The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)
My Lords, in the spirit in which the noble Lord, Lord Hunt, started his speech, I, too, make declarations, not only of my position as a trustee of academy trust Floreat Education, which I set up, but, given that he has brought his family into it, that my wife is also a journalist. I think it is probably worth saying that.
I sincerely thank all noble Lords for this thought-provoking and wide-ranging debate. When I got my marching orders from the Leader’s Office, I thought that, compared with my noble friend Lord Ashton, who opened so expertly, I had perhaps pulled the short straw. But the opportunity to reflect on the wise and incisive comments made by noble Lords has been a privilege, and I am grateful for it.
I am particularly grateful for the speeches from the Front Bench from the noble Baronesses, Lady Sherlock and Lady Walmsley, and the noble Lords, Lord Hunt and Lord Storey, for their as ever searching questions. I also wanted to highlight what I felt were some of the more uplifting speeches. The right reverend Prelate the Bishop of Ely talked about how we could live well with difference and create a society that supports common flourishing. My noble friend Lady Stowell talked about the importance of behaving with dignity and respect for one another. I join the noble Baroness, Lady Masham, in paying tribute to the emergency services. My noble friend Lady Cumberlege mentioned a phrase that stuck with me: “treat me kindly”. The right reverend Prelate the Bishop of Gloucester talked about providing hope for the most vulnerable, and the noble Earl, Lord Listowel, about encouraging exchanges between young people. The noble Baroness, Lady Benjamin, in her fantastic way, gave a wonderful and optimistic exposition of the preciousness of childhood. My noble friend Lord Grade talked about bipartisanship —there is a thing—in praise of Gordon Brown. I may move off that slightly.
Before turning to noble Lords’ specific comments and questions, I would like to reflect on some of the measures in this Queen’s Speech. Some noble Lords have criticised the legislative agenda set before Parliament last week. I believe that that criticism is misguided. This Government are delivering on the British people’s desire to leave the European Union—a desire echoed in the recent general election when more than 80% of votes cast were for parties that supported leaving the European Union—and we wish to do so on good terms. The only magic trick at work here, the only illusion, is the attempt by the Liberal Democrats to pretend otherwise. This has rightly been described as the greatest peacetime challenge ever faced by any Government. Unambitious it ain’t.
Yet beyond that, the Queen’s Speech demonstrates the Government's commitment to broader social reform, and the business of government very much goes on. In the areas that we are discussing today, it includes enhancing our efforts to make the NHS the safest health system in the world, helping people to make more informed financial decisions, correcting 70 years of policy failure to deliver a high-quality system of technical education, improving the quality and safety of our digital economy, and challenging the culture of indifference that ranks mental health below physical health. This is an agenda that will deliver a strong and safe society in which everyone should have the chance to thrive. It is one of which any Government can be proud, and this Front Bench is delighted to be playing its part in delivering it.
The actions outlined in Her Majesty’s most gracious Speech build on a record of success, despite the gloomy prospectuses of so many noble Lords in this debate. I mention in passing that the ONS started collecting self-reported happiness measures in 2012 and, despite the tone of the debate, believe it or not they have never been higher. The ONS only started collecting them in 2012, so in the halcyon days of Tony Blair no doubt they were much higher. However, I believe that the word “crisis” has been used far too liberally. I gently chastise the noble Lord, Lord Pendry, for politicising the NHS in the way he did. The BMA was against the founding of the NHS some time ago, but things change, and the Conservative Party is deeply supportive, as supportive as any political party in this country, of what my noble friend Lord Lawson once described as the closest thing we have to a religion.
We recognise the pressures that our public servants are under, and I would not want to be involved in running down their achievements over the past seven years. We have 1.8 million more children in good and outstanding schools, the best ever health outcomes, low crime rates, record employment, the closing of the gender pay gap, and reductions in income inequality so that they are the lowest since 1984. These have been possible because of the sound economic management of this Government and their willingness to take decisions to restore public finances to order. These decisions have enabled record investment in schools and hospitals despite the need to reduce borrowing.
The Government recognise absolutely the impact these actions have had on public servants’ pay, and I agree with the noble Lord, Lord Storey, that they are our greatest asset. I also know that this period has been difficult for people in both the public and private sectors. That is all the more reason to finish the job so that we can deliver the pay increases that staff want. The alternative, set out in the Labour manifesto is, if I may say so, to promise free things for everyone. But nothing is free. It all has to be paid for by someone, so the question is: by whom? Either, as the Institute for Fiscal Studies has pointed out, by ordinary taxpayers, not just the rich because there is not enough there to soak, or through more borrowing and more debt, loading yet more costs on to future generations.
I do not believe that it is fair to ask the young to continue to support older generations, which is what is happening now. The noble Lord, Lord Whitty, laments the end of the benefits that his generation enjoyed, such as pensions, secure jobs and so on, but I wonder whether he has reflected on the fact that the reason young people do not have access to these things may be at least in part because of the choices made by his generation. Perhaps, as my noble friend Lady Browning hinted, the baby boomers might consider footing the bill to improve conditions for the young. We had some ideas for that in our manifesto. That might satisfy the desire for more taxes, which appears to have been picked up in the British Social Attitudes survey, as the noble Lords, Lord Kirkwood and Lord Warner, pointed out.
I shall move on to education and start where the noble Lord, Lord Hunt, finished: on the purpose of education, if you like—the philosophical element. I agree with him that the purpose of education is to provide a broad, rich and rounded education. At Floreat Education, we use a quote from Martin Luther King, who said:
“Intelligence plus character—that is the goal of true education”.
It is the development of that wider human flourishing that I think we are all seeking. That absolutely includes gardening, as the noble Baroness, Lady Benjamin, pointed out. Indeed, I do not know whether she noticed, but one of her colleagues, the noble Lord, Lord Wallace of Saltaire, is a chief grandparent at Floreat Wandsworth school and has been deeply involved in planting the new garden that has opened there in the past year, so I am a deep believer in it. Indeed, the Government’s purpose is to provide more good school places that are open to any pupil.
I turn now to school funding. We know that the current funding arrangements in England are unfair. That is why we have recently consulted on the national funding formula for schools and we will work with Parliament to bring forward proposals. The core schools budget, which the noble Baroness, Lady Sherlock, and the noble Lord, Lord Storey, referred to, has been protected in real terms since 2010 and is set to rise to £42 billion by 2019-20, albeit with increasing pupil numbers. Teacher numbers have also increased in recent years. There are more than 450,000 teachers in state-funded schools, which is up by 15,000 since 2010.
A great deal of concern has been voiced in the debate about the EBacc and arts education. I agree that every child should experience a high-quality arts and cultural education. Since the EBacc was announced, and bearing in mind that the point of the EBacc is to provide the foundation of a rich and robust academic education for every child, the proportion of state-funded pupils taking at least one arts subject increased from 45.8% in 2011 to 48% in 2016. Noble Lords may be wondering how that squares with some of the facts, but it is quite possible that each pupil is taking fewer subjects but more are taking subjects, meaning that more students are actually getting the balanced education that we want to see.
The right reverend Prelate the Bishop of Ely talked about the importance of character education. I am delighted to say that he has visited one of my schools, and that we continue to invest in that element. I can also reassure him that religious education is compulsory at all key stages and that entries into the RE GCSE full course have been rising each year since 2009.
On apprenticeships, raised by the noble Lord, Lord Aberdare, and the noble Baroness, Lady Bonham-Carter, we believe in the importance of apprenticeships in delivering skills. That is why the £2 billion raised by the apprenticeship levy is being invested. That is being designed by business; it is about having something that fits the needs of businesses.
As we set out in the manifesto, we want to look at the funding of further, technical and higher education to ensure that there is parity of esteem and the right approach so that we have the skills we need. As my noble friends Lady Stowell and Lady Stedman-Scott pointed out, it is vital that we value not just people who have been through the university route. That lies at the heart of our proposals to provide an extra £0.5 billion a year for technical education.
I should take this opportunity to respond to points made by the noble Baronesses, Lady Lawrence and Lady Cohen, about international students. We absolutely value the significant contribution that they make to our universities and our society. The UK remains the second most popular destination globally for international HE students. Our purpose as we leave the European Union is to gain control of, not to end, immigration. It becomes much easier to defend immigration to those concerned about it if there is a sense that the Government are in control.
Several noble Lords, including my noble friends Lady Stowell and Lady Stedman-Scott and the noble Lord, Lord Aberdare, talked about careers advice. The Careers & Enterprise Company is promoting careers education. As the noble Earl, Lord Kinnoull, pointed out, that is a vital part of social mobility. I welcome his committee’s report, which is influencing the way government thinks. However, as my noble friend Lady Stowell pointed out, we need to tread slightly carefully with social mobility. There is a version of social mobility that says simply that the most important thing is to get out of your community, but, as she said, we should provide the ability to succeed in your community; you should not need to leave where you come from to be considered a success.
The right reverend Prelate the Bishop of Gloucester, the noble Earl, Lord Listowel, and the noble Lord, Lord Addington, talked about vulnerable young people with learning difficulties. I can reassure them all that this is still very much a priority for the Government. I share their sadness that Edward Timpson lost his seat. We all acknowledge that he was an excellent Minister who was a truly passionate proponent of the issues relating to such children. I deeply hope he will be back; I am sure that he will be working hard on those issues in some other guise in the meantime.
The noble Lord, Lord Clement-Jones, asked about the data protection Bill and the digital charter, and about responding to and being guided by the reports from the Royal Society and the British Academy. We welcome those reports, which will be a useful contribution to the Government’s work across this agenda. We are looking at measures to share data in a way that is safe but brings benefits to citizens. HMRC holds a lot of data which are highly sensitive. The Digital Economy Act, taken through this House by my noble friend Lord Ashton, allows those data to be used subject to rigorous safeguards. We will bring those powers into force shortly.
The noble Baroness, Lady Sherlock, asked about protection for people using social media. As I have said before, as a parent of young children who are on the brink of getting into that world, what is possible frankly terrifies me. However, I think the manifesto— which, as we know, had some strengths and weaknesses—was commendably robust on those issues. We will bring forward an internet safety strategy to try to make the UK the safest place in the world to be online.
As for Channel 4 moving out of London, I can see that this could become a bun fight between different corners of the country. I do not want to weigh into that and suggest any kind of preference—I was born in Maidenhead, the Prime Minister’s constituency, so there might be a chance.
Lord O’Shaughnessy
It is our intention that Channel 4 should move out of London to provide that stimulation to regional creative industries.
The noble Baroness, Lady Bonham-Carter, asked whether we would set up a licence fee committee. I shall have to disappoint her on that front.
There were a number of questions about the impact of Brexit on the creative and digital industries. This is an area where we can talk ourselves into a very negative position. As I stated at the beginning, the Government’s desire is to have a close and deep partnership with the European Union. The mood music we are picking up in Europe from industries—I know it is true in my own area of pharmaceuticals—is that there is that strong desire from the other side as well. It is about reaching for a strong and integrated partnership and not being tempted down a different route. The creative industries are clearly an absolute mainstay of the UK economy and a flagship pillar of the industrial strategy—I can reassure noble Lords that they are very much in our thoughts as the negotiations to leave the European Union go forward.
I have touched on immigration. The noble Lord, Lord Young, asked about cybersecurity. We are obviously under attack all the time in terms of cybersecurity. The Government have done a great deal in this area. There was a particular effect in the health service, as we know, back in May. There are new standards coming, through the Caldicott review for healthcare, which we will publish our response to in due course. The Government take this very seriously and have invested heavily in it.
The noble Lord, Lord Lee of Trafford, asked about tourism, another vital part of our economy which will remain vital.
Moving on to work and pensions, first, I thank the noble Lords, Lord Kirkwood and Lord McKenzie of Luton, for their support for the Financial Guidance and Claims Bill. It will make a big difference to people’s ability to make more effective financial decisions and to deal more competently with financial services.
The noble Baroness, Lady Sherlock, asked about this Government’s commitment to the welfare state. I can tell her that our commitment is as deep and as strong as ever. We believe that there should be a strong welfare state, consisting not only of the social security system but of pensions, care, health and education, committed to helping everyone, with extra help for those who need it. Part of the reforms to the welfare state, to make it fit for purpose, involves universal credit. I believe it is a simplifying rather than a complicating of the system. It has clearly been introduced carefully to make sure that it works, as is right. The current system does not make sure that work pays in every instance, but that is something that universal credit does.
The noble Lord, Lord McKenzie, asked specifically about Grenfell Tower and the passage in the speech of my noble friend Lord Ashton of Hyde. I can confirm that no one will be worse off as a result of rehousing because of the fire at Grenfell Tower if they move into larger accommodation. I think that that provides the reassurance that the noble Lord was after.
Disability issues were raised by a number of noble Lords, including my noble friend Lord Shinkwin. I think we were all very moved and rather shocked to hear of the treatment he had received. I know I was when I read about it and then spoke to him about it. The Minister for Disabled People is taking an active interest in this and I know that my noble friend is talking to her. Improving the lives of disabled people is a core part of this Government’s approach. We had a Green Paper in October last year and a consultation was launched in February. Responses are being considered before we move ahead. The noble Lord, Lord Addington, talked about disability employment advisers and disability recruitment. There is not yet perhaps the coverage he would like, but there are nearly 500 employment advisers across the country and those numbers have been increasing. We will aim to get a million more people with disabilities into employment over the next 10 years. I think the Government have a very good record on that.
Finally, on health, the fundamental question that has been raised by the noble Baroness, Lady Masham, the noble Lords, Lord Warner and Lord Pendry, and others is the sustainability of the NHS. It has been working hard to manage its finances in a challenging period and yet, of course, it has been experiencing real-terms increases as well. Although I do not for a minute underestimate the challenges that it faces, with a growing and ageing population, we are planning to spend £8 billion more in real terms over the next few years to improve it. As a result, there are more people going through treatments, more people being seen in A&E and the targets that the noble Lord, Lord Hunt, referred to are still very much part, as he knows, of the NHS five-year forward view. Clearly, one of the ways we can improve health outcomes is to prevent accidents in the first place, as the noble Lord, Lord Jordan, my noble friend Lord Ribeiro and the noble Baroness, Lady Donaghy, said. I utterly agree with them about the importance of good health and safety. Public Health England works with the Child Accident Prevention Trust on these issues and preventing accidental injuries is part of the public health outcomes framework.
The noble Lord, Lord Pendry, and my noble friend Lady Browning talked about dementia. Dementia Friends has been a core part of the Government’s strategy and we understand just how deeply loneliness can harm health outcomes and cause misery and pain in people’s lives. Addressing that is an important part of this approach.
That brings me on to social care. The noble Baroness, Lady Pitkeathley, encouraged us to be bold and honest. I think if you could say anything about the manifesto promise, it is that it was bold and honest. Nevertheless, the ageing population presents one of our most difficult and profound challenges. As noble Lords know, more money is going into social care to put it on a stable footing in the short term. The proposals on which we will consult will include a floor and a limit on the amount that people can be asked to pay. I hope that provides reassurance to those who asked whether there will be proposals or yet more open-ended questions.
As part of our strategy, we need to think about carers. They do an amazing job in often extremely difficult circumstances—particularly older people looking after a spouse or children caring for their parents. We are considering carefully how to help those people.
My noble friend Lady Cumberlege, the noble Baroness, Lady Masham, and the noble Lord, Lord Freyberg, asked about maternity care. I feel very deeply about this issue. My eldest daughter was born in quite difficult circumstances and had to be delivered by emergency c-section. It was, frankly, a terrifying time. I want to ensure that there is good maternal safety, so that we do not risk what in her case was a strep B infection that had almost got up the umbilical cord—she had a raging temperature within the womb and a heart rate of 150 beats per minute. Your Lordships can imagine what that was like for us all, and for my wife in particular. So I feel that point very deeply and we have a real commitment from the Secretary of State on this issue.
I congratulate my noble friend Lady Cumberlege on her national maternity review. We are taking forward many of the ideas that she is interested in promoting, such as the rapid resolution and redress scheme, backed with more funding so that we can have a safer, more personalised and kinder approach to maternity, and prevent some of the awful injuries and deaths that sadly happen in that environment.
One issue that affects maternity and other areas is when there are staff shortages. The number of midwives has increased over the past few years. We know that there is growing demand from a growing population and we want a workforce that is capable of dealing with the challenges ahead—even more so given the impact of not only Brexit but, as we were discussing the other day, the language tests. That is why we are increasing the number of staff in training and offering new routes into the profession, such as the nursing associate and nursing apprenticeship.
I will touch briefly on the payment of the national minimum wage for sleep-in shifts, which was raised by the noble Baronesses, Lady Jolly and Lady Brinton. Through the living wage we want to make sure that pay is fair in all sectors of social care—but I understand the problem with this issue. We are looking at it and I will come back to update both noble Baronesses on the particular concerns they raised in the debate today.
Regarding mental health, the Government have a better story to tell than perhaps we have been given credit for. There is much more money going in—and, yes, it is getting to the front line, as well as other commitments, including waiting time commitments on treatment. There is an issue to be discussed, at another time, about the extent to which we have ring-fencing and direction, because the whole way the NHS works is predicated on clinical autonomy. Just as with the operational autonomy of the police force, that autonomy is rather important. Of course there should be targets—or goals, if you like—and sometimes they will be in conflict with one another. Nevertheless, it needs to be for professionals to make that decision. We will bring forward the Green Paper on children’s and young people’s mental health that the noble Earl, Lord Listowel, hoped for. I can reassure him on that front.
My noble friend Lady Browning asked about people in prison. They should absolutely be getting the same level of care as those who are out of prison. Patient safety has been talked about, and is at the core of this Queen’s Speech. We have the draft patient safety Bill, and it is our intention, as the noble Lord, Lord Freyberg, and my noble friend Lord Ribeiro, said, to learn the lessons from other sectors such as aviation, to make sure that we have one of the safest healthcare systems in the word. We intend to publish the Bill in draft later this year, ahead of pre-legislative scrutiny within this two-year Parliament.
The noble Lord, Lord Rennard, asked about tobacco control. I am afraid I cannot give him a precise date for the plan, although I know he is itching for one. He will understand that there has been a reorganisation of Ministers in our department since the election, but our commitment to it remains.
My noble friend Lord Astor asked about Lyme disease. There is a public health pathway on this issue, but I realise the seriousness—the growing seriousness—of it, and will write to him on the further work that we are doing.
My noble friend Lord Bridgeman raised the issue of GP surgeries. General practice is changing: partnerships are merging into federations, and there are other things going on, but improving primary care is at the heart of the five-year forward view. The nature of practices will change over time, but I totally understand what he says about making sure we do not punish those who are most entrepreneurial.
I am sure that your Lordships will be delighted that I am about to bring my speech to a close. I have tried to be comprehensive, but we have also agreed on the importance of arts and culture for children, and I am due to take my children to see “The Wind in the Willows” tonight, so I will bring my comments to a close.
Discussions in this Chamber are not always conducted without rancour, and I am as guilty of that as others, but on reflection it is noticeable that the speeches I highlighted to begin with for their uplifting qualities came largely from either Baronesses or Bishops, despite their being in a minority in this House—that is probably a lesson for us male, temporal Lords.
In an attempt to reach the bar that they have set, I would like to close the debates on the humble Address by turning to an idea that has motivated me through my life, and which I know motivates every Member of this House, those in another place and millions of citizens throughout this country. We are here and we serve our country because we believe in Britain. We believe that it has a great past but an even better future, and that our country is at its best when it pulls together in pursuit of an ambitious and admirable goal.
We have seen that attitude at work in response to the tragic incidents of which we have suffered too many recently. These tragedies all hit home in various ways, whether because our Parliament was attacked or because we live with, know or work with people affected. I can see the burned-out remains of Grenfell Tower from a window at home. It is right next to the leisure centre where I take my children swimming—no doubt some of the children who swam in that pool have died. It is a black scar on London's landscape and a dreadful reminder of the importance of looking after one another more carefully than we sometimes do.
However, it should not need tragedy to pull us together. As Brendan Cox, the courageous husband of murdered MP Jo Cox reminds us with great dignity, we have more in common than that which separates us. The task for this Government, and indeed this House and Parliament, is to bring people together. We need to create more and new opportunities for common enterprise—joint endeavours that allow our people to achieve happiness for themselves, their families and their communities. If this is what motivates us all in the years ahead, then, despite the challenges, I believe that we can face the future with confidence.