information about where to refer young people to afterwards?
Baroness Warsi
My Lords, as I said earlier, the position of PSHE in the curriculum is under review. It would be wrong to predict the outcome of that review and to predict where that subject would be taught. Of course, noble Lords will be aware that the responsibility for holding local agencies, including schools, to account for the effectiveness of safeguarding work relating to children rests with the local safeguarding children boards. All these boards have some sort of teacher representation, so there is ongoing contact with local child protection services and schools. Where this will be taught in the curriculum is currently under review.
The Earl of Listowel
My Lords, will the Minister consider looking at the services for children who sexually harm other children? There has been considerable concern in the past about the variable quality and availability of those services. Will she consider looking at that and perhaps write with her findings to noble Lords taking part in this short debate?
Baroness Warsi
There has been research; indeed, the NSPCC specifically looked at abuse between children and the pressures that young people face when a relationship turns abusive. Indeed, the video that I referred to—which, if noble Lords have a few moments, is worth looking at—is a very hard-hitting video that specifically highlights the pressures that can be placed upon young people when they are in relationships. That video is being played not just as a resource within schools but during primetime viewing for that particular audience on television.
Baroness Gardner of Parkes
My Lords, I am sure that we all in this House are glad that the Minister has made clear that there is no religious basis for these marriages. Nevertheless, does she think that there is a long-established cultural tradition that will take a long time to change and that making it criminal might help to speed up that process?
Baroness Warsi
My noble friend makes a very valid point. There are certain countries of origin in which this practice of forced marriage is more prevalent. Statistics show that it is more likely to occur in the Indian subcontinent, specifically in Pakistan and Bangladesh. The Forced Marriage Unit is hugely active in those countries and a great amount of resource has been put into that. This has been a long journey and I must give all credit to the opposition Benches and the noble Lord, Lord Ahmed, of Rotherham, who did a huge amount of work on this in the late 1990s and in early 2000. This is an ongoing journey. The current consultation is about whether we are prepared to take the next step and criminalise it, and I am delighted that I have the support of noble Lords from across the House in taking that initiative forward.
Crime: Domestic Violence
(12 years, 9 months ago)
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Baroness Gould of Potternewton
To ask Her Majesty’s Government what direct support they are giving to refuges providing protection for women fleeing from domestic violence.
Baroness Verma
My Lords, because the Government take domestic violence so seriously, we have ring-fenced nearly £40 million of stable funding for specialist local domestic and sexual violence support services until 2015. Accommodation is the foundation to ensuring that victims are afforded safety and security, which is why homelessness legislation in England provides one of the strongest safety nets in the world for families with children and vulnerable people who become homeless through no fault of their own.
We are also piloting domestic violence protection orders in three police force areas by which the police and magistrates can put into place protection for the victim so that they need not flee their own property, and the perpetrator is prevented from returning to the residence and from having contact with the victim for up to 28 days.
Baroness Gould of Potternewton
I thank the Minister for that reply and for any action that the Government are taking to protect women suffering from domestic violence. In spite of her comments, will she justify why up and down the country refuges are closing down or facing cuts? On a typical day, Women’s Aid is turning away about 230 women because it does not have the funding to accommodate them. Women are literally having to find places to sleep outside—such as in the Occupy camps, hospitals or night buses, and I have even heard of a case of a woman sleeping in an internet cafe—or are having to return to an abusive partner. Can the Minister indicate what action the Government propose to take to ensure that women are not subject to such a position and do not have to return necessarily to an abusive home rather than find a place of safety? How will places of safety be found?
Baroness Verma
My Lords, I fully understand the noble Baroness’s concerns but I reiterate that we are committed to ensuring that victims have a place to go if they are in need of such a place, which is why we are conducting a pilot in three police areas. I should also like to say to the noble Baroness and to noble Lords that we are in difficult circumstances. We have to deal with that alongside funding for all sorts of organisations. We have made this an issue that is dealt with locally. We have ensured that £6.5 billion is in place to support the Supporting People programme. At any one time, that programme looks after 1 million people. We have increased spending on housing-related support for victims of domestic violence from £62 million in 2007-08 to £71 million this year. A lot is going on, but we are in difficult times and we have economic constraints.
Baroness Seccombe
My Lords, does my noble friend agree that some of these victims of domestic violence are men? Does she feel that on this special day we might spare a thought for and celebrate the men in our lives?
Baroness Verma
I think that my noble friend has had her question answered. On a more serious note, any victim will be supported by this Government. Victim support will always be gender neutral. We are seeing rising numbers of men being violently abused, so I agree completely with the sentiment expressed by my noble friend. This is a gender-neutral issue that we need to take in the round.
The Earl of Listowel
My Lords, while recognising the devolution to local areas, can the Minister say a little about specialist services to provide access to adult, child and adolescent mental health services in situ in refuges? Are there any special arrangements for those parents and their children?
Baroness Verma
The noble Earl has raised another serious issue and of course we will find a prevalence of mental health issues in these cases. I very much take on board what the noble Earl has said, but I would rather write to him specifically about the work that is being done because this is a broad question that needs to be answered in detail.
Baroness Royall of Blaisdon
My Lords, I accept entirely that the Government have ring-fenced some money for dealing with the problems faced by the victims of domestic violence. However, as my noble friend Lady Gould said, refuges up and down the country are either closing or are under threat of closure, including in the Forest of Dean. Can the noble Baroness tell me whether the Government expect local authorities to undertake impact assessments before refuges are closed to see what the impact will be on vulnerable women who will be left homeless or without a place to stay when they close?
Baroness Verma
My Lords, I will repeat myself and say that we have difficulties with finances simply because there is no money to spare, as the noble Baroness will be aware. However, the homelessness strategy will not see people who require support and housing being left without refuge. There is a close relationship between what we are doing nationally and the work that we are making sure local authorities do through the funding that we have secured with them. Of course, local authorities will make decisions about need in their areas, and I would say to the noble Baroness that authorities have a duty to ensure that any victims of any form of violence are supported in securing refuge.
Baroness Hamwee
My Lords, I welcome the financial contribution that this and the last Government have made to the national domestic violence helpline, but will my noble friend take away from the exchanges today the message that it is direct provision that is so important? Things such as telephone advice are helpful, but they cannot carry out the whole job.
Baroness Verma
My noble friend makes an important point, but she will also understand that these are difficult times.
Equality: Pay and Opportunities
(12 years, 9 months ago)
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Baroness Prosser
To ask Her Majesty’s Government what action they are taking to reduce the gender pay and opportunities gap.
Baroness Northover
My Lords, the Government are committed to making full use of the skills and experience that women bring to our economy. We are increasing flexibility in the workplace and extending help with childcare. We are supporting women’s enterprise through identifying and training 5,000 business mentors. We are encouraging greater transparency on gender equality in the workplace and, with the noble Lord, Lord Davies of Abersoch, we are helping more women reach the boardrooms of our leading companies.
Baroness Prosser
I thank the noble Baroness for that reply. Does she agree that as the reasons for the continuing gender pay and opportunities gap are many and various, the solutions must be multilayered as well? Can she tell the House about any proposals the Government may have to address the unaffordability of childcare, the paucity of good quality part-time employment and the training needs of women working below their capacity?
Baroness Northover
I pay tribute to the noble Baroness for her work in this area and for chairing the Women and Work Commission and its later update, which is an impressive piece of work. She will be aware that the trend is in the right direction. It is very marked. If you look at 1970, there was a 38.2 per cent gender pay gap and in 2011 it was 9.2 per cent. But we cannot be complacent and the issues that she has flagged up rightly identify some of the challenges that face women in work.
Under the universal credit, we will be extending the amount of support to childcare for those working less than 16 hours a week—so those working part-time—and that should assist 80,000 families. We are extending the right to request flexible working to employees. It is also extremely important to note that there are many more apprenticeships, often being taken up by women in later life so that they can more easily get back into work if they have taken time out.
Baroness Kramer
My Lords, my noble friend will be aware that students taking maths at A-level almost always go on to higher education and earn something like £17,000 more a year than their counterparts. That is true also for those taking subjects such as physics and engineering. What are we doing today to try to persuade girls that they can choose this route, which would very quickly close a great deal of the earnings gap?
Baroness Northover
My noble friend is absolutely right. Gender stereotyping in schools has tended in the past to direct girls way from the areas that she is talking about. The new National Careers Service will encourage girls and young women to challenge those stereotypes and encourage them to choose from the broadest possible career options. That includes providing good information, which girls, certainly from my experience, are very interested in, about the wide range of career opportunities that studying science and maths can lead to.
Baroness Pitkeathley
My Lords, does the Minister agree that, with the demographics of an ageing population, the provision of elder care and care for disabled people is just as important, if not more important, than the provision of childcare in enabling people to return or stay in the workforce? What provisions are the Government making to help people with caring responsibilities enter or remain in the workforce?
Baroness Northover
The noble Baroness is absolutely right. We often debate how we can better develop the support of social care. I look forward to future debates this year on that area, as she knows. She is quite right that many people find themselves trapped in a situation where they are responsible both for the care of children and for elder care. That means that it is extremely important that our extension of the right to request flexible working for all employees—men and women, as we seek to share that responsibility—is taken forward. It is very important that this does not simply fall on women. At the moment, many men support their parents as well, so I hope that this is something that will move forward steadily.
Baroness Howe of Idlicote
My Lords, does the Minister agree that one of the most important issues is to ensure that men have equal access to flexible and part-time working and that that is seen as important in all the firms that employ men? That is one of the gaps that still exist. I also congratulate the Government on the progress—there are visible signs of progress—in opportunities and on pay. This Government have done a fair amount to increase that and the previous Government did a great deal to start the climb.
Baroness Northover
I am very grateful to the noble Baroness for those comments and I also pay tribute to the previous Government for their work in that area. It is indeed extremely important to extend flexible working to make sure that both sexes take full advantage of that and play their part—whether looking after children or helping with elder care, as we have just discussed.
Lord Boswell of Aynho
My Lords, while in no sense seeking to denigrate the importance of equality legislation, where we must not take our foot off the pedal, will my noble friend agree that it is time to trumpet the positive benefits to companies and organisations of a workforce and decision-makers who are diverse in experience and attitudes? More wisdom will come out of that diversity than out of a monolithic offer.
Baroness Northover
I could not agree more with my noble friend. That was emphasised in the debate on women last week. I note that 24 per cent of all appointments to FTSE 100 boards are now women, up from 13 per cent the previous year. That is one area where it is extremely important to carry through the points that my noble friend made.
Lord Dannatt
My Lords, on this day when we focus on women and are mindful of the loss of six soldiers in Afghanistan, bringing the number who have lost their lives in that campaign to 404, will the Minister and the whole House join in paying tribute to women— mothers, daughters, girlfriends and wives—who are at home while their men are on the front line? We must also bear in mind that some of those on the front line are women. We pay tribute to women who serve at home by supporting those who are on the front line on this day when we focus on women in particular.
Baroness Northover
I am very happy to pay tribute to the men and women who serve for us on the front line and their families at home—their partners, wives and husbands, and their children.
Manufacturing
(12 years, 9 months ago)
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Lord Bates
To ask Her Majesty’s Government what assessment they have made of the United Kingdom’s international competitiveness in manufacturing, in the light of the recent investment by Nissan in north-east England.
The Minister of State, Department for Business, Innovation and Skills & Foreign and Commonwealth Office (Lord Green of Hurstpierpoint)
My Lords, the United Kingdom has an internationally competitive manufacturing sector, with companies across a wide range of activities. The automotive sector is a great example of that. We were delighted to see the unveiling of Nissan’s new concept car in Geneva this week. We welcome the news that the production model will be built at the Sunderland plant next year, creating about 2,000 new jobs at Nissan and in its supply chain.
Lord Bates
I am grateful to my noble friend for that Answer. It is indeed very good news. Does he recall that three years ago the confidence of the north-east was shattered by three simultaneous announcements: the lay-off and mass redundancies at Nissan, the closure of the Corus steel plant and the shelving of plans for a £5 billion investment in new high-speed trains? Does he recognise that over the past year we have seen the reopening of the Corus steel plant, the go-ahead for the Hitachi investment in new trains, and now the thousands of new jobs coming through Nissan’s investment? Does he agree that this demonstrates restored confidence in manufacturing in Britain and also in the policies pursued by the Government?
Lord Green of Hurstpierpoint
Before I answer that question, I am sure that the whole House would like to join me in congratulating my noble friend on just completing a 3,000-mile walk around Europe in support of the Olympic Truce initiative.
Yes, I agree with my noble friend that this is a sign of confidence in the British economy and in the north-east in particular. There is recent evidence of inward investment into this country in a range of sectors—not just cars but also rail, as my noble friend mentioned, renewable energy and steel. The investment comes from a range of countries—Japan, India, Thailand, China, as well as the more traditional sources of Europe and the United States. This is a welcome sign of the rejuvenation of the British economy.
Baroness Armstrong of Hill Top
We in the north-east are very pleased that Nissan, in my home town of Sunderland, is investing even more. It is a real tribute to the quality of the workforce and to the support that Nissan has had—it is proud to acknowledge it—from One North East, which has been so important in getting this investment. One North East is not there any more. What is also not there is a lot of jobs. Sunderland now has an unemployment rate of around 11 per cent and many young people feel that their opportunities have gone for another generation. What will the Government do to make sure that those lives are not written off?
Lord Green of Hurstpierpoint
The noble Baroness points to the significant challenges that we still face in many parts of the country. The north-east is a graphic example of an area that has become overly dependent on the public sector, where youth unemployment is at unacceptable levels and the role that foreign direct investment can play is significant in rejuvenating the economy and creating new job opportunities. Of course that is not the only thing that we need to see but it is a key part of it.
Lord Bilimoria
My Lords, as a proud manufacturer in one of the world’s brewing capitals, Burton-on-Trent, I wonder whether the Government agree with the Leader of the Opposition that British manufacturers should proudly mark their products “Made in Britain” rather than “Made in the EU”, as many of us do at present? Furthermore, what are the Government doing to help improve productivity in UK manufacturing and to learn from the United States, which has bounced back from recession? One of the key drivers there is the United States’ impressive track record of ramping up its productivity.
Lord Green of Hurstpierpoint
The noble Lord makes two very important points, one of which is about “brand Britain”, if I may use that phrase. I have travelled to over 30 countries in the past 12 months and, wherever I go, I find that brand Britain is extraordinarily well appreciated. In the next breath, people will often say, “Where are the British businesses? We would like to see more of them”. I absolutely agree that we should be proud of the “Made in Britain” brand.
We have a continuing task of upgrading productivity. This is about a number of things, including the new Catapult centres and apprenticeship schemes. We need to continue to invest because we are behind the curve in productivity in a number of sectors.
Lord Razzall
My Lords, in this burst of Sunderland euphoria it would perhaps be unkind to ask the Minister whether he agrees with the recently leaked letter from Vince Cable to the Prime Minister on the subject of growth. However, perhaps I may ask whether the Minister believes that the Government are seriously considering the possibility of breaking up the Royal Bank of Scotland, which would, of course, lead to increased lending to the manufacturing industrial sector?
Lord Green of Hurstpierpoint
On my noble friend’s first question, I believe that my right honourable friend the Secretary of State made an important point about a strategy that looks at the various sectors of this economy and identifies the appropriate measures that government can take to support them. It is of course true that while deficit reduction and fiscal consolidation is the most urgent challenge, we need to find a path of growth for this country that is more balanced and stable. On the question of the Royal Bank of Scotland, the answer is clear: we do not believe that breaking up the RBS is the right answer to addressing the financial issues in this country.
Lord Barnett
My Lords, before the Minister sits down, could he tell us what specific strategy his department has to deal in this area of manufacturing with the Chinese, if we are ever to hope to be able to compete?
Lord Green of Hurstpierpoint
The noble Lord raises a very important question. The Chinese are becoming more and more formidable competitors across a range of sectors, and we have to assume that that will continue. For the next generation, they will continue their fast growth and become more and more international. There are two answers to that question. One is to make sure that we are as innovative as we can be—that we move up the value chain, in short. Secondly, we need to be open to Chinese investment in this country. A key priority of my own brief is to encourage and nurture Chinese investment in this country, because they bring capital and, in some cases, expertise, which is valuable to this economy.
Health and Social Care Bill
(12 years, 9 months ago)
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12:44 - Division on Amendment 220A - Ayes: 154 / Noes: 212 - Amendment 220A disagreed.
15:24 - Division on Amendment 223A - Ayes: 165 / Noes: 189 - Amendment 223A disagreed.
17:20 - Division on Amendment 231B - Ayes: 168 / Noes: 91 - Amendment 231B agreed.
18:15 - Division on Amendment 238H - Ayes: 59 / Noes: 146 - Amendment 238H disagreed.
“( ) Until section 8 comes into force, the references in this Part to the National Health Service Commissioning Board (other than the reference in section 95(11)(b)) are to be read as references to the NHS Commissioning Board Authority.
( ) Until the day specified by Secretary of State for the purposes of section 14A of the National Health Service Act 2006, the references in this Part to a clinical commissioning group (other than the reference in section 95(11)(a)) are to be read as references to a Primary Care Trust.
( ) Until section 180 comes into force, the following provisions in this Part are to be read as if the words “and its Healthwatch England committee” were omitted—
(a) section 84(4)(c);(b) section 85(5)(a)(iii);(c) section 96(2)(e);(d) section 100(2)(e).”
Baroness Thornton
“(1B) Annual proper accounts and proper records must be separately prepared and kept which separately detail the income and expenditure derived—
(a) from private charges, and(b) in relation to the provision of services to NHS patients.(1C) “Private charges” means charges imposed in respect of goods and services provided to patients other than patients being provided with goods and services for the purposes of the health service in England.”
Baroness Thornton
My Lords, I start by wishing everybody in the Chamber a happy International Women’s Day.
We turn to the discussion about the private patient cap. We have three amendments in this group, and I will talk to each of them.
Amendment 218A seeks to ensure that proper information is available on private patient income—that is, more than just the final line of total income. This is relevant to ensure that there is no possibility of cross-subsidy from the NHS to the private sector, either directly or by some accountancy magic. There needs to be absolute clarity. As we see new foundation trusts emerge that are neither mental health nor acute-based trusts—ambulance trusts, for example—the issues may be different but the need for transparency and accountability is just the same. This is important for openness and transparency and makes easier the kind of considerations that the governors need to apply. It is also a means of sending a signal that this activity is separate and, at least in some sense, subordinate to the principal purpose, which is to treat NHS patients.
The amendment seeks to delete the part of Clause 163 that brings in the 49 per cent test, which is a new way of making explicit the “principal purpose test” that all foundation trusts have to meet. I think we could all agree that the reaction to the figure of 49 per cent shows how strongly many believe that this is an obvious signal that there should be a great increase in private income that is neither anticipated nor desired. We know that in reality very few foundation trusts even get to 5 per cent, let alone 50 per cent, and there is no immediate prospect of them doing so. It is therefore difficult to see why the Liberal Democrats or indeed Mr Lansley would be so crass as not to see how the 49 per cent figure would be greeted.
There are several dangers with this late pre-Christmas addition to the Bill. It sends the wrong message. We believe that it may tempt bureaucrats and quangos charged with funding to say that some foundation trusts should get less funding as they have not done enough to push up their other sources of income, as we have seen with local authorities that rely heavily on other income. This would be totally wrong and an inappropriate target for the NHS. We also think that there is a danger that high levels of foundation trust income may exacerbate fears of queue-jumping and charging.
There is a serious argument that when private patient income is as the result of innovation and intellectual property, as we all wish to be the case, then high levels of benefit should be shared more widely rather than being kept in one trust. Since the NHS as a whole will have nurtured that opportunity, the NHS as a whole should benefit. A high-performing trust with little or no private income is certainly no worse than any other, and some may argue that it may even be better if its focus is in the right place—that is, NHS patient care. We suspect that this might be an attempt to shift foundation trusts from being NHS providers that focus on NHS patients to some sort of multinational health business, and that their success or otherwise will be measured against a new benchmark of how much private patient income they generate.
Of course we recognise the special place that some of our leading hospitals have in the high private patient cap that they need to reflect their partnerships with research and other institutions across the world. None of these amendments seeks to diminish that—indeed, quite the reverse—but those hospitals will only ever be a small number, and the amendments address the majority of foundation trusts.
In Committee I asked the Minister for any evidence of benefits to NHS patients. It seems that the Government were just relying on claims made by a number of foundations trusts eager to expand. One day perhaps a proper independent study will be carried out. Some would say that independent studies into claims that foundation trusts are more innovative or that they improve faster than non-foundation trusts have been disproved by evidence. The real test is how private income benefits NHS patients, and that is not the same as benefiting the organisation or the prestige of some of its senior staff. Removing the 49 per cent and relying on the principal purpose, plus the role of governors, is a much better route to providing the flexibility that is needed to change private patient income caps. Our Amendment 220C addresses that issue, and it has been the subject of much discussion. I hope that the misrepresentation of that amendment, particularly by the Prime Minister, will not be repeated here. We accept the need for flexibility, and were looking at this matter when in office.
Lord Marks of Henley-on-Thames
My Lords, this group of amendments is on the question of foundation trusts’ private income cap. All of us are agreed that the number of private patients and the amount of private income are important considerations for foundation trusts. The risks to the NHS of too much private income and private treatment in foundation trust hospitals are clear and perhaps do not need rehearsing at length. If too many beds in such hospitals are taken up with private patients, unless we are very careful, that may limit accessibility of those beds to NHS patients. The development of foundation trust hospitals with an unusually great proportion of private income may—again, unless we are very careful—threaten to undermine the commitment to reducing health inequalities that runs through the Bill. Emergence of “star hospitals” could threaten other hospitals in the region.
Finally, the threat of foundation hospitals being subject to EU competition law would have been greater if it were possible to have foundation trust hospitals a majority of whose income was private; that, at any rate, is our view. This is one of the principal reasons for the cap on caps, by which the principal purpose of foundation trust hospitals can only be fulfilled if more than half of foundation trusts’ income is NHS income. That is the so-called 49 per cent.
I say to the noble Baroness, Lady Thornton, that the only reason that that majority provision can be said to send the wrong message is that, sadly, some in her party have taken to the airwaves to say that there is a hidden agenda to the Bill by which the Government seek to make national health foundation trust hospitals have 49 per cent of their income from private patients. There is no such hidden agenda. Frankly, it has not been responsible politics to raise people’s fears by going around the country suggesting the contrary.
Baroness Thornton
Does the noble Lord think that it was necessary to put 49 per cent in the Bill? Why did the Government have to put a percentage in at all? Does he think that the communication issues, as it were, around this were handled very well?
Lord Marks of Henley-on-Thames
My Lords, on these Benches we take the view that it was sensible to include this provision. The advice that we have is that the risk of the application of competition law is reduced by ensuring that the majority of income for NHS foundation trust hospitals will always be for the purpose of treating NHS patients. It is not an absolute guarantee but it is a sensible risk-reduction exercise and it was put in for that purpose. There is no point in taking a risk unnecessarily. The communication problem has frankly been the result of the efforts of opponents of the Bill, partly in the party of the noble Baroness, in stressing the 49 per cent and suggesting that it is the purpose of the Bill, which, as I say, it is not.
That is not to say that private income in NHS foundation trusts is bad. The Labour Government recognised that throughout. In her speech, the noble Baroness herself very properly recognised it. Private income represents an opportunity for foundation trusts to attract innovation, to buy new and expensive equipment and to develop world-class centres of excellence. We recognise and applaud those features of private income. However, when tabling Amendment 220B, we were concerned that there should also be an individual arrangement for foundation trusts by which individual limits would be subject to agreement with Monitor.
Lord Campbell-Savours
Will the noble Lord explain, in very simple language that people outside can understand, what is to prevent a central London teaching hospital with an international reputation ending up taking almost half its business from overseas patients who pay by private means?
Lord Marks of Henley-on-Thames
I take the noble Lord’s question to mean: why should a proportion not exceed 50 per cent? As I have explained, the reason is that we regard that as having a risk. If the question is why should a central London hospital not take nearly half its income from private patients, the maximum taken at the moment is, I believe, some 39 per cent. There is a limit of 5 per cent on any increase to be proposed, more than which the governors would have to agree to by a majority. It could not just be a simple majority; a majority of the governors must vote to approve the change. It may well be that some hospitals will wish to go nearer to 50 per cent, which is why there is a reference to 49 per cent.
Lord Campbell-Savours
So that we can have it absolutely on the record, is the noble Lord saying that a teaching hospital in central London—
Lord Marks of Henley-on-Thames
My Lords, I believe that I have answered the question. I accept that it is important. We believe that the provisions that are now to be in the Bill, given the government amendments and an assurance that I hope to receive from the Government, will cover the position.
I was explaining that, when we tabled Amendment 220B, we believed that there should also be an individual arrangement for agreement with Monitor so that all considerations could be balanced when considering any substantial increase in private income. However, in discussions, the Government agreed to respond to amendments that Liberal Democrat Peers tabled in Committee on the involvement of governors. Those amendments that the Government now pursue—Amendments 220BZA and 220BZB—represent that response. They ensure that any increase of more than 5 per cent would have to be approved by the governors voting, as I say, by a majority. The governors have to be satisfied that the plans put forward by the foundation trusts for attracting private income would not interfere with the treatment or welfare of NHS patients. I suggest that that scheme represents a devolved, local scheme that is consonant with the structures in the Bill and the desire to keep local decision-making at a local level.
There may still be concern that the governors of individual foundation trusts will primarily have in mind the concerns of their own foundation trusts. However, under amendments that have been agreed, Monitor is now to have continuing powers of supervision and intervention over foundation trusts. If we are assured that in every case where the governors approve a proposal for an increase in private income in excess of 5 per cent Monitor will consider whether the interests of NHS patients as a whole are to be safeguarded, and if it is not so satisfied it would intervene, I suggest that that assurance will meet that concern. We will not move Amendment 220B but we seek that assurance from my noble friend the Minister.
Baroness Finlay of Llandaff
My Lords, I have an amendment in this group. I recognise that it is badly worded and simplistic and I shall not be moving it. However, I would like to address other amendments in this group which are far better worded than mine. The adversarial debate that we have had has been unconstructive in view of the importance of the amendments we are discussing. Amendment 220C has the great advantage of involving all stakeholders. Some people will be affected when the balance of provision within a foundation trust changes. I am concerned about the amendment to which the noble Lord, Lord Marks, has just spoken because, as he admitted, the concerns of the foundation trust governors may be paramount as it is in their interests to look after their foundation trust and therefore the interests of others will be secondary in their minds. However, it is important to know what the local health and well-being board thinks about a proposed change, and that the clinical commissioning groups are involved and consulted on what could effectively be a change of provision.
I make it clear that I am not opposed to foundation trusts having private patient business. Indeed, I can see that it would be beneficial to all patients if we were to revert to the position that applied 30 years ago when these bodies were completely integrated. If highly specialised consultants provide outpatient and inpatient services to private patients on one set of premises in an area, they are on hand when things go wrong or an opinion is needed on a patient who has come in as an NHS patient. By driving some private provision outside that hospital campus, those consultants may be unavailable when they are needed because they are on premises down the road or they are on the end of a phone and cannot run down the corridor, see the patient and plan what is to happen strategically with the rest of the team and then monitor it.
An issue that has been resolved is the situation where a UK patient receives private treatment but something goes wrong and they need to go into intensive care, a renal unit or some other unit provided by the NHS. That previous episode of care has finished, they are now in a new episode of severe critical care and they go in as an NHS patient. That integration is therefore solved. But I hope that the Government will look kindly on Amendment 220C, despite some of the tone of the debate, because it ensures that all stakeholders are involved in the discussion. The change in provision is therefore planned and can happen smoothly and that decision is not taken on business grounds alone but can be for the benefit of the whole population that is being served.
Baroness Murphy
My Lords, it is evident that everyone around this House who has participated in the discussions on the Bill in effect wants the private patient and other private income to be of benefit to and contribute to institutions whose primary focus, not just their duty, is to public patients. That is what we have all been trying to achieve and it is a matter of finding the right words. Actually, I was going to say to the noble Baroness, Lady Finlay, that I quite liked her Amendment 220. The amendment might not have the right wording but it encapsulates exactly the principle that we are trying to get into the Bill. The amendment is admirable.
I do not have any problem at all with Amendment 218A, which is about accounts, because foundation trusts already produce very detailed accounts in order to indicate to Monitor how near or far they are from meeting their existing private patient cap, which is carefully monitored. Those sorts of accounts are already there. The only difficulty is that accounts, being made up by accountants, do not always reflect which service line is supporting another service line. Therefore, I am not quite sure that requiring this great detail will do quite what the opposition Benches hope. However, in principle, I see nothing wrong with the amendment.
It is worth while remembering all the time during these debates that we are talking about a situation where the vast majority of hospitals—apart from a handful of internationally renowned specialist hospitals in London and the suburbs and in one or two other cities outside—have a private patient income of about 2 per cent. That is not likely to change very much. However, we need to add something that is reassuring because we all understand the anxieties out there. Amendment 220BZB, in the name of the noble Earl, Lord Howe, is an excellent solution. The change to a 5 per cent limit during the year means that there will be no great energy thrown at changing this area, which is the most important thing. We want the board of the hospital and the governors to focus on public patients. If they have some other income coming in from private activity, that is fine, but we do not want them suddenly to throw a lot of energy at it. Therefore, I think that 5 per cent is about right. I know that some foundation trusts have asked for 10 per cent, but 5 per cent is fine.
Requiring hospitals to warn everyone in advance what they are going to do is also helpful. I seek reassurance from the Government that that will still protect the confidentiality of plans, because I know that trusts have expressed anxiety about that. However, I cannot see any problem with it.
The reason that I prefer the amendment of the noble Earl, Lord Howe, to Amendment 220C is because his amendment involves the governors. Crucially, they are the people responsible for the institution, whereas Amendment 220C involves the much wider membership—often 10,000, 12,000 or 20,000 members. That is just too unwieldy a group to be seriously involved in the governance of an organisation. They are vital people in getting local communities to be involved in and have knowledge about the hospital but they would not be the right people when it comes to these sorts of changes.
I support much of what the noble Lord, Lord Marks of Henley-on-Thames, has said, but I am attracted to the Government’s amendment, which solves the problem that we are all looking for a solution to.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)
My Lords, this has been a good and constructive debate on NHS foundation trusts. It is right that we should focus on the removal of the private patient income cap, as I am acutely aware that that is where the majority of noble Lords’ concerns lie.
We need to focus on one core point at the outset. Fears have been expressed that removal of the cap could see foundation trusts increasing private income at the expense of NHS patients—in other words, that it could create a two-tier NHS, with those who can afford to pay going to the front of the queue. That is wrong and, I believe, alarmist. There are robust safeguards in place to prevent that kind of outcome.
Allowing a foundation trust to generate more private income does not release it from its prime duty to its NHS patients. Foundation trusts will still have to meet their legally binding contractual obligations on waiting times and provide the highest standards of care for NHS patients. Foundation trusts themselves are very clear about that. Removing the private patient income cap would allow them to bring extra investment in infrastructure and leading-edge technology to benefit NHS patients. Today, foundation trusts can be prevented by the cap from treating private patients who wish to be treated at the trust even when the income that the trust would earn would support its NHS services. The point made by the noble Baroness, Lady Finlay, was absolutely spot on. The cap leads to the ridiculous situation where NHS consultants are forced to get into their cars to drive to independent providers to perform private patient work in their non-contracted hours. Removing the cap would improve clinical safety for all patients in NHS hospitals, because doctors would be more likely to remain on site for longer.
It may well be, as the noble Baroness, Lady Murphy, pointed out, that most foundation trusts will not be affected at all by the removal of the cap. Many of them are earning below their caps at the moment. It is worth noting that NHS trusts, as distinct from NHS foundation trusts, which are not subject to a cap at all, are not earning proportionately more than corresponding foundation trusts. The point is that removing the cap gives the most innovative organisations the opportunity to boost income for NHS services.
I can also assure the House that we have put in place substantial safeguards to protect NHS patients. NHS foundation trusts will remain first and foremost NHS providers. Their principal legal purpose, to treat NHS patients, has been in legislation since 2003. I tabled an amendment in Committee to clarify its legal meaning. A foundation trust’s principal purpose requires it to earn the majority of its income from the NHS. That is very different from saying that 49 per cent of the work of foundation trusts will be with private patients, as some have misinterpreted it. The Bill does not mention 49 per cent, as I hope the noble Baroness is aware. Amendment 220A would remove the clause. That would be most unfortunate, because its effect would be to leave governors and local communities unclear that foundation trusts must remain predominately NHS providers.
There have been worries that the internal governance of foundation trusts will not be strong enough to exercise the requisite control in that area. I hope that I can provide reassurance on that point. As the local community's representatives, it is the responsibility of the governors to hold the board to account for its management of the trust. The governors should also consider whether the level of private activity is in the best interests of their organisation. The Bill will ensure that governors are better able to do that. It strengthens their arm by giving them new powers to hold directors to account and, if necessary, to remove the chair and non-executives of the board of directors. It would be entirely appropriate for the governors to use these powers if they felt that non-NHS activity was not operating in the interests of NHS patients.
At this stage, I should like to thank my noble friend Lord Clement-Jones for setting out a very persuasive case for adding to governors’ powers to oversee a foundation trust’s private income. I have tabled an amendment, which I hope will address his concerns, requiring directors to detail in the trust’s annual plan—that is, the forward look—any proposals to earn private income and the income that they expect to receive. By law, directors already have to take into account governors’ views in preparing this plan, but this amendment would place an explicit duty on governors to consider the plan and be satisfied that any proposals to increase private income would not significantly interfere with their foundation trust’s principal legal purpose to treat NHS patients.
With regard to the point raised by the noble Lord, Lord Campbell-Savours, a plan to increase private income substantially—that is, to increase by 5 percentage points or more the proportion of total income earned from non-NHS activity—must secure agreement by a majority of governors in a vote. For example, governors would be required to vote where a foundation trust planned an increase in non-NHS income from 2 per cent to 7 per cent or more of its total income, or from 3 per cent to 8 per cent or more. To make it quite clear, the vote would be triggered by plans for large increases in non-NHS income. Other matters, such as significant transactions, are for foundation trusts to decide. These proposals would complement the amendment that we introduced in Committee to require directors to explain in a foundation trust’s annual report how private income had benefited NHS patients.
Lord Campbell-Savours
We all know of cases where in the real world GPs have said to their patients, “Go private and go early. Effectively, jump the queue”. That is going on all over the country and in certain parts it is happening on a great scale. If that is the case, what is to stop GPs working with governors and consultants to try to move patient activity more towards the development of private operations within National Health Service facilities? Will the impetus not come from GPs working in conjunction with consultants and governors who might be sympathetic to the cause?
Earl Howe
With respect to the noble Lord, perhaps I may point to a later group of amendments in the name of my noble friend Lord Phillips, which gets to the heart of that question. I do not think that the noble Lord’s question is directly related to the private patient income cap but, if I may, I should like to cover the answer to it when we reach the later group.
Baroness Thornton
This goes back to the maths, which partly relates to the question that I asked the noble Earl earlier. I think that the Minister and his colleagues may need to look at what his proposals actually say about the proportion. His amendment refers to 5 per cent, and I am not sure that that is not a very tiny amount. I do not want it to be a particularly big amount but I am not sure that the Bill says what the noble Earl says it says. That is the clarification that I need.
Earl Howe
I shall gladly seek clarification and, if I have misled the noble Baroness, I apologise. By the time we reach the end of the debate, I shall have made doubly certain that what I said was correct. I hope that the approach that I have just laid out will allay noble Lords’ concerns, subject to any clarification that I am able to offer the noble Baroness. I am now told that I was absolutely right in what I said.
One thing that these arrangements may well do is nurture the working relationship between directors and governors. I think that they would help to ensure that directors worked collaboratively with their governors to develop non-NHS activity in the best interests of NHS patients. A planned increase of 5 percentage points or more in one year would be a very significant increase in non-NHS income for any foundation trust. Such an increase would certainly be due to a major development becoming operational, such as a new private patient facility. Requiring governors to vote on such a significant development strengthens directors' accountability to their local communities. However, I take the point made by the noble Baroness, Lady Murphy, about confidentiality. In all of this, we should be aware that the strengthening of the governors' oversight in this way places increased responsibility on the governors to maintain an appropriate level of confidentiality while a new project is initially developed. I would expect the directors and governors to ensure that a foundation trust's constitution would protect that.
Lord Avebury
I am sorry if I am a little late in raising this point. The Minister was talking about the burden that would be placed on the accounting system by having separate accounts for the private sector when it was a small proportion of the total. How will the person scrutinising these accounts know what the profitability of that private work is when that small amount of the total is not separately itemised in the accounts?
Earl Howe
We would certainly expect boards of directors to satisfy themselves on that point through management accounting systems and, if necessary, produce the relevant evidence to governors, if a question were asked about that. I think that the point that we were alive to was the cost involved in compelling all foundation trusts—some of them hardly have any private income at all—to go to the trouble of producing statutory accounts and separating out those two income streams. Although my noble friend’s question is well placed, it is perhaps a different question from the one that I was addressing.
We can allay all these anxieties in this area through one simple principle, and that is transparency. Today, I have tried to set out an open and transparent regime for the oversight of a foundation trust’s planned increase to non-NHS income. The governors, as representatives of local communities, would hold the directors to account for ensuring that non-NHS activity does not significantly interfere with their foundation trust’s principal legal purpose to provide NHS services. I think our proposals strike the right balance between the powers of the directors—
Baroness Williams of Crosby
Before the Minister concludes, perhaps I may press him on what is implicit in Amendment 220B, although I shall not move it. If, for example, the governors were to oppose a figure of more than 5 per cent, and the figure were greater than appears to be proper in the light of health services, what steps would be available to ensure that health services are protected?
Baroness Northover
As we are on Report, perhaps noble Lords will allow the Minister to develop his argument and then put brief questions in the light of what he said—otherwise he will lose his train of thought.
Lord Hunt of Kings Heath
My Lords, I hesitate to take issue with the noble Baroness because clearly she is in a position to help the House. However, interventions on Report are quite allowed. I am very puzzled that the Government are trying to seek to rule that Report stage procedure should change so that we simply listen to the Minister. That is not Report.
Baroness Northover
My Lords, I am not saying that short questions cannot be put. However, it might be beneficial to the House if the Minister were able to develop his argument. Then, if noble Lords had questions that he had not addressed, that would be the relevant time to put them.
Baroness Northover
That is what the noble Lord, Lord Hunt, preferred when he was a Minister. I hear from around the House some sympathy for the point. If the suggestion does not work, no doubt we can take the matter to the Procedure Committee and look at a different way of doing things.
Lord Hunt of Kings Heath
My Lords, the noble Baroness is not in a position to dictate to the House that it should change its procedure on Report. Surely the beauty of debate lies in interventions, and responses by Ministers. When I was a Minister for 10 years at the Dispatch Box, I always took interventions and welcomed effective and proper debate. I am on my feet—
Baroness Northover
For clarification, perhaps I may remind the noble Lord that the Companion sets out that a Member shall not speak after the Minister on Report,
“except for short questions of elucidation to the minister”.
I realise that noble Lords are putting short questions of elucidation. The Minister made it clear that he wishes to make progress and that at the moment he does not wish to take interventions so that he can develop his argument.
Baroness Northover
He certainly did to me. Perhaps the Minister would like to make it clear—if he wishes to be interrupted many times and not develop his argument, so be it. Perhaps my noble friend would like to clarify—
Lord Campbell-Savours
I object to the procedures of the House of Lords being changed by a junior Minister.
Earl Howe
My only frustration was that I was getting to what my noble friend wanted me to cover but she did not give me the chance to do it. Otherwise, I am more than happy to take questions from noble Lords on points of clarification.
I was explaining that governors, as representatives of local communities, will hold directors to account for ensuring that non-NHS activity does not significantly interfere with the foundation trust’s principal legal purpose, which is to provide NHS services. Our proposals strike the right balance between the powers of the directors and the responsibility of the governors.
The answer to my noble friend’s point, and that of my noble friend Lady Williams, is that Monitor will publish guidance for NHS providers on the requirements it sets for them to maintain the continuity of NHS services. We fully expect this guidance to cover conditions for foundation trusts relating to the need to ensure that the continued provision of NHS services is not put at risk by non-NHS activity. As the House will know, foundation trusts will be required to demonstrate how non-NHS income contributes to the foundation trust’s delivery of improved NHS services. In particular, if a foundation trust is increasing its non-NHS income by more than 5 per cent of its total income in a year, we will expect Monitor in every instance to review whether there is any cause to intervene in order to safeguard the ongoing provision of NHS services. This will be in addition to the required scrutiny and approval by the foundation trust’s governors. I hope that fully reassures my noble friends that this matter is not just a question that will be looked at within the confines of a foundation trust. It will have wider exposure than that.
I am afraid I am going to disappoint the noble Baroness, Lady Finlay, not as regards her amendment, which she did not speak to, but as regards Amendment 220C. The problem with it is that it would give Monitor the discretion to agree private income caps for foundation trusts. It would also retain the current cap and, as I have indicated, we think that the cap is unfair and has definitional complexities. That is an undesirable road to go down. It would burden foundation trusts with a governance regime that would be bureaucratic, costly and at odds with a foundation trust’s ability to manage itself.
Requiring governors to vote on any increase to their trust’s private patient cap, and therefore any increase to non-NHS income, would unreasonably inhibit the board of directors’ ability to manage its organisation. We surely do not want foundation trusts being run by boards that are constantly requiring votes by governors. The proposal in Amendment 220C would also require a majority vote by the members of a foundation trust for any increase to the trust’s private patient cap. That is a completely misguided approach. It would undermine the authority of the governors. Governors represent the members, the majority are elected by the members, and they should be allowed to get on and fulfil their responsibilities.
Securing a majority vote by members would also be very expensive. Many foundation trusts have several thousand members. Do we really want scarce NHS resources being spent on polling members about any increases to non-NHS income? I gently ask noble Lords opposite to think again about that.
Finally, Amendment 220C proposes that Monitor should be required to approve any increases to private patient caps beyond 5 per cent. My objection to that is that it would undermine foundation trusts’ autonomy to manage themselves. Directors and governors are better placed than Monitor to decide what is best for their organisation. Monitor’s involvement could also dissuade foundation trusts from pursuing innovative approaches if they are required to go through an external assessment and, in effect, a second approval process.
The central point is this: Part 4 has been built on the experience of what foundation trusts know will work. It represents the opportunity to realise what value foundation trusts can bring to the NHS. It will enable them to develop as responsive, transparent, autonomous and accountable bodies. Removal of the private patient income cap is about foundation trusts making the most of the opportunities they have to earn additional income for investment in the NHS. It is precisely why many NHS leaders and clinicians wrote an open letter to this House urging support to remove the cap. I hope that what I have said will reassure noble Lords that we have the right checks and balances in place while also giving foundation trusts the freedom that they need and have asked for. I also hope that the noble Baroness will feel able to withdraw her amendment.
Baroness Thornton
I thank the Minister for those remarks. I might be able to make him happy at least in one or two respects. This has been an interesting and useful debate, but I would like to start by making two comments. The first is about the remarks made by the noble Lord, Lord Marks. I know that he and his colleagues have been frustrated about the interpretation that has been put on the 49 per cent. The noble Lord spoke about that being there to mitigate risks. The only point that I would make to him and his colleagues is that the opportunity to mitigate those risks was there earlier this week, and they did not take it.
I would also like to apologise to colleagues on the Cross Benches if they have found the adversarial style in this part of the Bill unhelpful. On these Benches, it partly stems from our very grave disappointment that we have not managed on Report to protect the NHS in the way that we felt was necessary. I am afraid that those arguments are political arguments and the arguments that we have had to have. I put that on the record. I do not apologise for the fact that they have been political, but I apologise to my colleagues that sometimes they have not been entirely comfortable with that.
Lord Turnberg
“(c) the promotion of education and training”
Lord Turnberg
My Lords, this amendment brings us back to the subject of education and training. We had long debates on education and training earlier in the considerations on the Bill. The Government went a very long way when they accepted earlier amendments that set out the duties of the Secretary of State, the Commissioning Board and the clinical commissioning groups, as well as private providers. I am extremely grateful for the acceptance of those amendments.
This amendment simply completes the task by placing the same responsibility on foundation trusts. Foundation trusts have great freedoms but as so much of the education and training of doctors and nurses takes place there, there should be a straightforward indication in the Bill that education and training is an important part of their role too.
I commend this amendment to the noble Earl. I know that an earlier amendment might be thought to have covered foundation trusts too, but they are right at the centre of this. They are key responsible funders and supporters of education and training. Most of it goes on there. I hope that this amendment will find favour and I hope that the noble Earl will take this kindly.
Baroness Finlay of Llandaff
My Lords, we have, I hope, threaded education and training through the Bill and established it as a core principle for all providers.
In support of the comments by the noble Lord, Lord Turnberg, it is essential to place on record that the vast majority of specialist training for all those specialties in secondary care occurs in those places that will have foundation trust status, if they do not have it already. That future investment in the specialist workforce to provide services is essential and there is merit in restating the importance of it.
Baroness Wall of New Barnet
My Lords, I also support the amendment. Adding to what the noble Baroness, Lady Finlay, has said, the House may be aware that trusts are now committed to quality accounts, certainly for clinical staff, and an integral part of those quality accounts is education and training. I would like to see it being widened beyond the clinical staff, because there are lots of staff in a hospital who need that constant education and training, to make sure that patient care overall is as good as we would all want it to be.
Lord Hunt of Kings Heath
My Lords, I refer to my chairmanship of a foundation trust. From the opposition Benches, we very much support this amendment and wish to reinforce the importance of education and training.
It is right that we should emphasise the importance of NHS foundation trusts recognising their responsibilities in relation to education and training. It is equally important that they have an influence over the architecture for education and training. As the noble Earl will know, there are going to be local boards responsible for commissioning the education and training of professional people. It is very important that the people who run hospitals should be very much involved in the selection of students and ensuring that the curriculum is effective. The noble Earl will know that the Future Forum paper chaired by the chief executive of University Hospitals Birmingham NHS Foundation Trust emphasised the importance of looking at these matters.
We will be debating the quality of nursing next week, but there is no doubt that there is a real problem with public perception of the quality of nursing in particular, and issues to do with nutrition and basic nursing skills. I am convinced that there is a real problem that the universities that train our nurses, in the end, are much more focused on academic practice, because that is what universities do. I am anxious that no one has been able to put their finger on the solution. One way of improving the quality is to involve the foundation trusts much more in these matters. My noble friend’s amendment is very helpful in that respect.
Earl Howe
My Lords, as noble Lords will know, we have had a number of earlier discussions about education and training and I welcome this new opportunity to return to the subject. As the noble Lord, Lord Turnberg, is aware, we are putting in place what we see as a strong national system for education and training, with a strengthened focus on quality outcomes.
In the Bill we have introduced a clear duty on the Secretary of State to ensure that such a system is in place. We are now making good progress in establishing Health Education England and the local education and training boards. We are acutely aware of the importance of a safe transition to the new system. We are proceeding with care and at a sensible pace to ensure that the new system is fully up and running by April 2013.
We have also introduced amendments to strengthen links with the wider system. Our Amendments 61 and 104, which were accepted in an earlier debate, place duties on the board and on clinical commissioning groups to have regard to the need to promote education and training. They are designed to ensure that commissioners of NHS services consider the planning, commissioning and delivery of education and training when carrying out their functions.
We also accepted an amendment tabled by the noble Lord, Lord Patel, to strengthen co-operation among providers of NHS-funded services, which would place a duty on commissioners to ensure that any person providing services as part of the health service would have to co-operate with the Secretary of State in the discharge of his education and training duty, or with any special health authority discharging that duty—that is, Health Education England. This aims to ensure that providers, too, play an active role in education and training.
The noble Lord, Lord Hunt, spoke with his customary authority on this subject and I agree with what he said. I particularly agree that employers best understand the workforce they employ and the kind of workforce they want to employ. They also understand the need to link service planning and workforce planning. They are able to focus on the whole workforce and to recognise the levels of contact with patients and service users, and the varying local needs. Evidence from other sectors and feedback from providers has been clear that in order to deliver successful and responsive world-class services, employers need to have clear ownership and involvement in the education and training and planning of their workforce. I am entirely at one with the noble Lord on that.
Employers have welcomed our plans for education and training. They believe that this approach should provide real opportunities so that healthcare providers have the right incentives to secure the skills that they wish to have, invest in training and innovate to improve the quality of services that they provide. They welcome the opportunity to have the incentives to align service, financial and workforce planning, and to have greater flexibility to respond to the strategic commissioning intentions of the NHS Commissioning Board and clinical commissioning groups.
The NHS Confederation, NHS Employers, Foundation Trust Network and the Association of UK University Hospitals all support a system that provides greater accountability for employers. Strategic health authorities are working with employers to support them in developing these local partnerships so that they can take full responsibility for workforce planning, education and training.
I hope that that is of reassurance to the noble Lord, Lord Turnberg. What is happening on the ground almost pre-empts the speech he so articulately made. We are rapidly moving towards the kind of system to which he and other noble Lords aspire. Having secured the amendments that are already in the Bill, we do not believe that it is necessary to build in any more. On the strength of what I have said, I hope that the noble Lord will feel comfortable in withdrawing his amendment.
Lord Turnberg
My Lords, I am well aware of the lengths to which the Government have gone to support education and training, for which I am truly grateful. I am also aware that earlier amendments might appear to have covered the points that I raised about the need for foundation trusts: there is a particular recommendation for them. I am a little disappointed that my amendment cannot be accepted but I understand the reasoning. The foundation trusts are key providers and, therefore, it should be clear to them that they have this responsibility. I know that they are willing providers of education and training but it should be in the Bill. However, I beg leave to withdraw the amendment.
Lord Hunt of Kings Heath
“( ) for “The” substitute “An”,”
“(3B) Each document prepared by an NHS foundation trust under paragraph 27 of Schedule 7 (forward plan) must include information about—
(a) the activities other than the provision of goods and services for the purposes of the health service in England that the trust proposes to carry on, and(b) the income it expects to receive from doing so.(3C) Where a document which is being prepared under paragraph 27 of Schedule 7 contains a proposal that an NHS foundation trust carry on an activity of a kind mentioned in subsection (3B)(a), the council of governors of the trust must—
(a) determine whether it is satisfied that the carrying on of the activity will not to any significant extent interfere with the fulfilment by the trust of its principal purpose or the performance of its other functions, and(b) notify the directors of the trust of its determination.(3D) An NHS foundation trust which proposes to increase by 5% or more the proportion of its total income in any financial year attributable to activities other than the provision of goods and services for the purposes of the health service in England may implement the proposal only if more than half of the members of the council of governors of the trust voting approve its implementation.”
Lord Phillips of Sudbury
Lord Phillips of Sudbury
My Lords, in moving this amendment I shall speak also to Amendment 220BB. If passed, they will amend Section 44 of the National Health Service Act 2006, which deals with private healthcare. I am supported in these amendments by three highly distinguished consultants: the noble Baroness, Lady Finlay of Llandaff, and the noble Lords, Lord Kakkar and Lord Darzi of Denham. Indeed, I would not have had the confidence to persevere with the amendments if it had not been for their support, which I did not canvass. Each of them volunteered to support the amendment and I am much reassured by that because, if I can put it this way, they know what they are talking about and I do not. They live in the health world and have a great deal of engagement with the National Health Service, and for at least two of them, I think, they have a private engagement as well.
The fact is that there is an abuse which should be dealt with more effectively than it is at present: the abuse which some might call queue jumping. I am not in a position to say that it is widespread. I would like to think that it is not and that it happens only rarely. However, there is no doubt that there is queue jumping, and I know from many doctors—I have relatives who are doctors—that it is a phenomenon of the status quo. My position is that, on any reckoning, this legislation—this 450-page statute—is a major upheaval of the National Health Service. It seems bizarre that it should at no point include a clear statement of this fundamental principle of the National Health Service. I should say that the wording of Amendment 220BB is somewhat different from the wording in the amendment—Amendment 299B to Clause 162—that the four of us tabled in Committee. The amendment now talks of,
“equality of access to essential clinical care and treatment”.
As I say, that is a principle which I do not think anyone disagrees with. It is a paradox as clear as the nose on your face to have a National Health Service that actually favours private clients over national health patients. To be fair to my noble friend the Minister—who, as always, has been extremely accommodating in discussing this—he accepts absolutely that the Government wholly support the principle and wish to uphold it. The difference, I suppose, lies in how to do that.
Lord Kakkar
My Lords, I support the amendment moved by the noble Lord, Lord Phillips of Sudbury, to which I have added my name. I refer to Good Medical Practice, the document produced by the General Medical Council, which sets out the principles and values on which good medical practice is founded. Indeed, it is the document to which we as clinicians are obliged to practise. In so doing, I remind noble Lords of my own entry in the register of interests as a consultant surgeon at University College London Hospital NHS Foundation Trust, an institution that has a private healthcare facility that might avail itself of any change in the cap on private income.
In paragraph 9, Good Medical Practice makes important reference to decisions about access to medical care. It states very clearly that, as a clinician,
“you must give priority to the investigation and treatment of patients on the basis of clinical need, when such decisions are within your power. If inadequate resources, policies or systems prevent you from doing this, and patient safety is or may be seriously compromised, you must follow the guidance”,
elsewhere when raising your concerns. I support the amendment because it provides an important opportunity to place on hospital managements and healthcare systems in the National Health Service the same obligation that currently rests on clinicians: their absolute obligation to provide and take decisions about access to treatment on the basis of clinical need and priority.
It is not entirely clear that hospital managements have that same obligation. In promoting this amendment, one hopes that that obligation will be placed on hospital managements in such a way that in future, when there may be greater opportunity for income from outside the funding of the National Health Service—private income—into NHS institutions, no opportunity arises for pressure to be applied to clinicians. For instance, when there is limited access to operating lists or scanning facilities, and where two patients—one an NHS patient and the other a private patient—need to avail themselves of those facilities, the decision might be taken by the hospital management that preference be given to the private patient because it could provide further income for the NHS institution. When accessing facilities that are essential for clinical care, the same principle must always apply: the clinician uses their clinical judgment to determine on the basis of clinical need alone, rather than any other financial consideration for the institution, that the patient with the greatest clinical need at that particular moment is able to avail themselves of the necessary facilities. I hope that Her Majesty’s Government are able to ensure that that principle is enshrined or at least properly and effectively known so that there may be no misunderstanding in this matter in future.
Baroness Finlay of Llandaff
My Lords, I also have my name down on this amendment. I follow the same theme as my noble friend Lord Kakkar, who has just spoken. Good Medical Practice states:
“You must be honest and open in any … arrangements with patients”.
We have already discussed a duty of candour in relation to errors. There is also a requirement to give patients accurate information, as the noble Lord, Lord Phillips of Sudbury, has already said. Giving a patient information about what is available to them can entail informing them, for example, that other drugs are available but not currently funded by the NHS, or that clinical trials are available that they may wish to consider going into. You must answer the question, “Would I get treated quicker?”, honestly and with factual, correct information.
Of course, as has already been said, such stringent criteria do not apply to hospital managements. It would easy for them to see that there is something to be gained by increasing the private patient provision. I hope that this amendment encapsulates within it, in much more sophisticated wording, the spirit that I tried to capture in Amendment 220, which I withdrew. That spirit was to state that the provision should not be to the detriment of NHS patients. That is a fundamental principle that should go right the way through. I know that my wording was inadequate.
Lord Warner
My Lords, I have been puzzling about the practical effect of this particular amendment. I will pose a number of questions to the Minister but also to the movers of the amendment. In the real world, which some of us occupy, it has always been the case that, as we live in a democracy, people can use some of their disposable income to get diagnosis of a condition as quickly as possible. Sometimes, in some parts of the country, the NHS is unable to provide that diagnostic service as quickly as some people might want it. They are entitled as citizens to use their disposable income to, for example, get an MRI scan after a sports injury or where they suspect that elective surgery may be needed.
In those circumstances, they may be under the jurisdiction—if I may put it that way—of a consultant who works in the NHS and also has a private practice. Again, there is nothing evil about private practice. It was enshrined in the 1948 legislation by a Labour Government. This kind of conundrum has been around for some time. However, the technology has moved on with things such as MRI scans. You can often accelerate the diagnosis of a person’s condition. I welcome being corrected on this and seek the Minister’s guidance, but, as I understand it, if I as a citizen get my MRI scan from the guy near Waterloo station, that is usually at a unit price a bit lower than the cost to the NHS.
I would like to finish my line of argument. I can see that the noble Lord, Lord Phillips of Sudbury, is ready to pounce on me for daring to challenge this, but I listened patiently to his line of argument and would like him to listen patiently to mine before he bursts in. I am happy to take an intervention in a minute, but let me first deploy the argument.
Let us say that I get my MRI scan and am aware of a consultant in an NHS hospital who can respond to my sports injury—a fanciful thing, given my age—and this consultant is practising in a foundation trust but also has facilities to practise in a private hospital. I may be quite badly injured, with a cruciate ligament injury. What happens under this amendment? Does it mean that the only safe thing for the consultant to do, in case he gets called up before the GMC, is to treat me, however urgent my case is, in the private hospital? Or does he, despite his clinical judgment, have to seek the approval of the foundation trust management and compare me against all the other people who may be on the waiting list? Let us be real—waiting lists will be rising as we move through the kind of financial circumstances that the NHS faces. If we make this amendment to the Bill, those consultants will be put into a rather difficult position in those kinds of circumstances, which are not fanciful. That is a question for the noble Lord, Lord Phillips of Sudbury, but I would welcome the Minister’s view as well.
Lord Phillips of Sudbury
I did not want to leap on the noble Lord, Lord Warner, because that would do him an injury, but I wanted to assure him that the amendment does not affect his trotting off to the chap down at Waterloo station. He can buy whatever private patient care he likes, wherever and whenever he likes—
Baroness Northover
I remind my noble friend that he can reply on his amendment at the end. I am sorry to keep on intervening on my noble friends in defence of the noble Lord, Lord Warner, who wanted to continue his argument, as he did. My noble friend has the opportunity to respond at the end.
Baroness Murphy
I have concerns similar to those of the noble Lord, Lord Warner, but this amendment is different from those that I have seen floating around from the noble Lord, Lord Phillips. I also have questions, but we must be very clear about what we mean by “queue-jumping”. If an NHS patient goes to an ordinary NHS hospital consultant and is told that they need an operation, it is completely legitimate for them then to ask to go privately and pay for the operation. That is, as the noble Lord, Lord Warner, said, enshrined in the NHS Act of 1948, and completely legitimate. Queue-jumping is when a patient sees a private consultant who then inserts the patient into the NHS list ahead of other NHS patients. That is what we want to avoid, and it is already completely illegal and highly frowned on. Most hospitals do what they can to exclude it, but I take the point made by the noble Lord, Lord Phillips, that it goes on, and we know that it does. It is an unpleasant practice and should be stamped out, but I do not know whether this amendment does that.
As the noble Lord, Lord Kakkar, reminded us, the conundrum of private units in NHS hospitals must be borne in mind. That may be the most constructive way in which to ensure that NHS consultants are available to NHS patients when they need to be, as the noble Baroness, Lady Finlay, said. But often private patients have operations that go wrong—and then, if there are two patients in need of an NHS intensive care bed, the patient who takes priority is the person with the clinical need. It is very much the same as someone on a battlefield. It does not matter whether it is an enemy soldier or a domestic soldier.
Lord Hunt of Kings Heath
I thought that the amendment was focused not so much on clinicians but on the board of the trust. That is a slightly different argument.
Baroness Murphy
The noble Lord may be right. If the change in wording applies to how the management behaves but makes no change in clinical priorities—the noble Lord, Lord Kakkar, said that it would not interfere with clinical priorities—I would support it. It is necessary to ensure that management acts like that, as long as it does not cut across the clinical priority that the sickest person comes first, whether private or NHS.
Lord Ribeiro
I have one question for the noble Lord, Lord Phillips of Sudbury. I agree with the comments made about management. When I worked as a surgeon, during a period when we were desperate to get patients into hospitals because we had already completed our NHS quota of work by January and had from January to April to make money, pressure was often placed on us as consultants by management to bring private patients into the NHS so that we could make the income. I hear “Oh!” from the other side. However, one problem that came from separating and withdrawing private beds from the NHS was that most consultants have established private practice in private hospitals outwith the NHS. The point that the noble Baroness, Lady Finlay, made was that part of the reason for removing or adjusting the cap and why she supported earlier amendments was to try to get integration of care to allow consultants to be on the spot.
The amendment refers to NHS foundations trusts. As we know, there are trusts that are not foundation but ordinary. What would apply to them? Would they therefore be free to undertake private work in a way that has been described here? This refers only to NHS foundation trusts.
Lord Campbell-Savours
I want to intervene briefly because we want to vote on these matters today. The amendment subtly gets to the problem at the heart of the Bill, which totally underestimates the new pressures that will build up within foundation trusts on management to change the nature of the patient body that comes into the trust for financial reasons. The noble Lord who has just spoken in many ways let the cat out of the bag. Pressures are exerted on clinicians by management to take actions that they do not necessarily want to take. If a trust is building up a substantial body of patients referred to it by insurance companies, it will want to be sure that within that trust’s operation some element of priority is given to its patients if only to minimise the liability that the insurance company has to the patient to pay their bills. In 10 years’ time, when the Government review the Bill, they will find that the pressure on management to change what happens in hospitals will lead to the beginning of the destruction of the National Health Service as we know it.
Lord Hunt of Kings Heath
My Lords, I have a great deal of sympathy with the amendment. When I first worked in a hospital in 1974, the Nuffield Orthopaedic Centre in Oxford, we had a private patients’ ward called Mayfair. The succession of senior consultants, the head OT and head physio, gave me an impression of the priority that was given. There will always be debate about the phasing out of paid beds—this was the case even under Barbara Castle—but some of it arises from real concerns over differentiation in equity of treatment.
I take the amendment to be very focused on the board of an NHS foundation trust, not on individual clinicians. It is an important safeguard regarding the way in which the board of a foundation trust may wish to deal with the financial pressures that it is under. We should not be under any doubt, and I speak as an FT chair, that many foundation trusts are facing financial pressures alongside the rest of the NHS. They are required to make efficiency savings and, probably, to move resources from acute hospitals into primary care without any reassurance that primary care is going to demand-manage. There is a real worry that GPs will give more money to themselves but with no guarantee that that will impact on the flow of patients through acute hospitals. There is concern that the pressure on acute hospitals, instead of reducing, which we would like to see, will actually grow.
Earl Howe
My Lords, before I address the amendments in the name of my noble friend, I would like to come back to some of the comments made by the noble Baroness, Lady Finlay. She mentioned one of the most pernicious myths about the Bill. The paper that she quotes is not just factually inaccurate on a large scale but is also, frankly, scaremongering. As she herself knows, the Bill does not extend current arrangements for charging; indeed, the Government have committed to introducing no new charges for healthcare during this Parliament. I felt that I had to make that abundantly clear. I know that the noble Baroness realises that that is the case but it is important for the world out there to understand what the Bill does and does not do.
I agree completely with the sentiments behind the amendment that my noble friend has tabled. Patients’ access to essential clinical care and treatment should be on the basis of clinical need, not their ability to pay. That has been a fundamental principle of the NHS since its inception, and we fully support that. I understand that there is some concern that private healthcare by NHS providers might represent a better deal for patients in need of essential treatment. However, I hope that I can convince my noble friend and other noble Lords that there are already adequate safeguards in place, because that is what I firmly believe.
First, I shall cover the issue from the perspective of clinicians—I shall move on to hospital management in a moment. Ethically and professionally, clinicians are required to treat all their patients to the same standard and should not discriminate in any way. It would be wrong to suggest that the vast majority who provide an excellent standard of care would not do so, and I am sure that my noble friend would never suggest that. The General Medical Council’s Good Medical Practice states that the overriding duties for doctors include making the care of patients a doctor’s first concern and never discriminating unfairly against patients or colleagues. The Government also have in place a robust system of regulation on the quality of services. The Bill strengthens that system and makes it more accountable.
Secondly, Good Medical Practice ensures equality of access. It requires all doctors to treat their patients on the basis of clinical priority and to the same standard. Therefore, if a doctor did not treat a patient on the basis of clinical priority or was treating a private patient to a better clinical service, they could be in breach of the principles set out by the GMC and could be putting their registration at risk. In addition, the terms and conditions of service in NHS consultants’ contracts make it clear they are responsible for ensuring that their private work,
“does not result in detriment of NHS patients or services”.
That principle was reiterated in the department’s guidance on NHS patients who wish to pay for additional private care alongside their NHS treatment, which was published by the previous Government following a review by Professor Sir Mike Richards in 2008. The guidance makes it very clear that patients who choose to pay for additional private treatment,
“should not be put at any advantage or disadvantage in relation to the NHS care they receive. They are entitled to NHS services on exactly the same basis of clinical need as any other patient”.
The NHS consultant contract also binds them into adhering to the principles set out in a code of conduct for private practice. These are recommended standards of practice for NHS consultants published by the department. This says that,
“the provision of services for private patients should not prejudice the interests of NHS patients or disrupt NHS services”,
and that,
“with the exception of emergency care, agreed NHS commitments should take precedence over private work”.
It is important to note the point about NHS commitments taking precedence over private work. I strongly believe that professional regulation through the General Medical Council combined with guidance from the Department of Health is the best way to ensure equality of access for patients. It allows regulators to respond to changing circumstances and practice without departing form the central principle involved.
Putting the amendment into statute would risk endless arguments about what is and is not essential care and treatment. Perversely, it could prevent a foundation trust giving preferential treatment to its NHS patients because of the amendment’s reference to equality. The primary purpose of a foundation trust is to provide NHS services. A foundation trust may want to prioritise NHS patients where there is equal clinical need. The amendment might well prevent that; at the very least, it would create legal ambiguity and confusion.
Some noble Lords have voiced concerns that a foundation trust might pressurise its consultants into prioritising private healthcare ahead of its NHS patients. There are safeguards to prevent that as well. First, foundation trusts have a public service ethos; they are governed by the public and by NHS staff. They have a principal legal purpose to treat NHS patients. Secondly, the NHS Commissioning Board and clinical commissioning groups would be responsible for ensuring that NHS patients continued to be offered prompt and high-quality care. With regard to managers, my noble friend will wish to know that we have already commissioned the Council for Healthcare Regulatory Excellence to produce standards of conduct and competence for senior NHS leaders, and these are currently the subject of public consultation.
I remind noble Lords of the points that we debated earlier. If there appeared to be a trend or a significant increase in the level of a trust’s private income, not only would that be picked up by the governors but it would be seen by Monitor, which will have extensive powers to direct foundation trusts through the licence. Foundation trusts will also be required to explain in their annual reports what the impact will be of their non-NHS income on NHS services. One might say that there is going to be no hiding place in this regard.
The noble Lord, Lord Campbell-Savours, asked earlier about GPs channelling patients to NHS private patient units. GPs’ responsibility is to ensure the best care for their patients. They would have nothing to gain from trying to collude with foundation trust managers and commissions to increase a foundation trust’s private income. More to the point, they would risk being reported to the GMC for not serving their patients’ interests. If the noble Lord’s point is that clinical commissioning groups may try to do this, then it would clearly be unethical and would give grounds for the commissioning board to intervene. I hope that that provides the noble Lord with reassurance on that point.
I make a further point to my noble friend around any possible incentive that trust management might have to channel patients into a private wing, a concern raised by the noble Lord, Lord Kakkar. The Bill will establish a transparent and legally enforceable pricing system that will reward foundation trusts for treating NHS patients. In other words, money will genuinely follow the patient, and foundation trusts will be paid a fair price for treating complex cases. The current system has not always achieved these simple aims. An independent report into the current system published last month makes this clear; I have placed a copy of that report in the Library of the House for noble Lords who are interested. As the report makes clear, although foundation trusts should have been paid for every NHS patient treated, this has not always been happening. There have been unacceptable levels of cross-subsidy that have meant that the prices payable for complex cases have sometimes been woefully inadequate. One important facet of the reassurance that I can give my noble friend is that the pricing system proposed under the Bill will address those problems and ensure that foundation trust managers have the right incentives and rewards for prioritising NHS patients.
For some—although not, I think, for my noble friend—the amendment has been prompted by fears around the consequences of the private patient income cap for foundation trusts being removed; again, the noble Lord, Lord Campbell-Savours, voiced that fear. I suggest to him that those fears are misplaced. It is not, to my mind, a valid argument to suggest that removing the cap, a restriction that does not apply to NHS trusts, would lead to foundation trusts ignoring NHS patients as their prime concern and responsibility. Foundation trusts are the only NHS organisations which have never been subject to a cap on the amount of private income that they can earn. However, some foundation trusts can and do earn high levels of private patient income. There are also some NHS trusts which earn private incomes well in excess of many foundation trusts. There is no evidence that these NHS providers have ignored NHS patients as their main responsibility. The NHS constitution guarantees fair access to NHS treatment. The Government are putting in place a quality improvement framework that will improve outcomes for patients. Therefore, there is no scope for NHS patients to be harmed by private provision. Indeed, I say again that the extra income that the NHS would earn through the lifting of the private patient income cap would help to provide better quality care for all in the future.
I hope that my noble friend will accept that he and I are on the same page—on the same side—on this question. The difference between us lies in how to tackle it. As the noble Lord, Lord Warner, was right to remind us, privately funded and NHS healthcare have always co-existed in NHS hospitals. Governments of all parties have preferred to use professional regulation rather than statute to ensure equality of treatment. I am sure that that is right. It is unnecessary and, I think, a mistake to use primary legislation to establish the same principles. Of course, over the length of time for which the NHS has been in existence, professional regulation has, on the whole, been an effective safeguard of equality of access. On that basis, I hope that my noble friend will feel genuinely reassured and able to withdraw his amendment.
Baroness Finlay of Llandaff
Before the Minister sits down, I seek clarification. It is extremely reassuring to hear about the code of conduct that will be coming through for managers. I seek reassurance that the code of conduct will cover managers at every level. While there is clarity over consultants, consultants’ contracts and the GMC guidance which we have discussed at length, there are many others in the healthcare team who are not managerially answerable to the consultants. They are managerially answerable in other streams. There needs to be consistency across all those aspects of management. That includes other professional managers such as nurse managers, allied healthcare professional managers and so on, not just those who are caught, perhaps, by the council guidance because they are managers coming from a non-healthcare background. We were seeking that consistency of conduct with the amendment. I hope that the Minister can give me reassurance.
Lord Phillips of Sudbury
My Lords, I first thank the seven Peers who added their voices to the amendment. I thank my noble friend the Minister for an extremely thoughtful and comprehensive reply. None the less, it would be dishonest of me to say that he convinced me on all counts. It is perhaps asking too much on such a complicated business to have full satisfaction.
The one thing that I am bound to say is that the Minister’s interpretation of these various provisions in the various codes is different from mine. I am a lawyer extremely long in the tooth and I do not think that the provisions that he quoted, although they look helpful on the face of it, actually work in practice. That is evidenced by the total absence of any disciplinary measures—ever, as far as I can see—against doctors acting improperly in relation to queue-jumping. However, that is in the past.
I must quickly answer questions raised of me by the noble Baroness, Lady Murphy, and the noble Lords, Lord Warner and Lord Ribeiro. The noble Lord, Lord Ribeiro, is the easiest to answer: the amendment does not cover the existing NHS trusts, only the NHS foundation trusts. However, I think that the NHS trusts are going to be out of existence in a couple of years’ time. I saved the House by not including that; I would have had it at Third Reading if necessary. As to the noble Lord, Lord Warner, he can go to his private knacker any day, any place, any time and pay what he likes. To the noble Baroness, Lady Murphy, the answer is that, if you are having private treatment within an NHS hospital, the amendment would prevail, had it passed; namely, you could not then barge the queue because you were a private patient in respect of essential clinical care. It really is as simple as that.
I do not get the sense from the House that noble Lords want a Division on this matter. I do get the sense that they are impressed by what the Minister said, particularly in relation to the management code. That could make a very big difference. The only thing that I ask my noble friend the Minister—if he is with me—is that he just keeps an eye on the issue at the heart of this amendment and the debate, and, in the new regime that we are ushering in, on the concerns behind this amendment, shared by many in the country.
Earl Howe
Before my noble friend withdraws the amendment, I give him that reassurance. The NHS constitution will be monitored at every level in the system, from the Secretary of State downwards, as will the provisions within relating to access to healthcare for NHS patients. Of course, if there is any sign that that pledge in the constitution is being jeopardised in any way, appropriate action will of course be taken.
I am told that I should clarify what I said in answer to the noble Baroness, Lady Finlay, about to whom manager training will apply. It will apply to “leaders across the NHS”—it says here. It will primarily be aimed at very senior managers with a cascade of good practice down to more junior levels.
“( ) If, at any time before section 8 comes into force, Monitor obtains the approval of the NHS Commissioning Board Authority to publish guidance under section 65DA(4)(c) or (5) of the National Health Service Act 2006, that approval is to be treated for the purposes of subsection (6)(b) of that section as approval obtained from the National Health Service Commissioning Board.”
“Charities Act 2011 (c. 25)The Charities Act 2011 is amended as follows.
In section 149 (audit or examination of English NHS charity accounts), in subsection (7), omit paragraphs (c), (d) and (e).
In section 150 (audit or examination of Welsh NHS charity accounts), in subsection (4)—
(a) in paragraph (b), omit the words from “all or most” to the end,(b) in paragraph (c), omit “falling within paragraph (b)”, and(c) in paragraph (d), omit “such”.”
Lord Patel
“( ) After Section 158 (Duty to consult Board in relation to regulations about patient information) insert the following new Section—
“Representation of Patients’ InterestsHealthwatch England
(1) There shall be a body corporate known as Healthwatch England.
(2) The primary duty of Healthwatch England shall be to represent the interests of patients and users of national health services and social care services (hereafter known as “patients and users”) in relation to providers, regulators and the Secretary of State.
(3) Healthwatch England shall be independent of any provider of national health or social care services or of any regulator of health or social care or of any other body established by this Act or otherwise.
(4) Healthwatch England shall have the following functions—
(a) to establish a local healthwatch organisation for each local authority area;(b) to provide each local healthwatch organisation with such resources as may be agreed by Healthwatch England;(c) to provide local healthwatch organisations with advice on, and assistance in relation to, their functions and on such other matters that Healthwatch England may determine; and(d) to provide relevant persons with information and advice on—(i) the views of people who use health and social care services and of other members of the public on their needs for, and experiences of, health and social care services; and(ii) the views of local healthwatch organisations and of other persons on the standard of provision of health and social care services and on whether or how the standard could or should be improved.(5) Relevant persons referred to in subsection (4)(d) are—
(a) the Secretary of State;(b) the National Health Service Commissioning Board;(c) the Care Quality Commission;(d) Monitor; and(e) English local authorities.(6) A person provided with advice under subsection (4)(d) must inform Healthwatch England in writing of his or her response or proposed response to the advice.
(7) Healthwatch England shall in addition have powers of investigation as prescribed in subsections (8) and (9) and powers to require disclosure of information as prescribed in subsection (6).
(8) Healthwatch England may investigate—
(a) a complaint made by or on behalf of a patient or user or a local healthwatch organisation which appears to the Board to raise one or more issues of general relevance; or(b) any matter which appears to the Board of Healthwatch UK to be or be related to a problem which affects or may affect patients or users generally or patients or users of a particular description.(9) For the purposes of subsection (8) a complaint raises an issue of general relevance if it raises—
(a) a novel issue which affects or may affect patients or users in general or patients or users of a particular description, or(b) any other issue which has or may have an important effect on patients or users generally or patients or users of a particular description.(10) Healthwatch England may by notice require a person within subsection (11) to supply it with such information as is specified or described in the notice within a reasonable period as is so specified and the information so specified or described must be information that Healthwatch England requires for the purpose of exercising its function.
(11) The persons referred to in subsection (6) are—
(a) any provider of health or social care services licensed by the Care Quality Commission and Monitor under the provisions of this Act;(b) the National Health Service Commissioning Board;(c) Monitor;(d) Care Quality Commission; and(e) any other person specified or of a description specified by the Secretary of State. (12) If a person within subsection (11) fails to comply with a notice under subsection (10) the person must, if so required, give notice to Healthwatch England of the reason for the failure and if that reason for failure is not acceptable to the Board of Healthwatch England then the Board of Healthwatch England may take steps to publish the notice and the reasons for failure provided or to seek enforcement of the said notice through the courts.
(13) Healthwatch England must publish details of arrangements it makes under this section, including details of payments of remuneration or other amounts.
(14) In performing functions under this section, Healthwatch England must have regard to such aspects of Government policy as the Secretary of State may direct.
(15) As soon as possible after the end of each financial year, Healthwatch England must publish a report on the way in which it has exercised its functions during the year.
(16) Healthwatch England must—
(a) lay before Parliament a copy of each report made under subsection (15); and(b) send a copy of each such report to the Secretary of State.(17) Healthwatch England may publish other reports at such times, and on such matters relating to health or social care, as it deems appropriate.
(18) Before publishing a report under subsection (15) or (17), Healthwatch England must, so far as practicable, exclude any matter which relates to the private affairs of an individual, the publication of which, in its opinion, would or might seriously and prejudicially affect that individual’s interests.
(19) In this section “financial year” means—
(a) the period beginning with the date on which Healthwatch England is appointed and ending with the following 31 March, and(b) each successive period of 12 months ending with 31 March.”.”
Lord Patel
My Lords, Amendment 223A and those that follow, which relate to local healthwatch, are the key amendments that address public and patient involvement in the Bill. The Bill says a lot about how the patient will be centre stage in the whole reorganisation. Therefore, it is important that the patient’s voice be heard. How will we do that?
I say at the outset that my amendment is about the independence of HealthWatch England in statute and its ability to get the information about health services that it will need to do its job. Public involvement in health and social care in England has been in a turbulent state since 2003. Despite the genuine aspiration of the Government to establish an effective system of public involvement, they have failed. This is now the fourth, or even the fifth, attempt to do so.
In 2003, more than 500 patient forums were set up around the country, many with a tiny membership. They had an independent national body, which was distant and isolated from local patient forums. It failed because it was neither useful to nor respected by local forums. The abolition of patient forums led to Local Involvement Networks being established with no statutory national body. The name LINks made them invisible to the public. They were often isolated and struggled against the odds to develop successful systems to monitor services and influence commissioning. Nevertheless, after two or three years, many LINks have done well; they have established a good local reputation and had an important impact on the effectiveness of local services. However, they need a national body to support them, enable them to develop successfully and give a hand to those that are failing.
Recognising the problems and weaknesses of some LINks, the Government decided to abolish them and replace them with HealthWatch. The plan—to have a national body called HealthWatch England, working closely in a supportive relationship with local healthwatch—is very good. The intention is for HealthWatch England to be up and running by 1 October 2012 and local healthwatch by 1 April 2013. Ministers had a vision of a relationship between the local and the national that went in the right direction but needed some tuning to make it work for the benefit of the public. However, the plans that the Government now have for both HealthWatch England and local healthwatch may risk that vision being realised.
To succeed, HealthWatch needs strong input from people with practical experience of building a successful national HealthWatch England that works in tandem with local healthwatch. A national governance framework is required from the centre to enable local people to get on with the job. Supportive governance from the centre reduces local friction and speeds the process of local development. HealthWatch England should provide a national vehicle to drive standards in health and social care and identify areas of poor practice. It has a very special mission, which is quite different from that of the regulator, the CQC, of which the Government want HealthWatch England to be a committee.
HealthWatch England should be the voice of the people—the voice to which the Secretary of State must listen in making the CQC, Monitor and the Commissioning Board have a strong relationship. HealthWatch England is the voice of the abused patient, the forgotten person with dementia on the second floor of a nursing home, of the child with a learning disability who is getting poor care on a children’s ward and of the people waiting excessive periods for emergency care in an A&E department. When local healthwatch or a member of the public raises their voice because of a persistent local problem—as occurred in Mid-Staffordshire—HealthWatch England must hear it and respond immediately. To do this, independence is critical.
Embedding HealthWatch England in the CQC is a fundamental error. To call it a committee is a fundamental error. It diminishes the power and influence of HealthWatch England if it becomes a committee of the CQC. The only people who think that a committee is important are the people who sit on it. Having sat on many of them, I might agree. Most people think a committee is a talking shop. HealthWatch England must not be thought of across the country as a talking shop.
The CQC has a huge and important job to do and needs to be supported. I do not deny that. However, the way in which it deals with that job is seen to be highly bureaucratic. It has the wrong culture for a public body such as HealthWatch England. Members of the public will not wish to go through a CQC call centre or website to raise urgent issues. They will want to speak to an expert in HealthWatch England who will understand the problem and can act immediately. Combining the people-facing body of HealthWatch England with the regulator by making it a committee of the CQC, which is focused on data and regulation, will quickly suffocate it. That cannot be what the Government want to do.
It has been argued that locating HealthWatch England within the CQC puts it at the centre of regulation, where it can have real power and influence. However, it cannot have power and influence if it is a committee of the regulator. To have power and influence, it needs independence and the ability to challenge the regulator. HealthWatch England needs to be trusted by the public and to be seen as a big hitter. It must be seen to be able to hold the CQC, Monitor and the NHS Commissioning Board to account, and to have influence with every local authority in England. It must be seen to be independent, and not just called independent.
Being independent and being seen to be independent requires HealthWatch England to be run by a board that has public trust and confidence, meets in public and speaks to the public, not a board—as the CQC is—that does not even allow questions to be put by the public. It would be absurd for England’s leading public involvement body to be the statutory committee of a board that does not even recognise the need to be open and accountable to the public. HealthWatch England must have its own board, which must meet in publicly accessible places to discuss issues of national importance in healthcare. It must be seen as a body that people will want to connect to by attending its meetings, raising issues with it, watching it live on the internet and engaging with it. It must be what might be called a living organisation, not an obscure committee of some other big national regulator.
The CQC seems very anxious about having members of the HealthWatch England committee elected directly from local healthwatch. Why is it so worried about a little democracy? The recent consultation on the regulation of HealthWatch England was silent on independence and elusive on elections. It considered the possibility of election to HealthWatch England, but not directly to the HealthWatch England committee as it sees it. It would have to be through some intermediate mechanism just in case a rogue representative was elected to the committee who might challenge the CQC, I suppose. HealthWatch England cannot be seen to be a part of the CQC and to operate in its shadow, fearing direct public involvement. As a regulator, the CQC may have to keep a distance. To ensure objectivity as the people’s voice, HealthWatch England must invite the people in and be disappointed if they do not turn up. If they do not show up, HealthWatch England will have failed in its job as a public and patient representative. Direct election from local healthwatch organisations to HealthWatch England would ensure that HealthWatch is a national and local organisation that people can trust.
Lord Harris of Haringey
My Lords, I think this is the part of the Bill which I assume the Minister had hoped would give him a quiet time. Indeed, he has passed on the responsibility for answering this amendment to his noble friend Lady Northover. Originally, one had to respect the Government’s intention with regard to HealthWatch because I am sure the intention was to create effective patient representation at national and local level. That intention has been challenged in the discussions that we have subsequently had and in some of the changes that have occurred over the past few months. However, it is worth going back for a moment to first principles. What constitutes effective patient representation? The first significant element of that has to be independence. The organisation representing patients’ interests has to be independent of the providers of health services, those who commission them and those who regulate them because the act of representation can potentially challenge any or all three of those interests.
Secondly, effective representation at national level must be representative. There must be real representativeness within that structure. It must be derived from local groups and local individuals and have that authority which is derived from being a representative structure. With the best will in the world, you cannot be an organisation which can speak with proper authority on behalf of patients or, indeed, any consumers if you are simply appointed from on high by a Secretary of State. In my time, I have worked for organisations that have been structured like that and I have to say that although they can do good work, they cannot be properly representative. They cannot properly have the authority that comes from being derived from the grass roots. The third element which is critical is that the work and the comments that these bodies produce have to be derived from sound local information, which necessitates being able to pick up information from local networks around the country. That has to be safeguarded in whatever proposals are put forward.
The Government originally promised us that HealthWatch England would be the independent patients’ champion. However, as the noble Lord, Lord Patel, has just pointed out, being a subcommittee of the Care Quality Commission does not demonstrate independence. It demonstrates a subsidiary role in relation to the Care Quality Commission. I am sure that the people currently at the Care Quality Commission are motivated to try to create an arm’s-length structure. We do not know, of course, whether that desire for independence would survive the first occasion when HealthWatch England challenged the decisions made by the Care Quality Commission, or how often it would survive after repeated such challenges. However, independence is also about the perception and the appearance of being independent. How can you appear to be independent if you are a subcommittee of one of the organisations that you may have to criticise from time to time?
This amendment seeks to do three key things. It would set up HealthWatch England as an independent statutory body and write that independence into statute, set out a clear relationship with local healthwatch organisations and safeguard their funding mechanism. I recall some very wise words said to your Lordships' House in July 2007 when we were debating the creation of the Commission for Patient and Public Involvement in Health. It was stated that,
“one signal advantage of the commission is that the money that it distributes to forum support organisations cannot be used for purposes other than those for which forums were established. Under the arrangements in the Bill, however, there is no guarantee at all that money intended to support the activities listed … will actually reach the front line. It would be possible for a local authority to say that it was delivering the activities in the Bill when, in reality, those activities were so minimal that they were hardly worth the name of patient and public involvement. What steps could be taken, in those circumstances, to ensure that such involvement in health and social care is delivered properly?”.—[Official Report, 23/7/07; col. 615.]
The person speaking said that the answer was not delivered by the Bill brought forward at that time by the Labour Government. Who was the person who delivered those words? It was, of course, the noble Earl, Lord Howe—the current Minister. He made it quite clear that the arrangements which he is now seeking to replicate were not adequate and would not, and could not, work. Yet the proposals which were going to establish the independent patients’ champion are weakened precisely because he has not accepted the lessons of his own words.
The noble Earl, Lord Howe, went on to say that he was concerned that, as:
“LINks are going to assume different forms and guises in different localities, it is axiomatic that the level of activity that they undertake is going to vary”.—[Official Report, 23/7/07; col. 615.]
He asked how the amount of money in any given area was to be assessed. Therefore, I ask the noble Baroness—who will respond on behalf of the noble Earl, who gave us that wise advice in 2007—what will be the mechanism for determining how much money is allocated to each local authority for healthwatch in its area? Will this be a global sum that will go from the Department of Health to the Department for Communities and Local Government, and then be allocated to local authorities by the mysterious process by which the block grant from the DCLG is decided for each local authority area? Or will there be a separate formula that will go with that money and decide how much money is allocated to local healthwatch around the country? If it is the latter, will that information be published? Will it be possible for residents in a local area to know how much money has been allocated so that they can see whether it is being used? I suspect that unless we have the answers to those questions we will know that the reality is that this money will disappear in the wash and not be effective. The point about the amendment is that it provides a solution to that problem because the same money would be channelled through a body that would be dedicated to the provision of local healthwatch organisations and want to ensure that the money was spent properly and appropriately.
The Government’s arguments—we have had several discussions about this with Ministers, and I am grateful to the noble Earl and the noble Baroness for providing those opportunities—seem to be broken down into three areas. First, they argue that there is a natural synergy with the work of the Care Quality Commission. However, I have already pointed out that the CQC is one of those bodies that HealthWatch England may have to criticise. There is also a synergy with the work of the NHS Commissioning Board, Monitor, Public Health England and all sorts of other parts of the new NHS. Why is there specifically a synergy with the CQC?
The Government’s second argument was that there would be cost efficiencies and that this would be the most efficient way of doing this because there would be savings due to the collocation. However, as the noble Lord, Lord Patel, pointed out, you can achieve that in many ways. You can simply say that one of the things that HealthWatch England, as an independent statutory body, could be required to do through guidance, would be to look at how its back-office operations could be provided from a variety of organisations of appropriate stature and size, where the issue of conflict would not necessarily arise. That provision could then be made by way of a clear legal agreement. However, that is not being done, and I am not quite sure why the Government are saying that there are efficiencies and cost savings that could be made only by the precise structure that they propose. In terms of providing the funding to local healthwatch, our proposal has to be a more efficient provision that will deliver the resources without leakage and without local authorities deciding that perhaps there is a greater local priority than local healthwatch.
The noble Baroness, Lady Northover, spoke vehemently about the way in which the former Commission for Public and Patient Involvement in Health had operated, and how it had a wasteful and top-heavy way of distributing resources to local patients and for public involvement. That is not the only way to distribute resources. The only reason that the former commission distributed resources in that wasteful and inefficient way is because the Department of Health at that time—I regret, led by a Labour Minister—insisted that it was done in that rather ridiculous and cumbersome way. If Ministers want distribution done efficiently and simply, perhaps that can happen. If you appoint the right people to the initial board of HealthWatch England, I am sure that they would want to ensure that that is the case. It does not have to be done in the way I described.
The third argument that I have heard Ministers make for locating this body within the CQC is that it will provide all sorts of informal support and guidance—that there will be a library, information resources and so on. However, the Government have told us how important the duty of collaboration is within the new NHS and how significant it will be. Why do you need to collocate and have HealthWatch England as a subordinate structure within the CQC when there is a duty to collaborate? Indeed, why cannot HealthWatch England collaborate with other national bodies as part of the NHS?
Baroness Masham of Ilton
My Lords, with so many changes over the years to volunteers supporting patients, it is important that HealthWatch England and local healthwatches should be effective. First, there were community health councils, most of which did a good job—some did not. Then there were health forums, which lasted only two years. Then there were LINks, which have not been very well supported. The way that these volunteers, who were supposed to be a voice for patients and people using social care, have been treated has not been good. Unless healthwatches have a strong voice and enough support to operate, they will not be able to do a worthwhile job. They need to be independent so that when they see something that needs to be improved they can speak out.
In the Mid Staffordshire Hospital, where the culture was wrong and patients suffered, no one spoke out when they should have done—except the relatives. I hope that lessons will be learnt and strong safeguards put in place, including a strong healthwatch. I know that the noble Earl understands the need for a body supporting patients that is fit for purpose. If the House thinks that HealthWatch England and local healthwatches are not fit for purpose, as suggested in the Bill, and if the amendments are not accepted, perhaps with the help of the Minister there is still time before Third Reading to get it right.
I ask him whether children’s services are to be included in healthwatches. If not, they should be. Just think of what happened to Baby P. We must not forget. It will be very disappointing if we do not get it right in your Lordships' House.
Baroness Cumberlege
My Lords, I have several amendments in this group and the next one. There are synergies between the two groups, so I shall speak briefly introducing both groups and go on to those in this group.
I have tried hard throughout our debates to ensure that we have a more robust accountability framework. As I see it, the framework is in three parts. First, there is the local authority. Secondly, there is HealthWatch England. Thirdly, there is the local community. I will not go into the independence of HealthWatch England, because I debated it very fully in Committee, but I understand the passion that has been expressed on that issue. For me, those three elements balance each other, and it is important that they do, because that will improve transparency.
To give an example, if HealthWatch England makes recommendations to local authorities on how they commission local healthwatch, local healthwatch and the community can hold the local authority to account for how it commissions. That gives it a yardstick by a third party, HealthWatch England, against which to measure the local authority commissioning arrangements. The policy document produced by the Government on Friday, Local Healthwatch—The Policy Explained, states that the Government are considering how the constitution and governance of local healthwatch needs to ensure that it operates for the benefit of and is accountable principally to its local community.
The third element is local people. They are critical to the accountability framework. As the noble Baroness, Lady Masham, said, in many eyes, they are the most important.
The government amendments, including those laid on Friday, go some way to addressing that, but they also introduce fresh concerns, which I shall refer to later. The loss of statutory structure is a great threat to independence. The value for money and rationale still have to be adequately explained, but I am sure that my noble friends on the Front Bench will do that shortly.
My noble friend Lady Jolly and I tabled Amendment 224, which improves accountability nationally by linking the perspectives of HealthWatch England more closely to the grassroots by electing the members of local healthwatch to the HealthWatch England statutory committee. The noble Lord, Lord Harris, gave that a warmish welcome, although I say to him that that is not a sub-committee, it is a committee. It is not subservient to a committee, it is a committee.
The Government have sought broader opinion with their public consultation on that and other topics which closed on Friday. That elected membership would serve two functions: first, as a counterweight to the influence of the Care Quality Commission, making HealthWatch England more independent; and, secondly, as an agent for the accountability of HealthWatch England, keeping it in touch with the patient and user reality. If local healthwatch does not think that HealthWatch England is really speaking out for people, it can say so through its elected representatives. They would be elected against a skill specification to ensure that they were the right people to fulfil that important role. Without that, HealthWatch England is a free-floating organisation with no local connection, a mere national harvester of local data. I hope that the Minister can reassure me again that that accountability gap will be dealt with.
Government Amendment 226 is very much welcomed. I strongly support it, because it responds to my amendment in Committee. It provides for the majority of the members of HealthWatch England to be made up of non-CQC members, making it independent of the CQC, which therefore cannot dominate HealthWatch England. My Amendment 226A stitches the accountability framework together transparently, by providing for local healthwatch to have regard to the standards set by HealthWatch England. I hope that my noble friend can give me some assurances as to how that last element can be covered.
The introduction of the HealthWatch trademark under government Amendment 235C is a very interesting device and may well help. Amendment 228 was also tabled by my noble friend Lady Jolly and me. It enhances independence and transparency nationally by providing for the Secretary of State to issue conflicts guidance to which both the CQC and HealthWatch England must have regard. I hope that the Minister finds that sensible. Amendment 229 is another government amendment which I support. It includes a risk management strategy, so that what may have gone wrong in one place may stimulate vigilance in another. I strongly support that.
I am sure that my noble friend will wish to speak to her amendments, but I have introduced mine and hope that some of them find some favour with those on the Front Bench.
Lord Whitty
My Lords, I want to add a couple of brief points to the already powerful case made by the noble Lord, Lord Patel, and my noble friend Lord Harris. I do so from some experience of the consumer interest in other markets. First, I resort to what the clause says is the purpose of the HealthWatch England committee. It states that it is,
“to provide the commission or other persons with advice, information or other assistance”—
not to challenge, not to represent the user interest, not to deal with issues of general complaint but to provide assistance to the body of which it is a committee. That is not a sufficiently powerful role to fulfil the requirements for independence.
This has been tried in other sectors. Until 2006, when I brought legislation through this House, there was a panel to represent consumers within Ofwat. Since that has been removed, and in contrast to the first 20 years of the privatised water industry, the Consumer Council for Water has represented the consumer interest effectively in terms of price review and influence on the individual water companies, region by region. That has been an improvement.
There are two other examples where regulations have required panels within existing regulators. One is in communications, where Ofcom had a consumer panel. Frankly, that has withered on the vine because Ofcom has not supported it or given it adequate resources. The other is in financial services, where the Financial Services Consumer Panel has done some sterling work, but no one could claim that the interests of consumers has been fully protected through the past five years of financial service provision. Noble Lords may remember that when our colleague, the noble Lord, Lord Lipsey, was briefly chair of that panel and attempted to extend the interests of consumers more independently from the regulator, he found it necessary to resign. That is not a good model for independence either. Although that panel does good work, it has to follow the rhythm and priorities of the regulator, not the priorities, concerns and interests of consumers. If you are part of an organisation, a committee or sub-committee of an organisation, that inevitably follows.
The other point that I wish to raise concerns powers, my views on which are set out in subsections (7) to (12) of the proposed new clause. Unless the consumer organisation has separate powers from those of the regulator to require information and advice, then, again, it cannot be truly independent. The powers are very similar to those of the other independent, statutorily based consumer organisations, and it will require information from the regulators, the commissioners and the providers within the complex new structure of the health service that we are setting up here.
On both those counts, there is no experience elsewhere of consumers’ interests having been effectively represented by a committee, a panel or a sub-committee within one of the three overlapping regulators, all of which impact on the users of the health service under the Bill.
Unless the Government rethink this, they will be doing a great disservice to all the hundreds and thousands of people out there who depend on care services and on the National Health Service. The reality is that all the Minister needs to do is to tell us today that he is going to reject the idea of a committee and genuinely come forward with a proposition that gives independence to consumer representation within the new structure. If we get anything short of that, I think we will have let down the users of the National Health Service.
Baroness Jolly
My Lords, I have a couple of amendments in my own name in this group, and I shall also speak to amendments in the names of my noble friends Lady Tyler and Lady Cumberlege.
We welcome the decision to set up a patient and public involvement organisation and network across England based on local authority geography and with HealthWatch England at the centre. It offers the possibility of real engagement for all stakeholders and the consequent improvement of health and social care services for all. However, there are still some areas for concern in relation to HealthWatch England, whose role is to engage with all the key national players—the Secretary of State, the NHS board, Monitor, the CQC and the local authorities to which I referred a moment ago. It is charged with providing the views of those in receipt of services, their carers and other members of the public, and also with offering advice to the key stakeholders to whom I have just referred. It will thereby be influencing the Secretary of State mandate, commissioning practices, the process of registration of providers and the authorisation of clinical commissioning groups.
However, there is a deficit in the Bill. There is no representation on the HealthWatch England board of a local voice. Reports may be sent by local healthwatch organisations and they may be read, but there is no one on the board of HealthWatch England who can tell it as it is at a local level. The board, as with all other boards, is charged with making decisions involving running the organisation but, without a local perspective, it runs the risk of being metrocentric, south-east based and out of touch. Therefore, I support Amendment 224 in the name of my noble friend Lady Cumberlege and, as a good Liberal Democrat, I of course welcome elections run by STV.
The relationship between HealthWatch England and local healthwatch organisations has to be pivotal to the success of this proposal, and one certain way to cement that is with the presence on the HealthWatch England board of members of local healthwatch organisations, as we have just discussed. However, another way would be to use Amendments 229A and 234ZA in the name of my noble friend Lady Tyler. These allow for local healthwatch organisations to have a power to recommend to the board of HealthWatch England the reports that they think, from their local information-gathering, HealthWatch England should carry out, and HealthWatch England is bound to have regard to these recommendations. This should help to avoid situations such as Winterbourne and Mid Staffs. An effective local healthwatch organisation would have confidence that its advice would be considered and acted upon by HealthWatch England, precipitating early intervention and service improvement. It would also allow HealthWatch England the opportunity to spot national patterns, determine their significance and take appropriate action.
I have an amendment in my own name which concerns specialised services commissioned by the board—in particular, those for rare and complex conditions. Here, I need to declare an interest as chair of the Specialised Healthcare Alliance. I should be very grateful if my noble friend could clarify how it is envisaged that information can be collected about these services, how patients and carers can have confidence in a local healthwatch organisation dealing with issues with which they might only rarely get any concerns, and how HealthWatch England can put these scarce data together in a useful and timely manner for stakeholders. That will need careful management and crystal-clear guidance to ensure that the information gathered and the advice based on that information find their way to the board. Many people with such conditions are keen to hear the Minister’s response and I would welcome total clarity from her in that regard.
Baroness Pitkeathley
My Lords, I wish to speak in support of the powerful case made for the independence of HealthWatch England by the noble Lord, Lord Patel, and by noble friends on these Benches. It is a mystery to me why, in the face of a genuine commitment by successive Governments to public and patient involvement, we have made such a mess of it thus far. I am not one who looks back on the work of community health councils as some kind of nirvana. As someone who was briefly a chief officer of a CHC, I know that they were very patchy and variable in quality. However, they had a strong national voice, and I pay tribute to my noble friend Lord Harris of Haringey in that regard.
Since then, we have struggled. I think that the failure of the Commission for Patient and Public Involvement in Health has made successive Governments frightened of setting up one of these national organisations. It has put them off having a national body to support local groups, to help them to develop successfully and to help them when they are in difficulties, as well as provide a national, challenging voice for patients. Will HealthWatch England, as currently envisaged, be this missing national body? I am afraid that at present the answer is certainly no. As a committee of the CQC—an organisation for which I have the highest regard—it will not be independent or accountable to the patients and public it represents, and its links with local healthwatch organisations, which we will discuss later, will be very variable and often not sufficiently robust for them to be in full receipt of the amount and range of information that they need. We simply must have a proper governance structure with an independent, publicly appointed chair. Surely the independence of the whole organisation is essential to how it will provide the strong voice for patients that everyone involved say they want.
Lord Warner
My Lords, it gives me great pleasure to follow that sterling contribution by my noble friend Lady Pitkeathley. The real problem with the Government’s approach is that they really have not properly defined the functions of this body. One of the great strengths of this amendment is that it sets out what the functions of a truly independent body should be in this area. I make no defence of the previous Government’s attempts to wrestle with this idea, but I think that we have continued to go backwards in this area since the days of community health councils, despite their patchiness.
I was very optimistic when the Government made their first announcements about healthwatch, and I was a great supporter of the brand name that they had created, which I thought was very powerful. Unfortunately, the functions that they have given it and the way they have set it within the CQC do not enable it to live up to the strength of that brand.
I was full of admiration for the creative way in which the noble Baronesses, Lady Cumberlege and Lady Jolly, loyally tried to make the sow’s ear a bit more of a silk purse. However, it really does not cut the mustard. I think that we need to pay attention to the points made by my noble friend Lord Whitty, who emphasised very well the extent to which the model that the Government are pursuing has failed in a number of other areas of public policy. The Government should learn from that evidence and rethink this matter before we get to Third Reading.
I have one other point which concerns the rather spirited exchange that we had in Committee with the noble Baroness over the issue of campaigning. I shall return to that for a few moments. The whole point of having a body like healthwatch is to enable it to join forces with other people when there is a serious challenge to the public interest and to patients’ interests in this area and allow it to campaign. I cannot see how it can be very easy for a committee of the CQC to join in that campaign. I asked the noble Baroness whether it would be able to campaign and, to her great credit, she said that yes, it would. Most of us who have knocked around the public sector for any length of time would find it very difficult to believe that a committee of the CQC would be able, despite what the noble Baroness says, to join in a campaign that was highly critical of the CQC. We need to be clear on whether it can campaign; and if it can, I would like, as the noble Baroness said, a very convincing explanation of how it will be able to when it is sitting within the structure of the regulator and it is the regulator's deficiencies that it is campaigning against.
Baroness Murphy
My Lords, I hope I shall be allowed to put a contrary point of view to that of the noble Lord, Lord Warner, and those who have tabled Amendment 223. First, I apologise for not contributing in Committee on this area; I happened to be away during the debates on this, but I read the reports with much interest.
This area of patient and public involvement is one that, as many noble Lords have said, we have struggled with for many years. I hark back to the CHCs with some nostalgia. They were a very mixed bag of organisations, but those that were good worked very effectively. I too pay tribute to the noble Lord, Lord Harris of Haringey, for the work that he did in supporting CHCs around London, which made my life an utter misery, as they were intended to do. I am very grateful for that.
Unfortunately, the arrangements that were put in place after their abolition have not worked. I say to the noble Lord, Lord Whitty, who is very persuasive in his arguments, that we have been there, done that and it did not work. As the noble Baroness, Lady Pitkeathley, said, the Commission for Patient and Public Involvement in Health was a total disaster. It was an extremely expensive quango—it was bureaucratic, totally isolated from other health bodies, the Department of Health did not know what it was up to and I do not think it knew what it was up to itself. It fell out with all the local patient and public forums. It was a disaster. It did not have any symbiotic relationships with those who make the health and social care services work; it was not in any way linked in with local authorities, which is a huge difference from these arrangements; and it seemed to me then that you had to have a structure in which all the core patient and public involvement organisations locally were crucially interlinked with what makes things work.
Baroness Wheeler
My Lords, with an additional 68 government amendments tabled at the end of last week on the issue of HealthWatch England and the now much altered healthwatch organisations, it is somewhat of a challenge to work out exactly what the Government want from HealthWatch England and local healthwatch organisations. Why has not the Government’s time since Committee stage been spent on trying to address the issues and concerns raised by noble Lords which would ensure that HealthWatch England and local healthwatch organisations have the real status and authority to do the job that we all recognise is required of them? Instead they have concentrated on compiling one of the most confusing additional sets of amendments that we have seen on this Bill, which will seriously undermine the ability of both the national and local organisations to act as an effective and robust watchdog for patients and the public.
The new local arrangements for healthwatch organisations provide a plethora of contradictions and confusions and we shall discuss those under a later group. Sadly, none of that addresses the continuing concern across the House and among key patients’ groups and organisations about the HealthWatch-CQC relationship. Fortunately, Amendment 223A, from the noble Lord, Lord Patel, my noble friends Lord Harris, Lord Whitty and myself does. Those noble Lords have all made a coherent and powerful case for the amendment and for ensuring that HealthWatch England is independent. The amendment provides for a body corporate, with clear primary duties to represent the interests of patients and users of the National Health Service and of social care services, independent of any provider or regulator of those services. As well as powers to provide information and advice on the views of patients and standards of quality of care, the amendment provides HealthWatch England with powers to investigate complaints made by or on behalf of a patient or user of a local healthwatch organisation and to raise and investigate complaints relating to wider issues affecting patients or users in general.
The Government have said that they want to see HealthWatch England with genuine operational independence from CQC. However, attempts to do that by, for example, providing the majority membership of HealthWatch members on the HealthWatch board, or reassurances after the last debate in Committee in terms of HealthWatch England being able to speak out publicly in certain circumstances, even if their views conflict with its host body or government, miss the point. None of these small steps gives the unequivocal reassurance of independence that a robust patients’ watchdog, acting in the interests of patients, must have. In the new market-dominated system that we will soon have, independence and a collective voice for patients is more vital than ever. In the end, it will come back to how the proposed measures will play out in practice and how conflicts of interest between HealthWatch England and the CQC, or indeed healthwatch organisations in the local authority, will be dealt with.
Most important of all is the issue of public perception, understanding and confidence in the independence of HealthWatch. It is important that HealthWatch is seen to be credible and truly independent, able to challenge and to scrutinise the work and decisions of the regulators, both CQC and Monitor. The niceties of whether there is a majority of HealthWatch members on the board, whether they can combine or exchange data and whether they are part of an organisation that the Secretary of State keeps under review will escape a patient, carer or representative who, for example, makes a complaint about how CQC has investigated care in a residential home, only to find that the body investigating the complaint or championing improved quality of care on behalf of patients is a committee of the CQC itself.
I hope that the noble Baroness will address these concerns: in particular, points that were repeatedly made about how the culture clash between healthwatch and the CQC will be addressed and managed; how we will stop CQC—in the words of the noble Lord, Lord Patel—“suffocating” HealthWatch England; how the potential serious conflict of interest will be dealt with; and how public faith, trust and confidence in healthwatch can be achieved under the relationship with the CQC, particularly in light of that body’s major organisation and resource problems so starkly highlighted in the Department of Health’s recent CQC performance and capability review.
In the debate on the duty of candour, the Minister referred to the CQC as an organisation that was remote from patients. We need an independent HealthWatch England and we need local healthwatch bodies that everyone can rely on to be genuine patient representatives. I am afraid that the Bill gives us neither.
Baroness Northover
My Lords, this has been another excellent debate. I listened very carefully—as I did before—to the views expressed. Overall, there is clearly complete agreement on all sides of the House that the voice of patients and the public should be at the heart of the NHS. As the noble Lords, Lord Patel and Lord Harris, and the noble Baroness, Lady Masham, and others indicated, the history of how previous Governments tried to implement this is tortuous. The recent past has borne witness to a number of attempts to do it, and noble Lords referred to some of the problems. No attempt—not even Community Health Councils—managed to fulfil the worthy intentions of its architects, and we went from one to another.
As the noble Lord, Lord Patel, recognised—I appreciate his words—we seek here to take the strengths from past attempts, build on them and ameliorate the weaknesses as we develop our proposals for HealthWatch England. In the light of the comments of the noble Lord, Lord Harris, and as the noble Baroness, Lady Murphy, emphasised, it is worth remembering one of these previous attempts: the Commission for Patient and Public Involvement in Health. It was established in July 2003 and operated nationally and regionally, following regional government boundaries. Within five years it had been abolished after being seen to lack clout, to be too bureaucratic and too top-down for the public and those on the ground. Perhaps I may again remind the House of the judgment from the Health Select Committee’s 2007 Report into Patient and Public Involvement in the NHS, which stated:
“The evidence we received was overwhelmingly critical of the Commission”.
We are convinced that trying to recreate the commission is not the best way forward, and instead propose that HealthWatch England should be a statutory committee hosted—that was a very good description from the noble Lord, Lord Patel—by the CQC, which is a far more viable option.
I am well aware that this proposal has met with concern.
Baroness Northover
I will finish and then I will respond to the noble Lord if I need to. I am well aware that this proposal has met with concern from some quarters. I will explain why we are proposing this arrangement and why we do not feel that the case for having a separate body is stronger.
HealthWatch England will have clout. It will have a seat at the top table, taking centre stage in providing advice on patient and public views to the CQC, Monitor, English local authorities and the Secretary of State for Health. Noble Lords were right to say that Healthwatch England must influence all these bodies; that will be its responsibility. My noble friend Lady Jolly, too, made that clear. Each of these persons or bodies will have a duty to respond to the advice. Through local healthwatch, HealthWatch England will be closely linked to the views of people expressing views about the services that most directly impact on their lives. Our proposals for HealthWatch England will place it at the heart of the system—not at the top, divorced from the views of local people, as CPPIH turned out to be.
As a committee of CQC, HealthWatch England will be able to draw on the best of CQC’s evidence base on quality and standards of care. The enthusiasm with which CQC wishes to learn via healthwatch is instructive. It will be helpful to CQC to have information coming from local healthwatch and HealthWatch England to CQC to alert it to problems such as those at Winterbourne View. This will give HealthWatch England a prominent position within a CQC that will have a strengthened role in assuring the safety and quality of health and adult social care services, and a strengthened focus on the concerns of health and social care consumers. This will ensure that from the outset HealthWatch England will have a greater presence and ability to influence than would a body established from scratch.
The Bill already contains significant safeguards to ensure that HealthWatch England will be able to operate effectively in that situation. For example, it will provide advice to a wide range of organisations. I have just mentioned central national organisations and local authorities. However, we listened carefully to concerns expressed in Committee about possible conflicts of interest between the CQC and HealthWatch England. This issue was raised again today. We therefore welcome Amendment 228, tabled by my noble friends Lady Cumberlege and Lady Jolly. It places duties on CQC and HealthWatch England to have regard to guidance from the Secretary of State about managing conflicts between these bodies. This is a sensible suggestion, and we are happy to support the amendment.
While acting independently, HealthWatch England must of course be accountable. Government Amendment 229 places a duty on it to send all local healthwatch organisations a copy of its annual report. It was the noble Lord, Lord Harris, who thought that this was a good idea and tabled an amendment to this effect in Committee. We agreed that it would help to secure the intended wide transparency and communication between HealthWatch England and local healthwatch. I am grateful to the noble Lord for flagging that up and suggesting the idea.
It is also important that local healthwatch—
Baroness Northover
No, I am going to continue, and if there are things that need to be dealt with at the end, I shall deal with them. It is also important that local healthwatch is able not only to provide information to HealthWatch England but to influence HealthWatch England’s actions on matters raised locally that may have national importance. Various noble Lords made that point and they were quite right. We therefore welcome, and will support, the amendments of my noble friend Lady Tyler.
Lord Warner
Are we allowed under the Standing Orders to hear the question of the noble Lord, Lord Harris? I would very much like to know what his point is.
Baroness Northover
If I wish to continue with the thrust of my argument—as the noble Lord, Lord Warner, said in the previous debate—I can do so. At the moment it is better if I lay out my argument. If there are points of clarification that noble Lords want an answer on, I will be very happy to give way when I have completed my argument.
We welcome and support—
Baroness Jay of Paddington
My Lords, I was not present when the noble Baroness had an exchange with the noble Lord, Lord Warner, on this matter. However, I have been in the House for 20 years and it is my widespread experience that of course the Minister is right to say that she must complete her argument. However, she has spoken for some minutes since the first intervention by the noble Lord, Lord Harris, and her argument has been well made.
Baroness Northover
The noble Lord, Lord Warner, wished to continue his argument against my noble friend Lord Phillips, and he did continue his argument.
Government Amendment 226ZG will enable HealthWatch England—
Lord Warner
May I just correct the noble Baroness? I actually anticipated that the noble Lord, Lord Phillips, was going to jump up. I did not stop him jumping up. He chose to withdraw.
Baroness Rawlings
May I just remind the noble Lord that the Companion sets out that a Member shall not speak twice on an amendment on Report.
Lord Hunt of Kings Heath
My Lords, I have to say that we are seeing a reinterpretation of the normal procedure on Report. Nothing in the Companion prevents a noble Lord intervening and asking the Minister a short question. The fact is that by ploughing on and refusing to answer questions, the Minister is not serving the House appropriately.
Baroness Rawlings
I shall just read from the Companion:
“A member of the House who is speaking may be interrupted with a brief question for clarification. Giving way accords with the traditions and customary courtesy of the House. It is, however, recognised that a member may justifiably refuse to give way, for instance, in the middle of an argument, or to repeated interruption, or in time-limited proceedings when time is short. Lengthy or frequent interventions should not be made, even with the consent of the member speaking”.
Baroness Northover
My Lords, it may help the House if I continue, but I am very happy to give way to noble Lords who wish to ask questions once I have gone through the various elements.
Government Amendment 226ZG will enable HealthWatch England to make recommendations of a general nature to local authorities about the making of arrangements for local healthwatch organisations and, where HealthWatch England is of the opinion that local healthwatch organisations’ activities are not being carried out properly, to draw this to the attention of the local authority.
Amendment 226A, tabled by my noble friend Lady Cumberlege, would place a duty—I see Companions spinning all around the House, so while noble Lords are studying that—
Lord Harris of Haringey
I want to ask a question, and I think the Minister has moved on to another point.
Baroness Northover
I am very happy to take noble Lords’ questions completely out of order, if need be, at the end if I have not addressed them.
Amendment 226A would place a duty on local healthwatch organisations to have regard to any advice or assistance provided by HealthWatch England under new Section 45A(2). We believe that this is too prescriptive. While we anticipate that local healthwatch organisations will welcome advice and assistance from HealthWatch England, a blanket requirement to have regard to the advice and assistance does not seem appropriate.
The Government very much agree that it is very important to get the membership of HealthWatch England right, the better to ensure its independence, and I thank noble Lords for their contributions on this issue. The Bill already gives the Secretary of State the power to make regulations about the appointment of members, and it is a power that we intend to use. In Committee, we said that we would take away and consider the suggestions put forward by noble Lords. We have heard what was said and have undertaken a public consultation on these regulations. Noble Lords have flagged up that a number of noble Lords are interested in local elections from local healthwatch organisations to HealthWatch England, and that is one of the issues flagged up in that consultation.
The consultation closed on 2 March, and the responses are now being analysed. Government Amendments 225 and 226—I thank my noble friend Lady Cumberlege for adding her name to Amendment 226—would ensure that regulations are able to make adequate and appropriate provision about HealthWatch England’s membership, including procedures for appointing members. It would also ensure that the regulations must require that the majority of members cannot be members of the CQC.
I now turn to aspects of the amendments relating to specific functions of HealthWatch England. It is interesting that some of these have not been flagged in the debate. Amendment 223A includes elements on patients’ complaints, and I think it is important for noble Lords to be aware of some of the elements in it. I would point out that statutory mechanisms have been in place for the investigation of NHS and adult social care complaints for a number of years, and a great deal has recently been done to improve these arrangements.
In 2009, the previous Government—and I give credit to them—following considerable public consultation, introduced new complaints arrangements for the NHS and adult social care. These reforms placed a greater focus on the outcome of the complaint and on speeding up the process. Importantly, they placed emphasis on resolving complaints at local level with recourse to the independent Health Service Ombudsman, if appropriate, so that organisations were better able to learn from their mistakes and to use the information to improve future service delivery. While there is room for improvement in the local handling of complaints, we support the reforms put in place by the previous Government, and it remains this Government’s view that complaints are best dealt with initially at local level. We wish to build upon these solid foundations. However, it is extremely important that the information that can be gathered from people’s experience is fed in and that an individual complaint is taken forward in a largely satisfactory way.
The relevant part of Amendment 223A, which deals with complaints, could, we believe, fundamentally change the nature of HealthWatch, compromise its primary role of consumer champion, lead to confusion among service users, duplicate current arrangements and impact adversely upon the role of the Health Service Ombudsman.
The noble Lord, Lord Patel, laid out extremely clearly what HealthWatch England needs to do. It is extremely important that it is recognised as a very important body in the new structure and that it has input from practical experience. The noble Lord is quite right that information needs to come up from local level to national level and that it needs to feed in at every point of the new architecture. HealthWatch England needs to be part of what drives up standards, and it is different from the regulator. Many noble Lords emphasised that. It is indeed the voice of the people. All, including the Secretary of State, have to listen to HealthWatch England, so it has a huge and important job. The noble Lord is quite right. It will not be buried in the CQC. Hosting is a very good way of describing its situation. It does not have to spend time and effort on back-office functions as CPPIH had to.
How Healthwatch England will be made up, its relationship to local HealthWatch and elections will be dealt with through regulations that will be informed by the consultation to which I have referred.
I now turn to the noble Lord, Lord Harris—
Lord Goldsmith
When will we know when the noble Baroness has reached the end of the argument so that we can hear the question that the noble Lord, Lord Harris, wants to ask? I am worried that the noble Baroness thinks that argument means speech. That has never been my interpretation or my practice at the Dispatch Box.
Baroness Northover
I am very happy to indicate when I think I have finished. I now come to answer some of the points made by the noble Lord, Lord Harris, or to address them at least. He may feel that I have not adequately answered them and, after that, he might like to hop up.
Baroness Northover
I bear in mind a long history with the noble Lord, Lord Harris, that goes back quite a way and includes his very complimentary remarks when I gave my maiden speech in your Lordships’ House. Noble Lords might want to look at them.
Both HealthWatch England and local healthwatch have statutory forms—perhaps the noble Lord, Lord Harris, might wish to hear this.
Baroness Northover
I am so glad. Both have statutory forms and functions so they cannot simply disappear in the way that he fears. I pay credit to him for all his work in this area over many years.
It was a shame that the noble Lord, Lord Harris, was not at the meeting yesterday to which the noble Baroness, Lady Murphy, has referred. With his formidable local government experience, I am quite surprised that he does not welcome the local authority involvement in the arrangements that we are putting forward. Had he been there yesterday, he would have heard the enthusiasm of the LGA, the chief executive of East Sussex County Council and others for their new involvement in health services. They are extremely keen to be best informed by flourishing local healthwatches. As they take on their new task, they see having that information as very important.
The noble Lord, Lord Harris, asked about the funding formula. Funding for local healthwatch will continue in a very similar fashion to LINks. It will be allocated primarily through the formula-based grant. Like LINks, this funding will not be ring-fenced, but each local authority’s allocation through the formula-based grants will be publicly available. I hope that that is of help to him. In addition, local healthwatch will receive additional funding through the DH learning disabilities and NHS reform grant.
I have various other responses to various other people, but perhaps the noble Lord wishes to put a question to me.
Lord Harris of Haringey
I am enormously grateful to the noble Baroness. She has answered some of the questions that I put. However, the question I wanted to ask related to her remarks about 15 minutes ago, when her argument seemed to be that this amendment recreated the former Commission for Patient and Public Involvement in Health. Does she acknowledge that this is a completely different structure, because it would be derived from the bottom up, with the support of local healthwatch organisations? What is more, it would not have to be encumbered by the bureaucracy that the Department of Health formerly imposed on that commission. It is a completely different structure.
Baroness Northover
I hear what the noble Lord says, but if he remembers the relationship and the aims of CPPIH, a lot of them echo the arguments that he has been making about such a structure. We may simply have to differ. The Government are very keen to have a structure that is up and running immediately, linking to, plugged into and influencing the national bodies that it needs to, and that it is not spending its time on its central structure. That is why this arrangement has been sought and that is the philosophy behind it.
The noble Baroness, Lady Masham, raised a number of issues, some of which will be considered in the next grouping. Perhaps I could come back to them then so that I do not take too long. I am astonished and delighted to see so many noble Lords who are interested in what I have to say on this.
My noble friend Lady Jolly asked about information-gathering, and she is absolutely right. In many ways this bears out how the CQC is very useful in this regard. By being hosted within the CQC, HealthWatch England will gain support from CQC expertise on the best methods of gathering and making the most of intelligence from local healthwatch. As part of HealthWatch England’s set-up plan, the CQC has dedicated resources to identify and develop the system that will support information flow between HealthWatch England and local healthwatch. I take on board very strongly what she said about the need for that information to be produced in a form that can be generalised and applied nationally, and that there are not lots of disparate bits of information that cannot be put together.
The noble Lord, Lord Warner, asked again about campaigning. I said in Committee that HealthWatch England and local healthwatch can campaign. I followed that up with a letter confirming that, which I hope he got—but perhaps he did not—and I reiterate it here. I hope that that is of help to the noble Lord.
Baroness Scotland of Asthal
My Lords, now that the noble Baroness has sat down, perhaps I may raise a point of order. I have to tell the House that I found the exhibition we have just had rather extraordinary. I have not been in this House for very long. Noble Lords will know that I came to the House only in 1997 but I had an opportunity to answer for the then Government from the Front Bench. It is certainly my experience that what would normally happen in this House is that if a noble Lord wanted to intervene, particularly at this stage in the proceedings, that person would be allowed to complete the sentence or the paragraph and would then sit down. Bearing in mind that it would be regrettable if this should become a pattern, I wonder whether we could ask the usual channels to look at these issues so that we will have clarity if we are about to adopt a new procedure.
Baroness Northover
In response to the noble and learned Baroness, if I was in any way discourteous, I apologise but I hope that I gave the opportunity at the end for anybody who had further questions please to put them to me.
Lord Patel
My Lords, I thank the noble Baroness for her response. I think that the conversation, or lack of it, was unfortunate because not only did it not allow people to put their questions at the correct time, it probably interrupted the noble Baroness’s flow of speech and thoughts. Having said that, I am flattered by her compliments on what I had to say. However, she did not address the fundamental point when I speak for those who are concerned about public and patient involvement. She has said that the statute provides that HealthWatch England will be a committee. That is quite different from a statute which provides that HealthWatch England will be independent. Again, there is a vast difference. Also, in terms of its functions, there is nothing in the statute that says that HealthWatch England will have the power to ask for or demand information in the interests of patients and the public in order to demonstrate that the quality of care provided is not adequate. Although the statute recognises that HealthWatch England will have strong relationships with Monitor, the Commissioning Board and so on, it will not have the power in statute to demand that independently. It has the power in statute to work through the CQC to ask for that. That is what concerns people outside. Indeed, while listening to the debate I was getting e-mails saying, “This is not what we asked for and it is not what we want. This does not give us confidence that we will have the necessary authority to respond”.
The one lone voice in the wilderness, although it might have been loud, came from the noble Baroness, Lady Murphy. She suggested that this is ideal because of one very good chief executive in mid-Sussex. I wish we could clone her. For every one that is successful there will be 10 failures, and it is those failures which a good, powerful and independent HealthWatch England would be able to address when a local healthwatch organisation fails because the chief executive is not being supportive.
There are many issues here. If we are serious about giving the public and patients a strong voice, the Government must recognise that they need strong support and that they need it for a long time. Although I have not been associated with patient and public organisations in England, I have been involved with them on three different occasions. In fact, I set up one of them. I should say to the Minister that I thought I did a brilliant job. I gave it all the powers one could possibly give in terms of setting standards, inspecting hospitals, writing reports and criticising every service. It worked well, but it fell down because its strong support was withdrawn. It is important to recognise that if we are serious about giving patients and the public a strong voice, we need to give them status. We should not treat them like juveniles who do not understand the issues. They should be treated with the respect they deserve and be given strong support.
Unless the Minister is about to tell me that suddenly she is hearing a different message and that we can have a further conversation and another opportunity to look at this, I am afraid that, for those outside who are concerned about this, I will have to seek the opinion of the House.
“(3) After sub-paragraph (5) insert—
“(5A) Regulations under sub-paragraph (1A) must make provision requiring a person who has power to appoint a member of the Healthwatch England committee to secure that a majority of the members of the committee are not members of the Commission.
(5B) Regulations under sub-paragraph (1A) may specify other results which a person who has power to appoint a member of the committee must secure.
(5C) Regulations under sub-paragraph (1A) may, in particular, make provision as to—
(a) eligibility for appointment;(b) procedures for selecting or proposing persons for appointment.(5D) Regulations under sub-paragraph (1A) may, in particular, make provision as to—
(a) the removal or suspension of members of the committee; (b) the payment of remuneration and allowances to members.”.”
“(aa) the making of arrangements in pursuance of arrangements made under section 221(1) of that Act (see section 222(2B) of that Act);”
“(2A) The function in this subsection is a power to make recommendations of a general nature to English local authorities about the making of arrangements under section 221(1) of that Act.
(2B) The function in this subsection is a power, where the Healthwatch England committee is of the opinion that the activities specified in section 221(2) of that Act are not being carried on properly in an English local authority’s area, to give the authority concerned written notice of its opinion.”
Baroness Massey of Darwen
Baroness Massey of Darwen
My Lords, first I apologise on behalf of the noble Baroness, Lady Tyler, who cannot be here today due to another speaking engagement. My amendments in this group seek to cover listening to the voice of the child in whatever structures or systems we end up with in the course of the Bill. The voice of the child is clearly important and I wish to address this one issue today. This is not just about adult patients among the public but children, too. I make explicit that HealthWatch England’s advice on the views of patients and members of the public must also refer to the views of children. These amendments are supported by numerous children’s groups and by the Royal College of Paediatrics and Child Health.
Children’s involvement in healthwatch organisations was debated in Committee on 15 December. The Government acknowledged that,
“local healthwatch needs to represent the views of all people within the local population, including children and young people”.
However, they rejected amendments that cited children as a specific group to be reached by healthwatch, saying,
“if you list one group you are in danger, therefore, of excluding others”.
Taking account of those concerns, I have tabled a new set of amendments, drafted to make explicit that the remit of healthwatch includes children without inadvertently suggesting that they should take preference over adults or any other group. In Committee, the Government offered assurance that when,
“the pathfinder local healthwatch organisations come into play, we will ensure that what noble Lords have said is flagged up to them”.—[Official Report, 15/12/11; col. 1499.]
I am concerned that flagging up the issue to emerging local healthwatch organisations will not be sufficient. I seek further assurances that consultation of children and children’s rights will be addressed. There must be a clearer steer at national level to make sure that the voices of children and young people are heard in the health system. I call on the Government to do three things. First, they should develop and disseminate guidance for local healthwatch organisations on effective engagement with children, drawing on pathfinders’ experiences. Secondly, they should conduct a review on how HealthWatch England and the local healthwatch organisations have involved children in their work two years after commencement. Thirdly, they should appoint a champion for children within HealthWatch England to oversee this work and drive forward standards on children’s engagement and decision-making.
This Bill is the first opportunity that parliamentarians have had to respond to the findings of the Kennedy review, published in September 2010, Getting it Right for Children and Young People. The Government response to the review accepted Sir Ian Kennedy’s powerful arguments about the need to engage children in the NHS, saying:
“In the past, the NHS was not always set up to put the needs of patients and the public first. Too often patients were expected to fit around services rather than services around patients. Nowhere was this more the case than for children, young people and their families … If we are to meet the needs of children, young people, families and carers, it is vital that we listen to them in designing services, gather information on their experiences and priorities, provide them with the accessible information that they need to make choices about their care, and involve them in decision making”.
In a welcome move, the Government promised in December 2010 to give due consideration to the Convention on the Rights of the Child when making new law on policy. As a signatory to that convention, the UK must take all possible steps fully to realise the rights and freedoms in the convention, including Article 12, which says that children should have a say in all issues affecting them and that their views should be,
“given due weight in accordance with the age and maturity of the child”.
The international monitoring body for the CRC, the UN Committee on the Rights of the Child, has been clear that the article applies to collective decision-making processes as well as matters affecting the individual child. Among its main recommendations was that the UK should promote respect for the views of the child. My amendments would implement recommendations in relation to children’s healthcare.
Local healthwatch will take forward the work done by local involvement networks, or LINks, in seeking the views of local service users in health and social care and involving them in the development of services. I urge noble Lords to amend the Bill today to make it clear that HealthWatch England and the local healthwatch should effectively involve children in their work.
A great deal of research has been done on this, including by the National Children's Bureau, which found that not all LINks understood that engaging children was part of their official remit. The review of law policy and practice by Participation Works found that although 41 per cent of GP practices had patient participation groups there was no evidence of children’s engagement in these forums.
The Council for Disabled Children document, Managing My Way, researched with disabled children and healthcare professionals, found that the majority of professionals felt they did not receive enough training to develop their skills in communicating with young people, especially those who have different communication needs. Research by the Institute of Child Health has found that the views of under-16s were sought in only one of 38 national surveys of patient experience in the NHS between 2001 and 2011. Young Minds found that in 80 per cent of cases young people were not involved in shaping local services. The Royal College of Paediatrics and Child Health and the NHS Confederation recently published a guide to involving children and young people in health services, which underlined the key role that children can and should have in planning and service delivery. The report says that,
“there is little incentive for organisations to systematically ensure a good and consistent standard of service for children and young people”,
unless they are involved in those services.
I look forward to the Minister's response, particularly the three issues—guidance to the local healthwatch, a review of the involvement of children in healthwatch and a champion for children in healthwatch. I beg to move.
Baroness Finlay of Llandaff
My Lords, I added my name to these amendments because I agree with all the comments that the noble Baroness has just made. Children and young people are stakeholders in health. They are also the future of our nation. They may be dependent at the moment while they are children and young people, but they are the leaders of the future. They have specific needs and their own views about the way that they are treated. If they are not listened to and considered in the way that services are planned, they will continue to feel that they are not valued as much as they should be by healthcare itself and that healthcare is not really placing their needs at its heart in provision.
In the Royal College of Paediatrics and Child Health handbook called My Right to the Highest Standard of Health, Professor Terence Stephenson wrote,
“we cannot afford to continue as we are. The health of our children is at stake and we need to address real issues, with real change that brings about real positive impact on the health outcomes for children and young people”.
Children and young people must no longer be treated as passive recipients of services. It is by feeling valued that their well-being will be increased. Particularly in prevention in healthcare, the engagement of young people is critical to ensure that health improvement policies and the whole public health agenda are taken up by the very group of people who will get the most benefit from them and will be most harmed if public health measures fail—that is, those who are in adolescence and about to transition into early adulthood.
Until now, unfortunately, as has already been said, some LINks have not seen fit for their remit to include children. Through these amendments, I seek reassurance from the Minister that healthwatch will be provided with the resources, knowledge and capacity to involve children and young people effectively and will therefore be able to represent their needs and interests on a local and national level. It cannot be viewed as a tokenistic voice.
I shall cite an unfortunate example that the RCPCH has brought to my attention. A large teaching hospital trust was preparing an application for foundation trust status. As part of the process it was asked to show evidence of patient and public participation, including the involvement of children and young people. In response to this, the trust asked for some young people who were in-patients to receive a patient satisfaction questionnaire. A number of young people completed the questionnaire as requested, but the results were not used during the foundation trust application as the opinions voiced by the young people were at odds with the views of the management team. That is a clear example of tokenistic consultation but then doing nothing about the answers that are received.
Children are able to contribute in a very generous way to the shaping of healthcare services because they will comment quite openly, not only on what they need and what would make their journey through health better but on the experience of others that they encounter on the way. Children and young people with chronic conditions will form close friendships and bonds with other patients in their cohort, whom they will meet regularly when they attend different treatment sessions, and will be concerned about the welfare of those other children. In the days when I was working in paediatrics, I recall vividly how children in the leukaemic unit would ask about the welfare of other children. They would want to know what had happened to a child who had died and to talk about where that child had gone. One little boy commented on another, “At least now he’ll be able to do what he always wanted to do. He’ll be playing football, but it’ll be in heaven”.
Children know what they need, where they want to go and how they want to be involved and consulted. The whole tenor of our health services can be greatly improved by actively seeking out their views and acting on them, however difficult and uncomfortable those views might be.
Baroness Masham of Ilton
My Lords, I also have my name to the two amendments in this group. Children need protection and the support that my noble friend Lady Finlay has just talked about. So much more should be done for children, but the big problem is that they fall under so many different departments which are far too isolated. I am thinking now of the young people who are at risk from drugs and alcohol. I went to a presentation last week where there were photographs up of young children who had died from a combination of drugs and alcohol. So much should be done.
I hope that the Minister will answer my question from the previous debate about children and the risks that they face, taking Baby P as an example. Again, many departments came in and he fell through the net: health, the police, child protection and local authorities. They should be working together for children. We really need to protect them.
Lord Warner
My Lords, I speak from a background of having been a director of social services and being involved in reforming youth justice. Collectively, the adult world is very bad at representing the needs of children to service providers. It would be a modest but important change in this legislation if we brought out that the term “people” does include adults and children. A lot of people in the adult world simply assume that “people” means “adults” and does not mean “children”. We see in the NHS, for example, particularly for the teenage years, that services are often provided in a way which is almost bound to deter engagement and involvement by young people in receiving those services and in dealing with some of the problems that they have.
We need to change the culture. We must ensure that in the new healthwatch system—whether it is the one that some of us would have liked or the one that there will actually be—people are sensitive to the needs of children, particularly at the local healthwatch level, and that those needs are not overlooked. It is not just a matter of making children feel better and that they are being listened to. It is actually about how we can get the services shaped to head off at a much earlier stage some of the trouble that is looming for many of these children, in terms of obesity, drugs, sexual health and unwanted pregnancy. I hope that the Government will listen sympathetically to this and move the kind of amendment that my noble friend Lady Massey has moved so ably.
Lord Low of Dalston
My Lords, I cannot speak with anything like the authority of the noble Baroness, Lady Finlay. Few of us can. The noble Baroness, Lady Massey, has obviously been working off the same brief that I have been looking at, so there is little that I can add to what she said. However, I was struck by the research findings that she told us about, which make clear the lack of attention that is paid to the involvement of children. I note also that there were concerns expressed around the involvement of children in patient and public voice mechanisms in the NHS. These concerns were reflected in the report of the Future Forum. Therefore, I think there is every reason to make the involvement of children explicit on the face of the Bill.
Baroness Thornton
My Lords, we welcome the amendments. Anxiety has been expressed by children’s organisations on two fronts throughout the course of the Bill. One is that the fragmentation and reorganisation proposed in the Bill mean that the safeguarding of children’s health may be lost in some way. The second is that it is not clear that children’s voices will be heard, which is the subject of these two very modest amendments. I hope that the Government will accept them. I cannot see any reason why they should not.
Baroness Northover
My Lords, we have great sympathy with Amendments 227 and 233. It is indeed vital that the voice of children is sought throughout the system and we agree that HealthWatch has a key role to play in this at both national and local levels. I thank the noble Baroness, Lady Massey, for the important points to which she and others drew attention. As we know, the noble Baroness has a long record of promoting the rights of children.
We are aware that some LINks have, as the noble Baronesses, Lady Massey and Lady Finlay, said, struggled to engage fully with children and certain groups of adults. It is very important that local healthwatch learns from that and is clear about the importance of engaging with children and young people. However, we do not feel that we should specify particular sections of the population in the Bill, although local healthwatch and HealthWatch England need to seek out views, especially of those who are hard to reach.
The noble Baroness, Lady Massey, spoke about guidance on engagement with children for local healthwatch. I can assure her that professionals and service users’ representatives are, through the Children and Young People’s Health Outcomes Forum, currently working with the Department of Health to develop a children and young people’s health outcomes strategy and to ensure that detailed design and development work is done with children and young people in mind. This includes HealthWatch. I can confirm that five local healthwatch pathfinders include a focus on children and young people. We hope to learn from that and that other local healthwatch organisations will learn from their experience. HealthWatch England will be able to use the work of the children and young people’s health outcomes strategy, the experience of the pathfinders and wider development work to develop advice and assistance to local healthwatch organisations on effective engagement with children, young people and their families.
The noble Baroness, Lady Massey, also suggested that we conduct a review of how HealthWatch England and local healthwatch involve children in their work. That is a very valuable idea. We fully agree that we should look at reviewing this, perhaps after three years of operation, to see how effectively HealthWatch England and local healthwatch have involved children and other hard-to-reach groups in their work.
The noble Baroness also suggested having a champion for children within HealthWatch England to drive forward children’s engagement. I hope I have reassured her that involving children will be a priority for HealthWatch England and local healthwatch. However, we believe that it would not be appropriate to have a children’s champion or, indeed, a specific representative for any patient group.
In the next group of amendments we will look at a definition of “people” that came from my noble friend Lady Jolly. That rather bears out what many noble Lords have said about making sure that we do not have just a narrow focus but recognise that we must not overlook groups such as children or hard-to-reach adults which have not necessarily had their voices heard in the past.
I was asked by the noble Baroness, Lady Finlay, whether HealthWatch will have the resources to involve children fully. Yes, it will. Representing people of all ages will be a core function of HealthWatch and will be resourced at a level to ensure that it can fulfil its duties and functions. The noble Baroness, Lady Masham, spoke strongly about how important it is to involve children and young adults, as did the noble Baroness, Lady Finlay, and others. I very much agree and feel that HealthWatch offers great potential to improve involvement in this area. Throughout everything that we are doing we are seeking to join up and integrate in the important way that she flagged up in her comments.
Although I cannot take forward the idea of the champion, nevertheless we understand and take on board the other suggestions that the noble Baroness, Lady Massey, has made. We are keen that HealthWatch England and local healthwatch groups reach out to a number of groups whose voices have not necessarily been heard in the past. Even if the noble Baroness is slightly disappointed with that response, I hope that with these other reassurances she will feel able to withdraw the amendment.
Baroness Finlay of Llandaff
Before the noble Baroness sits down, does she recognise that the legal status of children differs from that of adults? That is why they do not fall into the same category as many other vulnerable groups. Children do not reach the age of majority until they are 18, although they can consent to some things at 16. Therefore, they are always dependent on a responsible adult to speak for them or to open the door for them, as it were. They cannot form a group in the way that others in the population can to speak up for their rights and what they need. Will the noble Baroness reassure us that the Government recognise that the legal status of children differs from that of adults, and that if these amendments are not to be accepted, careful consideration will be given as to how that can be made explicit in the Bill before it completes its passage?
Baroness Northover
The noble Baroness made a poignant case for why children need to be listened to. I hope I can reassure her that HealthWatch England and local healthwatch have a responsibility to hear the voices of everyone, whatever their age. I accept what she says about the legal status of children. However, as she made very obvious, that does not mean to say that we cannot hear their voices and take very seriously their perception of how they can best be treated.
Baroness Massey of Darwen
My Lords, I thank all noble Lords who have taken part in the debate on this amendment. I am aware that there is a very powerful lobby in this House which supports the voice of the child in all matters and supports children’s welfare generally. There is also a very powerful lobby outside of children’s organisations that are dedicated to providing children with what they need.
I thank the noble Baroness for the reassurances that she has given. However, I stress that the research I quoted contains clear evidence that the voice of the child is often overlooked. We must be vigilant that it is not overlooked in the future. One of my three queries to the Government concerned disseminating guidance. I fully accept that there will be a health outcomes strategy for children. However, we have to keep an eye on that and see what happens in relation to the contribution of children’s voices to carrying out that strategy.
The noble Baroness said that there would be a review of how HealthWatch England and local healthwatch involved children. I suggest that two years after commencement is a sufficiently long period. I am disappointed about the champion issue because without advocacy some vulnerable groups will be neglected, which is never a good thing. I will follow up these issues with the Government. In the mean time, I beg leave to withdraw the amendment.
Baroness Cumberlege
“45AA Conflicts of interest
(1) In making arrangements under section 45A(1), the Commission must have regard to any conflicts guidance issued by the Secretary of State.
(2) In exercising functions on behalf of the Commission, the Healthwatch England committee must have regard to any conflicts guidance issued by the Secretary of State.
(3) In this section, “conflicts guidance” means guidance about managing conflicts between—
(a) the exercise of functions by the Commission, and(b) the exercise of functions by the Healthwatch England committee on the Commission’s behalf.”
Baroness Jolly
“(3A) Where a recommendation is made to the committee under section 221(2)(ga) of the Local Government and Public Involvement in Health Act 2007 (reports under subsection (3)), the committee must have regard to the recommendation.”
“(14) The Healthwatch England committee is to be treated for the purposes of section 2(1) of the Public Bodies (Admission to Meetings) Act 1960 as a body that includes all the members of the Care Quality Commission.”
Baroness Bakewell
“Healthwatch England’s Commissioner for Older People
(1) The Health and Social Care Act 2008 is amended as follows.
(2) In Chapter 3 of Part 1 (quality of health and social care), before section 46 and the preceding cross-heading insert—
“Healthwatch England’s Commissioner for Older PeopleHealthwatch England’s Commissioner for Older People
(1) A member of Healthwatch England shall be designated as the Commissioner for Older People in England.
(2) The Commissioner shall exercise their functions independent of their role as a member of Healthwatch England.
(3) The general functions of the Commissioner shall be to consult with and garner the opinions of older people, and to represent those opinions in all arenas of public discourse including Parliament.
(4) The Commissioner shall be free to set its own parameters within the broad context of monitoring institutions.
(5) The Commissioner must encourage the involvement of older people in the work of the Commissioner.
(6) The Commissioner must, in a particular, take reasonable steps to listen to and consult with older people on the work to be undertaken by the Commissioner.””
Baroness Bakewell
My Lords, the amendment calls for a commissioner for older people. When I moved such an amendment in Committee, I suggested the role as a freestanding one. In this amendment, I seek to have it subsumed into the agenda of HealthWatch England, requiring a commissioner to be a member of HealthWatch England but exercising this function entirely independently.
After a fruitful meeting with the noble Earl, Lord Howe, I realise that there are certain limitations around this suggestion—also put to me by other Members of this House—to which I shall come in a moment. However, first let me briefly revise the need for such a position. On every hand, the calls get stronger for the case of the old to be heard. Earlier this week, some 1,000 older and disabled people came to lobby their MPs about the crisis in social care. The Care and Support Alliance, which organised the event, represents more than 60 charities and organisations across the social care and health sectors. MPs heard stories from some of the estimated 800,000 people needing care who are currently not receiving it. Recent reports from the Equality and Human Rights Commission and the Commission on Dignity in Care have reported neglect and abuse. All this since the Committee stage of the Bill. Older patients take up most of the beds in our hospitals where they are patronisingly accused of bed blocking. Given the demographics of a growing population, this situation is set to get worse. No one now doubts that there is a growing national crisis.
All these commissions and reports are fine and often very thorough. However, they tell us about “them”, the old—a category of the population who need to be dealt with and have their needs met. But the old are not a lumpen mass; they are each as highly individual as those in any other age group. They need someone to speak in different terms and in a different tone about, “what we need” and, “what I am asking for”. A commissioner for older people would answer that need and relate directly to the personal stories that arrived in my post bag when I was the Voice of Older People. I feel confident in saying this because Wales already has an Older People’s Commissioner—Ruth Marks, who has a fine record of touring the country, visiting care homes, day centres and individuals, and bringing individual concerns to bear on the Government in Cardiff.
Let me now come to the limitations of this role. The NHS Future Forum report states:
“If the fundamental purpose of the Government’s proposed changes to NHS—putting the patient first—is to be made a reality, the system that emerges must be grounded in systematic patient involvement”.
The problem here is the word, “patient”. Older people are indeed patients, but their needs extend much further than this. As the noble Earl discussed with me in our very useful meeting, the needs of the old extend much further. They extend to matters that concern not only health but work and pensions, housing and transport. They extend across all other activities of life and all departments of government. I am wary of confining the function too tightly within the health Bill agenda. I take the noble Earl's argument, and other Members of the House have expressed similar concerns. I would value their views on this matter put on the record.
However, we have to start somewhere. Some initiative has to start the ball rolling. People want their voice, our voice, a voice, to speak out about our needs. The impulse to establish such a post is right, but the move to have a commissioner for older people has to be triggered somewhere. I hope that it will be triggered by the amendment. I beg to move.
Lord Hunt of Kings Heath
My Lords, my noble friend has made a powerful case for having a champion for older people to look not just at the impact of decisions made in the NHS but going much wider. She is right to refer to pejorative remarks such as bed-blocking being very insensitive to old people. We face a considerable challenge within the health service to ensure that we are sensitive and reflect that there is huge demand from frail older people which is not being met as effectively as we would wish.
My noble friend said that the amendment may not be perfectly formed but that we have to start somewhere. I wonder whether the noble Earl, late on this Thursday afternoon, might give some comfort. After all, it would not be impossible within HealthWatch England to have a designated person with responsibility for overseeing—or, if you like, monitoring—services for older people. It could be well worth exploring whether the thought behind my noble friend's amendment is worth pursuing.
Baroness Barker
I just make two or three simple points. I have enormous sympathy with the amendment of the noble Baroness, Lady Bakewell. My party's policy is in favour of the establishment of an older people's commissioner in England, building on the interesting work that has been done in Wales. I have a great deal of sympathy with what she is trying to do. She made the argument that one has to start somewhere. I disagree with her that this is the right place to start. If one had to start somewhere, it should be in social care. The deficiencies in social care matter more to more older people than those in health.
Having said that, the noble Lord, Lord Hunt of Kings Heath, is right. Given that older people are by far the biggest users of NHS services, it would be remarkable if healthwatch were not to include people with the expertise to follow up older people's issues.
My deep resistance stems from two things. First, I think that the biggest challenge set out in the Bill, which has been overlooked, which is why I take the opportunity to mention it again, is the challenge for the NHS to get to grips with social care and enabling older people—all people, but, by definition, older people—to live healthier lives for longer and not to wait until they turn up in the NHS.
However, my fundamental point is that I have talked to lots of older people over the years and I believe that old age has to be about more than the health service. If the only government recognition that older people have is the right to have someone to complain about the health service, I think we will be in danger of medicalising old age and inadvertently removing the full experience, wealth creativity and knowledge that older people bring to many aspects of life. I know that, given her former role, the noble Baroness, Lady Bakewell, would not intend that. Therefore, I hope that she will accept my support for what she is trying to do and my reservations about the way that she is trying to do it with this amendment.
Baroness Masham of Ilton
My Lords, perhaps I may ask a question following the speech of the noble Baroness, Lady Barker. Does healthwatch not cover health and social care? If it does, the noble Baroness, Lady Bakewell, has a strong point.
Earl Howe
My Lords, while, for reasons which I shall explain later, I do not feel able to accept this amendment, I say immediately to the noble Baroness that she has raised a very important issue with which the Government are in complete sympathy.
It is important for older people to have a strong voice to champion their interests and to ensure that their needs are addressed in public services. Both I and my honourable friend the Minister of State for Care Services have met the noble Baroness over recent months to discuss this issue and have been struck forcefully by the powerful case that she has made. As she is aware, my honourable friend would like to continue these discussions with her, as we are particularly grateful for the expertise that she brings to this area.
I am sure noble Lords will agree that older people are affected by a wide range of issues—not only health and social care but areas of policy such as housing and pensions. The Government recognise this. The UK Advisory Forum on Ageing, co-chaired by the Minister of State for Care Services and the Minister of State for Pensions, provides advice across government on the additional steps that they and their partners need to take to improve well-being and independence in later life.
In health, a range of functions in relation to older people are already carried out in this country. That should not surprise us because we all know that a very large proportion of the NHS budget is accounted for by healthcare delivered to the elderly. The Department of Health is pursuing a number of initiatives to improve the care of older people in hospitals, care homes and other settings. These initiatives cover all stages of the care pathway—from helping individuals to stay healthy and to stay in the community all the way through to end-of-life care. For example, the department already has a National Clinical Director for Older People, Professor David Oliver, whose remit is to promote the better care of older people across the NHS and social services, and to provide clinical leadership for cross-government work on older people.
My noble friend Lady Barker rightly stressed the key role of social care in relation to older people. Looking across the spectrum of health and social care, each health and well-being board will be required to develop a joint strategic needs assessment, identifying the current and future needs of the local population, and a joint health and well-being strategy to set out how those needs will be met. I can say to the noble Baroness, Lady Bakewell, that it is intended that health and well-being boards will bring together the key local commissioners to enable them, first, to consider the total resource available to improve their population’s health and well-being, and then to come to a joint understanding about how those resources can best be invested. This will undoubtedly help to encourage a more integrated local service which is better able to meet the needs of older people by joining up NHS and social care services. I hope that that offers some reassurance to the noble Baroness that the voice and needs of older people in health is absolutely a priority for this Government.
Amendment 231A proposes that the role of commissioner for older people should fall on a member of HealthWatch England. I am afraid that I cannot agree that that would be an effective approach. The first reason is the one that I mentioned earlier: the role of an old people's champion goes wider than health and social care. Equally importantly, the job of HealthWatch England will be to carry out functions in relation to people. The word “people” is a deliberately broad term and its ordinary meaning would include older people of course, so we do not feel that it would be appropriate to give a member of HealthWatch England a remit for older people, which would give additional weight to one group of people over another. It could also lead to calls for a commissioner for other groups like those with learning disabilities and it would be difficult to see where the list would stop.
Although I completely understand the concern that older people have often lacked a voice within the system, and the need to ensure that they are not overlooked, we do not agree that the singling out of this group over others, within the context of healthwatch, would be the best way to achieve that. We want to address the concerns of the noble Baroness but not in this way. In the light of that and on the basis that she will continue to have discussions with my honourable friend on the issue in a wider sense, I hope that she will feel sufficiently reassured to withdraw her amendment.
Baroness Bakewell
I thank the noble Earl for that engagement with the argument which I hope to start. Having a toe in the door, I hope that I can keep it open and perhaps prise it a little bit further open.
The noble Earl cites all the amazing institutions which are responsible for older people and one wonders why there is such a catalogue of misery across the country. Why are things going wrong? Why do they not answer the needs of older people? Why are there so many people catalogued as living wretched lives and writing letters of complaint, virtually with tear-stained ink? This is a major problem that the system is not answering. Therefore, I hope to take the issue further.
I very much agree with the noble Baroness, Lady Barker, that we should not medicalise the issue of being old. We have to keep old people fit so that they can enjoy old age. If this matter is to be referred to other government departments, I would include the DCMS so that access for older people to theatres and cinemas, help with hearing and so on can improve their quality of life. There is much to be improved, as we all know. I welcome the noble Earl’s commitment to making that so and I hope to follow it up in future. I beg leave to withdraw my amendment.
Baroness Northover
Baroness Northover
I shall speak also to the other government amendments in this group relating to local healthwatch. Local healthwatch goes to the heart of the Government’s ambition for a health and care service that is centred around patients and users. In the consultation paper Liberating the NHS: Local Democratic Legitimacy in Health, published in July 2010, the Government stated:
“Local authorities have a vital role in commissioning HealthWatch arrangements that serve their local populations well … In the event of under-performance, a local authority should intervene; and ultimately re-tender the contract where that is in the best interests of its local population”.
Local healthwatch will go further than just gathering views; it will be there to support individuals by providing information and advice about access to services and choice. We firmly believe that this will enable people to take more control of their own health, treatment and care, and understand and use the increased choices available to them. I am sure noble Lords will agree that this kind of support will be invaluable.
As a corporate body with a statutory function of carrying out statutory activities, local healthwatch will gather information about people’s views and experiences of the health and social care system. This will enable the voice of people to reach commissioners and providers of health and social care services, a link that has been lacking in the past.
Local healthwatch will have a seat on every statutory health and well-being board which will prepare statutory joint strategic needs assessments and joint health and well-being strategies, which will inform local commissioning plans. Through local healthwatch the patient voice will influence and inform the work of the health and well-being board. I hope that noble Lords will agree that this will give local healthwatch much more influence at the decision-making table and will help hardwire public engagement into the strategic planning of health and care services from the start.
The evidence and insight gathered by local healthwatch will also inform HealthWatch England and enable it to advise on the national picture—for example, where it sees a pattern across a number of local concerns—which will ensure that local views will be able to influence national policy, advice and guidance. This role will be strengthened following the amendments of the noble Baroness, Lady Tyler, which we accepted earlier when debating HealthWatch England.
We have always envisaged that local authorities, which will be responsible for commissioning local healthwatch, will have flexibility about its organisational form. This will enable them to take account of local needs and circumstances. We are pleased that senior voices within local government support the Government’s policy intentions and are willing to use their leadership role to help support local authorities to drive effective commissioning and implementation at local level. This approach to local healthwatch aligns with the Government’s localism agenda. However, on reflection we realised that greater flexibility was needed over the organisational form of local healthwatch, and for this reason we tabled the amendments in this group. We do not now think that prescribing from the centre that local healthwatch must be a statutory body corporate with an exact form is the best way forward.
Before listening to the views of noble Lords, perhaps I may address some concerns around the Government’s approach to local healthwatches. The first relates to their status as statutory bodies with statutory functions. One issue that LINks have faced is the model itself. As they are inherently loose networks, they require a host to provide administrative and other support, which has caused difficulties in some areas. By establishing local healthwatch as a body corporate we will avoid the difficulties of this, as the local healthwatch will be able to employ staff as well as involving volunteers.
It is important that local healthwatch organisations will be corporate bodies with statutory functions setting out their powers and duties. We agree with the assertion of the National Association for Voluntary and Community Action that,
“a network of vibrant community led organisations, answerable to local people, will have far more bite than over 150 unaccountable quangos”.
If we were to set out the more rigid requirements that statutory corporate bodies would have, this would be more likely to lend itself to the creation of such quangos.
Secondly, a number of noble Lords are concerned that there is a risk that a local authority will not wholeheartedly embrace entering into a contract with a body that will then criticise it. It is not new for local authorities to commission bodies, partly or fully, which then make their views known in feedback or reporting arrangements, with the net result of improving services locally. Examples include citizens advice bureaux, tenant organisations, legal advice centres and advocacy support. I assure noble Lords that these groups tend not to be afraid to come forward, and that most local authorities welcome such insight—as we heard yesterday from the LGA and others at the meeting to which noble Lords referred. It follows that there should be no problem were a local healthwatch organisation to share differing views or constructively criticise a local authority’s commissioning or provision of care services. It will be useful for local authorities to hear that feedback.
The needs of local communities should play a part in who is contracted to become the local healthwatch. We want to ensure that the expertise that exists in the community has the opportunity to contribute to local healthwatch. For example, a local authority could commission a community interest company, charity or other form of social enterprise that meets the prescribed criteria. Local authorities will be best placed to make such decisions, based on their knowledge of their local area, and it will be right to allow each to commission a local healthwatch that is right for them.
Thirdly, a key failing of many LINks is their inability to involve a wide range of people and different sections of the community. We discussed this when debating the previous group of amendments. The result is that they lack diversity in their membership, which makes them unrepresentative of their local population. These issues are being addressed by healthwatch. There is a duty on healthwatch to be representative, in the sense of the population demographics of an individual local community, when carrying out its functions. In order for local healthwatch to be truly representative across the individual local community, the ambition is that it will be part of a system rooted in local experience, harnessing the expertise of the public, community and voluntary sectors and others at the local level, particularly those working with people and groups who have a difficult time getting their voices heard. I beg to move.
Baroness Cumberlege
My Lords, I have three amendments in this group. My Amendment 232, which is supported by my noble friend Lady Jolly, limits the role of the local authority vis-à-vis local healthwatch to just “pay and rations plus”: that is to say, it makes sure that local healthwatch operates economically and efficiently, and develops work plans and delivers them, but does not interfere with what is in those work plans. This addresses local healthwatch independence and the local authority’s accountability for respecting it. I see that the Government’s policy document reflects this at paragraph 3.7, which states that local healthwatch will be,
“able to decide their own priorities and programmes of work, they will account to the local authority for their effectiveness and use of public funds. In turn, local authorities will be responsible for ensuring they are adequately funded and able to operate effectively”.
That goes back to the point raised earlier by the noble Lord, Lord Harris, about funding.
After the concessions that have been made by the Government to my amendments, I am very reluctant to appear to be ungrateful or ungenerous, but I have to say that I am extremely concerned. I have had meetings with both my noble friends on this issue, but I am extremely concerned that as a result of new subsection (2B) proposed in government Amendment 235D—it puts lay people in, as I see it, a subsidiary foot-soldier role with no decision-making power—it is only paid staff in the local healthwatch social enterprise who will make decisions, for example, about criticising services in a local authority on which they depend for their employment. I fear that this wipes out the independence of local healthwatch from the local authority at a stroke. I am seeking assurances that the Government will think again on this as it undermines the whole plan and their intention to give local healthwatch the voice that it so badly needs.
My Amendment 237 provides a regulation-making power on how local authorities make their decisions about local healthwatch and, particularly, its funding. The Government’s Amendments 226ZB to 226ZG help to address this by expanding the HealthWatch England role, especially by broadening its advice from specific to general in Amendment 226ZC and its new functions in Amendment 226ZG. This is very welcome, again providing we can have reassurances on Amendment 235D. At local level, my Amendment 236 puts beyond doubt that local healthwatch has statutory functions rather than mere activities, so that it can be clearly held to account for what it does by local people. I am very glad to see that the Government have addressed this in new subsection (2A) proposed by their Amendment 235D.
The accountability framework that I am seeking consists of local authorities influencing whether local healthwatch performs its functions, and I shall give three very quick examples. First, has representative membership taken place in local healthwatch and does it undertake enough work to make productive reports and recommendations? Secondly, are local people dictating what local healthwatch chooses to focus on when doing so? I am thinking of care homes, for example. Thirdly, does it work to the standard set by HealthWatch England? I am thinking of the quality of governance and the rigour of engagement. Local healthwatch needs to be able to get on with the job of giving local people influence on their local services as soon as possible with maximum support and minimum interference. Many of the latest amendments from the Government are a positive contribution to this objective, but there are new, very significant concerns, particularly about lay leadership, and I hope that the Government will address those issues today.
The greater their independence and transparency, the easier local healthwatch organisations will find it to recruit local people to their cause. We know that there are some highly motivated, very courageous and experienced members of local involvement networks who have the knowledge, skills and relationships to give us value for money. This is particularly important at this time of transition. I agree with my noble friend Lady Northover that it is important to get over the administration process as soon as possible.
We know that there are people getting less than good care and treatment who need a voice, who need advocates to speak for them, advocates who are not treated as mere complainers but knowledgeable people who have real power and influence to improve health and social care. I hope that my noble friend will think about these issues.
Baroness Jolly
My Lords, I was happy to add my name to Amendment 232, tabled by the noble Baroness, Lady Cumberlege, which puts in the Bill that it absolutely is the responsibility of the local authority to provide the finance for the local healthwatch to carry out its functions.
The local authority needs to develop confidence in its local healthwatch organisation—to see it as a partner, not a threat—enabling it to deliver not only its own services more effectively but those of its health partners. I hope that the Minister can indicate what might be the route to resolve any disputes about funding allocations to local healthwatch.
I will now talk about lay leadership on local healthwatch organisations. Lay leadership is absolutely critical to local healthwatch, and the noble Baroness, Lady Cumberlege, has outlined exactly why that is. It is a new PPI organisation and will need quickly to demonstrate integrity and independence to inspire local trust. The Government’s own model for user-led organisations points the way and I commend it to the Minister. It calls for 75 per cent lay or user representation on the board. Will my noble friend confirm that any guidance the Government produce will give clarity on the composition of lay membership and the involvement of lay members in the day-to-day work of the local healthwatch and that the results of the government consultation exercise will be taken due note of?
Finally, I come to a definition contained within my Amendments 234 and 235. “Local care services” are defined in the Health and Social Care Act 2008 as both health and social care, but “local people” are not defined. This definition is to ensure that no one is omitted from the remit of local healthwatch. It encompasses people living in the council area covered by the local healthwatch, people receiving care in the area and people from the area who are receiving care elsewhere.
Local healthwatch organisations will be critical in the monitoring of the new patterns of health delivery called for within this Bill. They will be vital to ensure that standards do not fall in the time of austerity, and I wish them success.
Lord Harris of Haringey
My Lords, this is a complicated group of amendments. There are, I think, 50 government amendments in this group that completely change the direction of this part of the Bill. Of course, we do not have the benefit of a Committee consideration of these changes, which is unfortunate, given the nature of the changes that are envisaged.
In fact, what we are being confronted with is an almost extraordinary volte-face by the Government about how local healthwatch organisations are going to operate and proceed. As it stood, before these amendments, the Bill provided local healthwatch with a very clear structure and very clear governance. It defined membership and it defined their role. As such, the arrangements were better than LINks, better than PPI forums and, in one or two respects, better than community health councils. It was a very clear statement. There remained the problem that local healthwatches were going to be the creatures of local government without the benefit of ring-fenced money and with the potential issues around conflicts of interest concerning social care. I am reminded that on 15 October 2007, the noble Earl, Lord Howe, clearly took the view that it was inappropriate for a local authority to be host to a LINk. Presumably, the same arguments that influenced his thinking then apply on this occasion.
We have been offered guidance on conflicts but, again, it is not clear how this will work, which is something that we could have pursued perhaps in detail in Committee. The amendment refers to having regard to the guidance on conflicts, which I suspect will not necessarily be strong enough for the sorts of conflicts of interest that potentially could arise. We also have the enormous concession, to which I referred earlier, of Amendment 226ZG, which enables HealthWatch England to write a letter if it feels that something has gone wrong.
That is where we were but now the Government, without explanation or consultation, have decided that local healthwatches will no longer be statutory bodies. We are told that that is all in the name of the need for flexibility. The noble Baroness has mentioned repeatedly the briefing which took place yesterday evening, to which, incidentally, I was not invited. Even had I been, I would not have been able to attend because the meeting clashed with the regular meeting of Labour Peers, which one would think that the Government would wish to avoid. At that meeting various papers were tabled which referred to the importance of flexibility but we are not clear as to what that flexibility will deliver.
In moving the amendment the noble Baroness talked about the Government’s proposals in the Bill as creating a series of “unaccountable quangos”. I recall previous briefings which I attended with Ministers and the Bill team when it was explained that there would be guidance about how the membership of local healthwatch was going to be derived and to demonstrate that these were going to be accountable bodies and not unaccountable quangos. Somewhere along the line, in the past few weeks, there has been this amazing change of attitude, which does not seem to follow the benefit of any real explanation or consultation with those who might take an interest in it.
That underpins the amendments spoken to by the noble Baronesses, Lady Cumberlege and Lady Jolly. The noble Baroness, Lady Cumberlege, highlighted the difficulty that would arise between members and staff. The noble Baroness, Lady Jolly, talked about the importance of lay leadership. In terms of the changes, the Government are going to make it more difficult for there to be lay leadership and the role of members versus staff will be blurred still further. Indeed, the staff will be the dominant influence.
This is not a matter on which there has been consultation. I have received a note from the National Association of LINks Members, which states:
“Ministers say that they are ‘not convinced’ that LHW needs to be a stand-alone, statutory body corporate. It is not ministers who will be relying on LHW to get them a fair shake but the old, sick, vulnerable, frightened and marginalised and these, along with the rest of the patients and the public, are the ones who need to be ‘convinced’ that we have a model that will work”.
It says that it is not convinced. It points out that local healthwatch should,
“have a standard ‘platform’ of presence everywhere in England, not merely through logos, straplines and brands”—
which the Government’s amendments will make happen—
“but through a locally elected membership, a single ‘address’ and identifiable staff that it has appointed”.
It says that only:
“Statutory, body corporate status would deliver this”.
It continues:
“Government says it does not want a top-down model but it is making top-down decisions, and these fly in the face of all the evidence of the past three and a half years of LINks, all the advice of all the LINks’ members of the government’s own HealthWatch Advisory Board, of the National Association of LINks Members, all the advice of many, many LINks all over England. ‘Being heard’ has simply vanished from the national scene. The government pontificates on what it does not practise. It legislates but it does not listen”.
It suggests, although I could not possibly automatically agree, that:
“What the Government actually fears is 152 statutory LHWs, with genuine independence, with real clout and public buy-in, a separate identity, and powerful and committed membership”.
If that is the concern, where do we go from here? I am taken with the sage advice your Lordships received from the noble Earl, Lord Howe, when we debated the creation of LINks, the slightly ill-fated proposal by the previous Labour Government. The noble Earl, in his typically courteous but forceful way, said then—given these government amendments, you can simply substitute HealthWatch for LINks:
“We have come to a group of amendments most of which in their different ways relate to the same problem. I use the word ‘problem’ as the most neutral term I can readily think of for what many of us regard as a most serious and regrettable weakness in this part of the Bill; namely, the absence of even the slightest hint of a statutory identity for LINks. There is a complete lack of any descriptive reference to what a LINk might look like and practically no definition of a LINk”.
That was the noble Earl, Lord Howe, talking about the creation of LINks. Yet today he has brought forward amendments—admittedly he has delegated this to the noble Baroness, Lady Northover, who is acting as his mouthpiece on this occasion—that will do precisely what he complained that the previous Government did.
Of course he said much more than that. I will not burden the House by repeating all the remarks he made in October 2007, but if we substitute HealthWatch for LINks every time it appears, we will get the flavour. He went on to say:
“As the Bill stands there are no provisions for LINks to have any form of governance arrangements; it is left completely open as to how a LINk would be able to make decisions or authorise people to act on its behalf. This is a major issue because without some form of governance you cannot have accountability. If there are no people authorised to act on its behalf, a LINk cannot be accountable”.—[Official Report, 15/10/07; col. 567.]
He later said:
“The key issues around governance are really three: how decisions are to be made; how activities are to be undertaken; and, who is to do these things? Without those minimum requirements we would be left with a situation where someone who has joined a LINk, but who never attended any meetings or received any training or signed any code of conduct”,—[Official Report, 15/10/07; col. 568.]
could proceed in particular ways. So the lack of statutory identity was something that the noble Earl, Lord Howe, told this House was absolutely critical when we debated the creation of LINks. And he was absolutely right. I remember agreeing with him at the time and feeling that my Government had got it wrong. But this is the point. The Government have now brought forward amendments which undo all his fine words at that time and all his attempts to put this right, and that is because statutory status at the local level was what was going to give HealthWatch a cutting edge, an authority in terms of its relationships with other bodies.
The noble Earl also had a few words to say about the underlying argument that this should be delegated down. He said then, and we could say it to him now, that we were told that the Government did not want to be “prescriptive” and that it would be up to each LINk to set itself up in the way it wanted.
In June 2007, he quoted a telling Greek legend. Indeed, he may remember using this example:
“I think it was Proteus who was able to assume any shape or form that he liked. The reason why he did this was in order to avoid foretelling the future. For us debating this part of the Bill, it is almost impossible to foretell the future because neither the governance arrangements of LINks, nor their structures, nor their powers, nor even the precise scope of their activities, are set out here. In a real sense, as with Proteus, we do not know who or what we are dealing with”.
With these amendments before us today, the Government are substituting something else when we would have known what we were dealing with and where there were precise governance arrangements. But they are taking all that away and moving towards something that the noble Earl also, presciently, described in that debate, saying:
“As I understand it—the Minister may correct me—because LINks are not defined they are not classifiable as statutory bodies. We may know a LINk when we see it—although I am not completely sure about that—by virtue of the things that it does … The Bill refers to activities being ‘carried on’”.
I look at these amendments and, my goodness, Amendment 236C in the name of the noble Earl talks about,
“activities carried on for the benefits of the community in England”.
Incidentally, how a local organisation is supposed to act in the benefits of “the community in England” seems to be a very odd use of words. However, phrases such as “activities carried on” were precisely what he said then was the wrong way of going on.
The noble Earl went on to say in that June 2007 debate:
“In fact, in one way or another, there is quite a lot of carrying on in this part of the Bill. There may be a joke there somewhere but I shall refrain from trying to find it. But that nebulous form of drafting is as far as we get. It will be incumbent on us in Committee”—
we do not have the benefit of being in Committee today—to sort out this unsatisfactory regime. He continued:
“The main problem with the Bill is that because LINks”—
and you could say the same about HealthWatch now—
“have no identity or definition, they can be seen neither as bodies whose independence is guaranteed, nor as bodies which have the power to hold local health and social care commissions to account”.—[Official Report, 20/6/07; cols. 252-3.]
Those were the wise words of the noble Earl, Lord Howe, then, but he is the same noble Earl who is bringing forward amendments that create the same precisely the structure that he said was totally inappropriate then.
Let us look at what the Government are doing and I will be brief. Amendment 231B removes the statutory status. Amendment 231C removes all structure, form and governance from the Bill. Amendment 234A talks about “one set of arrangements”. It implies not just a single arrangement in any local authority area, but a set of arrangements, so it would not necessarily be one contractual arrangement: it would be a set of contractual arrangements. The word “arrangement” is in the plural.
Amendment 235C is the great catchall that tells us it is all going to be all right and that all these bodies are going to be the same in that there will be a licence to use a trademark. I am enormously reassured by that. Amendment 235D provides for subcontractors for the different functions. So what we are envisaging is that a local authority will divide up the functions of HealthWatch organisations and contract each of them to a separate organisation. Does that really make sense? Is that the strong patient voice that we were promised at local level?
In Amendments 238ZM and 238ZN there are specific references to contractors. This is essentially moving from a position where there will be a clear number of local statutory bodies delivering patient representation on behalf of their communities, with members from those communities running those organisations, because that is what the governance arrangements were before. This is essentially privatising that process, albeit by so-called social enterprises. This is privatising consumer representation.
How can contractors be representative? Yes, there is an amendment that says that these contractors will be broadly representative of the local community, but how can an enterprise itself be representative of the local community? I find this concept difficult to understand. Because we are not in Committee, we do not have the opportunity to have it explained to us fully and a chance to probe the Government.
The amendments that we talked about a few minutes ago envisaged that local healthwatch would be able to have local representation on the board of HealthWatch England. How will we have representatives from local healthwatch organisations—the arrangements that will be subcontracted for different functions to social enterprises— at the national level for HealthWatch England? Is this going to be board members of a social enterprise, charged with the effective running of that enterprise not the representation of the community? Will it be the staff? That comes back to the point about lay leadership that the noble Baroness, Lady Jolly, raised earlier.
Last night, I got an e-mail from an existing LINk member, with whom I have never previously communicated, saying:
“I’m much involved with my local LINk, which it can be argued, has already been ‘taken over’ by its Host in advance of the Privatisation of the Public’s voice when HealthWatch comes about. Lay ‘Volunteers’ have been demoted from being Members to Participants”—
there is the lay leadership of the noble Baroness, Lady Jolly—
“and our Management Committee has been redesignated as an ‘Advisory Group’”—
again, lay leadership—
“with few if any powers over anything. Expulsions have been initiated against those who don’t toe the new autocratic line—and the local authority just turns a blind eye despite appeals to the Council Leader, CEO and Portfolio holder. What hopes for a voice for the public/patient when Local Healthwatch is in place?”.
I believe that the Minister received a letter from another member of a local LINk who talks about his dedicated service. He lists at some length all the different bodies that he has sat on representing the public, then says that,
“My most precious resource—the time I have given—has, at a stroke, been set to nought”.
There is no local lay leadership in these arrangements. That is why these amendments are so sad.
We have to ask why the Government are doing this. Is it because some unit in the Cabinet Office has suddenly discovered this bit of the Health and Social Care Bill and said, “Oh, they have missed something out about the opportunity to introduce competition so let us put it in this bit of the Bill”? Or perhaps it is because Government Ministers have suddenly realised that the Bill is rather unpopular. There are some difficulties with it, the public’s perceptions of it are increasingly negative, so having proper patient representation would now be extremely dangerous.
Lord Trefgarne
My Lords, the noble Lord has been going on for a considerable period in connection with the government amendment. He now speaks about the Bill in general. That is really a Second Reading issue. This is Report. Could he indicate how much longer he intends to be?
Lord Harris of Haringey
Actually, I had finished my last sentence when the noble Lord stood up. I raised that because the question arises as to why the Government have introduced these amendments. Given the attitude to the whole Bill, one has to question their motivations. I hope that when the noble Baroness eventually—I assume—gives us her usual, extremely full exposition, she will explain precisely the motivation for this change, so as to indicate that the fears being expressed are totally misplaced.
Lord Low of Dalston
My Lords, I will be briefer than but have a good deal of sympathy with the noble Lord, Lord Harris, who has just spoken. It seems that the consumer’s voice in the health service has been progressively watered down since the days of community health councils—almost to the point of extinction in the legislation before us. As is clear from the debate, there are many concerns over the question of independence, nowhere more than in relation to the proposed structure in which, as I understand it, there is no longer to be a distinct healthwatch organisation. Rather, local authorities will be able to put the local healthwatch functions out to tender on a piecemeal basis.
I apologise to noble Lords but my technology is playing up a bit today. Concerns have particularly focused on the threat to independence which might arise from the possibility that, in the current climate, local authorities will seek to retain some of the healthwatch funding for other purposes, given that it is not ring-fenced. The proposed funding regime is the same that obtains for LINks—that is, from central government via the local authority. We can perhaps gain some idea of the credibility of the concern by considering what has happened in relation to LINks funding.
In a study of LINks funding for the current financial year, the National Association of LINks Members revealed that most LINks had their funding cut. An informant from my local LINk told me that after discussion that he has had with other LINks it would appear that a number of local authorities will keep the funding of LINks for 2012-13 at the same level as for the present year. The effect is that while the Department of Health may have increased the funding of LINks to allow for inflation, that is not being passed on. He says that in respect of his own LINk in Hackney, in 2010-11 it received £206,000, which represented the whole amount of the funding provided by the Department of Health. In 2011-12, only £100,000 was provided, and the same amount will be provided for 2012-13.
In relation to the argument that local authorities may retain some of the funding for HealthWatch, the Government argue that local authorities will be under a statutory duty to fund HealthWatch. That may be true, but local authorities are currently under a similar duty in relation to LINks and that has not stopped them cutting LINks budgets. For that reason, as well as for conflict of interest and status reasons, HealthWatch needs to be a consolidated, coherent and independent body with standing—or at least, as a minimum, to have a ring-fenced budget.
Baroness Wheeler
My Lords, on behalf of these Benches, I want to express our concern and exasperation at these cobbled-together, last-minute changes to the status and organisational arrangements for local healthwatch. We are utterly opposed to depriving local healthwatch of its statutory status. It is hard to see the logic behind the new approach, even for those of us who are supportive of the local development of social enterprises.
The noble Baroness has not explained why this last-minute change is taking place 14 months into the consideration of the Bill. Why was this new approach and dramatic change not spelt out and included in the consultation that the Government have conducted since Committee stage on healthwatch membership? Why such a fundamental change of direction at this late stage?
The Government’s argument is that the new arrangements will provide local authorities with the flexibility that they need in establishing healthwatch organisations and facilitating their networking with other local community organisations. In practice, this means that not only will each local healthwatch be very different, and it will take more than the proposed national kite mark to provide them with any joined-up coherence, but they will all develop at a very different pace as local authorities take time to decide on the form of structure, and then draw up and implement their commissioning arrangements, or further subcontracting arrangements, if they want to make things really confusing, and so on. This is hardly the smooth transition from LINks organisations to the proper and coherent structure of patient representation at local level that we need. Like so much in this Bill, what could be simple and straightforward is made fragmented and complicated and requires detailed explanation. The Government also make strong play of local healthwatch organisations having a statutory function through a seat on health and well-being boards, through making a contribution on that board and the statutory joint strategic needs assessments and the joint health and well-being strategy. healthwatch will also have statutory status through the statutory health and well-being boards’ ability to refer back to the NHS Commissioning Board plans that do not meet the needs of the local communities. So we have a second-hand, reflected statutory authority by participating in bodies that have statutory status.
It is interesting, too, that with clinical commissioning groups the Government have repeatedly argued that the Bill was needed to enable CCGs to be statutory bodies in their own right. Now we see exactly the opposite argument when it comes to patient representation.
Finally, there is the relationship of local healthwatch with the local authority, where there is again huge potential for conflict of interest, and concern that even the well intentioned authorities facing severe budget cuts could struggle to find the required funding for healthwatch organisations. Government amendments to address this and potential conflicts of interest by requiring local authorities to,
“have regard to ... any Secretary of State guidance on this matter”,
do not provide the safeguards that would be needed to ensure that patients, their carers or representatives should be able to expect if they are concerned that their complaint about a social services department is channelled through a non-statutory body funded and linked to the local authority itself.
As with the rest of the Bill, these are complicated structures understood and supported by no one, with details fleshed out at the last minute and sprung upon the House, in effect, only three working days before we are due to consider them, and with no opportunity for consultation on such fundamental change. Arguably most important of all is that it is impossible to see, among all these amendments, how these local organisations will relate to national healthwatch. Perhaps the kite marks are designed more to help HealthWatch England recognise who it has under its umbrellas than to assist local organisations networking with each other.
I hope that even at this late stage the Minister will acknowledge the concern, confusion and demoralisation, particularly among key patient organisations and groups, at the last-minute decision to change the status of local healthwatch organisations. I hope that she will agree to withdraw these amendments and instead restore statutory status to local healthwatch, enabling them to be organisations that everyone can rely on to be genuine patient representatives, fully trusted and supported by patients and the public.
Baroness Northover
Again, my Lords, what shines through is a great commitment to public and patient involvement at a local level; the only dispute is over the form of that. Again, noble Lords are familiar with the fact that various models have been tried, and I emphasise once again that we are seeking to build on the strengths of what has worked and mitigate some of the problems that have been encountered.
My noble friend Lady Jolly has tabled Amendments 234 and 235, the result of which would be to replace references to “people” with “local people” in Section 221 of the 2007 Act and insert the definition of “local people”. We talked about the difficulty of organisations— LINks in particular—reaching groups that were defined as hard to reach. The definition in my noble friend’s amendment says that when carrying out its functions, local healthwatch has to be representative of people who live in the area, service users and people who are representative of the local community. That applies to people of all ages and emphasises the need for local healthwatch to champion the views of the whole breadth of the local community. I am therefore grateful to my noble friend for this contribution, and I am happy to support her amendments.
Although I am sympathetic to the sentiment behind my noble friend Lady Cumberlege’s Amendments 232, 236 and 237, I hope I can reassure noble Lords that, as corporate bodies, local healthwatches will have the flexibilities to make their own arrangements for securing staff, accommodation and so on, so the local authority should not have to make such arrangements on their behalf. There is no need for express provision on payment of expenditure because the legislation requires local authorities to make arrangements to ensure that the relevant activities can be carried on in their area. Necessarily, that means providing adequate funding to enable the functions to be carried out. This is an important point that I hope reassures noble Lords: the statutory functions must be delivered, and that is a protection of these bodies.
My noble friend Lady Cumberlege is quite right about local healthwatches working out their own priorities and work, and they will no doubt be doing that in conjunction with what is found to be good practice around the country, information coming from HealthWatch England and so on. I assure my noble friend that staff are there to help to facilitate such work, not to dominate it. My noble friend Lady Jolly is right: local healthwatch is a partner with local authorities—the eyes and ears, as the noble Baroness, Lady Murphy, and others have said.
My noble friend Lady Cumberlege was concerned that government amendments would damage local healthwatch’s independence. I do not agree: the amendments do not dilute in any way the statutory functions of local healthwatch, including the ability to give advice to local authorities among others. In response to concerns that local authorities may try to suppress local healthwatch, we specifically brought forward Amendment 236E giving the Secretary of State the ability to publish conflicts of interest guidance that both local authorities and local healthwatch would have to have regard to.
The noble Lord, Lord Harris, raised a number of issues. He regretted the fact that yesterday he was not at the seminar that I mentioned. I regret that he was not there. It was interrupted by a couple of votes, but I am sure that he would have engaged with those who were speaking there. That would have helped to inform everybody. All Peers were invited and some from his group attended. I see a few shaking heads.
Lord Hunt of Kings Heath
My Lords, the seminar was held during the regular meeting of Labour Peers which has occurred at 5 pm on Wednesday evenings since time began.
Baroness Northover
I am very sorry if there was a conflict of timing. Obviously it is difficult to schedule all the various meetings. My noble friend Lord Howe has had 100 meetings on this Bill.
Baroness Northover
I am very sorry if that was the case. If it was the case all the way through, as the noble Baroness, Lady Thornton, indicates, perhaps it might have been an idea to feed that in.
Baroness Thornton
The noble Baroness might like to check with the Box. I informed the noble Earl’s office of the times of our group meetings at the beginning of proceedings. Meetings and seminars have clashed all the way through.
Baroness Northover
I am very sorry if that is the case. I would hope that we would be able to have other such meetings. As these arrangements are taken forward, it would be extremely useful to have people’s engagement. I was extremely glad that, even in such a clash, the noble Baroness, Lady Wheeler, and her noble friend were there.
The noble Lord, Lord Harris, should have received the letter about the amendments, but I gather that he thought he had not. A letter and briefing notes were sent to all Peers when the amendments were tabled and a full narrative of local healthwatch policy has been published on the Department of Health website. If the noble Lord has not seen the letter then I will feed that into the department to make sure that he receives this information so that he has it at his fingertips when he is contacted late at night by people who email him with concerns.
As I have mentioned before, it is very important that the local healthwatch seeks out views right across the area. It is an important factor in this arrangement that the local healthwatch will have a seat on the health and well-being board. I hope that that will help to reassure people of the influence of local healthwatch.
The noble Lord, Lord Harris, talked about privatisation by so-called social enterprises, or he flagged that up as a concern. I emphasise that the Government are huge fans of social enterprises, which perform a range of roles across the NHS. Social enterprises such as Turning Point are, of course, extremely valuable. This is not about privatisation or competition, as I feel we have made very clear.
The noble Lord, Lord Harris, also referred to my noble friend Lord Howe. My noble friend’s concern in 2007 was that local LINks should have at least a basic structure of governance. That is precisely the concern that has led us to propose that local healthwatches should be social enterprises. The question of governance is quite separate from the question of whether or not an organisation should be statutory. Perhaps the noble Lord, Lord Harris, can enter dialogue with my noble friend Lord Howe on all of that in due course.
The noble Lord, Lord Harris, also asked about the possibility of there being more than one local healthwatch. Only one local healthwatch will be permitted for each local authority area. Each local authority will be able to make only one contract. If the local healthwatch wishes to subcontract some of its functions it can do so if the local authority permits, but the functions would still remain the responsibility of the local healthwatch. I hope that that clarifies the position.
Lord Harris of Haringey
I was trying to establish whether it would be possible, under these amendments, to segment the various functions of local healthwatch and contract them separately. I think the noble Baroness has just confirmed that. Am I right?
Baroness Northover
The key fact is that there is one local healthwatch for any local authority area. If it decides that it wants to subcontract something to best achieve what it needs, that is up to that local healthwatch. The noble Lord might want to bear in mind the statutory functions of local healthwatch and its responsibilities as eyes and ears. If it was not working, I am sure that noble Lords such as he would flag that up. Local healthwatch would then have to justify what it was doing and might need to move away from it.
I realise that time is pressing and it is a Thursday afternoon. I have listened to the concerns expressed about the need for local healthwatch to have strong lay involvement. I completely agree. This will be vital to the success of local healthwatch. Therefore, I confirm to the House today that we will use the power of the Secretary of State to specify criteria, which local healthwatch must satisfy, to include strong involvement by volunteers and lay members, including in its governance and leadership. This will have the effect that a local authority cannot award a local healthwatch contract to a social enterprise unless this condition is satisfied. I hope that that provides reassurance to noble Lords. My noble friend Lady Jolly also flagged this up.
The noble Lord, Lord Low, the noble Baroness, Lady Wheeler, and others raised the issue of funding for local healthwatch. It is important that local authorities can manage local priorities, since they are best placed to respond to their local communities. Therefore, local healthwatch will remain within local authority funding mechanisms, as I mentioned earlier. This view was supported by the NHS Future Forum, which made clear in its Patient Involvement and Public Accountability report that it did,
“not agree that budgets for local Healthwatch should be ring fenced”.
However, to reassure noble Lords, I point out that statutory functions must be delivered. This helps to protect what local healthwatch is there to do.
I believe that there is consensus over our ambition for local healthwatch. We do not disagree about what we want it to do for people or to accomplish in order to raise the quality of care. I hope that I have reassured noble Lords that it is right for local healthwatch to be delivered at a local level by organisations that are accountable locally. To embed healthwatch in localism will not only enable the organisational form of local healthwatch to best meet the needs of the local population but better enable local healthwatch to play an effective role in feeding back people’s views and promoting their involvement in the scrutiny and provision of local care services. I refer again to the positive reaction of several different local authorities and councillors who are very pleased that they will now be involved in many elements of the healthcare services, as they are in public health.
Lord Harris of Haringey
Could the noble Baroness tell us how many LINks have been in touch with the department to say that they welcome these changes?
Baroness Northover
Like the noble Lord, I recognise that the organisations which are in place when change occurs are always concerned. LINks have rightly expressed concern about whether what they know works well in what they do will be taken forward. They are very open about the challenges that they faced and some of the areas in which they have not done as well as intended. I pay tribute to the then Government for trying to make the system work when it was set up. It was a reaction to what had been done before and a looser model. Everybody in the system wanted that to work as a model. However, I think that the noble Lord has admitted that it has not worked universally. It is therefore understandable that the relevant organisations expressed concerns. I hope that they will become involved in the new system and that what they have contributed—the volunteers among them have made an effective contribution in many areas—will feed into local healthwatch. With that, I hope that noble Lords will accept the Government’s amendments.
Baroness Jolly
(a) in each of paragraphs (a) to (c), before “people” insert “local”, and(b) ”
Baroness Tyler of Enfield
“(ga) making recommendations to that committee to publish reports under section 45B(3) of the Health and Social Care Act 2008 about particular matters;“
“( ) After subsection (3A) insert—
“(3B) Each local authority must ensure that only one set of arrangements under subsection (1) in relation to its area is in force at any one time.””
Baroness Jolly
“( ) In subsection (6), after the definition of “local care services” insert—
““local people”, in relation to a local authority, means—
(a) people who live in the local authority’s area,(b) people to whom care services are being or may be provided in that area,(c) people from that area to whom care services are being provided in any place, and(d) people who are (taken together) representative of the people mentioned in paragraphs (a) to (c);”.”
“(7) In the title to section 221, omit “: local involvement networks”
“( ) For the cross-heading preceding that section substitute “Local arrangements”.”
“( ) After section 45B of the Health and Social Care Act 2008 (inserted by section 180(4)), insert—
“45C Granting licence to use trade mark
(1) The Commission may grant a Local Healthwatch organisation a licence authorising the use, in relation to the carrying on of activities under arrangements made under section 221(1) of the Local Government and Public Involvement in Health Act 2007, of a registered trade mark of which the Commission is the proprietor.
(2) A licence under this section may not provide for the grant of a sub-licence by the licensee other than a sub-licence authorising the use of the mark by a Local Healthwatch contractor in relation to the carrying on of Local Healthwatch arrangements.
(3) In this section—
“Local Healthwatch arrangements” has the meaning given by section 222 of the Local Government and Public Involvement in Health Act 2007,
“Local Healthwatch contractor” has the meaning given by section 223 of that Act, and
“registered trade mark” and “use” have the same meaning as in the Trade Marks Act 1994.””
“(2) The arrangements must be made with a body corporate which—
(a) is a social enterprise, and(b) satisfies such criteria as may be prescribed by regulations made by the Secretary of State.(2A) For so long as the arrangements are in force, the body with which they are made—
(a) has the function of carrying on in A’s area the activities specified in section 221(2), and(b) is to be known as the “Local Healthwatch organisation” for A’s area.(2B) But the arrangements may authorise the Local Healthwatch organisation to make, in pursuance of those arrangements, arrangements (“Local Healthwatch arrangements”) with a person (other than A) for that person—
(a) to assist the organisation in carrying on in A’s area some or all of the activities, or (b) (subject to provision made under section 223(2)(e)) to carry on in A’s area some (but not all) of the activities on the organisation’s behalf.”
“(3) In subsection (3), for the words from the beginning to “who is not” substitute “None of the following is capable of being a Local Healthwatch organisation”.”
“(4) For subsection (4) substitute—
“(4) The arrangements must secure the result that Local Healthwatch arrangements will not be made with a body of a description specified in subsection (3) or with the National Health Service Commissioning Board.””
“(7) For subsection (8) substitute—
“(8) For the purposes of this section, a body is a social enterprise if—
(a) a person might reasonably consider that it acts for the benefit of the community in England, and(b) it satisfies such criteria as may be prescribed by regulations made by the Secretary of State.(9) Regulations made by the Secretary of State may provide that activities of a prescribed description are to be treated as being, or as not being, activities which a person might reasonably consider to be activities carried on for the benefit of the community in England.
(10) In subsections (8) and (9), “community” includes a section of the community; and regulations made by the Secretary of State may make provision about what does, does not or may constitute a section of the community.””
“( ) For the title to section 222 substitute “Local Healthwatch organisations”.”
“( ) After section 222 insert—
“222A Local authority arrangements: conflicts of interest
(1) In making arrangements under section 221(1), a local authority must have regard to any conflicts guidance issued by the Secretary of State.
(2) Arrangements under section 221(1) must require the Local Healthwatch organisation, in exercising its function of carrying on the activities specified in section 221(2) or in making Local Healthwatch arrangements, to have regard to any conflicts guidance issued by the Secretary of State.
(3) In this section, “conflicts guidance” means guidance about managing conflicts between—
(a) the making of arrangements under section 221(1), and(b) the carrying-on of the activities specified in section 221(2).(4) In this section, “Local Healthwatch arrangements” has the meaning given by section 222.”
“Local arrangements: power to make further provision
(1) Section 223 (power to make further provision about local authority arrangements) is amended as follows.
(2) In subsection (1), for “require prescribed provision to be included in local involvement network arrangements” substitute “include prescribed provision”.
(3) After that subsection insert—
“(1A) The Secretary of State may make regulations which provide that local authority arrangements must require Local Healthwatch arrangements to include prescribed provision.”
(4) In subsection (2)—
(a) for “must require local involvement network arrangements to include” substitute “must include or (as the case may be) must require Local Healthwatch arrangements to include”,(b) in paragraphs (a), (c) and (d), for “a local involvement network” substitute “a Local Healthwatch organisation or a Local Healthwatch contractor”, and(c) after paragraph (d) insert “; (e) prescribed provision relating to the activities which a Local Healthwatch contractor may not carry on on a Local Healthwatch organisation’s behalf;(f) prescribed provision relating to the obtaining by a Local Healthwatch organisation of a licence under section 45C of the Health and Social Care Act 2008 and the grant by the organisation to a Local Healthwatch contractor of a sub-licence;(g) prescribed provision relating to the use by a Local Healthwatch organisation or a Local Healthwatch contractor of the trade mark to which a licence under that section relates;(h) prescribed provision relating to the infringement of the trade mark to which a licence under that section relates;(i) prescribed provision relating to the imposition of a requirement on a Local Healthwatch organisation to act with a view to securing that its Local Healthwatch contractors (taken together) are representative of—(i) people who live in the local authority’s area,(ii) people to whom care services are being or may be provided in that area, and(iii) people from that area to whom care services are being provided in any place.”(5) After subsection (2) insert—
“(2A) The provision which may be prescribed in relation to a Local Healthwatch contractor includes provision that relates to the contractor—
(a) only in so far as it assists the Local Healthwatch organisation in the carrying on of activities specified in section 221(2);(b) only in so far as it carries on such activities on the organisation’s behalf.(2B) Regulations under this section may make provision which applies to all descriptions of Local Healthwatch contractor, which applies to all those descriptions subject to specified exceptions or which applies only to such of those descriptions as are prescribed.”
(6) In subsection (3)—
(a) before the definition of “a local involvement network” insert—““care services” has the meaning given by section 221;”,
(b) omit the definition of “a local involvement network”,(c) for the definition of “local involvement network arrangements” substitute—““Local Healthwatch arrangements” has the meaning given by section 222;”
(d) after that definition insert—““Local Healthwatch contractor”, in relation to a Local Healthwatch organisation, means a person with whom the organisation makes Local Healthwatch arrangements;”, and
(e) after the definition of “prescribed provision” insert “;“trade mark”, and “use” and “infringement” in relation to a trade mark, each have the same meaning as in the Trade Marks Act 1994.””
“( ) a complaint under section 73C(1) of the National Health Service Act 2006; ( ) a complaint to a Local Commissioner under Part 3 of the Local Government Act 1974 about a matter which could be the subject of a complaint under section 73C(1) of the National Health Service Act 2006; or”
“(a) a person providing services under arrangements under this section;(b) a person arranging for the provision of services in pursuance of arrangements under this section;(c) a person providing services under arrangements made in pursuance of arrangements under this section.”
“(b) in compliance with a requirement imposed by virtue of section 223(2)(i).”
“(3A) For the purposes of subsection (1), something is done by a Local Healthwatch contractor if it is done by that contractor in the carrying-on, under Local Healthwatch arrangements, of activities specified in section 221(2).”
“( ) After subsection (4) insert—
“(5) In this section—
“Local Healthwatch arrangements” has the meaning given by section 222;
“Local Healthwatch contractor” has the meaning given by section 223.””
“(7) In subsection (4), in paragraph (a), after “section 221(1)” insert “or Local Healthwatch arrangements”.”
“( ) After subsection (5) insert—
“(5A) In this section—
“Local Healthwatch arrangements” has the meaning given by section 222;
“Local Healthwatch contractor” has the meaning given by section 223.””
“(7A) For the purposes of this section, something is done by a Local Healthwatch contractor if it is done by that contractor in the carrying-on, under Local Healthwatch arrangements, of activities specified in section 221(2).”
“( ) In subsection (8), before the definition of “overview and scrutiny committee” insert—
““Local Healthwatch arrangements” has the meaning given by section 222;
“Local Healthwatch contractor” has the meaning given by section 223;””
“(2) In subsection (2), omit “by a local authority with another person (“H”)”.”
“(ii) omit “, for each local involvement network,””
“(iii) for “the network”, in the first place it appears, substitute “the Local Healthwatch organisation”,(iiia) for “the network”, in the second place it appears, substitute “the organisation”,”
“(c) omit sub-paragraph (ii),”
“( ) In subsection (9), after the definition of “financial year” insert—
““Local Healthwatch contractor” has the meaning given by section 223;”.”
“(3) A scheme under this section may make provision for rights and liabilities relating to an individual’s contract of employment; and the scheme may, in particular, make provision which is the same as or similar to provision in the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).
(3A) A scheme under this section may provide for the transfer of property, rights or liabilities—
(a) whether or not they would otherwise be capable of being transferred;(b) irrespective of any requirement for consent that would otherwise apply.(3B) A scheme under this section may create rights, or impose liabilities, in relation to property, rights or liabilities transferred.
(3C) A scheme under this section may provide for things done by or in relation to the transferor for the purposes of or in connection with anything transferred to be—
(a) treated as done by or in relation to the transferee or its employees;(b) continued by or in relation to the transferee or its employees.(3D) A scheme under this section may in particular make provision about continuation of legal proceedings.”
“( ) A scheme under this section may include supplementary, incidental and consequential provision.”
“Consequential provision
(1) In the Schedule to the Public Bodies (Admission to Meetings) Act 1960, after paragraph (bk) (as inserted by paragraph 2 of Schedule 13) insert—
“(bl) Local Healthwatch organisations, as regards the carrying on of activities specified in section 221(1) of the Local Government and Public Involvement in Health Act 2007 (local care services);”.(2) In Part 3 of Schedule 1 to the House of Commons Disqualification Act 1975, at the appropriate place insert—
“Director of a Local Healthwatch organisation.”(3) In Part 3 of Schedule 1 to the Northern Ireland Assembly Disqualification Act 1975, at the appropriate place insert—
“Director of a Local Healthwatch organisation.”(4) In Part 2 of Schedule 1 to the Freedom of Information Act 2000 (local government), after paragraph 35D insert—
“35E A Local Healthwatch organisation, in respect of information held in connection with—
(a) arrangements made under section 221(1) of the Local Government and Public Involvement in Health Act 2007, or(b) arrangements made in pursuance of arrangements made under section 221(1) of that Act.” (5) In section 65H of the National Health Service Act 2006 (NHS foundation trust special administration provisions: consultation requirements), in subsection (8), for subsection (e) substitute—
“(e) a Local Healthwach organisation;”.(6) In section 4 of the Health and Social Care Act 2008 (matters to which the Care Quality Commission must have regard)—
(a) in subsection (1)(c)—(i) for “local involvement networks” substitute “Local Healthwatch organisations or Local Healthwatch contractors”, and(ii) omit “in their areas”.(b) for subsection (3) substitute—“(3) In subsection (1)(c), “Local Healthwatch contractor” has the meaning given by section 223 of the Local Government and Public Involvement in Health Act 2007.””
Lord Ramsbotham
Lord Ramsbotham
My Lords, I shall be brief. First, I pay tribute to the noble Earl, Lord Howe, and thank him very much for his letter on this subject. I declare an interest as chairman of the All-Party Group on Speech and Language Difficulties. We have been campaigning in many Bills—education, welfare and justice—to make certain that every child is properly assessed not just for learning disabilities but for learning difficulties and particularly to enable every child to engage with the education system. The Minister has assured me that health visitors are being trained by speech and language therapists to enable that to be done. I hope very much that this will soon be the norm throughout the United Kingdom. Therefore, Amendments 238A, 238B, 238C, 238D and 238E add a little more to the debate that we had at earlier stages of the Bill.
In particular, I am anxious to make certain, if we possibly can, that the variability in commissioning between local areas is reviewed. In her recent report, the communications commissioner, Jean Gross, stated that there was considerable variety and that she expected to find such commissioning in only 70 per cent of local areas. This is unfortunate. I do not think it is right that there should be a postcode lottery in assessing our children’s ability to engage with education.
I introduce the words “allied health professional” in Amendment 238B because the allied health professionals have responsibility for liaising between the primary and secondary sectors and therefore cover a wide number of disciplines. I include the words “education or children’s services” in Amendments 238C, 238D and 238E in order to make certain that those services, along with the NHS and local government, are properly represented in ensuring that this opportunity is available to every child throughout the United Kingdom.
I appreciate that it may not seem appropriate to make these amendments to the Bill. However, I hope that the Minister will be able to assure me that these points will be made in instructions that go out about the health and well-being boards, the joint strategic boards and so on, even if they are not included in the Bill. I beg to move.
Baroness Whitaker
My Lords, in supporting the noble Lord, Lord Ramsbotham, I have very little to add, which I imagine will be welcome to noble Lords at this hour. He has really said it all extremely comprehensively but I would just add that, if the Bill cannot provide the framework that these amendments would ensure, particularly in respect of integration of the education services, children in particular will suffer. I briefly remind noble Lords that speech and language deficits are among the most common disabilities in childhood. They affect significant numbers, who will lose out on education, employment and relationships as a result. I hope that the noble Earl will be able to provide the reassurances that we seek.
Baroness Massey of Darwen
My Lords, I shall speak to Amendments 238AZA and 238CA, which concern integration of services. Integration is a word that is used very often in the Bill.
My amendments would require all health and well-being boards to take a local lead on integrating health-related services with health and social care. General duties to promote such integration are held by the NHS Commissioning Board and clinical commissioning groups. The amendments would ensure that health and well-being boards also played their part.
Integration of the planning and delivery of health and social care with health-related services is crucial for improving the health and well-being of local populations. Evidence and experience show that health and care services can be made more effective, efficient and accessible when integrated with wider support services. The Bill references this network of support as “health-related” services. This covers a wide range of provision that contributes to children’s and adults’ health and well-being. The National Children’s Bureau, the National Housing Federation, St Mungo’s and Homeless Link have come together to call for a clear role for health and well-being boards and they support close integrated working between health-related services and health and social care. This is clearly an issue that has implications across all sectors—health, education, children, housing and employment.
As the Bill stands, clinical commissioning groups and the NHS Commissioning Board will have a general duty to promote integration of health services with health-related services, as well as with social care. Health and well-being boards’ duties to support close working and partnership arrangements are limited to health and social care, with only a power to encourage close working with health-related services.
I am concerned that, without the support of their local partners through health and well-being boards, the NHS will struggle to deliver on this wider integration agenda. As health and well-being boards will be the key forums for local partnership working, they should have duties in this regard; for example, with children and young people. Schools and colleges, children's centres and youth services are vital settings for delivering health outcomes. The national evaluation of Sure Start found that a child with access to a children's centre—formerly Sure Start—had more immunisations and fewer accidents than young children living in other areas. School health initiatives have had a positive impact on health and behaviour among pupils.
Evidence suggests that health, social care, education, early childhood, youth and other services are not always working in partnership to secure good health outcomes for children and young people. The Marmot review identified a lack of consistent partnership working between such bodies as a barrier to delivery. Similarly, the Kennedy review highlighted the fact that the requisite links between the NHS, social care, education and the criminal justice services to support children and young people are not always made. This report recommended that local partnerships, covering all services for children, should have a duty to ensure that local organisations work together. Close working between local partners is particularly vital for children with complex needs, such as disabled or looked-after children, who need co-ordinated interventions from a range of services.
Improving people's health is rarely achieved by clinical interventions alone, but is dependent on the wider determinants of health; for example, housing support acts as a health intervention and can help people to improve their well-being, manage their health better and prevent the need for more acute services. A lack of good housing can also be a major determinant of poor health: eight out of 10 homeless people have one or more physical health needs and seven out of 10 have at least one mental health problem. The average age of death of a rough sleeper is estimated to be 40 to 44 years.
I chair the National Treatment Agency for Substance Misuse and I am well aware that, in tackling drug and alcohol use, we also need to tackle the social issues such as housing, employment and education. The Marmot review, Fair Society, Healthy Lives, noted that,
“this link between social conditions and health is not a footnote to the ‘real’ concerns with health … it should become the main focus”.
The role of health and well-being boards in promoting integration across local services was debated in Committee on 19 December. The Government acknowledged the role that housing, schools and other services might play in promoting health and well-being.
However, in response to separate amendments aimed at strengthening the role of health and well-being boards in engaging and working with specific health-related services, the noble Earl, Lord Howe, responded:
“we want to avoid being overprescriptive. On the other hand, we are clear about what best practice looks like, and … we have provided for statutory guidance”.—[Official Report, 19/12/11; col. 1542.]
The relevant statutory guidance has been published in draft form by the Department of Health. Although it makes broad references to vulnerable groups and wider services like housing, there are no clear expectations for how, when and where this integration could take place or which client groups or needs would particularly benefit from this. The Bill offers opportunities to integrate services beyond traditional primary and secondary care to reach across initiatives to improve lives. These amendments would ensure such opportunities will be taken by local partners. I look forward to the Minister’s response and hope that he can give me some reassurance.
The Earl of Listowel
My Lords, I support the amendment spoken to by my noble friend, to which my name is attached. I will strive to be as brief as possible at this late hour, but the issue is very important.
I will begin with an aside and refer to the short debate on productivity and manufacturing industry instigated at the start of business today by the noble Lord, Lord Bates. I will highlight the point made recently by Education Minister Sarah Teather that what happens in schools is important, but that the most important thing for children’s success outcomes is what happens in the home, outside school. As one academic put it, when one considers what makes the difference to a successful outcome for a child, only 10 per cent of it will depend on schools; the rest will depend on what happens in the background, in the family.
Of course, whether a parent is successful in their education is the single most important indicator that their child will be successful in their education. Businesses might be more aware, when they push for schools to teach children to read, write and do arithmetic better to get their apprenticeship skills, that they should think also very much about early intervention and getting it right in the family as well. If we are to compete with China in future, we need to think very carefully about the successful integration of services to support families and children.
I will speak briefly, on International Women’s Day, about another matter raised in an earlier debate today: namely, domestic violence and women fleeing to refuges. A few years ago I spoke to a child and adolescent psychiatrist, Professor Panos Vostanis of the University of Leicester. He had gone into these refuges and worked with the mothers and children over time, providing them with support. He said how important and effective it had been, but how rare the service was. He has now been commissioned by the European Union to conduct EU-wide research into support for families where there has been domestic violence.
This theme recurs in children's homes, refuges and other settings. It seems elementary that a mental health professional such as a psychiatrist or clinical psychologist should visit a children's home or refuge once a fortnight, to speak to mothers, work with children and support staff. That is best practice and it happens—but very often the model gets overlooked because, understandably, clinicians are under pressure and there are high thresholds of access for children and adults to these services.
Perhaps I may give one further example on the matter of schools. I recently attended an international conference on the mental health of children in schools. It was organised by Dr Rita Harris, head of child and adolescent mental health services at the Tavistock and Portman NHS Foundation Trust. We were given a presentation by two wonderful mental health nurses who had tried to revive a service in the Sunderland area. They found that schools had given up using child and adolescent mental health services because they would write to the service and it would respond by saying: “I am sorry, your child is not sick enough for us to see. Wait until he gets sicker and then we might see him”. The nurses had tried to mend the relationship with schools, build trust and ensure that every school had a mental health professional allocated to it. However, one school simply did not want any truck with them because it had had such a bad experience in the past of trying to work in this integrated way with child and adolescent mental health services.
The record is very poor. Given the concerns that many have raised in the past about the possible fragmentation that might arise from the Bill, and the many clinical commissioning groups that will come into being and the large upheaval that will take place, I am looking to the Minister for reassurance that the Government will improve a situation that has been so disappointing in the past, that we will see a better integrated service that will better meet the needs of children and families, that we will see better outcomes for children and they will be more successful in school in part because health and social care services will have been better integrated for them and they will have received, early in their lives, the support that they need. I look forward to the Minister's response.
Lord Shipley
My Lords, I rise to speak to Amendments 238AA, 238AB, 238BZA and 238BA and to declare my interest as a member of Newcastle City Council.
These amendments relate to the membership of health and well-being boards. As currently proposed, the boards will have at least one councillor of the relevant local authority—so it could be one councillor, or it could be more. The choice will be with the council. However, several other people who have membership will be officers or unelected co-optees. This means that the board as currently proposed is effectively a board of directors, not a council committee which—unlike all other council committees—is made up of those who are publicly elected. Yet the board as proposed is legally a council committee; and because it is legally a council committee, only councillors can vote—officers must advise. For officers to vote, specific regulations will have to be put in place, and of course they can be. However, I hope that the Minister is willing to think further about this. Councillors, being elected, have both a democratic mandate—unlike officers—and a perception of service provision which comes from a geographical perspective as well as a service perspective. At times that can be very valuable, particularly in a geographically large council area.
To have just one councillor—which is what the Bill permits—would be a mistake. It would mean a council committee, the health and well-being board, would be dominated by officers and co-optees. It would also mean that only one political group was in membership of the board, which in my view would be deeply unwise.
Given the board’s terms of reference, I do not argue that councillors have to be in majority. However, I do argue that councillors are important; that geographical differences in a council area should be acknowledged; and that more than one political group should be fully represented on a board. Amendment 238AA solves this problem. It defines the minimum number of councillors as three. That would give the board greater breadth and enable political proportionality to be effective. Amendment 238AB states that where a council is a county council and part of a two-tier system of local government, there should be a district council representative as well as county representatives because district councils have statutory duties in relation to health and well-being. Having one district councillor appointed in this way as a representative of several district councils is normal procedure for those councils when duties span the two tiers. The other two amendments are simply enabling amendments assuming that Amendments 238AA and 238AB are agreed.
In Committee there was a discussion about councillor membership—how many there should be, whether they should be in a majority and whether they should have powers over the budgets of other health organisations not managed by the council. There was no conclusion to that debate, but I have thought long and hard about it. I have concluded that the amendments in my name and those of the noble Lord, Lord Bichard, and the noble Baronesses, Lady Eaton and Lady Henig, which reflect all parts of this Chamber, give a solution to this problem and would enable us to balance professional knowledge with the necessary democratic accountability.
I do not propose to press this to a vote, but I hope that the Minister will be willing to engage in discussion on it. What is being proposed from all parts of the House is a solution to a problem that needs to be resolved. It will prevent difficulties arising further down the line should a council decide to have only one councillor as a member of the board.
Baroness Finlay of Llandaff
My Lords, I shall speak briefly to Amendment 238A, which is in the name of my noble friend Lord Ramsbotham. I rather hope that the Government will take on board its spirit, if not its actual wording. The reason is that in creating a joint strategic needs assessment, there will be a requirement for those involved to begin to work in a completely new way. Human nature is such that people tend to repeat the patterns of things they have done before. In addition, they do not know what they do not know. When they feel insecure, they are less—not more—likely to consult, because it is quite threatening to have to consult and go beyond the boundaries of what you thought you knew and discover all the things that you did not know.
The beauty of the amendment is that it creates an obligation to,
“consult relevant health professionals and any other”
person, without specifying who they are. It leaves it very broad but it pushes forward the boundaries. We have already discussed the problem of children. The difficulty, if people do not consult widely, is that if children miss out at a developmental stage and one aspect of their development—for example, motor development, speech and language development or emotional development—does not occur, they never catch up. It is missed out for good; they always lag behind.
It is really important to make sure that the provisions are there right the way through the trajectory from birth onwards to make sure that the needs of children as they develop are met, that deficits are identified early and that interventions take place immediately.
Lord Beecham
My Lords, I will speak to my Amendment 238H, as well as amendments moved by other noble Lords. I am pleased to confirm that the Opposition entirely support the amendments moved by the noble Lord, Lord Ramsbotham, the noble Baroness, Lady Massey, and the noble Lord, Lord Shipley. Once again, I am pleased to say that Newcastle is united on the issue of the composition of health and well-being boards.
The only amendment about which I have not so much a reservation as a question is that to be moved by the Minister, Amendment 239, which refers to the possibility of a local authority giving permission to the health and well-being board to carry out,
“other functions of the authority”.
I wonder whether the Government have borne in mind the fact that there is now a general power of competence for local government, and whether it is the intention of this amendment to embrace not only the statutory functions of local government as things that may be delegated to the health and well-being boards but anything that the local authority is empowered to do. Given that there is now a general power of competence, that would be a very wide remit indeed. It is not necessarily a wrong line to take but it would be interesting to know whether the Government have considered that potential implication, and if they have not—and I would not blame the Minister if he had other, more pressing things on his mind—perhaps he might come back to us at Third Reading or before.
I particularly welcome the amendments moved by the noble Lord, Lord Ramsbotham, because they raise the issue of children’s services and health, which has to a significant extent been overtaken in this Bill by other considerations around traditional health services and adult care. I very much welcome those points.
In relation to the amendments moved by the noble Lord, Lord Shipley, I join him in thinking that it would be very helpful for the Government to send a signal as to the representation of elected members— not merely one, who could be regarded as a token, but a significant number. I would have gone perhaps slightly higher than three, but three would be a working basis.
In Committee, the Minister said that it is up to councils to decide the composition of these boards. That is true, but I think a signal would be welcome in that respect. I am particularly glad to join the noble Lord, Lord Shipley, in returning to a theme which I am afraid I have sounded more than once in debates over this Bill about the necessity for district authorities to be represented. It is a very important point in relation to the shire county areas.
Earl Howe
My Lords, this group of amendments all relate to health and well-being boards and in particular their statutory minimum membership, responsibility for preparing both joint strategic needs assessments and joint health and well-being strategies, as well as their role in promoting integration.
Amendments from the noble Lord, Lord Ramsbotham, and my noble friend Lord Shipley, relate to changes to the statutory membership of health and well-being boards, which I know we have previously debated. As noble Lords will be aware, we have consulted extensively on the membership of health and well-being boards and one of the consistent messages we have heard is that local people want a balance between the flexibility to add members alongside some consistency in representation from key players, such as elected representatives and clinical commissioning groups.
The Future Forum looked at this and, following its report, we made a commitment that it will be for local authorities, or in some cases the leader or mayor, to determine the precise number of elected representatives on its board, although we have stipulated that there must be at least one. I would ask my noble friend Lord Shipley to note the words “at least one”. We believe that it is right for local areas to be able to have the flexibility to determine the wider membership of their boards based on local need. I am of course happy, however, to engage with my noble friend in further discussions.
The Bill allows local areas the flexibility to develop the arrangements that best work for them. It is important to be clear that the purpose of this policy is not primarily about setting up a committee but about stimulating effective joint working for and with local people and communities. The health and well-being board will be central to this joint working but must not represent its limit.
We can be encouraged by what is now happening on the ground. We know that a large number of local areas are already working with all the relevant stakeholders to explore and agree how they can work together in the future to make the biggest difference to local people. For instance, from our work with shadow health and well-being boards, we have had lots of feedback to suggest that two-tier county councils are working closely with district councils through the boards in a range of creative and positive ways based on local need and circumstances. In fact, I understand that in many two-tier areas, shadow boards are already operating with more than one district council representative ranging from the leader, the chief executive or a senior officer. However, developing these relationships and understanding how best everyone, whether it be district councils, health professionals, local providers or the voluntary sector, can contribute in the most appropriate way, is something that we feel strongly is best left to these conversations rather than being prescribed on the face of the Bill.
Amendments 238C, 238D and 238E, tabled in the names of the noble Lord, Lord Ramsbotham, and the noble Baroness, Lady Whitaker, relate to placing a particular emphasis on educational and children’s services. They would make explicit reference to education and children’s services in the Bill, in the context of the duty and powers of health and well-being boards, to encourage close working between the commissioners of health and social care services, with itself and with commissioners of health-related services in the area. I should like to take this opportunity to reiterate some of the points made during our previous debates on this topic. I fully agree that joining up health and social care services for children as well as for adults is crucial, but I believe that the existing provisions set out in the Bill are sufficient to ensure that the voices of children are heard. Indeed, I should like to remind noble Lords that in preparing the JSNA and joint health and well-being strategy, health and well-being boards will have a statutory duty to involve people who live or work in the area, and this will include within it young people. The director of children’s services will be a statutory member of the health and well-being board to ensure that the needs of children are taken into account, and local healthwatch will also be able to use its membership on the boards to help ensure that the voices of the whole community, including those of young people, are fed in.
In addition, the statutory guidance—I think this is a reassurance that the noble Lord, Lord Ramsbotham, wanted—we are producing on JSNAs and joint health and well-being strategies will emphasise the importance of understanding and addressing the needs of children and young people. We are also supporting the efforts of local partners by bringing together emerging health and well-being boards into a national learning network, which is developing ways to engage effectively with local people, including a focus on effective joint working to improve services for children and families.
Baroness Whitaker
I am sorry to interrupt the noble Earl, but before he moves off our amendments, I did not actually hear the words “education services” in his helpful remarks. Could he explain how they will come in?
Earl Howe
I was going to come on to that in replying to the noble Earl, Lord Listowel. If the noble Baroness will bear with me, I hope that I will cover the point.
Amendment 238A would require local authorities and CCGs to specifically consult relevant health professionals when preparing the JSNA. As I have said before, in preparing the JSNA and joint strategy, local authorities and CCGs will be under a duty, which the health and well-being boards will discharge, to involve people who live or work in the area. In practice this could well include health professionals. Indeed, I thought that the noble Baroness, Lady Finlay, made a powerful point in this regard, and I do feel that we are broadly accepting the spirit of the amendment.
In relation to Amendment 238AZA in the name of the noble Baroness, Lady Massey, and the noble Earl, Lord Listowel, I should like to reassure both of them that the health and well-being strategy will be a shared, overarching response addressing the health and social care needs of an area identified through the JSNA. In the joint strategy, the board will be able to consider how the commissioning of wider health-related services could be more closely integrated with health and social care commissioning. For example, the board could consider whether and how housing, education or local authority leisure services could affect health and, if they do, how commissioning could be more closely integrated with the commissioning of health and social care services. The model we have chosen for health and well-being boards is designed to enable those wider conversations to take place, and in answer specifically to the noble Earl, Lord Listowel, I genuinely believe that the arrangements in the Bill afford a much better chance of us having joined-up thinking and joined-up services than we have had before. Clinical commissioners will be best placed to work in the interests of children, especially when this requires working with other professionals. There are strong duties on commissioners as to promoting integration, as the noble Earl will be aware.
On Amendment 238H, in the name of the noble Lord, Lord Beecham, we believe that health and well-being boards will provide an opportunity to build strong relationships with an open culture of peer-to-peer challenge. The JSNA and joint strategy will provide all members with a common understanding of local needs and priorities. However, giving boards a power of veto over commissioning plans would undoubtedly undermine that relationship. I am afraid that we are firmly against that idea.
We are in agreement on that matter with the Future Forum and the Local Government Association, both of which recognise that placing a duty on CCGs to agree commissioning plans with the health and well-being boards would confuse lines of accountability and be unworkable—confusing and unworkable were the words of the Future Forum. CCGs are ultimately responsible for their budgets and to give the health and well-being boards the right to make decisions that might incur costs for commissioners without taking responsibility for expenditure would be wrong.
I hope that I have been able to reassure noble Lords adequately—although I know that I will not have reassured the noble Lord, Lord Beecham—and they feel able not to press their amendments.
Finally, I should like to speak to the government amendment in this group, Amendment 239, which is a minor technical amendment in relation to Clause 195. The purpose of this amendment is to clarify that a local authority may delegate any functions exercisable by it to the health and well-being board. I hope that it will receive the support of the House.
Lord Beecham
I remind the noble Earl of my question about whether that extends to general powers of competence rather than statutory functions. I invite him to communicate later as I suspect that he may not be in a position to do that immediately.
Lord Ramsbotham
I thank the noble Earl for his habitually courteous and balanced reply and I am reassured on some of the points that I raised. I am grateful to the noble Baroness, Lady Whitaker, and my noble friend Lady Finlay in particular for supporting the amendments and to the noble Lord, Lord Beecham, for mentioning them. Like the noble Baroness, Lady Whitaker, I have this nagging fear that education, education, education is something that will need to engage the health and well-being boards. The link between education and health, particularly in the assessment, which was the subject of the amendments, is absolutely crucial. During the passage of the then Education Bill, noble Lords described what they wanted but of course they could not have it because they were health matters funded by health. Therefore, it is terribly important that joint working happens.
I was very glad that the noble Earl mentioned “effective joint working”, because I am sure that that is what we all seek. That was what was behind each and every one of the amendments. On the basis of that and knowing the noble Earl and that if he says something it is usually likely to happen, I beg leave to withdraw the amendment.
Lord Beecham
“Functions of Health and Wellbeing Boards as to clinical commissioning groups’ commissioning plans
All commissioning plans prepared by a clinical commissioning group as set out in section 14Z9 of the National Health Service Act 2006 must be agreed by the relevant Health and Wellbeing Board.”