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Oral Answers to Questions
(6 years, 5 months ago)
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Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
The Department is considering evidence about the strategic road network gathered by Highways England and stakeholders over the past two years, alongside responses to the consultation that took place over the winter. The Department will be announcing the decisions about which new enhancements will be included in the second road investment strategy in 2019.
Sir Geoffrey Clifton-Brown
I thank my hon. Friend for that answer. On the A417 missing link scheme Swindon to Gloucester, can he confirm that it is the Government’s intention that a preferred route will be announced in the first quarter of next year, followed by the development consent order process, followed hopefully by RIS2 funding, and with an intention to commence in the early 2020s to build this much-needed road where there has been a fatality recently?
Jesse Norman
This road is both dangerous and highly congested. Highways England has been carrying out a consultation on improving the missing link near the Air Balloon pub, as my hon. Friend will know, and I have recently met him and colleagues. Once the responses have been analysed there will be further consultation ahead of the preferred route announcement. We certainly hope there will be a PRA early in 2019.
Mr Clive Betts (Sheffield South East) (Lab)
I am sure the Minister is aware that road links between Sheffield and Manchester are as bad as between any two major cities in Europe, and I invite him to join me to demonstrate that fact, as one of his predecessors did. Will he confirm that even if construction work will not start in the next funding period, at least design work will start on the promised scheme to link the two cities together?
Jesse Norman
I can make no such confirmation; the hon. Gentleman knows the structure of RIS2, and we will make the announcement in 2019, but I will be delighted to have further conversations with him about the scheme in question.
Mr Mark Harper (Forest of Dean) (Con)
I listened very carefully to what the Minister said in reply to my hon. Friend the Member for The Cotswolds (Sir Geoffrey Clifton-Brown). The A417 missing link road scheme is important to all Members of Parliament for, and the county of, Gloucestershire, so I welcome what the Minister said and urge him to follow through on his commitments to my hon. Friend, and remind him that we will all be watching and waiting to make sure he follows through on the commitments he has made at the Dispatch Box.
Jesse Norman
I am always grateful for reminders of the importance of parliamentary accountability, and I take that cue. My right hon. Friend will recall that this is not an inexpensive scheme. We are hoping to bring it to birth, and have given it a very strong commitment and continue to do so, and we are looking for a PRA early in 2019, as I have said.
Conor McGinn (St Helens North) (Lab)
Haydock island in my constituency is where junction 23 of the M6 meets the East Lancs road and very busy local roads. The system has been reconfigured but still is not working, and my constituents, residents and local businesses are suffering. Will the Minister meet me and local representatives to ensure we can improve it by including it in the next scheme in 2019?
Jesse Norman
If that scheme has been placed into the RIS2 consultation it will presently be a matter for consultation with officials. I am happy to have a meeting with the hon. Gentleman, but not in any sense that puts the formal process of consultation and deliberation at risk.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The Secretary of State for Transport (Chris Grayling)
The Government are investing record sums to deliver the transport infrastructure that Britain needs. The Department for Transport’s annual capital spending will more than double over this decade, from £8 billion in 2009-10 to £17 billion in 2019-20. This money will deliver our ambitious five-year investment plan for the rail and strategic road networks, take forward delivery of High Speed 2, and help improve air quality.
Dr Whitford
First, I am going to use my position to wish all staff in the NHS a very happy 70th birthday.
The Secretary of State makes the classic mistake of thinking infrastructure is just steel and concrete, but the airspace routes above the UK were designed in the ’60s and simply cannot cope with the 2.3 million planes that use them every year. The NATS air traffic centre at Prestwick has invested in the technology to allow more direct planning and shorter routes and to save fuel and reduce noise. When will the Government actually reform the airspace?
Chris Grayling
I echo the hon. Lady’s comments about the NHS: I am looking forward this afternoon to travelling out with my local ambulance service to see the work of NHS staff, which, as she rightly says, is first rate.
As you will be aware, Mr Speaker, we have already launched the process of airspace reform in this country. We are currently depending on technology that is decades old; it is not now fit for purpose and we need to move to a world that is controlled by state-of-the-art digital technology. That will create the capacity we need, and a rolling programme is planned for the coming years of modernisation of our airspace across the UK.
Justine Greening (Putney) (Con)
A second entrance at Putney station would not only ease congestion, but would finally give connectivity with East Putney tube station. This project is supported financially by Wandsworth Council. Can the Secretary of State, following our recent meeting, look carefully at what support his Department can give this scheme so it can finally get the go-ahead?
Chris Grayling
I regard that scheme as a quick win that could make a real difference to passengers. I have asked my officials to consider it carefully, and I will carry on talking about it with my right hon. Friend. I am sympathetic towards the potential benefits of creating a better interchange between the underground and the mainline railway in her constituency.
Emma Reynolds (Wolverhampton North East) (Lab)
The Transport Secretary mentioned technology. Since the Government have devolved funding for speed cameras to local police forces, cameras have been switched off due to policing cuts. Will the Government reconsider that? There have been some severe accidents on the A449 Stafford Road in my constituency, including a fatality, and we need new speed cameras on that route.
Chris Grayling
I will absolutely take a look at that issue. We try to devolve responsibility for such things, but I will look carefully at that. We should always be mindful of stretches of road where there have been fatalities.
Philip Davies (Shipley) (Con)
I am extremely grateful to the Secretary of State for his interest in the Shipley eastern bypass and for coming to visit my constituency to see the route at first hand. Will he update me, the House and my constituents on the progress being made towards finally introducing a bypass?
Chris Grayling
My officials are currently considering what it would take to move the project forwards, and I have had discussions with the combined authority. The potential route sits alongside a growth area in West Yorkshire, so I am personally taking an interest in the scheme, which is now subject to careful assessment.
Judith Cummins (Bradford South) (Lab)
In recent weeks we have seen endless delays, cancellations across the north and a report from the Select Committee on Transport that confirmed a bias against northern regions in rail investment decisions, and we now hear reports that the trans-Pennine electrification will be scrapped altogether. Will the Secretary of State now respond properly to the One North campaign and commit to giving Transport for the North the full powers and funding it needs to deliver the necessary changes?
Chris Grayling
I am afraid that this is a total misnomer. First, the part of the country that will receive the highest Government spending per head on transport over the next five years is the north-west. Spending is higher per head of population across the north than it is in the south. Secondly, as I have already announced, we will start the £3 billion trans-Pennine upgrade next spring, which will substantially rebuild the railway line between Manchester, Leeds and York and deliver much better services to passengers. It is long overdue.
Alan Brown (Kilmarnock and Loudoun) (SNP)
Network Rail plays a key role in delivering rail infrastructure investment projects both north and south of the border. Given that many of the Secretary of State’s colleagues think that Network Rail is too big, that he often gives it a kicking himself and that the Scottish Government have responsibility for the strategic delivery of rail north of the border, will he at last take steps to devolve Network Rail fully to the Scottish Government?
Chris Grayling
The hon. Gentleman keeps arguing for that, but it was not recommended by the commission that examined what powers the Scottish Government should have. My advice to the Scottish Government is to try to use the powers they have well rather than ask for more.
Simon Hoare (North Dorset) (Con)
I urge my right hon. Friend to look favourably upon applications for investment in smaller schemes on de-trunked roads, such as the A350 and the C13 in my constituency. They are vital arteries for growing the economy in Dorset and, indeed, the wider south-west.
Chris Grayling
De-trunked roads are an important priority for me. We are shaping our plans to introduce the major road network and to start making funds available for things such as bypasses on roads that were de-trunked 20 or 30 years ago and where there is a pressing need for improvement.
Ruth Cadbury (Brentford and Isleworth) (Lab)
The Secretary of State for Transport (Chris Grayling)
I have been absolutely clear that expansion will be privately financed, and the Government have taken independent expert advice which demonstrated that expansion is capable of being financed without Government support. I have been clear that airport charges must be controlled, which is why I set out in 2016 that expansion should be delivered with airport charges remaining as close as possible to current levels. It is the Civil Aviation Authority’s job to enforce that, and I am certain that it will do so.
Ruth Cadbury
The Airports Commission has indicated that landing charges would have to rise by around 70% per passenger, and British Airways has warned that any such increase would make many routes from Heathrow no longer commercially viable. Would that not have significant consequences for regional connections and/or increase ticket prices for passengers?
Chris Grayling
We have of course been working to ensure that the cost of the original scheme was brought down in order to avoid a 70% rise in landing charges, but I have been clear that the requirement to set aside around 15% of slots for regional connections is non-negotiable and fixed. It will not be possible to change those slots to long-haul destinations because they are an essential part of the reform.
Greg Hands (Chelsea and Fulham) (Con)
When will the flightpaths be published?
Chris Grayling
I expect that we will complete plans for airspace modernisation over the coming months. There will be a rolling programme in the early 2020s, and I expect details of that plan to be made clear, probably in 2019.
Graham P. Jones (Hyndburn) (Lab)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
Highways England has gathered evidence about the performance of the strategic road network, and future pressures on it, to inform the decisions we have taken as part of the second road investment strategy. This process of evidence gathering and public consultation has taken into consideration the idea of extending the M65.
Graham P. Jones
The Secretary of State has invested in the idea of a rail link between Liverpool and Hull, connecting the east and west through the central low Pennines. Do the Government accept that a road link would be complementary? It would go through deprived communities and provide a huge economic uplift. Do the Government recognise that this is the great northern powerhouse project?
Jesse Norman
As the hon. Gentleman will be aware, we are already investing £1.5 billion in road systems in the north-west. Of course the M65 is, in a way, a legendary road because it ends in a carpark, and no one thinks that is a satisfactory arrangement. I would welcome a further conversation with him about this, but the situation is far from straightforward.
John Grogan (Keighley) (Lab)
Will Ministers also look favourably on restoring a rail link between Keighley and Colne by restoring the Skipton to Colne rail link, starting in the Government Chief Whip’s constituency? Will they look carefully at the feasibility study that is under way?
Steve Double (St Austell and Newquay) (Con)
The Secretary of State for Transport (Chris Grayling)
UK ports are adaptive and market-oriented. They are ready to facilitate growth in trade when we leave the EU. Over the medium and longer-term, patterns of maritime and inland traffic may be affected by the trade agreements we reach with the EU and with countries elsewhere. It is too early to predict in detail what those patterns will be, but ports nationwide are prepared for all likely eventualities.
Steve Double
The stunningly picturesque river port of Fowey is a magnet for visitors by both land and sea, but it is also a busy commercial port that ships the world’s finest china clay around the world. How will the Department’s recently published port connectivity study assist small river ports like Fowey?
Chris Grayling
As we plan infrastructure improvements over the coming years, I want us to look at how we best connect, in the most effective way possible, the ports upon which our country depends, both large and small. Of course, my hon. Friend will be aware that we are already demonstrating our commitment to improving the road network in his area, with the planned completion of the new link road up to the A30.
Fiona Onasanya (Peterborough) (Lab)
The Government have moved from saying they want trade with the EU post Brexit to be tariff-free to saying that they want it to be as tariff-free as possible. In which sectors of the economy and industry does the Secretary of State think it will be acceptable for there to be tariffs?
Chris Grayling
As the hon. Lady will be aware, this is not really a transport matter. Our ports will be ready, and our plans for how we manage our borders will be ready for all eventualities, but I want, I believe and I expect that we will have a sensible agreement with the European Union that avoids the charging of tariffs. That is certainly what the EU wants, and it is what we want.
Ronnie Cowan (Inverclyde) (SNP)
My Inverclyde constituency has a thriving port at Greenock, with cruise ships and container ships docking on a daily basis. Can the Secretary of State assure me that the systems, including IT systems, that will be required post Brexit are well on their way to completion so that ports such as Greenock will not be adversely affected by the UK leaving the European Union?
Chris Grayling
The answer is yes but, of course, most of our ports are well used to dealing with traffic from both inside and outside the European Union. Those handling freight move it through extremely quickly and effectively, and they have great expertise in doing so. I am very optimistic that our ports will do a great job in the post-Brexit world.
Alan Brown (Kilmarnock and Loudoun) (SNP)
In his opening remarks the Secretary of State said it is too early to predict the effects on transport at ports. That is ridiculous, considering that we will leave the EU in March 2019. Half of his Cabinet is arguing for a no-deal Brexit, so it is coming at us really fast. We already know it is predicted that an extra two minutes of checks at Dover would result in 30-mile tailbacks, so what is he doing to put in place IT systems and border infrastructure systems that allow joined-up, continued free movement?
Chris Grayling
The Government and Her Majesty’s Revenue and Customs are doing extensive work for all eventualities. As I have previously said in the House, we do not intend to impose any form of hard border in Dover. It would be logistically impossible to do so, and therefore any flow of customs through Dover in the post-Brexit world will have to be managed in an online, electronic way. It is not possible to create fixed systems at Dover.
Gillian Keegan (Chichester) (Con)
The Secretary of State for Transport (Chris Grayling)
Transport infrastructure has an important role to play in helping to increase our productivity. That is why we have set out to more than double our capital investment in transport over the decade to 2020, and why it is a central part of our industrial strategy.
Gillian Keegan
Many of my constituents in Chichester and the surrounding area lose hours and hours each week sitting in traffic on the A27. That has a knock-on negative impact on productivity, the local economy and the environment. Will my right hon. Friend ensure that road investment decisions for areas such as Chichester, which are already over capacity, are prioritised in the road infrastructure investments for 2020 to 2025?
Chris Grayling
I pay tribute to my hon. Friend, who has been doing a fantastic job of trying to get the A27 project back on track. I am absolutely aware of its importance to her constituency and to the south coast. It is important that the community in Chichester reaches a consensus about the right option, and of course I then want to see the project go ahead.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Secretary of State knows the effect on productivity in places such as Yorkshire and my constituency. On the 70th anniversary of the NHS, when we wish all those workers a very good day, is it not a fact that many of them are struggling to get to work because of his policies and his lack of sense of direction on transport infrastructure?
Chris Grayling
Actually it is this Government who are investing in rail and are providing new trains right across the north; who have just opened the last stretch of motorway-grade road between London and Newcastle; who are investing money in smart motorways; and who are putting money into Leeds, to ensure better connectivity there, and into towns and cities around the north. I wish Opposition Members would start to talk up the north and the improvements that are happening, rather than talking it down and pretending nothing is happening.
Mark Menzies (Fylde) (Con)
I have a wonderful piece of transport infrastructure in my constituency called Blackpool airport. Will the Secretary of State tell me what steps will be taken to ensure that with a third runway at Heathrow, we will see improved connectivity to my part of the north-west?
Chris Grayling
This is why I am committed to saying that the 15% of slots set aside for regional connections are set in stone. We are not going to see those suddenly disappear from 15% to 10% to 5%, with routes diverted elsewhere. The expansion of Heathrow is a really important part of delivering improvements right around the United Kingdom, and I am committed to making sure that happens.[Official Report, 12 July 2018, Vol. 644, c. 8MC.]
Jessica Morden (Newport East) (Lab)
This summer, my constituents who commute by rail have had to put with up with delays, cancellations and ineffective bus services as a result of work on the great western main line, and we now learn that equipment is rusting in the Severn tunnel. Although the infrastructure investment is welcome, will the Minister ensure that this is not an excuse for train operating companies to provide a reduced quality service? Will he also ensure that there is no more disruption than there needs to be?
Chris Grayling
This is one of the great conundrums. We are spending money around the country and it is impossible to deliver investment without some disruption. I absolutely would not accept a train company using that as an opportunity to do things that are not right for passengers, but we have to accept that if we are going to modernise different parts of our road and rail infrastructure, some disruptive consequences are inevitable, however much we might wish that was not the case.
Nic Dakin (Scunthorpe) (Lab)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
The Department absolutely recognises, as the Government do, the importance of clean air, and established a working group with the fuel industry and others in November 2017 to look at issues relating to the potential introduction of E10 fuel. This group has also considered the new fuel labelling requirements introduced by the alternative fuels infrastructure directive. We intend to consult on proposals later this year and, in some cases, potentially very soon.
Jesse Norman
I can certainly confirm that we will be consulting shortly on E10 and that we are looking closely at the issue of fuel labelling, which, as the hon. Gentleman knows, has to be addressed relatively quickly.
John Spellar (Warley) (Lab)
Does the Minister accept that what is really needed is an overall, measured, strategic approach to the propulsion mix for vehicles? That will rightly include E10, but it will also include diesel. What has been so damaging to that industry has been the Government’s war on diesel, which has been hugely damaging to our automotive sector, as well as our engine manufacturing.
Jesse Norman
I can only salute the right hon. Gentleman’s expertise in crowbarring a question about diesel into exchanges about E10. We are taking a strategic approach. We introduced changes to the renewable transport fuel obligation earlier this year. We have changed the status of the crop cap. We are pushing for the increased use of waste-based biofuels, and we are supporting the introduction of higher-performance fuels in other sectors of the transport world.
Mr Speaker
The right hon. Member for Warley (John Spellar) did mention diesel, which is a fuel, so I am not sure that a crowbar was altogether required. It is a matter of terminological preference, I think.
Andrew Rosindell (Romford) (Con)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
As my hon. Friend will know, the A12 in London is managed by Transport for London as part of its route network. The Department for Transport consultation on proposals for the creation of a major road network was launched in December and included an indicative network of the expected future major roads. That included the A12 and A127 at Gallows Corner. We aim to publish a consultation response this summer. The roads forming the final major roads network will be confirmed by the end of 2018.
Andrew Rosindell
The Minister will be aware that the Gallows Corner flyover at the A127-A12 junction is a very congested accident hotspot. The hopelessly inadequate response from TfL and the Mayor of London should be dealt with by the national Government. Will money from the national highways budget be used so that the Government can step in to help us to resolve this ongoing problem?
Jesse Norman
My hon. Friend has regularly and properly raised this issue. It is a matter for TfL, but I am happy to have a further conversation with him about how we can look into it.
Sir Greg Knight (East Yorkshire) (Con)
The Secretary of State for Transport (Chris Grayling)
My right hon. Friend will be aware that the Government are in the middle of a £23 billion programme of investment to upgrade our strategic road network. We are also investing money in pinch points, with an additional £220 million going to tackle them last year. Throughout the country, that money is being used for smaller local projects such as junction improvements that can really make a difference to traffic flows.
Sir Greg Knight
Is my right hon. Friend aware that some councils cause avoidable congestion themselves by the use of unnecessary and poorly-phased traffic lights? Will he encourage local authorities to audit their traffic-light usage to see whether some can be switched off? Will he also encourage the greater use of traffic-sensitive traffic lights?
Chris Grayling
I agree with both those points. Traffic lights play an important part in the management of traffic flows, but if they are synchronised in the wrong way or used in the wrong way, they can make things worse, rather than better. I absolutely join my right hon. Friend in sending to councils the message that they should keep traffic-light usage under constant review.
Graham Stringer (Blackley and Broughton) (Lab)
The chaos on Northern rail is apparent, but even had there not been the timetabling problems, the Northern rail and trans-Pennine franchises were let on a no-growth basis. Does the Secretary of State now realise that it was a mistake to let rail franchises on a no-growth basis and that it led to road congestion?
Mr Speaker
That was an extraordinarily interesting question, but we were supposed to be talking about road congestion.
Mr Speaker
Oh, did you? I beg the hon. Gentleman’s pardon. I heard a reference to rail electrification.
Graham Stringer
I was pointing out that particular franchises led to road congestion.
Chris Grayling
It is simply not true that the Northern franchise was let on a no-growth basis, although it was under the Labour party when it was in power. One reason why we have had the timetable problems, apart from the delay to the electrification—the investment that we are putting into the railway line from Manchester to Blackpool—is that we were in May introducing hundreds of new services, additional services and longer trains throughout the Northern rail region. That is hardly a zero-growth franchise.
Mr Speaker
One thing is clear to me: if the hon. Member for Blackley and Broughton (Graham Stringer) encounters road congestion, his antidote to it is to pursue what might be called an indirect route.
Rebecca Pow (Taunton Deane) (Con)
One thing that would reduce road congestion is, of course, getting people out of their cars and on to their bikes. We very much welcome the upgrade of the A358 in Taunton, but does the Secretary of State agree that whatever route is chosen by Highways England, the provision of adequate cycling infrastructure should very much be part of upgrades?
Chris Grayling
I always hope that when a new road is put in place, provision will be made for other users—cyclists and pedestrians—alongside that road, particularly in respect of a major road like the A358. That new road will of course mean that there is substantial additional capacity on the old road, which will become much less congested, but I am sure that Highways England will be looking carefully into how it can make provision for all road users.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
The A38 from Exeter to Plymouth closes too often owing to accidents and congestion. Will the Secretary of State look favourably on funding bids from Plymouth City Council and Tory-run Devon County Council to upgrade this road, address accident blackspots and start the much needed process of extending the M5 from Exeter to Plymouth?
Chris Grayling
I am obviously aware of the pressures on the A38 and, indeed, of the pressures on roads north and west from Plymouth. I pay tribute to my hon. Friend the Member for South East Cornwall (Mrs Murray) who, last week, made a very strong argument to me when I visited Cornwall for improvements to the west of Plymouth. That is something that we are looking at very carefully.
Paula Sherriff (Dewsbury) (Lab)
The Minister of State, Department for Transport (Joseph Johnson)
Recent disruption on the rail service has been unacceptable and the Government have been clear that passengers will be appropriately compensated. Transport for the North has agreed that the special compensation should cover weekly, monthly and annual season ticket holders on the worst affected northern routes who experienced severe disruption before and after the May timetable change.
Paula Sherriff
Well, that all sounds very good in principle, but owing to weeks of chaos, cancellations and delays, my constituent, Alex Hodgson, has had to use a significant proportion of his annual leave. He is still being passed between departments at TransPennine Express and has now been offered the equivalent of £1 a day compensation. Despite assurances from the Secretary of State, he and other constituents feel let down and ignored. What will the Minister do about it?
Joseph Johnson
Transport for the North has set out high-level details of the scheme, which will enable passengers who have season tickets to be compensated for up to one month’s cash compensation where they have suffered severe disruption. That is in addition to the normal compensation schemes available to passengers through the delay repay mechanism.
Kevin Hollinrake (Thirsk and Malton) (Con)
Passengers are experiencing significant delays travelling from west to east on TransPennine Express services, owing to cancellations and other delays. Will the Minister do everything that he can to persuade TransPennine Express to improve these services and to offer proper compensation? Season ticket holders in Yorkshire are getting one week’s compensation, whereas those in the north-west are getting one month’s compensation. That does not seem fair.
Joseph Johnson
Transport for the North has determined that passengers on the most severely affected routes, principally on Northern services, will get four weeks’ cash compensation, as my hon. Friend rightly said, and those on the less severely affected routes, which happen to be in Yorkshire, will receive one week’s cash compensation. That is a matter for Transport for the North.
Lilian Greenwood (Nottingham South) (Lab)
The National Audit Office revealed that the Minister’s Department has allowed Govia Thameslink Railway to buy out its liabilities for poor performance through to September 2018. The Public Accounts Committee has concluded that the threat to strip GTR of its franchise is not a credible one. What can he do to protect passengers from a continuation of the current appalling performance if the 15 July interim timetable fails to bring stability?
Joseph Johnson
Rail operating companies will be held responsible for that portion of performance for which they are responsible and accountable, and that is now under way. The Secretary of State has set in train a hard review of GTR, and at the end of that hard review, all appropriate options will be on the table and available to the Secretary of State and to the whole Government.
Rachael Maskell (York Central) (Lab/Co-op)
It was a Labour Government who established the NHS, and today we thank all who have served in it since.
Following the Secretary of State’s statement on the timetable chaos to the House on 4 June, he said in his response to the hon. Member for Cleethorpes (Martin Vickers) that, with regard to compensation, the train operating companies
“will have to meet the cost of that.”—[Official Report, 4 June 2018; Vol. 642, c. 59.]
That is so untrue. It is Network Rail that will be funding the compensation. Last year alone, it paid out £482 million through schedules 4 and 8. Does the Minister agree that, while the operating companies write the cheques, it is the state that pays?
Joseph Johnson
The Secretary of State has always been clear that we will review where responsibility lies, and the rail industry will be responsible for undertaking that appropriate compensation to make sure that passengers have the right redress. As Members will be aware, the rail industry is partly in public control through Network Rail and partly run by private operators. Each will pay its fair share.
Rachael Maskell
Astonishing. Network Rail paying compensation means that this is coming from the public, so, in effect, passengers will be funding their own compensation for delayed and cancelled trains, for missing exams, for being sacked from their jobs or for lost business revenue—passengers paying their own compensation. How much has the Minister budgeted for to pay compensation for the Secretary of State’s decision to press ahead with this rail timetable chaos, or will he instead cut more Network Rail projects to pay for it?
Joseph Johnson
As I have already said, the compensation involves four weeks’ cash compensation for passengers on the most severely disrupted routes on Northern services and one week’s compensation further afield in Yorkshire. Similarly, GTR announced yesterday a comparable package of special compensation for passengers on the most affected Thameslink and Great Northern routes.
Fiona Bruce (Congleton) (Con)
The Secretary of State for Transport (Chris Grayling)
As part of the improvements to Northern Rail services, there are more frequent, hourly Sunday stopping services from Stoke to Manchester via Macclesfield. Congleton station will benefit from full waiting room refurbishment, new seating, customer information systems, new and improved signage and new ticket vending machines.
Fiona Bruce
I thank the Secretary of State for that reply—and all that in the north. It is encouraging that, after years of local campaigning by my constituents, a strategic outline business case has been developed for enhancing the mid-Cheshire rail line, including reopening Middlewich railway station in that growing town. What assurance can the Secretary of State give me that funding is available for this vital development work?
Chris Grayling
There are two routes in the north that I feel particularly keen to look at seriously reopening. One is the line from Skipton to Colne. The other is the line that passes through Middlewich in my hon. Friend’s constituency that, in my view, should be a commuter railway into Manchester. Transport for the North has been working on the options, and I am committed to ensuring that we take that work forward.
Jo Stevens (Cardiff Central) (Lab)
Justin Madders (Ellesmere Port and Neston) (Lab)
The Minister of State, Department for Transport (Joseph Johnson)
With two decades of almost unbroken growth, we have seen rail passenger journeys more than double since the mid-1990s. For the first time since 2009-10, statistics from the Office of Rail and Road show a small decline in rail journeys over the past year, although passenger kilometres have continued to increase.
Jo Stevens
Rail passenger usage is falling. Is it any wonder that my constituents in Cardiff Central are giving up on using the trains, when a standard return rail ticket to London for a morning meeting costs £235? With that money, they could fly from our Welsh Labour Government-owned Cardiff airport to Barcelona and back three times and still have change for a taxi home.
Joseph Johnson
The Government are conscious of the cost of fares to the travelling public. For that reason, we have ensured that fares have risen at a lower rate than they did under the last Labour Government. The causes of the decline in season ticket numbers are complex. Although the statistics show a fall in journeys made using season tickets, there has been an increase in journeys made using other ticket types over the past year. Factors such as strikes, station closures and weather have had an impact on season ticket use.
Justin Madders
After years of campaigning, my constituents in Neston were delighted when they heard that the new Borderlands franchise would include a half-hourly service on the Wrexham to Bidston line. However, that joy was tempered somewhat with the news that the new service might not stop at every station. Given that a frequent and reliable service is vital for the residents of Neston, will the Minister join me in writing to his Welsh counterpart to impress on him the need for this service to stop at every station?
Joseph Johnson
I suggest to the hon. Gentleman that he engage the Welsh Government in Wales, who have primary responsibility for specifications to that service.
Mr Philip Hollobone (Kettering) (Con)
Given growing demand for rail travel from Kettering, will the Rail Minister ensure that there is more capacity on local train services under the new midland main line franchise?
Joseph Johnson
I would be delighted to engage with my hon. Friend on that question. We are investing substantially in midlands services and ensuring that new trains provide extra capacity and reduced journey times.
Sir Desmond Swayne (New Forest West) (Con)
The most recent assessment must be that passenger rail usage is down, because people cannot get into London today. Can the Minister tell us why that is?
Joseph Johnson
Yes, I can tell my right hon. Friend why that is. There has been a major signalling outage on the Brighton main line service, which has affected services throughout the network. Although this is the responsibility of Network Rail, the situation has affected services substantially on the Brighton main line. That is why we are investing £300 million in this route, with work starting in the coming months.
Mr Speaker
The concept of a signalling outage was previously unknown to me, but I suppose that it merely reinforces one in the knowledge that one learns something new every day.
Andy McDonald (Middlesbrough) (Lab)
May I take this opportunity to convey my very best wishes to the NHS—the greatest social achievement in British history—and also to convey my best wishes and a happy birthday to my hon. Friend the Member for York Central (Rachael Maskell)?
Quite clearly from yesterday’s PMQs, the Prime Minister is clueless about the sharp decline in bus ridership that her Government have presided over. I hope that the Secretary of State has a better analysis of the collapse in rail passenger usage—although I am not holding my breath. Can he explain last month’s figures from the Office of Rail and Road that show the biggest fall in passenger journeys since privatisation? Is he not alarmed that there were 2 million fewer journeys on GTR year on year and millions fewer journeys on South Western Railway?
Joseph Johnson
As I said, the decline in passenger journeys is a relatively recent phenomenon. Passenger kilometres continue to grow. It is difficult to determine exactly why we have this decline in season tickets, but we believe that it is due to factors such as strikes and recent station closures. In areas outside of London where there have not been those factors, we have not seen similar declines in passenger journeys.
Andy McDonald
Poor, very poor. The fact that the Minister is not more alarmed by this sorry state of affairs will be of great concern to millions of long-suffering passengers. It has never been clearer that there is something very seriously wrong with the railways on his watch, with franchising failure, timetabling chaos, broken promises on investment and people shifting from rail to road. He says that he does not run the trains—which is self-evident, by the way—but, for goodness’ sake, does he not realise that he has to step in and get a grip before our great railway hits the buffers?
Joseph Johnson
Labour’s policies of nationalisation would be no panacea for the challenges we face. Indeed, those challenges spring to a very large extent from the publicly owned parts of the rail industry—namely, Network Rail, the part that is in state control. We see passenger interests as best served by bringing together in partnership the very best of the public and private sectors, as the Secretary of State set out in his strategic vision for rail last November.
Dan Carden (Liverpool, Walton) (Lab)
Thank you, Mr Speaker.
Northern powerhouse rail would transform rail journeys for passengers in Liverpool, with journey times to Manchester cut to 20 minutes, but it simply cannot happen without the electrification of the trans-Pennine line. So instead of playing party politics with the numbers, does the Minister not realise that his Government will be judged on the major infrastructure projects that they complete?
Joseph Johnson
We are just completing the £1 billion investment in the great north rail project, which included significant electrification of the Liverpool to Manchester route. We are now about to embark on the next control period for rail, in which we will spend £2.9 billion on the trans-Pennine route upgrade. This is the single largest enhancement programme across the entire country, representing a third of all such spending.
Kevin Foster (Torbay) (Con)
The Minister of State, Department for Transport (Joseph Johnson)
The rail network plays a vital part in supporting our economy across the country, including in Devon and Cornwall. That is why we are investing more than £400 million in the rail network in the south-west. This includes a fleet of brand-new trains for services to Devon and Cornwall.
Kevin Foster
I thank the Minister for his answer. He will be aware from our recent discussions that there is real disquiet in Devon and Cornwall about the references to it in recent consultation about the future of the CrossCountry franchise. Can he reassure me that there is no intention of ending vital direct services from key locations such as Manchester, Birmingham and Bristol to the heart of south Devon’s English riviera?
Joseph Johnson
As I said to my hon. Friend when we discussed this issue a few days ago, the south-west is a vital part of our rail network. I am looking forward to discussing these issues with him further, as well as with the Peninsula Rail Task Force, which I hope to meet next week when I am in Cornwall discussing rail issues. The CrossCountry franchise offers passengers the ability to travel to Birmingham and on to the north-east and Scotland, or they can change at stations en route to connect on to trains that take them to other parts of the country.
Kerry McCarthy (Bristol East) (Lab)
The Minister just mentioned the Peninsula Rail Task Force. In the Government’s response to the recommendations in February, they said:
“we will look at improving connectivity between the Peninsula, Bristol and beyond”.
However, as we have just heard, that does not sound like it is happening, particularly with the CrossCountry franchise. Can the Minister explain what is meant by “improving connectivity”?
Joseph Johnson
No decisions have been taken on any options for the next franchise. This consultation is a way for us to gather the views of the travelling public and of Members of the House, so that we have the best-informed choice of possible options when we take those decisions.
Mr Stephen Hepburn (Jarrow) (Lab)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
On a point of information, the NHS was brought into policy by William Beveridge, a Liberal, and it was framed in law in a White Paper by Sir Henry Willink, a Conservative. It is therefore—[Interruption.] It ill becomes the Labour party on the 70th birthday to make a party political issue of the national health service.
Mr Speaker
Order. I indulged the Minister, who is an historian and a philosopher, and these are matters of argument. If I may say so, Mr McDonald, you are almost unfailingly a good-natured person. You are, in addition, one of the most excitable denizens of the House. I do not know whether you rejoice in that status or regard it as an accolade, but there it is.
Jesse Norman
I am grateful, Mr Speaker. I think I can calm the hon. Member for Middlesbrough (Andy McDonald) by giving my answer to the question asked.
Highways England’s 2017 regional safety report assessed the safety performance of all the routes in the Yorkshire and north-east region, including the A19. The A19 is performing well compared with other routes of its type, but Highways England is not complacent, and a number of further studies and safety improvement schemes are planned.
Mr Hepburn
Happy 70th anniversary to the NHS—an institution that was opposed every step of the way by the Tories when the Labour party brought it in. Can I bring the Minister’s attention to the “Safe A19” campaign run by my local newspapers, the Shields Gazette and the Sunderland Echo, and supported by myself and my hon. Friend the Member for Easington (Grahame Morris)? It is of no surprise to anybody that the number of incidents and accidents on that road is linked to the fact that roads in the north get half the amount of investment as roads in the south-east. What is the Minister doing to protect the people of the north-east?
Jesse Norman
As the hon. Gentleman will know, we take all issues of safety very seriously, and the same is true in the case of the A19. I have visited the A19 and seen schemes at work. We have further work planned on it, always with safety in mind.
Mr Speaker
The hon. Gentleman should ask his Question 17. [Interruption.] I could have linked it, I suppose, but I did not.
Grahame Morris (Easington) (Lab)
The Minister of State, Department for Transport (Joseph Johnson)
The Government are committed to investing in infrastructure to support regional growth, and that is why we are addressing under-investment in the north with the biggest investment programme for a generation. The Infrastructure and Projects Authority’s analysis shows that between 2018 and 2021, central Government transport spend per head is in fact highest in the north-west.
Grahame Morris
The Transport Select Committee has found that a disproportionate amount of transport funding is being spent in the capital, at the expense of the regions. What steps will the Minister take to close the gap and to specifically address issues highlighted by my hon. Friend the Member for Jarrow (Mr Hepburn), including the “Safe A19” campaign, the Seaton Lane A19 junction improvement and ensuring that east Durham gets a rail halt at Horden?
Joseph Johnson
The Government are investing substantial sums in the north—£13 billion in the five years to 2020—and in the next control period for rail, we will invest £2.9 billion on the trans-Pennine upgrade alone. The hon. Gentleman, I am afraid, is factually wrong to say that Government investment per head in London and the south exceeds that of similar investment in the north. IPA analysis shows that for the three years to 2021, the north will receive £1,039 per head, which is £10 more than similar figures for the south of England.[Official Report, 9 July 2018, Vol. 644, c. 4MC.]
Layla Moran (Oxford West and Abingdon) (LD)
The Secretary of State for Transport (Chris Grayling)
We expect to make a decision on the preferred corridor for the Oxford to Cambridge expressway this summer. There then has to be further work on the detailed route within that corridor.
Layla Moran
I thank the Secretary of State for his answer. Given that any of these routes will have an enormous impact on both communities and the environment, does he not share my concern that the public have not been consulted at all?
Chris Grayling
No roads can be built without public consultation. We are working out in broad measure which route a corridor might follow, so that we can then do detailed consultation with the public.
Rosie Duffield (Canterbury) (Lab)
The Parliamentary Under-Secretary of State for Transport (Ms Nusrat Ghani)
Whether for commuting to work or seeing friends and family, buses play an important role in keeping communities connected, with 4.4 billion passenger journeys a year. Between 2015 and 2017, the number of live local bus services registered increased by 14% in England and by 6% in Wales.
Rosie Duffield
My constituents have had to face a 480% rise in the cost of their children’s bus passes in the past five years. The No. 14 bus connecting Canterbury to rural east Kent villages was cut in September, and replaced by only a twice-daily bus service. This is just one of the cuts proposed by Kent County Council. What steps is the Minister taking to protect much needed rural bus routes from being cut by cash-strapped local authorities?
Ms Ghani
Local authorities receive a substantial amount of money from central Government to support bus services. The Government paid out some £250 million last year to support bus services in England. Kent County Council receives over £1 million per year, and Canterbury City Council receives over £83,000 per year. The hon. Lady mentioned bus fares. They rose almost three times faster every year under Labour than under the Conservatives, with local bus fares across Great Britain rising by an average of 1.9% each year in real terms. Bus fares go up under Labour.
Mr Speaker
The hon. Gentleman from the Opposition Front Bench needs to be very brief, because time is against us, but we are happy to hear from the fella.
Matt Rodda
May I, too, wish the NHS a very happy birthday?
Nearly 500 bus routes have been cut every year under this Government, snatching away a lifeline from elderly, disabled and young people, as well as from rural communities, yet the Government seem unaware of the impact of these cuts. I have to say that the Prime Minster floundered yesterday, and sought to blame local authorities. Does the Minister share that view, or does she accept the undeniable truth that her Government have totally mismanaged bus provision in this country?
Ms Ghani
Bus passes for the most vulnerable, older and disabled people are being supported by this Government with £1 billion, enabling 10 million people up and down this country to travel for free. As you may be aware, Mr Speaker, this is Catch the Bus Week, so the hon. Gentleman could have said something about bus services to encourage people to jump on the bus. There are good case studies up and down the country. In Liverpool, for example, young people are taking buses 142% more than they did in the previous three years. In Bristol, bus patronage has gone up by 42%, and in South Gloucestershire by 38%. There are good case histories of places up and down this country where bus patronage is going up.
Matt Rodda
I appreciate the fact that the hon. Lady has mentioned Catch the Bus Week. Rural communities have been hit particularly hard by the crisis in our bus services. Interestingly, we have visited Northamptonshire—bankrupt Tory Northamptonshire, I should say—which has one of the worst track records for cutting services. What would the Minister say to the resident I met yesterday, who told me there is no bus to take her child to school and that an older daughter has been unable to take up her preferred job option because there is no bus service?
Ms Ghani
Bus service provision is the responsibility of local authorities. About £800 million of funding is made available for concessionary bus fares, and £40 million is given directly to local authorities to support journeys that might not otherwise be profitable. As I mentioned earlier, there are local authorities working hand in hand with bus companies to make sure services are viable and attractive. May I just mention one? In Brighton and Hove, bus patronage has gone up by 22% since 2009-10.
Mr Speaker
The Minister is a treasure trove of previously unearthed information, for which we are extremely grateful.
Sandy Martin (Ipswich) (Lab)
The Secretary of State for Transport (Chris Grayling)
May I take this opportunity to thank Members on both sides of the House for the support they gave last week to the vote on the expansion of Heathrow airport? I think that sent a powerful message about the future of our country. The support came from the Government side of the House, the Opposition, the parties in Northern Ireland and Scottish Conservatives, and it was a resounding vote for the country’s future.
Sandy Martin
Although Greater Anglia and the Government both say that they want 15 minutes to be the trigger period for passenger compensation, travellers from Ipswich are still unable to claim any compensation until their trains are more than 30 minutes late. Given the number of failed trains, failing overhead wires, failing rails, failing points and failing signals, when will the Secretary of State rectify this anomaly and ensure that my constituents can claim the compensation that is readily available to passengers in the rest of the country?
Chris Grayling
The move across the country to repayment after a 15-minute delay is being phased in with new franchises that will start over the coming years. I say to passengers in East Anglia that every single train there is being replaced with a brand new one. That will improve performance, stop the blight of broken down old trains, and mean a much better travelling experience.
Tom Pursglove (Corby) (Con)
The Parliamentary Under-Secretary of State for Transport (Jesse Norman)
My hon. Friend has been a tireless campaigner on this issue, and I absolutely recognise his point. This is, in law, a matter for local government. We have provided them with some funding, and I would be delighted to have a further conversation with my hon. Friend about other ways in which we could consider the situation.
Graham Stringer (Blackley and Broughton) (Lab)
Chris Grayling
What I will do is give a lesson to Labour Mayors about the reforms that we put in place in the last Parliament, which gave them franchising powers. The hon. Gentleman might like to ask the Mayor of Greater Manchester why his promise on bus franchising is years away from happening—the last estimate I heard was that it might just about be completed by 2023, which is way after his first term of office, and way after he made that commitment.
Theresa Villiers (Chipping Barnet) (Con)
Chris Grayling
Let me be clear: all Members of the House would like to see a long-term solution to the issues on the island of Cyprus. This country will continue to work with our friends in Cyprus to try to achieve that goal, but our policies on flights have not changed.
Gavin Newlands (Paisley and Renfrewshire North) (SNP)
The Minister of State, Department for Transport (Joseph Johnson)
The London North Eastern Railway started operations on 24 June. We are in the process of establishing the east coast partnership board, and we will ensure independent representation on that board. We are in consultation with stakeholders across the length and breadth of the line to ensure that their views are taken into account in the management of that new operation.
Rachel Maclean (Redditch) (Con)
In Redditch there are only two electric vehicle charging points, but nearby Coventry has 25. Redditchians are just as keen as Coventrians to take advantage of electric cars. What are the Government doing to help them?
Jesse Norman
My hon. Friend is right to focus on charging points. We have a large charging point network, and we are rapidly expanding it. As she knows, we have just announced a local charging infrastructure fund of £400 million. A lot of work is being done with local authorities, and I encourage her to work with us to develop further charging points in her area.
David Linden (Glasgow East) (SNP)
Chris Grayling
As I keep saying clearly, we do not intend to put in place measures that would create long incoming queues at our ports. Our ports successfully support inward trade from around the world, and in the post-Brexit world we have no intention of changing that.
Andrew Jones (Harrogate and Knaresborough) (Con)
You normally call me Andrew Jones, Mr Speaker.
Andrew Jones
Thank you. May I first welcome today’s announcement of an HS2 depot in Leeds, which is welcome news for the northern powerhouse? The A59 at Kex Gill is an important trans-Pennine route, and its closure is impacting on residents and businesses in my constituency. Will my right hon. Friend meet me to discuss what support the Government can provide to North Yorkshire County Council to carry out works on that site, including its potential re-routing?
Mr Speaker
I say gently to the hon. Member for Harrogate and Knaresborough (Andrew Jones) that one of his most endearing qualities is his gentleness and modesty. However, he should not be quite so modest—he is, after all, a distinguished former Parliamentary Under-Secretary of State with responsibility for buses, and that was a motivational factor in my calling him to ask a supplementary at Transport questions.
Jesse Norman
I, too, share my hon. Friend’s delight at the news about the HS2 depot. I would be delighted to meet my distinguished former colleague.
Conor McGinn (St Helens North) (Lab)
Chris Grayling
We have taken care—this is a genuine issue—to ensure that the Welsh Government, while they control the letting of the franchise, do not have the power to degrade services within England. That is very important. The Department holds clear responsibilities for making sure the Welsh do not take decisions that adversely affect the English.
Justine Greening (Putney) (Con)
Heathrow flights are capped at 480,000 flights a year. That was set as a condition of the 2001 terminal 5 planning consent. Will the Secretary of State confirm that there are no plans to override the existing cap for existing runways?
Bambos Charalambous (Enfield, Southgate) (Lab)
Joseph Johnson
The service on GTR’s Thameslink services has indeed been unacceptable. A hard review is under way, which will give the Secretary of State all options when it concludes. With respect to the size of that franchise, the Secretary of State has also indicated that he is open to breaking it up once the Thameslink programme is in place and when that franchise comes to an end in 2021. He has had discussions with the Mayor of London about some services moving to Transport for London.
Tom Tugendhat (Tonbridge and Malling) (Con)
We are approaching the summer and traffic will be driving down the M20. I am sure that you, like me, Mr Speaker, will wish to have a speedy exit towards the coast. Will the Minister explain what he is doing on the smart motorways programme on the M20 to ensure not just that it works but that communities are protected from noise?
Jesse Norman
I am very glad my hon. Friend mentions noise, because that is a topic of great interest to us. We are actively exploring whether we can bring to local concerns about noise-capturing the same kind of concerns we are bringing to the structure of the highway.
Thelma Walker (Colne Valley) (Lab)
Delays, non-accessible platforms, cancelled trains, failed investment—would the Secretary of State like me to add broken promises of electrification to the list of issues with the trans-Pennine route for my constituents?
Chris Grayling
We have already modernised the line from Liverpool to Manchester and we are about to start a £3 billion modernisation of the railway line from Manchester to Leeds to York, so I make no apology to the people of the north for the fact that we are spending £3 billion on upgrading their railway line when the Labour party, when it was in office, did absolutely nothing.
Stephen Metcalfe (South Basildon and East Thurrock) (Con)
As we reach the halfway point through the Year of Engineering, will my right hon. Friend join me in thanking all those who have joined the campaign so far and encourage those who have yet to get on board to join up and make 2018 the success I know it can be?
The Parliamentary Under-Secretary of State for Transport (Ms Nusrat Ghani)
I thank my hon. Friend for his question, especially as he is the ambassador for the Year of Engineering. We are working with 1,400 companies up and down the country to create 1 million interactions to encourage young people to take STEM subjects—science, technology, engineering and maths—and become engineers of the future.
Ian Mearns (Gateshead) (Lab)
There are some excellent new businesses housed in railway arches on the Gateshead side of the High Level bridge, such as Block and Bottle, Arch Sixteen Café and the Station East Public House, but Network Rail is about to sell off the leasehold for 5,500 arches around the country. Will the Secretary of State meet me and the representatives group, Guardians of the Arches, to discuss proposals that will not ramp up rents for these new businesses and businesses around the country?
Joseph Johnson
Network Rail is in the process of managing its estate to ensure it contributes towards housing and commercial development where that is sensible. I would be delighted to meet the hon. Gentleman and the campaign group he mentions.
Eddie Hughes (Walsall North) (Con)
Will the Minister update the House on what her Department is doing to investigate the use of distributed ledger technology, such as blockchain, in the maritime sector?
Ms Ghani
My hon. Friend, as you may be aware, Mr Speaker, is an intellect in blockchain, having published a report yesterday on unlocking blockchain. My officials explore new technologies such as blockchain, which may help to improve maritime trade. We have recently contributed to “Are You Decentralised Yet?”, a paper for the Transport Systems Catapult, analysing blockchain technologies and how they can benefit maritime.
Mr Dennis Skinner (Bolsover) (Lab)
A few weeks ago, the Secretary of State for Transport said that he would be meeting the people from Newton in Bolsover regarding HS2 and the alternative to knocking down 30 houses. Will he repeat that at the Dispatch Box, in view of the altercation that took place at the last Transport questions? We do not want another broken promise, do we?
Ms Ghani
I am not quite sure exactly what meeting the hon. Gentleman is talking about. Meetings take place between HS2 and the community engagement officers up and down the route. I believe that a meeting is already taking place, but this gives me an opportunity to remind Members from across the House of the importance of HS2, as well as the 100,000 jobs that it brings with it and that it connects eight of our 10 great cities.
Chris Skidmore (Kingswood) (Con)
Earlier this year, a joint feasibility study conducted by South Gloucestershire Council and Highways England into a new M4 junction 18A recommended a western option at Emersons Green be adopted rather than an ill-thought-out eastern option that would cut through green-belt land. For the sake of local residents, will the Secretary of State now rule out this eastern option, which nobody supports and which now needs to be erased entirely?
Jesse Norman
As my hon. Friend will know, this topic is under active consideration and consultation at the moment.
Several hon. Members rose—
Jim Shannon (Strangford) (DUP)
It certainly will be, Mr Speaker. Accessibility on bus routes is important for disabled people; in particular, what has been done to help wheelchair users to access buses?
Vicky Ford (Chelmsford) (Con)
On the NHS’s 70th birthday, can I give you the present of a spare badge, Mr Speaker? It is for the NHS, to which my family have dedicated their entire working life.
On the subject of trains, will my right hon. Friend look at extending the delay-repay system to cover the circumstances when our very popular trains are so crowded that people cannot actually get on to them, just until our new trains arrive with the extra seats?
Joseph Johnson
We do hold train operating companies to account for capacity in our monthly review of how they are performing under the terms of their franchise agreement, and remedial plans are put in place to address overcrowding when that is found to exist.
Ged Killen (Rutherglen and Hamilton West) (Lab/Co-op)
I have written to the Secretary of State about my constituent who had no access to a toilet on a bus replacement service or at any of the stops along the route between Salford and Preston. She is a pregnant woman, and she was forced to wet herself and then sit on the floor of the train from Preston to Glasgow because it was overcrowded and delayed. Does the Secretary of State believe that she should be compensated for that indignity?
Mr Philip Hollobone (Kettering) (Con)
I declare my interest as a member of Kettering Borough Council. Now that Kettering Borough Council and Northamptonshire County Council have resolved their differences over how a new decriminalised parking system might operate, will the roads Minister issue the order to enable this to happen?
Jesse Norman
I will certainly have a further conversation with my hon. Friend about the question he raises.
Several hon. Members rose—
Mr Speaker
Oh very well, it is always good to encourage a new young Member at the start of his parliamentary career. I call Mr Barry Sheerman.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Secretary of State knows very well that millions of our people are being poisoned by the filthy emissions from buses, trucks and cars. When is he going to do something about it?
Chris Grayling
Before I respond to that question, I just say to the hon. Member for Bolsover (Mr Skinner) that I had been under the impression that the meeting was already organised. If that is not the case, I will make sure that it is.
On clean transport, this is a central part of the Government’s strategy. It is why we are spending money on supporting low-emission bus vehicles and on encouraging people to buy low-emission vehicles. When we publish our Road to Zero strategy shortly, we will be setting out more of our plans to create a greener vehicle fleet on our roads.
Mr Speaker
Order. Just before I call the right hon. Member for Birkenhead (Frank Field) to put his urgent question, I should remind the House—I hope it is a question of reminding the House of something of which it is already conscious—that we have very considerable pressure on the parliamentary timetable today. There is of course the business question, and there are two ministerial statements, but I have also to have regard to the level of interest in the debate on proxy voting. This urgent question will therefore not run for longer than 20 minutes. The Front Benchers must stick to time; otherwise, I am afraid they will have to be sat down. After the expiry of that 20 minutes, that’s it—we will move on to the next business.
Petition
Mr Peter Bone (Wellingborough) (Con)
I am grateful that my hon. Friend the Member for Corby (Tom Pursglove) is in the Chamber because this petition affects his constituency as much as mine. I have presented many petitions in this House, but this is probably the one I am most concerned about. It refers to a planning application in my constituency for what is called a recycling plant, but is something that will create dioxins and other dangerous chemicals. There is no similar plant in this country. I do not want, in a few years, to find out that babies born in my constituency are deformed. The lead petitioners are Kaye Pentland, Tony Dawson and Martin Izzard, who are all members of RAID—Residents Against Inappropriate Development—which is the community group opposing the planning application. The petition has been signed by several hundred of my constituents.
The petition states:
The Humble Petition of Chelveston-cum-Caldecott and the surrounding areas,
Sheweth,
That the Petitioners believe that the proposed development by Energy Roots Ltd planning application No. 18/00006/WASFUL for a Construction of a Plastic Recycling and Recovery Facility, should be refused on the grounds of the great cost to the environment, agricultural land, and residents with harmful emissions from the plant. Hazardous emissions will include Nitrogen Dioxide, Sulphur Dioxide, Nitric Acid, Hydrogen Chloride, Ammonia, Particulate matter, Dioxins and Furans.
Wherefore your Petitioners pray that your Honourable House urges the Department for Environment, Food and Rural Affairs, the Department for Communities and Local Government, Northamptonshire County Council and East Northamptonshire Council to take in account the concerns of petitioners and refuse to grant the planning application for a Plastic Recycling and Recovery Facility to Energy Roots Ltd.
And your Petitioners, as in duty bound, will ever pray, &c.
[P002173]
Universal Credit
(6 years, 5 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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Frank Field (Birkenhead) (Lab)
(Urgent Question): Will the Secretary of State please use this opportunity to apologise for the three instances where she has dissembled on the National Audit Office report on universal credit?
Mr Speaker
Order. That is rather naughty of the right hon. Gentleman. I will say that it was an innocent error, but he is an immensely experienced Member of this House whom we all treat with great respect. The proper form in these cases is simply to read out the urgent question that is listed, not to invest the question with a degree of rhetorical licence. Anyway, I think it was probably innocent.
The Secretary of State for Work and Pensions (Ms Esther McVey)
I had information that the question was on the letter that I received yesterday, so that is obviously where we will be going: the letter that I received yesterday. Opening the letter was a comment about a meeting that the Comptroller and Auditor General had asked to have with me. He had written to me on 27 June. Our Department got back at the end of the week and that meeting will be on Monday. There was possibly an inference from that that I had not accepted a meeting or that there was not going to be one. That was not the case, and it is diarised for Monday.
The next bit was about the information we had received, and accurate up-to-date information being shared with the Department. We agreed that information had been shared up to 6 June, but when we signed off the factual information contained within the report, we raised concerns about the context and conclusions drawn from that information and where we went from there.
That goes on to the impact of the recent changes. We looked at the impact of the changes we brought through: waiting days being abolished on 14 February, the housing benefit run-on on 11 April, and advance payments on 3 January. As I said in my apology yesterday, the impact of those changes is still being felt and the definition therefore cannot be that it has been fully taken into account by the NAO. They also talked about slowing down the process, which we always agreed with. This is about the test and learn process, and we will learn as we go along. That is what we agree with, too. The Comptroller and Auditor General also said in his letter:
“I’m also afraid that your statement in response to my report claiming Universal Credit is working had not been proven.”
That is where we differ on the conclusions. While the NAO had the same factual information either way, we came to very different conclusions because the impact of the changes we brought in at the end of that period is still being felt.
So that is where I would like to leave it—[Interruption.]
Ms McVey
At the end of the letter it says that
“the Department cannot measure the exact number of additional people in employment ”.
We agree with that. We cannot measure the exact number of people in employment, but we knew that there was a plausible range—which we had had support on—of people going into employment. We also know that employment is increasing. Those were the key pertinent points from the letter, and obviously included with my apology yesterday for the phrasing of the words I got wrong—which I fully accept, which is why I came to the House—I will end that bit of the statement there.
Frank Field
We are grateful for the Secretary of State’s apology—again—for one aspect of her behaviour where the Comptroller and Auditor General criticised her for dissembling. There were two others. First, she told the House that the Comptroller and Auditor General had advised her to roll out faster, whereas he told her to pause so that vulnerable claimants would not be hit further. Secondly, that universal credit is working is not proven, as she said, with 40% of claimants finding themselves in financial difficulty, 25% unable to make a claim online, and 20% overall, but two thirds of disabled claimants, not being paid on time and in full, hence the demand of the Comptroller and Auditor General, a big regulator in this country, for her to pause the universal credit programme.
Ms McVey
We need to separate two parts of this. One bit is where I came myself to the House to apologise for using the wrong words. I used the words “faster rate” and “speeded up” on the premise that the report had said there was no practical alternative but to continue with universal credit and that there had been a regrettable slowing down. My interpretation of that was incorrect, which is why I came to the House yesterday and apologised for my words. We should separate that from the impact of the changes. I said—and I stand by this—that the impact of the changes could not have been felt because it was still being rolled out and those impacts were still being felt and therefore could not have been taken into account. We need to separate where I used the incorrect words, for which I came to the House to apologise, from the impacts of the changes and therefore the conclusions that can be drawn.
Helen Whately (Faversham and Mid Kent) (Con)
While my right hon. Friend has apologised, could she confirm that the Labour party has yet to apologise for its misleading statements—[Interruption.]
Mr Speaker
I am sorry but questions must be about the policy of the Government, not about other people not apologising for other things. [Interruption.] Order. I do not need any help in these matters. I do have some experience. The hon. Lady is a most assiduous Member, but this is an exploration of Government policy and ministerial accountability to the House. It is not about the Opposition. Sorry, but that is the position.
Mr Speaker
No, the hon. Lady has already had one bite at the cherry. Let us have a masterclass from Sir Desmond Swayne.
Sir Desmond Swayne (New Forest West) (Con)
Mr Speaker, if you complain to me that I am being too slow, am I unreasonable in assuming that you want me to go faster?
Ms McVey
I thank my right hon. Friend for the way he said that. That was my interpretation of what I read throughout the report. I therefore apologised when I checked on the words I had used—my interpretation, not the exact words in the report. I would say, however, on the subject of apologies, that I am more than happy to say, “Can I check on those words? Did I get them right? Did I get them wrong?” I then followed through: “What was the right process?” How did I do it? Nobody asked or told me to come to the House. I actually checked the words and came to the House.
Other people, it is true, have questioned and queried—even the right hon. Member for Birkenhead (Frank Field). Sometimes I think we are blessed in this House that the Opposition never get anything wrong, and other MPs do not get anything wrong. Whereas I am more than happy to come and apologise if I do, it seems that sometimes other people are not so happy to come forward and apologise. Perhaps what I did that was surprising to the House was to come of my volition and apologise for my words that were wrong.
Margaret Greenwood (Wirral West) (Lab)
The Secretary of State should be ashamed that she has been forced to come to the House again. Yesterday the Comptroller and Auditor General took the extraordinary step of writing an open letter to her pointing out that she had misrepresented the National Audit Office report on numerous occasions. He did so after she had failed to meet him, and she did not have the courtesy to do so before this point.
The NAO report is damning of the Government’s flagship social security policy, but, instead of responding to its findings, the Secretary of State misled the House over them. The report said that universal credit is not meeting the aims set for it, and that currently there is no evidence that it ever will. Why and how did the Secretary of State come to say falsely—on two separate occasions in Parliament—that the report had said that the roll-out of universal credit should be speeded up, that the report was out of date as it did not take account of changes made by the Government in the Budget, and that universal credit was working? How can these statements be inadvertent slips of the tongue?
In response to a point of order, the Secretary of State said that she had
“meant to say that the NAO had said that there was no practical alternative to continuing with universal credit.”—[Official Report, 4 July 2018; Vol. 644, c. 321.]
That is quite different from saying that it should be speeded up. In fact, the report states clearly that the Government should
“ensure that the programme does not expand before business-as-usual operations can cope with higher claimant volumes”.
Has the Secretary of State ever read the NAO report? If she has, how can she have drawn the conclusions that she has?
The Secretary of State has failed to apologise in relation to the other two key points made by the Comptroller and Auditor General in his letter. Will she now do so? If she misread the report so badly, this brings into question her competence and her judgment. If she read the report and chose to misrepresent its findings, she has clearly broken the ministerial code. Either way, she should resign.
Ms McVey
Let me start from the top again. I did not fail to meet the Comptroller and Auditor General. As I have said, the letter came in on 27 June, which was last Wednesday; our office got back to him at the end of the week, and I am seeing him on Monday. So that was not correct.
As I have said, I came to the House and apologised for my interpretation of what was there and the words that I had used. My right hon. Friend the Member for New Forest West (Sir Desmond Swayne), who is no longer in the Chamber, referred to how something could be interpreted.
As I also explained, we agreed on the factual information all the way through, but it is a question of how you interpret that information, with the judgments, the summaries and the context. It was on that basis that we said, “We do not agree. We do not agree on how the findings come out together.” As I said, the effects of the significant changes that the Government had introduced this year cannot have been fully taken into account, because they are still being rolled out.
Alex Burghart (Brentwood and Ongar) (Con)
I thank the Secretary of State for her apology. Like a number of other Members, I was very disappointed that the NAO report did not take account of the changes that the Department brought in on the basis of the recommendations made by the Select Committee. Will the Secretary of State confirm that she will continue to adapt and improve universal credit as new ideas and new evidence emerge?
Ms McVey
My hon. Friend is right. That is one of the key points, because this is one of the biggest changes in benefits. We always said that the slow roll-out would reflect the changes needed. Even within the last couple of weeks, I have made significant changes yet again. Whether they involved kinship carers, 18 to 21-year-olds and housing benefit or severe disability premiums, I made those changes after listening to people. Again, the impacts will not have taken effect yet because they are still being rolled out.
I agree that sometimes we have to do a “mea culpa”, hands up, as I did yesterday. I had the wrong words, I apologised to the House, and the apology was accepted by the House. Equally, I am more than happy and prepared when colleagues on either side of the House say, “Could you look at this? Can we look at it a bit more? Could you change this?”, and have made significant changes to this policy since I became Secretary of State.
Alison Thewliss (Glasgow Central) (SNP)
The Secretary of State appears to be willing to mislead Parliament and to get into a fight with the National Audit Office in order to protect her failing universal credit policy, but what she and none of her colleagues will admit is that the NAO report blows a hole as wide as the Clyde through everything the Tories have been saying on universal credit. The NAO felt forced into writing an open letter to put this matter straight, and I understand that this is Sir Amyas Morse’s first such letter in over a decade in service. This is an absolutely shameful state of affairs. We can all accept honest error, but the Comptroller and Auditor General points out in his letter that a number of the statements that the Secretary of State has made are without evidence, are not correct and are not proven.
Alison Thewliss
This is not about phrasing, as the Secretary of State has said, because speeding up is not the same as pausing. Did she actually read the National Audit Office report before her recent attendance in the House? And—
Mr Speaker
Thank you. [Interruption.] Order. I am a little disconcerted to see the SNP Front-Bench spokesman gesticulating at me as if to say, “What’s going on?” Forgive me, but I did say to the House very clearly that—[Interruption.] Order. It is no good shaking your head, I say to the hon. Lady, who is an extremely dextrous and committed Member of this House. She had a minute; she consumed her minute and I then move on. That is the right thing to do.
Ms McVey
We looked at the business case and looked through the conclusions, and for the £2 billion invested, there will be a £34 billion benefit to the UK economy over the next 10 years. We also foresee an increase in employment of 200,000. We believe that that is within the plausible range.
People want evidence, and we can give evidence about the changes this Government have brought through when we talk about getting people into work. We know we have got over 3.2 million people into work and we know we have got 600,000 disabled people into work in the last few years. At the time, we heard the assertions from Opposition Members. Labour said that 1 million more people would be unemployed if we pursued our policies—our changes to benefit and what else we did. That was never proved to be the case, yet I have never asked Labour to apologise for its misleading figures.
Several hon. Members rose—
Mr Speaker
Order. I do want to accommodate a few more questioners and we must work on that basis.
Maggie Throup (Erewash) (Con)
Jobcentre staff across my constituency where universal credit has already been fully rolled out inform me that claimants are more likely to get into work as a result of being on universal credit. Is that a trend across the country, because that would mean it is really good that we are rolling it out, at whatever speed that might be?
Ms McVey
That is what is coming out from the data we are gathering about what real people are saying about how universal credit impacts on their lives. My hon. Friend is right to say that people are getting into work faster, staying in work longer, and looking for work. For those in work, the data shows that on average people are earning an extra £600 a year. Those are the positive effects of this benefit change.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
I am staggered and disappointed that in answer to the urgent question we have a Secretary of State who is still arguing over the detail of a report. This is an important constitutional issue. The National Audit Office is the independent watchdog of Government spending. In this case, the Secretary of State has come to the House twice and there has been an unprecedented letter from the Comptroller and Auditor General. I have had two letters from the permanent secretary adding information on what was an agreed report on 8 June. Just for the record, will the Secretary of State declare clearly in the House today that she has full confidence in the National Audit Office and the Comptroller and Auditor General?
Ms McVey
What I would say is: they do their job. He came forward—[Interruption.] We need to separate this out. We said that we shared information. We agreed on that factual information. What we said is that we had made significant changes at the latter end of that period when information was collected, and therefore the impact of that could not have been felt. Obviously, I am meeting the Comptroller and Auditor General next week. That is what is important.
James Morris (Halesowen and Rowley Regis) (Con)
I commend the Secretary of State’s work in the Department—she has shown a great commitment to improving the lives of people across the country. Does she agree that the Department’s decision to take an incremental approach to the development of universal credit is exactly the right approach, and that we must cut through all this political nonsense and focus on the delivery of universal credit?
Ms McVey
My hon. Friend makes a good point. Like most other people here, I came into politics to help people into work, probably because when I grew up in Liverpool in the ’80s it was a difficult place to grow up and lots of people were not in work. To be in this position of being able to help people to get a job is what I want. It is disconcerting and upsetting that people sometimes, just for the sheer sake of opposing, want to change good measures that are helping over 3.2 million people into work. Those are the facts; that is what we know. Conservative Members are trying to improve people’s lives.
David Hanson (Delyn) (Lab)
At Monday’s Question Time, I asked the Secretary of State two questions. On Question 5, when I asked whether she would accept the National Audit Office report’s recommendation that universal credit should not be rolled out further, she said:
“The NAO made clear quite the opposite”.—[Official Report, 2 July 2018; Vol. 644, c. 8.]
It did not. At topical questions, I asked her to reconsider. I quoted the NAO report, but she stuck to her position. On both occasions, she told the House something that she knew was not correct. Will she apologise to me and to the House, and will she accept the NAO’s recommendation that the roll-out should be stopped now?
Ms McVey
When I answered the right hon. Gentleman’s questions, I said that the National Audit Office had said that there was no practical alternative to continuing with universal credit—that was how I answered. I will pay the right hon. Gentleman a compliment. It was due to his persistence that after I left the House I went back and said, “I’ve used these words.” I know that this is about the impact, and I know that what I said was substantially correct, but I wanted to double check. So I double checked whether I had used the wrong words, and it was after that that I made the apology, because my interpretation, although it was right, was not based on the exact words. That is what I came to apologise for. However, I stand by the fact that the impact of our changes could not have been felt and, as the NAO said, there is no practical alternative but to continue through and the slowness with which this has gone is regrettable.
Mary Robinson (Cheadle) (Con)
When I visited Stockport jobcentre and met its work coaches, I found an enthusiastic group of people who are keen to make a difference to people’s lives. Will the Secretary of State join me in congratulating them and all jobcentre workers across the country who are so enthusiastic about transforming lives and making a difference?
Ms McVey
Everybody wants to improve people’s lives. That is what we are all here to do, and that is what our work coaches do day in, day out. I hope that you will bear with me, Mr Speaker, if I refer to a letter I received. A lone parent wrote saying, “I was frightened to go into the jobcentre from what I had heard. Eight years ago, I was in the jobcentre, and the system did not work for me, so I was relieved and happy that I now have a job. Universal credit is working.” Since then, I have been collecting all those letters, because so many people—claimants and work coaches—are saying that this system is so much better than the one before.
Ms Angela Eagle (Wallasey) (Lab)
I suspect that the Secretary of State decided that she had to come to the House to apologise when she received the unprecedented open letter from the Comptroller and Auditor General pointing out that she had used—let us say—not correct assertions on three occasions about a report that her own officials had agreed. Will she now finally admit that she has got things very wrong on this, actually accept the National Audit Office’s conclusions, and show some respect to the NAO?
Ms McVey
If I may correct the hon. Lady, it was not to do with the letter. She incorrectly says that I came after the letter, but I asked whether I had got anything wrong and I checked things out myself. Nobody asked me or told me to come to House; I came here of my own volition. What I do not agree with—we stand by this—are the conclusions of the report in its entirety.
Mr Philip Hollobone (Kettering) (Con)
Will my right hon. Friend confirm that universal credit simplifies the benefits system, helps to get more people back into work, and better targets financial help at those people who need it?
Ms McVey
I am happy to provide clarification: universal credit does simplify the system. It also provides the individual with more help to get a job. We know that people are getting into work quicker, staying in jobs longer, looking for work for longer and, on average, increasing their income at the end of the year by £600. That is what it is about: helping people to get on in life.
Several hon. Members rose—
Stephen Lloyd (Eastbourne) (LD)
That is always a challenge, Mr Speaker, but I will try.
Regrettably, I believe that the Secretary of State gave only a partial apology, because she did not take account of the fact that her own Department confirmed to the NAO on 6 June that its report was based on the most accurate and up-to-date information, yet the other day she indicated that the NAO report could be out of date. I think that that is unacceptable.
Ms McVey
Again, if I may correct the hon. Gentleman, we had agreed that that information was coming forward. What we have said is that the changes this Government have made were done in January, February and April, and therefore those changes could not be taken fully into account—those impacts are still being felt—because the period of checking was from last year to April of this year.
Chris Green (Bolton West) (Con)
Like my right hon. Friend, I grew up in Liverpool in the 1980s and have a particular sensitivity to the problems caused by unemployment. Both the jobcentres that serve my constituents are fully supportive of the roll-out of universal credit, so will she maintain her focus on rolling out universal credit as the best way to help people into work and to help people in work?
Ms McVey
I did not know my hon. Friend also spent his formative years in Liverpool. There are so many Conservative Members who spent their formative years and grew up in Liverpool. [Interruption.] I smile because there are so many of us even in this Department.
My hon. Friend is quite right. This is what we are about: getting more people into work, which we have done—and significantly so. Now we are reaching out to help even more people, significantly so.
Stephen Timms (East Ham) (Lab)
For eight years Parliament’s only reliable information about the status of universal credit has come from the National Audit Office. Ministers have consistently responded with denials and cover-up statements that, as the Secretary of State has acknowledged this week, were simply untrue. Might her apology herald a new openness about the very real problems with the universal credit project?
Ms McVey
I thank the right hon. Gentleman for mentioning my openness and the fact that I was willing, by myself, to come and apologise for using the wrong words. People who know me will always say about me that I am open, that I am straight and that I say it as it is, which I will do. Equally, if we need to make more changes, which I have done from the moment I got here—I did not seek leave to appeal to the Court of Appeal because I did not feel it would have been right; and I looked at the position of kinship carers and did not think it was right, so we changed it, as we did for the 18-to-21 group—I am more than happy to change things when we can, if we can.
James Heappey (Wells) (Con)
The NAO report notes that jobcentre staff have said that universal credit systems have “improved significantly” since they were first introduced. Will my right hon. Friend join me in thanking Sedgemoor District Council and other councils among the first tranche to adopt universal credit for the quality of the feedback they have given, which has allowed those improvements to be delivered?
Ms McVey
I thank my hon. Friend, because nobody can do this in isolation or by themselves. We need the local councils to be on board, we need the housing associations to be on board and we need MPs to be on board—we need everybody supporting the most vulnerable. I thank him for that comment, and he is quite correct.
Chris Stephens (Glasgow South West) (SNP)
Does the Secretary of State agree with the National Audit Office that universal credit is moving people into debt and that the first debt is rent arrears? Claimants are not getting their rent paid and housing providers find out that a person is on universal credit only when they are in arrears. Is that not a reason why universal credit should be paused?
Ms McVey
Some of the key changes that were done during this year were the advances to provide extra support if people were in need of extra money and the two-week run-on in housing benefit. So we learnt, changed and adapted. Those things have been brought in, but only this year. Therefore, again, their impacts cannot have been felt. But we listened, we learnt, we altered and we have done.
Several hon. Members rose—
Mr Speaker
Order. I allowed some injury time on two accounts. The first was that I had to intervene a number of times in regularising the debate. The second was that I wanted to facilitate a reasonable number of questions, so I ran the urgent question for half an hour, rather than for 20 minutes. I am sorry that some colleagues are disappointed, but I think that was a reasonable treatment of the issue. I gather that the right hon. Member for Delyn (David Hanson) has a point of order that directly flows from the urgent question, and if he puts it extremely briefly, I will hear it, although I offer no guarantee of any response.
David Hanson
On a point of order, Mr Speaker. Given that the Secretary of State said that she had afforded her apology to the House on the basis of the interventions I made and my two questions on Monday, is it in order for her not to write to me, as the Member concerned, to tell me that she was making a statement and/or that she was correcting the record from Monday?
Mr Speaker
Nothing disorderly has happened. It is perfectly in order for the Secretary of State not to write to the right hon. Gentleman. In retrospect, it might have been wise for her to do so, but the past is the past and, to be fair, it is not for me to arbitrate on the merits or demerits of policy or even, outside the Chamber, of conduct. Suffice it to say that the Secretary of State did approach me and offered to come to the House yesterday, which she did. [Interruption.] She approached me the day before yesterday about coming here yesterday. She has come here today and we have had a half-hour exchange, which seems to me to be very reasonable. We must now move on to the next business.
Business of the House
(6 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Valerie Vaz (Walsall South) (Lab)
Will the Leader of the House please give us the forthcoming business?
The Leader of the House of Commons (Andrea Leadsom)
The business for next week will include:
Monday 9 July—Consideration of a business of the House motion, followed by proceedings on the Northern Ireland Budget (No. 2) Bill, followed by a motion to approve a money resolution on the Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill.
Tuesday 10 July—Consideration in Committee and remaining stages of the Non-Domestic Rating (Nursery Grounds) Bill, followed by motion to approve Standing Orders relating to the European Statutory Instruments Committee, followed by Opposition day (unallotted half day). There will be a debate on a motion in the name of the Liberal Democrats, subject to be announced, followed by a debate on a motion relating to the appointment of external members to the House of Commons Commission.
Wednesday 11 July—Opposition day (16th allotted day). There will be a debate entitled “Build it in Britain shipbuilding”, followed by a debate on blue light emergency services. Both debates will arise on an Opposition motion.
Thursday 12 July—Debate on a motion on the practice of forced adoption in the UK, followed by general debate on lessons from the collapse of Carillion. The subjects for these debates were determined by the Backbench Business Committee.
Friday 13 July—The House will not be sitting.
The provisional business for the week commencing 16 July will include:
Monday 16 July—Remaining stages of the Taxation (Cross-border Trade) Bill.
Tuesday 17 July—Remaining stages of the Trade Bill.
Wednesday 18 July—Consideration of Lords amendments to the Domestic Gas and Electricity (Tariff Cap) Bill, followed by Opposition day (15th allotted half day, part 2). There will be a debate on an Opposition motion, subject to be announced.
Thursday 19 July—Debate on a motion on the independent complaints and grievance policy, followed by business to be nominated by the Backbench Business Committee.
Friday 20 July—The House will not be sitting.
The provisional business for the week commencing 23 July will include:
Monday 23 July—General debate, subject to be announced.
Tuesday 24 July—Business to be nominated by the Backbench Business Committee.
I am delighted to wish the NHS a very happy 70th birthday. We are building an NHS for the future, ensuring it will be there for all of our children and grandchildren, just as it has been there for us. Today, we thank all the nurses and doctors, and all of our hard-working NHS staff for the extraordinary work they do, helping more people to live longer, healthier lives.
I am sure that everyone will want to join me in sending our best wishes to all who are taking part in the Pride celebrations in London this weekend.
Although I am a bit suspicious that the hon. Member for Perth and North Perthshire (Pete Wishart) may be practising his Swedish, I am hopeful that the whole House will join me in wishing England the very best of luck in their quarter final against Sweden on Saturday.
Finally, I am immensely proud that in my own constituency this weekend is the world-famous British grand prix at Silverstone. I wish all the teams and drivers the very best.
Valerie Vaz (Walsall South) (Lab)
I thank the Leader of the House for the forthcoming business, which I think takes us up to the recess, and for the two Opposition days. I suppose it is too cheeky and too early to ask for the Easter recess dates, but perhaps the Leader of the House could say when the next Queen’s Speech will be.
Given that Defence Question Time was moved, without the courtesy of letting business managers know, from its slot after the NATO summit and the publication of the modernising defence programme reports, may we have a debate on the summit and the reports? Or should we ring the Secretary of State for Defence so that he can ask Siri?
We now have a third option for the post-Brexit arrangement, although there was no clue in the Prime Minister’s statement on Monday as to what it is and how it will work. It will be an interesting house party tomorrow—I assume the Leader of the House will also be there—and they may end up playing Cluedo. It will be a Cabinet Minister, in the dining room, with the White Paper. [Interruption.] Those who have played it will know. Presumably, one side will take Sharpies to redact it and the other side will take highlighters to accept the good parts.
Yet again, the House is the last to know about the business. On Monday, a journalist tweeted about the publication of the White Paper, saying that
“it looks like the White Paper has been pencilled in for July 12th, the very day that Donald Trump arrives in the UK.”
Again, the courtesies to the House are not being followed. None of the Opposition business managers knew when the White Paper was going to be published. Will the Leader of the House confirm when it will be published and may we have a statement on it? Might I suggest the 23 July, when it seems there is a spare slot for a general debate? It would be possible to debate the White Paper then.
It is not clear how this third way will affect the Irish border and what will happen in respect of alignment. The Prime Minister is yet to visit the border; perhaps the away-day party could go there en masse. I met a farmer at the farmers market in Parliament last week, and he told me that his farm straddles the north and the Republic; what will happen to him? The Prime Minister said on Monday:
“In a no-deal situation, it will of course be up to the United Kingdom to determine what it does in relation to the border in Northern Ireland.”—[Official Report, 2 July 2018; Vol. 644, c. 59.]
That is not correct: there is more than one party on either side of the border and more than one party in the negotiations.
The Leader of the House congratulated the NHS on its 70th anniversary, and we do, too. It was the courage of Nye Bevan and the determination of a Labour Government that saw the birth of the NHS, which has completely transformed social justice in this country.
Why did the Secretary of State for Health and Social Care not come to the House to give a list of the 17 operations that are to be cancelled? I am sure that Members have read that list. I have had carpal tunnel syndrome—what would have happened to me? Would I not have been allowed to have that operation? Would I have had to ask for it? The Secretary of State is hiding behind the head of NHS England. May we have a statement from him on another step to privatisation and to explain the reasons why those 17 operations are on that list? Perhaps he could extend the consultation period over the summer.
While the Conservatives are dining at the Hurlingham Club, the country is falling apart on their watch. I am not going to go over the urgent question on universal credit, but suffice it to say that, as the National Audit Office said, the Government’s flagship universal credit programme has not delivered value for money, and it is impossible to know whether it will help to get people off benefits and into work. We need a proper debate so that we can find out who said what to whom and who understood what about the report. We need that debate, so may we have it as soon as possible?
What about a debate on the Public Accounts Committee report that said:
“After seven years of government funding reductions totalling nearly 50% and rising demand for services, local authorities are under real strain. Key services that support vulnerable people, such as social care and housing, are now under enormous pressure.”
Funding cuts have reduced public services such as libraries, waste collection and bus services. Our high streets are dying. Marks & Spencer and Poundworld are leaving Walsall town centre. High street names are either closing stores, or they are in administration.
What about students? Again, I raise the plight of our poor students. The House of Commons Library provided my hon. Friend the Member for Bootle (Peter Dowd) with some analysis that showed that the Government are causing more debt to students because of their use of the retail price index to apply interest to their student loans. Switching to CPI would result in £16,000 less interest being added over 30 years. We need a statement on what the Government will do to alleviate this debt.
The hon. Member for Aberdeen North (Kirsty Blackman) told me that there will be a memorial event in the Piper Alpha memorial garden in Hazelhead park on Friday evening. It is the 30th anniversary of the Piper Alpha explosion. The names of the 167 people who died in that explosion will be read out. Frank Doran, the former Labour MP for Aberdeen North, was assiduous in fighting for improved safety standards in the North sea.
I want to thank you, Mr Speaker, for allowing the Library to use Speaker’s House last Monday. There was a fantastic celebration of 200 years of the Library, and fantastic memorabilia were on display. I thank Penny Young and all her staff for the fabulous work that they put in there. I also thank other Members of the House: EqualiTeas has recorded 107,000 people taking part and 3,000 tea parties—that is an average of 4.5 tea parties per constituency. The pack was brilliant. David Clark, the head of education and engagement, and his team of Michelle, Rob, Beryl, Emma and Charles should be congratulated. It is an excellent and inspiring way to engage the public in celebrating Parliament and equality.
Andrea Leadsom
I start by absolutely agreeing with the hon. Lady that the EqualiTeas effort has been fantastic. We are all thoroughly enjoying it. I very much enjoyed cutting the first cake, which had this wonderful teapot on the top. It is wonderful to think of those very smartly dressed ladies 100 years ago primly having tea, but plotting on how to get the vote. It shows what can be done when we really try.
I also join the hon. Lady in commemorating the awful Piper Alpha disaster. It is right that we should remember it. I remember going on to a North sea oil rig when I was Energy Minister and realising how very vulnerable I was, so I absolutely join with her in that commemoration. She asked about future dates, and, of course, I will bring them forward as soon as I can. She also asked about defence questions being moved with Home Office questions. I sincerely apologise if she felt that there was any attempt to mislead in any way. The new oral questions rota was issued more than a fortnight ago, which I do consider is sufficient time for hon. Members to familiarise themselves with it. It was felt to be important that Defence Ministers were able to attend the opening day of the Farnborough air show, which is a very important day in the calendar for the Defence Department.
The hon. Lady asked about the Cabinet away-day. I can tell her that I am very much looking forward to it. I do not think there will be time for Cluedo, but I expect that there will be some very interesting discussions. The White Paper she mentioned will, of course, be brought forward just as soon as it can be. The Prime Minister has said before the summer recess; that is not too long to go. The hon. Lady asked about the Irish border. I also do not think that we will have time to go to the Irish border during the course of the day tomorrow. It was a good suggestion, but, possibly, without our broomsticks we might struggle to get there in time. None the less, she raises very important points about Northern Ireland and the Republic. It is vital that we keep to our red line of not allowing a hard border between Northern Ireland and the Republic and that remains absolutely the Government’s position.
The hon. Lady asked about universal credit. As she knows, we have just had an urgent question on that topic, so I do not propose to spend a lot of time on it other than to say that universal credit is intended to be a much simpler and more effective benefit. It does work for people. The Leader of the Opposition likes to use examples, so let me say that Nayim from Lancashire has said, “Universal credit gave me the flexibility to take on additional hours without the stress of thinking that this might stop my benefit straight away.” Roberta from Yorkshire, who had mental health issues, is now in work and loving it, and says, “My work coach helped turn my life around. He tailored his support to my situation and thanks to him I have found my dream job.” Real people’s lives are being improved by universal credit, and that is absolutely the point of it.
The hon. Lady said that local authorities are under strain. She will appreciate that this Government have sought since 2010 to get to a point where our economy is again living within its means and is succeeding. Just last week, BAE Systems won a £20 billion contract to build nine top warships for Australia. A business survey shows that we remain the No. 1 destination for foreign direct investment in Europe. Tech businesses attracted nearly $8 billion of funding last year—double the amount received in 2016. Employment is up to another record high, real wages are growing and the OECD is upgrading our growth forecast. What further evidence does the hon. Lady need to see that it is this Government who are taking the steps necessary to turn around our economy, and ensure that we can survive and thrive?
Sir David Amess (Southend West) (Con)
Will my right hon. Friend find time for a debate on the inequalities of the provision of personal independence payments for blind people? There seems to be a disparity in the age at which the payments can be made.
Andrea Leadsom
My hon. Friend is mentioning an important and serious question, and mentions disparities about the age at which payments can be made to blind people. I assure him that new claims for PIP are available for claimants aged between 16 and 64, regardless of their health condition or disability. Where a claimant is in receipt of PIP, they can continue to receive it after the age of 65, providing that they continue to meet the eligibility criteria.
Pete Wishart (Perth and North Perthshire) (SNP)
I thank the Leader of the House for announcing the business for next week, and join in with the 70th birthday wishes to our amazing national health service. I am particularly proud that in Scotland we have the best performing NHS in the whole United Kingdom. I also note what the shadow Leader of the House said about the Piper Alpha disaster 30 years ago today; it is an event that we should remember.
To the Leader of the House, “Heja Sverige!” We were brought up in the ’60s and ’70s in Scotland at the height of Jimmy Hill-ism, and it is really hard to love the English football team because of that particular experience.
I do not know whether the Leader of the House is down as an “accept” at the Chequers get-together tomorrow, but I have a sneaking suspicion about which side she is on in this great Cabinet battle of Brexit. It is now open warfare, with the Brexiteers lining up to rubbish the latest delusional proposal. I am just wondering whether the House will get the opportunity to debate this fantastical “third way” solution that the Prime Minister is promoting before the EU27 once again reject it out of hand.
Surely it is now time for electronic voting. I understand that some of my Conservative friends got just a wee bit upset on Tuesday evening about having to vote on our estimates process. Apparently, just doing their job got in the way of being able to cheer on the English national football team. Apparently it was all the fault of us nasty Scots Nats for daring to vote in a parliamentary democracy. How dare we? Well, salvation is on its way and there is a solution available for my footy-fixated Tory friends: stop wandering round and round aimlessly for 20 minutes in a headcount in stuffed Division Lobbies, introduce some modern voting facilities and come into the 21st century. That would save England having to be eliminated on penalties so that Conservative Members can continue to do their business in this Parliament.
Lastly, this Tory dark money scandal is simply not going away. We now know the address of the murky Scottish Unionist Association Trust and we know its trustees, but we still do not know how it got its money, where that money was invested and why it was not properly registered with the Electoral Commission. It stinks to high heaven and the Scottish Tories are going to have to come clean some time very soon.
Andrea Leadsom
I can absolutely assure the hon. Gentleman that the side that I am on—at Chequers or anywhere—is the side of the United Kingdom. May I gently ask the hon. Gentleman whose side he is on? That is the question that he and his colleagues need to answer.
With regard to the hon. Gentleman’s question about electronic voting, I would observe that Scottish National party Members certainly should not be playing in the World cup due to the slowness of the 33 of them going through the Lobby—they showed no ability to sprint. It is entirely in order for them to vote at all times, as was pointed out on the day. Nevertheless, the Serjeant at Arms having to go twice into the Lobby to find out what was causing such a delay in the 33 of them staggering through prevented not only those in the Chamber who wanted to watch the football from doing so, but the Doorkeepers and the many other staff who support us. It was just plain mean to do that.
In response to the hon. Gentleman’s point about donations, I can tell him that the Scottish Conservative party has recorded all donations in line with the law.
Dame Cheryl Gillan (Chesham and Amersham) (Con)
The current legal framework on referendums was based on two reports—the Nairn commission report on the conduct of referendums in 1996 and the report by the Committee on Standards in Public Life in 1998. The rules on referendums have not been updated for 20 years. Will the Leader of the House consider giving us a debate on the rules on referendums, particularly in the light of the fact that on Monday the report of the Independent Commission on Referendums, which I have been pleased to play a part in, is coming out? It was put together by the UCL constitution unit under the leadership of Meg Russell. We will have an opportunity to look at some of the suggestions on updating the rules on referendums, particularly with regard to social media and all the reports of people interfering with the process. I hope that she will take this request seriously and that we can have a detailed debate on the potential new rules that we could have surrounding this important part of our democracy.
Andrea Leadsom
I thank my right hon. Friend for her contribution to that debate. I certainly look forward to seeing the report. She may wish to raise her specific issue at Electoral Commission questions next Thursday.
Ian Mearns (Gateshead) (Lab)
I thank the Leader of the House for giving us the business right up until the recess on 24 July. I can let the House know that we have already pre-determined that on 19 July the business nominated by the Backbench Business Committee will be the first anniversary of the tobacco control plan and smoking policy. I suspect that our determination of the business for 24 July will come this Tuesday. I hope that the hon. Member for Southend West (Sir David Amess) will be happy with the outcome of that.
Yesterday in Prime Minister’s questions, my hon. Friend and neighbour the Member for Newcastle upon Tyne Central (Chi Onwurah) invited the Prime Minister to Newcastle for the great exhibition of the north. Of course, that is in both Newcastle and Gateshead, so I would like to extend that invitation to all Members to visit Newcastle and Gateshead for the great exhibition of the north. On the Gateshead side of the river, they can visit the Baltic Centre, the Sage Gateshead and the By the River Brew Co., all of which can be accessed via the Gateshead Millennium bridge—so welcome to Gateshead as well.
Andrea Leadsom
As ever, we all love to celebrate the great exhibition of the north and seize the opportunities to visit when we can. I am certainly looking into whether I could possibly get there; I would very much like to do so.
Mr Ian Liddell-Grainger (Bridgwater and West Somerset) (Con)
My constituents are currently being denied their legal rights to inspect the accounts of their local authority. Taunton Deane Borough Council’s spending data is currently a whole year out of date. My constituents have only a 30-day period in which to inspect the accounts. The council has blamed—believe it or not—a computer error. I am afraid that this is outrageous. The chief executive and the leader are wholly responsible, but the Government do have a duty on this. May we please have a debate in Government time on the ability of local councils to fulfil their statutory obligations to my constituents and many others?
Andrea Leadsom
My hon. Friend raises a very important and detailed point. I recommend that he raise it directly with Ministers or at Ministry of Housing, Communities and Local Government questions on 23 July.
Gloria De Piero (Ashfield) (Lab)
The national lottery is not fit for purpose. How can it be right that, in the same year, Ashfield gets £900,000, while a city constituency a few miles down the road gets £64 million? May we have a debate in Government time on how to ensure that our former coalfield communities get their fair share from the lottery?
Andrea Leadsom
I would like to pay tribute to all those who buy lottery tickets and to the amazing achievements of the lottery in supporting good causes around the country. The hon. Lady makes an important point, and I suggest she seek an Adjournment debate, so that she can raise that matter.
Mr John Hayes (South Holland and The Deepings) (Con)
Sylvia Plath, speaking of her beloved son, said:
“There is no guile or warp in him. May he keep so.”
In our time, our children are being warped by online gambling. The Gambling Commission reports that 25,000 children in Britain are problem gamblers and that a number of online gambling vehicles are predatory, using techniques to make children spend. Will the Leader of the House arrange for a Minister to make a statement or perhaps even hold a debate, to ensure that we take seriously this great menace? Graham Greene said:
“There is always one moment in childhood when the door opens and lets the future in.”
We can condemn our children to a future that is bitter and bleak, or we can craft a future that is joyful, hopeful and wonderful.
Mr Speaker
The right hon. Gentleman’s book learning is legendary, as is his willingness generously to share it with us.
Andrea Leadsom
My right hon. Friend is absolutely right to raise this appalling situation. I have seen myself with my own kids that when young children are playing a game, they are encouraged not to use actual money, because they do not have any, but to get addicted to the idea of buying some extra beads or something else to enable them to play that game even better. I have experience of that, and I share his grave concern. He will be aware that Department for Digital, Culture, Media and Sport Ministers are determined to keep children safe online and are doing all they can to tackle the issue. He may wish to seek a Backbench Business debate to look at what more can be done to protect young children.
Mike Gapes (Ilford South) (Lab/Co-op)
In the southern part of Syria at this moment, over a quarter of a million civilians are being bombed and attacked by Russia’s air force and the Assad regime. Is it not time we had another debate in this House on the crimes that are going on in Syria and the failure of the international community, including this country, to do anything about it?
Andrea Leadsom
The hon. Gentleman is quite right that this is an ongoing catastrophe. The conflict is now in its eighth year, and the UN estimates that more than 400,000 people have been killed and over half the population has been displaced. He is right to raise that, and he may well wish to take it up with Defence Ministers on Monday during oral questions. The UK can be very proud that we are the second largest bilateral donor to the humanitarian response in Syria. We have now committed more than £2.7 billion to the Syria crisis since 2012, which is our largest ever response to a single humanitarian crisis.
Mr Peter Bone (Wellingborough) (Con)
On pages 14, 15, 16, 17, 18, 19 and 20 of today’s Order Paper, there are more than 60 private Members’ Bills listed for Friday from 20 right hon. and hon. Members. The vast majority of those Bills will be objected to by a senior Whip on Friday. Can we have, for transparency’s sake, a statement tomorrow morning listing all the Bills that the senior Whip will object to on Friday, so that the House knows which ones to concentrate on?
Andrea Leadsom
My hon. Friend will know that the Government have always maintained the view that private Members’ Bills serve a very important function. They are an invaluable opportunity for Members to promote legislation on the causes they support. The Government have been keen to support a number of private Members’ Bills—I will not go into them now—and there are some excellent ones coming forward. I can also tell him that the number of private Members’ Bills passed under the Government in the 2010 Parliament was 31, versus only 22 in the 2005 Parliament. This Government have a very good record of supporting and enabling Back-Bench business to get on to the statute book.
John Cryer (Leyton and Wanstead) (Lab)
I think that it is widely recognised across the House that, in the past few months, there has been a rise in violent crime, particularly in London. The police are stretched to the limit and are using reserve powers repeatedly, particularly in my constituency, where section 60 powers have been used a lot. I know that we recently had a debate on crime, but the Security Minister really needs to come to the House to make a statement on the situation that London is now in.
Andrea Leadsom
The hon. Gentleman is absolutely right to raise the issue of serious violence. It is a grave concern, particularly, as he points out, in urban areas. Our serious violence strategy is focused on steering young people away from crime and putting in place measures to tackle the root causes. He will be aware that, with our Offensive Weapons Bill, we are seeking to make it much harder for people to gain access to the dangerous weapons that fuel the problem with violence we are experiencing at the moment.
Sir Christopher Chope (Christchurch) (Con)
May we have a statement early next week from the Secretary of State for Housing, Communities and Local Government arising from his statement to the Local Government Association conference this week, where he said he had
“no intention of forcing reorganisation on local government where it isn’t wanted or needed”?
As you know, Mr Speaker, reorganisation is neither wanted nor needed in Christchurch, where 17,676 people voted against it in a local referendum. If the Secretary of State came to the House to make a statement, it would give him an opportunity to withdraw the opposition he continues to make in the High Court to Christchurch’s case against the Government. If the Government now withdraw their opposition to Christchurch, we could all live happily.
Andrea Leadsom
I am grateful to my hon. Friend for raising this constituency issue again. He will be aware that Housing, Communities and Local Government questions will take place on Monday 23 July, and that is obviously a question that is best directed straight to the Secretary of State.
Dr David Drew (Stroud) (Lab/Co-op)
Mr Speaker, some years ago, you and I visited southern Sudan. When the country of South Sudan obtained independence, we hoped it would have a better future. Sadly, a crisis of biblical proportions is going on there, with famine, warfare and everything else. Will the Leader of the House call an urgent debate on South Sudan, so that we can raise the implications of the latest failure of the peace talks, with all its repercussions?
Andrea Leadsom
The hon. Gentleman refers to another humanitarian crisis in a part of the world that the UK is strongly seeking to support and in which the UK is endeavouring to find peaceful ways forward. I encourage him to seek an Adjournment debate so that he can discuss progress directly with a Foreign Office Minister.
Maggie Throup (Erewash) (Con)
I am delighted to inform the House that Erewash has topped the Which? magazine food hygiene survey, with 97% of medium and high-risk food retailers now compliant. Does my right hon. Friend agree that this is a significant achievement both for the food inspection and enforcement team at Erewash Borough Council and for local food retailers in my constituency? Will she consider holding a debate in Government time to highlight the important contribution that the food sector makes to our high streets?
Andrea Leadsom
I am very pleased to congratulate Erewash on this achievement. It is fantastic for my hon. Friend’s local council, but also for local food retailers. She is right to point out that local authorities across the UK are responsible for regulating food businesses to make sure that the food we eat is safe. She is also right that the sector makes a huge contribution to our high streets, and I encourage her to apply for a Westminster Hall debate or an Adjournment debate to raise further the contribution it makes.
Vernon Coaker (Gedling) (Lab)
May we have a debate on ministerial accountability? Many of my constituents who claim universal credit or other benefits but innocently get it wrong are sanctioned. Why do they think there is one rule for the Minister responsible for this and another rule for them?
Andrea Leadsom
I again say that universal credit is designed to be a better, much simpler benefit that enables more people to get into work. The Department for Work and Pensions has sought to listen to all the views expressed on both sides of the House over many months and to ensure wherever we can that we improve the service to claimants to make the experience for them much better. We will continue to listen to the experience and feedback and to improve the system so that it helps more people to get back into work.
Mrs Kemi Badenoch (Saffron Walden) (Con)
Headteachers in my constituency and representatives from Anglia Ruskin University have raised multiple concerns about unconditional offers being given to students, irrespective of their A-level results. They believe that such offers manipulate student choices and leave students ill-equipped to cope with rigorous undergraduate programmes. May we have a Back-Bench debate to explore that issue further?
Andrea Leadsom
My hon. Friend raises an important and serious issue, and the Minister for Universities, Science, Research and Innovation has been clear about the need for rigorous standards. Universities and the entire higher education sector should do all they can to encourage a diverse range of people to access the higher education system, and my hon. Friend might wish to raise her specific point through an Adjournment debate.
Layla Moran (Oxford West and Abingdon) (LD)
The welcome Gilligan report on cycling came out this week and included recommendations for major investment in Oxford. May we please have a debate on that important issue?
Andrea Leadsom
I know how important cycling infrastructure is to the hon. Lady’s constituency, and the Government welcome Andrew Gilligan’s report for the National Infrastructure Commission on that subject. We want cycling and walking to become the natural choice of transport for people of all ages and backgrounds, particularly in urban areas, and we are determined to make it safer and easier. I would recommend that the hon. Lady apply for an Adjournment debate, but I understand she has already done so.
Bob Blackman (Harrow East) (Con)
The whole country has rightly been celebrating three Tottenham players putting four penalties past an Arsenal goalkeeper this week. May I draw the House’s attention to the fact that the European Parliament is today debating the EU copyright directive, which will have incredible implications for internet users and also protect artists’ copyright? Will my right hon. Friend arrange for a debate in the House on that issue, which is of the utmost importance to our future?
Andrea Leadsom
Would you like to confirm your delight at the performance of those Spurs players, Mr Speaker? Not sure. On my hon. Friend’s substantive question, that is indeed an important topic, and having heard from the Chair of the Backbench Business Committee, I suspect there will be the opportunity to raise such a matter for debate in the pre-recess Adjournment debate.
Chris Stephens (Glasgow South West) (SNP)
On 10 May, I asked the Leader of the House, on behalf of my constituent, Heather Cameron, for a debate on pensions. Heather Cameron is in the Gallery today, so may I ask the right hon. Lady whether there will be time before the summer recess for a binding vote to secure justice for those women born in the 1950s who have been robbed of their state pensions?
Andrea Leadsom
The hon. Gentleman will be aware that I have just read out the business up to the summer recess. There will be opportunities for Adjournment debates and Westminster Hall debates in the usual way, and I encourage him to seek such a debate. I also encourage him to bear in mind that the Government have already sought to minimise the impact of these measures on the personal pensions of women born during the 1950s.
Douglas Ross (Moray) (Con)
May we have a debate on the NHS? As we celebrate the 70th anniversary of the establishment of the NHS, Moray has received a bitter blow. NHS Grampian has said that maternity services at Dr Gray’s Hospital in Elgin will be downgraded for up to 18 months, so hundreds of pregnant women will have to travel to Aberdeen or Inverness to give birth, rather than do so locally in Moray. Does my right hon. Friend agree with local campaigns, such as the Keep MUM campaign, which says that the proposals raise grave concerns about the safety of pregnant women, babies and sick children?
Andrea Leadsom
My hon. Friend is right, of course, to raise the importance of having local, good-quality care for pregnant mums, and the opportunity for women to deliver their babies safely and close to home is key. I pay tribute to my hon. Friend for his determination to campaign for such things in his constituency, and I wish him and the Keep MUM campaign every success.
Steve McCabe (Birmingham, Selly Oak) (Lab)
This week marks the 40th anniversary of when my secretary, Linda Spencer, first came to work at the House of Commons. I would like to thank Linda for all her hard work on my behalf and that of former colleagues, Gisela Stuart and the late John Fraser. Does the Leader of the House think she might find time for a short debate in which we can pay tribute to the hard work of all the staff—cleaners, catering staff, secretaries, researchers, admin workers, doormen and women, Hansard reporters, Clerks, librarians, maintenance workers, and police and security staff—because without their hard work, we could not possibly carry out our duties on behalf of our constituents?
Mr Speaker
Order. I just say to the hon. Gentleman that I am very much aware of this matter and that a letter from me will be winging its way to Linda Spencer today.
Andrea Leadsom
I join you, Mr Speaker, in paying tribute to her for her many long years of service. The hon. Gentleman is absolutely right to raise the fact that all the support staff right across the Palace of Westminster enable us to do our work and we owe them a huge debt of gratitude. I encourage him to make his points more fully in the pre-recess Adjournment debate.
Mary Robinson (Cheadle) (Con)
Last weekend, I attended an excellent EqualiTeas event organised by Bramhall and Woodford guides. I discovered that across my constituency hundreds of children are waiting to go into guides and scouts, but that a lack of volunteers is preventing them from doing so. Will my right hon. Friend join me, as a former beaver leader, in recognising the importance of the valuable work scouting and guiding volunteers do? Perhaps there could be a debate on this.
Andrea Leadsom
Yes. My hon. Friend raises the absolutely vital work of volunteers in all sorts of youth groups—beavers is just one of them. There is no doubt that across all our communities volunteering enables young people to have different opportunities and experiences, and that is very much appreciated. I certainly encourage my hon. Friend to seek an Adjournment debate, so she can pay her own tribute to them.
Alison Thewliss (Glasgow Central) (SNP)
The drug death figures for Scotland have just come out and they are absolutely shocking: they have increased since the 2016 figures. Will the Government arrange for a debate in Government time on their failing drug strategy, which is not supporting my constituents or people in Scotland?
Andrea Leadsom
I am incredibly sorry to hear about the drug statistics. I am not aware of them, but the hon. Lady might like to raise this matter directly with the Secretary of State for Scotland at Scotland questions next week. I can certainly assure her that the Government are very conscious of the need to get rid of the scourge of illegal drug-taking and the massive damage it causes to people’s lives.
Huw Merriman (Bexhill and Battle) (Con)
Mr Speaker, I know you have been a great supporter of Guide Dogs. Many right hon. and hon. Members will have seen its stand just off the Committee Corridor recently. Its big campaign is to try to make kerb parking illegal, as it is and has been in London since 1974. I know the roads Minister is looking at this issue, but perhaps a debate in Government time might persuade the Minister that it is about time those powers were extended outside London.
Andrea Leadsom
My hon. Friend is right that there was a fantastic exhibition in the Upper Waiting Hall. He is absolutely right that the big problem of pavement parking causes real challenges for people with visual impairments. I certainly encourage him, if he did not already raise this at Transport questions today, to raise it directly with Ministers, perhaps through an Adjournment debate.
Diana Johnson (Kingston upon Hull North) (Lab)
On 5 June, The Yorkshire Post and other great northern newspapers wrote to the Prime Minister about their “One North” campaign in relation to the rail timetable shambles and their request for Transport for the North to get additional powers over transport in the north. It is now a month on and they have not had a response from the Prime Minister, so I wondered if the Leader could do her best to get a response to those newspapers.
Andrea Leadsom
If the hon. Lady wants to write to me, I can find out what has happened to the response she is looking for. She will be aware, though, that it was this Government who created the great north rail project, which intends to provide investment of well over £1 billion by 2020 to provide space for more than 40,000 more passengers. It is designed to provide big improvements for rail passengers in the north.
Bob Stewart (Beckenham) (Con)
Fly-tipping is no longer a minor nuisance in Beckenham, and it is reaching almost endemic proportions in some places. The cost of dealing with even just one instance of it can run into thousands of pounds, not including checking it for hazardous waste and then trying to get evidence for prosecutions. Can we have a debate on the current level of financial support offered by the Treasury to local authorities to address the scourge of fly-tipping?
Andrea Leadsom
There is no doubt that the problem of fly-tipping has increased. My hon. Friend will be aware that as a Government, we are intending to reduce fly-tipping through better prevention, detection and risk-based enforcement. The National Fly-tipping Prevention Group promotes good practice and we are cracking down on offenders by strengthening the Sentencing Council’s guideline for environmental offences. We are also giving stronger powers for suspected fly-tippers’ vehicles to be seized and destroyed. There is no doubt that there is more to do but it is a priority for the Government, and he might like to seek an Adjournment debate to discuss it further.
Jim Shannon (Strangford) (DUP)
On this, the 70th anniversary of the NHS, colleagues might be surprised to hear of the £3.5 billion cost that alcohol causes to the NHS every year. That is enough to pay for the salaries of some 58,000 hospital doctors or more than 117,000 hospital nurses. With this in mind, will the Leader of the House find time for a debate in Government time, as this is important to every party in the House, on the harms and the cost of alcohol not only to health, but to our whole nation, as well as on the solutions we can use to address this problem?
Andrea Leadsom
The hon. Gentleman raises a very important matter. The Government fully recognise the devastating impact that alcohol misuse can have on individuals and their families, as well as the costs to our health service, which in Northern Ireland, are up to £900 million each year. We are developing a new cross-Government strategy for alcohol, which, among a number of measures, will invest £6 million over three years to support vulnerable children living with alcohol-dependent parents. However, he is absolutely right: as we celebrate the 70th anniversary of the NHS, we have to consider the big challenges that it continues to face, such as tackling the damage of alcoholism.
Andrew Selous (South West Bedfordshire) (Con)
Can we have an urgent debate on providing relief to communities whose lives and homes are being ruined by inappropriately routed traffic? The residents of Hockliffe have put up with days of really unacceptable disturbance. They want the A5 going through the village detrunked and a heavy goods vehicle ban, and this is entirely achievable as an acceptable alternative route exists.
Andrea Leadsom
I am sorry to hear about my hon. Friend’s problems with his A5. I have similar problems with an A5 in my constituency, and I am sure that all hon. Members suffer considerable problems with particular roads. The Government are investing £15 billion in the strategic road network between 2015 and 2021 to improve its performance for users and those who are affected by it, such as, as he points out, the residents of Hockliffe. If he was not able to raise this in Transport questions earlier, I encourage him to seek an Adjournment debate, or if he wants to write to me, I can take up his particular question with the Department for Transport.
Gerald Jones (Merthyr Tydfil and Rhymney) (Lab)
Many of my constituents worked at the Hoover factory in Merthyr Tydfil until it closed, except for distribution, in 2009, and they paid into what was a highly regarded pension fund. Despite the fund showing huge surpluses in past years, which paid into Her Majesty’s Treasury and the company, the pension pot is now in deficit and is being transferred to the Pension Protection Fund. Many of those who contributed the most risk having a 10% cut to their pension. With other companies taking this option, can we have a debate to consider the fairness of companies transferring their liabilities and pensioners losing out?
Andrea Leadsom
The hon. Gentleman raises a very important point. Clearly, we have seen examples right across the country of companies that have effectively removed assets from their pension funds—it is completely unacceptable. The Under-Secretary of State for Wales, my hon. Friend the Member for Pudsey (Stuart Andrew), would be happy to meet him to discuss this particular issue, or indeed, he could seek an Adjournment debate to discuss it directly with Ministers.
Andrew Jones (Harrogate and Knaresborough) (Con)
New rolling stock—refurbished class 170s—are starting to appear on the Harrogate and Knaresborough line. I have had much positive feedback from constituents on this, and they can see the end in sight for Pacers. These trains are a significant upgrade. On top of that, we will see the first newly built stock arriving into the franchise from the manufacturer this month, so can we have a statement from the transport team on the progress that is being made on bringing new rolling stock into the railways of Yorkshire?
Andrea Leadsom
I am really pleased to hear that my hon. Friend’s constituents have seen the improved quality that the class 170 trains are beginning to provide for passengers. Production of the new trains is well under way, with 14 trains already built. As he knows, this is part of a major programme, and both Northern and TransPennine will have bigger train fleets, all of which will be either brand new or fully refurbished. And, as he points out, this will mean the end of the unpopular Pacer trains.
Paula Sherriff (Dewsbury) (Lab)
Loraine Farren from the Red Box Project and Sarah Watkinson from Mirfield Winter Warmers are doing tremendous work in my constituency collecting and distributing menstrual products for girls in schools and young women who cannot afford to buy them for themselves. I am pleased to say that my office will be a collection point for anyone who wishes to drop off such products, and I hope that other MPs will be able to do the same at their constituency offices. May we have a further debate on period poverty?
Andrea Leadsom
The hon. Lady raises a really important issue, and I am pleased to tell the House that I was at a Youth Democracy Week event only this week where a young man raised exactly the same point. He asked why, when young men are being offered free condoms, young women cannot be offered free sanitary protection. I told him I completely agreed with him, and said that this would be exactly the sort of campaign that young people such as himself could use to raise the profile of this issue. The hon. Lady is also absolutely right to raise this, and I would be delighted to see her seek an Adjournment debate or indeed a Backbench Business debate so that this subject can be discussed more fully.
John Howell (Henley) (Con)
May we please have a debate on what is being done to support our high streets? They represent an important part of our towns, and it would be useful to have a debate on this matter.
Andrea Leadsom
My hon. Friend might have seen the Grimsey report, which promotes the idea of local leadership on the high street. He is right to say that high streets are vital to thriving communities, and as people change the way in which they shop, it is important that we do more at local level to ensure that we keep the heart of our communities going.
Several hon. Members rose—
Mr Speaker
Order. I am keen to accommodate remaining colleagues, but there should be a contract between us. Under the terms of the contract, colleagues should undertake to ask a question that does not exceed a sentence. If they do that, I will be able to get everybody in.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
What a test, Mr Speaker! May we have a statement on the inadequacy of personal independence payment assessments for people with acquired brain injury? My constituent has contacted me to say that his nerves are shattered and that he is now on anti-depressants because, although his neurology report has clearly stated that he will never work again due to the severity and impact of his brain injury, he has been assessed as ineligible for this benefit.
Andrea Leadsom
I am truly sorry to hear about the hon. Lady’s constituent’s case. I encourage her to take it up directly with Ministers, or if she wants to write to me, I will do that for her.
Chris Green (Bolton West) (Con)
Hot, dry weather is normally something to be celebrated, but it has led to, and sustained, a huge fire on Winter Hill overlooking my constituency. I pay tribute to the contribution of the fire brigade in controlling the fire, but may we have a debate on the contribution of the voluntary sector, and especially the Bolton mountain rescue team, in dealing with this crisis?
Andrea Leadsom
I think all hon. Members will want to join my hon. Friend in praising the efforts of the firefighters and the military who are really working hard to try to get these fires under control. I am sure he will want to seek an Adjournment debate or a Westminster Hall debate on this, so that there can be further discussion of the problems and the potential criminality that is causing the fires in the first place.
Judith Cummins (Bradford South) (Lab)
A recent report found that 40% of the Government’s top 100 suppliers failed to meet the basic legal requirements of the Modern Slavery Act 2015. May we have a debate on modern slavery in supply chains, and on what progress the Government are making on ending extreme labour exploitation here and overseas?
Andrea Leadsom
The hon. Lady is right to raise the issue of modern slavery. I am sure she will recognise that this Government have done a huge amount to try to tackle this scourge with the first ever Modern Slavery Act. She is right to raise the problem of continued slavery within the supply chain. We have Home Office questions on Monday 16 July, and she might want to seek a further update on progress at those oral questions.
Kevin Hollinrake (Thirsk and Malton) (Con)
Our all-party parliamentary group on fair business banking reports next week on dispute resolution, so that businesses that have been mistreated by their banks will be able to find justice for the first time. Bearing in mind that the kick-off for our event is 7 o’clock next Wednesday, would my right hon. Friend be willing to offer some Government time to enable these matters to be properly debated?
Andrea Leadsom
I first pay tribute to my hon. Friend for his assiduous efforts to ensure better banking that is fair to consumers and businesses—he has really fought hard on this topic—and I would certainly support the idea of a debate in this place. He might want to seek a Back-Bench debate, given that the issue is of great interest right across the House and that many Members have constituency cases of their own.
David Linden (Glasgow East) (SNP)
May we have a debate in Government time about how long it takes Ministers to respond to letters? I wrote to the Home Office about my Easterhouse constituent, Mr Kasharfeh, eight months ago, and I have only just had a holding reply. Does the Leader of the House think that is really good enough?
Andrea Leadsom
I am sorry to hear about that delay. I am sure there is a reason for it. As he will know, there are standard turnaround times for Departments to respond to correspondence, but occasionally letters do go astray. We have Home Office questions on 16 July, but if he wants to write to me, I can chase it up for him.
Vicky Ford (Chelmsford) (Con)
Could the Leader of the House look at the policy of flying the England flag on match days? It is obviously fantastic news that the England men’s football team have been so successful, but on Sunday the England women’s cricket team defeated New Zealand in the final of the three nations series—Australia, New Zealand and England—and they go into the world cup this winter as the hot favourites. Please can we fly the flag for women and men equally?
Andrea Leadsom
My hon. Friend should be reassured to know that the Prime Minister made clear her determination to fly the England flag for England’s women as much as England’s men, and indeed for all nations of the United Kingdom. We support our sporting teams. It is a great pleasure that we all come together to share the enjoyment of our national sporting teams.
Alan Brown (Kilmarnock and Loudoun) (SNP)
After suffering domestic abuse and with the support of the police, my constituent was able to leave the home she shared with her partner, but the bank refused to allow her to take her name off the mortgage without his permission. Of course, he would not give permission and he blocked the sale of the house. After five years of her not paying the mortgage, the bank repossessed and sold below the market rate, leaving her with a £35,000 debt. Can we have a statement outlining what help can be given to my constituent and what can be done to make banks fulfil their moral duty as well as their legal duty?
Andrea Leadsom
I have a vague recollection that the hon. Gentleman has raised exactly this point before about dual signatures—
Andrea Leadsom
No? Well, certainly another Member has. I am extremely sympathetic to the need to ensure that co-signatories in an abusive relationship can separate. It is unacceptable otherwise. If he wants to write to me with the details of the case, I can forward them to the Department for a substantive reply.
Alex Burghart (Brentwood and Ongar) (Con)
As the Leader of the House will know, small and medium-sized businesses are the lifeblood of my local economy. What opportunities will there be in the near future to discuss the opportunities they will have in a post-Brexit Britain?
Andrea Leadsom
I hope my hon. Friend will recognise that we have had one or two debates on the UK’s prospects as we seek to leave the EU; there will be many more opportunities, but I just remind all hon. Members that we had 37 days of debate on the withdrawal Bill and five Westminster Hall debates in the last month on Brexit and the opportunities arising from it. He is absolutely right, though, that we need to consider the opportunities and not just the negotiations. There are significant chances, particularly given that many UK companies do not do business with the EU but still have to abide by regulations that for many small and medium-sized enterprises can really hamper progress. I am very optimistic about their future, and I am sure he will find plenty of chances in the coming weeks to put forward his views on the opportunities that will arise.
Jo Stevens (Cardiff Central) (Lab)
Refugee families with young children settled in schools in Cardiff Central are being moved hundreds of miles around the country with just a few days’ notice because of a shortage of outsourced Home Office accommodation, which undoes all the good work that teachers and teaching assistants do to help these most vulnerable of children. Please can we have a statement from the Home Secretary about the expensive, shoddy and dysfunctional Home Office accommodation contracts?
Andrea Leadsom
The hon. Lady will be aware that this country has been incredibly generous and very careful in the way that it treats refugees who come to this country to seek asylum and to escape from appalling experiences overseas. However, she may wish to raise her specific concerns during Home Office questions, which will take place on 16 July.
Justin Madders (Ellesmere Port and Neston) (Lab)
On Tuesday a member of staff at the Countess of Chester hospital was arrested following the investigation of a number of unexplained deaths in the neonatal unit. Anyone who has attended baby loss debates in the House will know that it is impossible to overestimate how traumatic the loss of a newborn is, which is why I was so disgusted to hear of the doorstepping of my constituents by members of the press following the news. May we please have a debate on how we can stop this disgusting, immoral practice?
Andrea Leadsom
We have all been horrified to hear about the problem of unexplained deaths in that hospital, and I entirely share the hon. Gentleman’s disgust at the doorstepping of people who have suffered the appalling loss of a baby. It is utterly unacceptable. I encourage the hon. Gentleman to take this up directly with Ministers, or perhaps to seek a Westminster Hall debate in order to discuss the issue of intrusion in such very sensitive cases.
Chris Law (Dundee West) (SNP)
After 17 months of dithering, delays and doubts, the UK Government have still not made a full commitment to the Tay cities deal. They have not said how much they will provide and when they will provide it. The people of Dundee have a right to know, and they need to know now. May we have an urgent statement, most properly from the Treasury but perhaps from the Secretary of State for Scotland, about the progress of the deal and when it will finally be delivered?
Andrea Leadsom
As the hon. Gentleman will know, Scotland questions will take place next Wednesday, and I am sure that Ministers will be able to give him the answer then. However, I am also sure he will be delighted that four city region deals have already been arranged in Glasgow, Inverness and the Highlands, Aberdeen, and Edinburgh and south-east Scotland. So progress is being made, and the Government have shown their commitment to providing greater devolution so that local communities can make their own progress in the way that is most appropriate for them.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
This week The Guardian revealed that the Government are spending some of the £1.3 billion aid budget of the conflict, stability and security fund on promoting austerity with Saatchi and Saatchi in Tunisia. The Independent Commission for Aid Impact has said that the fund is badly managed, and the International Development Committee has asked for an immediate review of it. When will the Secretary of State for International Development come to the House and make a statement about how that review will take place?
Andrea Leadsom
I am afraid I am not aware of the report that the hon. Gentleman has cited. I suggest he take it up either by means of a written question or directly with International Development Ministers, so that he can be given an answer that is to his satisfaction.
Construction Sector Deal
(6 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Richard Harrington)
I note with respect, Mr Speaker, that you are wearing the same badge as I am, and I therefore hope you will join me in wishing the NHS a very happy birthday. That, of course, is also relevant to the construction sector deal, because the NHS is responsible for a large amount of construction.
With permission, Mr Speaker, I will make a statement in response to the Government’s publication of the sector deal for construction. Sector deals, in which industries are invited to come forward with plans for their future, embody the ethos of our collaborative approach. They show how industry and the Government, working in partnership, can boost the productivity and earning power of specific sectors. We have already struck ambitious deals with the artificial intelligence, life sciences, automotive and creative industries sectors, and the nuclear sector deal was announced last week. We look forward to building on that in the months ahead.
In keeping with the ethos to which I have referred, today’s deal represents a joint vision agreed by the Government and the construction sector which aims to transform the sector’s productivity through innovative technologies and a more highly skilled workforce.
Construction underpins our economy and society. Few sectors have such an impact on communities across the UK, or have the same potential to provide large numbers of high-skilled, well-paid jobs. The construction sector, encompassing contracting, product manufacturing and professional services, had a turnover of about £370 billion in 2016, and employs 3.1 million people. Given its size and importance, the sector has a vital role to play in achieving the vision set out in our industrial strategy: strengthening the foundations of our economy, achieving the grand challenges of putting the UK at the forefront of the artificial intelligence and data revolution, maximising the advantages from the global shift to clean growth, becoming a world leader in the future of mobility, and meeting the needs of an ageing society.
We are in the early days of what is one of the greatest construction programmes in our history, from delivering more affordable and safer homes in places where people want to live, to major infrastructure projects such as Crossrail and the third runway at Heathrow. This infrastructure pipeline represents more than £600 billion over the next decade, including at least £44 billion for housing. The pace of that change, and its size, demands a construction sector that is the best in the world, and today’s deal sets out to make that a reality.
First, the sector and the Government are making a joint £420 million investment to develop and commercialise digital design and offsite manufacturing technologies. We aim to reduce the cost of new buildings by a third, and to halve the time taken to deliver them. That will ensure that we get value for money from the Government’s national infrastructure and construction pipeline. The current projections are for about £600 billion of public and private investment in infrastructure over the next 10 years, as well as a doubling of expenditure on economic infrastructure in the decade to 2022-23. The investment will also support the Government’s aspiration to deliver 1.5 million new homes by 2022.
Secondly, we will ensure that the construction sector is able to attract, train and retain the workforce that it needs both now and in the future, as it meets the demographic challenge of a workforce in which nearly a third of workers are over 50. That includes working with the Construction Industry Training Board to ensure that there is a strategic focus on future skills needs, and to increase significantly the number of approved apprenticeship standards. The sector will also aspire to increase the number of apprenticeship starts to 25,000 a year by 2020, and will work with professional institutions and the higher and further education sectors to ensure that all those training for or working in the industry are able to develop and increase their skills.
Finally, to ensure that the construction sector is home to more sustainable, profitable businesses, the standard business model needs to change to one that is based on strong integrated supply chains and higher levels of collaboration. Key to that is a boost in the sector’s exporting capability, driven by our new investments in digital and manufacturing technologies to make the most of a market that is estimated to be worth £49 trillion between now and 2030. We will also ensure that construction firms have better access to the capital that the industry needs to invest and grow. That will include taking account of existing funding streams and the conclusions of the patient capital review, which aims to increase the availability of long-term finance to innovative firms.
History shows that the business community is best placed to identify what firms really need, and the Government will be there to support them. Sector deals rely on committed and visionary leadership. I therefore thank Andrew Wolstenholme, the sector deal champion, and the whole Construction Leadership Council, without whom this ambitious deal would not have been possible. After the statement I shall be visiting Battersea power station, where I will meet the leading members of the sector who have been so influential in bringing the deal to fruition.
The sector deal will drive economic growth, create well-paid, highly-skilled jobs in every part of the UK, and improve lives across the country. It represents a shared commitment to achieve those goals by establishing a strategic partnership between the Government and the sector, which we will seek to strengthen in the years ahead.
Bill Esterson (Sefton Central) (Lab)
I thank the Minister for early sight of the statement. It is welcome that there is a sector deal for construction, although the promised “a few weeks” from last November have become nine months.
Like last week’s nuclear deal statement, this appears to be a series of reannouncements of previous ministerial policies. The announcement about reducing emissions, although welcome, would be more credible if it were not so starkly at odds with other Government policies, such as last week’s cancellation of the Swansea Bay tidal lagoon. The steel, retail and rail industries are still awaiting responses to the proposals that they made last September. Perhaps the Minister will tell us when other sector deals will be agreed.
The collapse of Carillion of course caused at least some of the delay in today’s announcement, but that in turn was caused by the Government’s own lack of oversight, so what assurances will the Minister give to the sector that there will be no more Carillions, and that suppliers and workers can have confidence that Government will support them on Government-funded contracts? And what in this deal will address the concerns around late payment and retentions that the Carillion fiasco highlighted, with 30,000 suppliers owed £2 billion? What was changed during the review of this sector deal from what was announced last year? There appears to be nothing to tackle the problems endemic in public sector construction procurement.
The commitments in this sector deal on productivity and the speed of building are welcome, but they need to be matched by a significant increase in Government investment in infrastructure and house building projects. That is how we can properly support the construction industry. The TUC has shown that the £31 billion through the national productivity fund increases public investment to 2.9% of GDP, whereas the average spent on investment by leading industrial nations in the OECD is higher, at 3.5%. Labour is committed to a national transformation fund of £250 billion of capital investment over 10 years. Comparing those figures, we have to question whether the Government’s commitment to investment is meaningful. Similarly, the rhetoric about skills and technical education is welcome, but can the Minister give the sector an assurance that those skills will be developed to enable the radical transformation of construction that this country desperately needs?
There are great concerns about the exploitation of construction workers, often by the use of bogus self-employment, and the abuses of human rights and risks to the safety of too many workers through the behaviour of some unscrupulous employers. What are the Government’s plans to protect workers through this deal?
The deal appears to ignore the important role played by smaller firms. What is in the deal for small builders, for whom accessing investment in new technology is likely to be a challenge?
This week’s Jaguar Land Rover announcement that it might move production out of the UK and re-evaluate its planned £80 billion of investment is deeply worrying, not least for the 40,000 workers directly employed. JLR’s is just the latest in a string of warnings from manufacturers vital to the success of British industry, and the same warnings apply in construction and throughout the construction supply chain. The Government’s mishandling of Brexit makes a mockery of their industrial strategy; they must listen to businesses and place workers and our economy ahead of ideology.
Richard Harrington
I thank the shadow spokesman for taking us on a wider canter through industrial strategy and mentioning Brexit. I will try to answer his questions, but I will also do my best to stick to the sector deal, Mr Speaker, as I know you would like to make progress.
I make no excuses about the time this has taken because we wanted to get it right. We are always pressed on occasions like this to use words and phrases like “soon”, “imminently” and “at the end of the year”.
Richard Harrington
Well, this is a few weeks: we are talking about nine months, and nine times four is about 36 weeks, which is a few weeks compared with 5,000 weeks. But the hon. Gentleman makes a serious point, and we did want to get this right.
Sector deals are no longer just Government edicts. They are true partnerships with not just the usual suspects but lots of companies in industry, and we have done our best to get this right and make it as comprehensive as possible. I am sorry that the delay has put the hon. Gentleman out, but I believe we have got it right, and I welcome the more positive comments he made, among quite a lot of negative ones.
I would make the same point about the other sector deals the hon. Gentleman mentioned, such as that for rail. We are working on them: there is no go-slow; Ministers are not off playing golf. These are very important to me; this is a big chunk of my portfolio and I do hope that at least privately the hon. Gentleman will accept that I do my best with diligence to try to get to the bottom of these things. But they are very comprehensive: the documents may contain a few graphics and things in colour, but they are serious documents, and, more importantly, the deals behind them are very serious.
The hon. Gentleman rightly raises Carillion as that is an important matter. There are a lot of things to be learned for the future from what happened. The Government have worked very well with banks and other institutions. We have taken on board the wider lessons to do with the Insolvency Service and so forth, we have consulted a lot of people on Carillion, and we are on the way to showing companies like Carillion that directors cannot behave irresponsibly, because the consequences are very significant. They affect not only shareholders and banks; they can affect millions of people and small and large businesses alike.
The hon. Gentleman mentioned the Government’s attitude to research and development expenditure. I am proud of our aspiration of 2.9% of GDP for research and development. In dealing now with these bids for the industrial strategy challenge fund and so forth, we are seeing a very significant increase in Government expenditure on research and development. It is a very large part of BEIS’s budget.
The hon. Gentleman mentioned the Labour party’s view that everything should happen now or more quickly: well, it did not do so in all the years Labour was in power. I try not to make party political points if I can possibly avoid it, but I think history will show that our record in increasing research and development spending is very good, and in practice sector deals are the conduit through which it is used. Gone are the days when Government Departments and institutions like the National Economic Development Council, which I remember visiting as an A-level economics student at school, did this; gone are the days when civil servants and Ministers decided where this money was invested. There is now a thoughtful process, independently held, in our case through Sir Mark Walport, and I am very hopeful that in the future more money will be spent through this process.
The hon. Gentleman asked a reasonable question about how significant a part of the agenda skills were. For construction, skills are without doubt critical. Most people in construction currently talk about skills shortages, and the increased number of apprentices that is aspired to in this sector deal certainly cannot be taken lightly. I have seen the way young people are being trained up through apprenticeships, and there is also the retraining of older people, the T-levels and all the other related educational matters that I do not have time to go into today. They will all make a significant difference to skills.
It is true, too, that different skills will be needed in the future, as I saw from the type of skills being used during a recent visit I made to Skanska, in Rickmansworth near my constituency. Computers are now used not just to make the design we are so used to in building but in the detailed technicalities for each part of the project. I was shown an example in Paddington station where every material for every panel will be passed to owners of the future, because part of the sector deal is about the whole life of buildings, not just the original construction which was traditionally the most important aspect.
Finally, the hon. Gentleman mentioned workers’ conditions, and who is and who is not an employee and so forth. He will know about the Taylor review and that the Government are accepting almost every recommendation Taylor makes. That will make a significant difference to people’s lives.
Several hon. Members rose—
Mr Speaker
Order. We are immensely grateful to the Minister, from whom we had a Cook’s tour of his personal experiences as a constituency representative. We are deeply indebted to the Minister, although I was wondering at one point whether his response to the shadow Minister would be longer than his original statement, but there we go. I call Mr Kevin Hollinrake, whose beaming countenance is most suitable.
Kevin Hollinrake (Thirsk and Malton) (Con)
I welcome the statement. It mentions the patient capital review, which aims to increase the availability of long-term finance for innovative firms, so will the Minister confirm that that will be targeted at small and medium-sized construction companies?
Richard Harrington
I will try not to mention a constituency example here, Mr Speaker.
I thank my hon. Friend for that question. Capital is important. It is often spoken about in terms of large fundraising exercises, such as bond issues and initial public offerings, but it is important that small firm financing is also taken into account. The banks are proud of the fact that they are significantly increasing their small business lending, and we intend to monitor that carefully.
Ronnie Cowan (Inverclyde) (SNP)
I thank the Minister for advance sight of the statement. I noted with interest that the statement refers to
“a joint £420 million investment from the sector and government”
and
“£600 billion of public and private investment in infrastructure over the next 10 years”.
I was wondering about the split between public and private money. With Carillion in mind, where will the risk lie in such joint ventures? It would be remiss of me not to ask how much of the new money will be given to the Scottish Government to spend, because they have a good track record on major infrastructure builds.
The statement also says that 1.5 million new homes will be built. Will the Minister guarantee that, within the specifications for the new builds, every effort will be made to ensure that buildings are environmentally-friendly to build and energy-efficient to run? There are remarkable examples from around the globe that can be taken on board and copied. The efficiency and longevity of new buildings is crucial.
I welcome the intention to create more apprenticeships, which have been much neglected since the 1980s—hence why a third of the workforce are over 50. The Scottish Government have been leading the way in creating meaningful apprentice schemes, and I am really pleased that this place has decided to follow.
Finally, given that export capability has rightly been identified as so important, will the Minister fight for tariff-free access to European markets at tomorrow’s Cabinet showdown on Brexit?
Richard Harrington
I will do best to answer without the global canter that you so politely reprimanded me for using, Mr Speaker. There will be no more cantering, or indeed galloping for that matter. I shall do my best to trot, if that is possible—I promise the hon. Member for Inverclyde (Ronnie Cowan) that I am not trying to cut my answer down.
The SNP spokesman’s first question was about the mixture of public and private capital, but that depends on the projects that are available. We know what money is in the current spending plans, but we also know about projects that are coming through, such as Heathrow. I cannot give him an exact split, but we are certain that the total amount that was mentioned will come to fruition, and I am conscious of the fact that Scotland must get its share. That point was well put and well noted. I am certain that Scottish Conservative Members—[Interruption.] They are in Scotland. I am sure that all Scottish Members will take me and other Ministers to task if Scotland does not get its fair share.
Several hon. Members rose—
Richard Harrington
Scotland will get its fair share—[Interruption.] Ah, I thank the shadow Minister for pointing out what was happening behind me, because we do not yet have eyes in the backs of our heads, although I am sure that a Labour Government would give them out free to everybody.
The hon. Member for Inverclyde made a good point about fire safety and energy-efficiency specifications for new homes. I have visited the Building Research Establishment in my constituency—I thought you might be interested to know that, Mr Speaker—where state-of-the-art work is going on. If the hon. Gentleman was referring to the terrible tragedy at Grenfell, I am sure that lessons about construction types will be learnt.
Apprenticeships are an important part of the sector deal, and they mean a lot. Apprenticeships do not have to be for school leavers, which has been the tradition. There will be a lot of retraining, and the Government recognise that in their policies, but the purely physical tasks that made up the majority of construction jobs in the past are slowly being replaced with jobs that require a significant amount of training and a lot less physical effort.
Finally, the hon. Gentleman asks me to ensure that the Prime Minister makes it certain at tomorrow’s Chequers awayday that UK companies will be able to export their products to the European Union. I can happily assure him that that is very much the case.
John Howell (Henley) (Con)
I welcome what the Minister says about the 25,000 apprenticeships, but one of the grand challenges facing the Government is helping to meet the needs of an ageing population. How does the deal help to meet that need?
Richard Harrington
I thank my hon. Friend for his question. The answer is that the type of apprenticeships will be commensurate with the new types of skills within building. As I explained in answer to the hon. Member for Inverclyde, that will involve retraining at different ages, as well as jobs that involve skills other than physical skills, which were complex but were done just by young men in the past. In fact, I am pleased to say that many more women are now involved in construction apprenticeships, and we will start to see people of my age doing apprenticeships—quite a few people in my constituency probably hope that that will be me in a few years’ time.
John Spellar (Warley) (Lab)
I congratulate the Minister on his pre-reshuffle tour d’horizon of the industry and on a statement that is welcome in both its intentions and its aspirations. However, without any detailed measures, it is frankly just more waffle. For example, the Minister rightly drew attention to the forthcoming infrastructure programme, where local and national Government have huge clout as the client, so will the Government be using that influence to put into their contracts requirements for the prompt payment of subcontractors? In addition, will they demand proper ratios of apprentices on sites, by which I mean real craft apprenticeships to fill the huge skill gaps and to provide career opportunities for our youngsters?
Richard Harrington
I shall send the right hon. Gentleman a copy of the construction sector deal so that he knows that it is not just meaningless waffle, [Interruption] I am delighted he has one and I will do my best to respond to the numerous points that he made. He asked whether the Government would use their power over those things that they fund to ensure that small businesses are used—that is correct. The Government are keen on using their power in that way, such as by mandating the use of level 2 building information modelling for all construction projects to encourage the adoption of digital technologies. The Government will also be at the forefront of the manufacturing of buildings off-site for suitable projects, such as schools and NHS buildings.
The right hon. Gentleman was concerned that the Government should not use such powers to affect the number of apprenticeships on site. That is very much our policy, and it will be part of the tender documents to come. However, I hope that that will not be necessary, because the industry is desperate for apprentices and we will see a lot of the new types of apprenticeships.
Vicky Ford (Chelmsford) (Con)
In Chelmsford last week, local councillors approved a local plan that includes 8,800 homes on new sites, and 11,700 homes have already been approved. We are building schools, GP surgeries, community centres and the amazing new medical school, so masses of construction is ongoing. The sector deal is welcome, but Chelmsford College has two issues. One is finding tutors with the experience to teach apprenticeships; the other is getting apprentices placed with smaller businesses such as electricians. Can you focus on addressing those two pinch points?
Richard Harrington
Mr Speaker, I thought you were going to reprimand my hon. Friend for referring to me as “you”; thank you for forgiving her.
I accept that finding more tutors is a problem, and the Construction Industry Training Board is cognisant of that. The Government are making sure everything is done with the training board and there will be new apprenticeship standards. The number of starts will increase to about 25,000, which is a 15% increase. I regularly meet the training board, and I will happily ensure that it is aware of the specific points raised about Chelmsford.
Tom Brake (Carshalton and Wallington) (LD)
The Minister will be aware that 30% of people who work in the construction sector in London are EU nationals and that they are younger than their UK equivalents. Meanwhile, the number of apprenticeships has plummeted, particularly for under-25s. What guarantee can he give that we will have sufficient skilled people available, particularly given that the construction sector will be in competition with sectors such as agriculture for those employees? I expect, of course, a very comprehensive reply from the Minister.
Richard Harrington
I will do my best—under your supervision, Mr Speaker—to make sure that my reply is comprehensive.
Skilled labour from the European Union is critical to the construction industry, which already competes with all the other industries. Mr Speaker, you will be delighted to hear that last week I visited a wonderful business: Gateville in Watford, which was started by a Romanian gentleman, Bogdan Catargiu. The company is using his skills, and those of his colleagues from this country and the European Union, to build social housing in the UK. Following Brexit, I cannot envisage a situation in which we will not allow people with the necessary skills, such as those in the construction industry, to come to this country to work, and to provide a lot of prosperity to this country—and, I hope, to themselves—as they have over the past few decades.
Mr Speaker
It is always a great pleasure to listen to the mellifluous tones of the Minister, who I know from personal experience to be an extremely agreeable fellow, but I gently point out to the House that the statement has now run for half an hour and we have heard from only five Back Benchers. Perhaps there is scope for an improvement in productivity, to be brilliantly exemplified, I feel sure, by Mr Eddie Hughes.
Eddie Hughes (Walsall North) (Con)
I am approaching my 50th birthday in October and I am concerned by the undertones suggesting that that is in any way old.
I am a member of the Chartered Institute of Building and a fan of innovative technology such as blockchain. What can these new technologies do to improve productivity in the construction sector deal?
Mr Speaker
We often hear from the hon. Gentleman about this blockchain business. I feel I ought to educate myself on the matter.
Richard Harrington
Mr Speaker, I feel you are asking me to produce a sector deal for brevity of statements by junior Ministers—I will start work immediately.
The type of skills we need are changing, as we see more modular building and so on. I am sure that the skills that my hon. Friend the Member for Walsall North (Eddie Hughes) and I are aware of now will be very different from the skills needed by generations to come. I expect that he and I will use some skills in our 80s that we did not use 30 years ago. The important part of the sector deal is to make sure that apprenticeships are appropriate for a sector in which one third of the construction workforce are now over 50. Under this fantastic sector deal, the training board and the standards will evolve as the building industry evolves.
Diana Johnson (Kingston upon Hull North) (Lab)
I urge the Minister to get a gallop on and announce the sector deal for renewables, which is an important industry for us in East Yorkshire. We are keen to see that sector deal announced. When will he provide details on the local sector deals, which were first announced at the end of last year?
Richard Harrington
We have another horse analogy. I said that I would trot, and I have been accused of cantering, but now I will try to gallop. I note the hon. Lady’s point about the local sector deals, and her area is one of our higher priorities. I cannot answer her question about renewables because that is not one of my sectors, but perhaps I can drop her a line or meet her to discuss it.
Michelle Donelan (Chippenham) (Con)
I strongly welcome the construction sector deal. With productivity in the construction sector on average 21% lower than in the rest of the economy, it is vital that we tackle that to increase our housing stock. Does the Minister agree that investing in digital and off-site manufacturing technologies will also boost our STEM sector? That is vital for constituencies such as mine, which is a hub of engineering, design and technology.
Richard Harrington
The sector deal shows that those types of skills will be adapted to building. Digital technology, artificial intelligence and precisely the STEM skills that my hon. Friend mentions are an important part of the sector deal and of the future construction industry.
Jim Shannon (Strangford) (DUP)
What discussions have there been with the devolved Assemblies on match funding for energy-efficient new builds? What is being done to encourage every region to make full use of this initiative?
Richard Harrington
The devolved authorities are very much part of all our thinking. We will continue to work closely with them. I would be happy to meet the hon. Gentleman to discuss Northern Ireland in this context. I congratulate him on his question—and on the questions he has asked at every single statement I have given and every single urgent question I have answered in Parliament.
Huw Merriman (Bexhill and Battle) (Con)
Is it not the case that if there were further incentives for construction companies and developers to build out, they would be forced, as it were, to recruit and train more people, because they would need them, rather than moving people from one site to another? Is it possible for the Government to consider compulsory purchase powers for local authorities if developers do not build after a couple of years or, indeed, to consider charging council tax 12 months after a planning application is approved, rather than when the build-out occurs?
Richard Harrington
The review by my right hon. Friend the Member for West Dorset (Sir Oliver Letwin) is considering those points, and I am sure that we will be delighted to report the review’s progress to the House.
Alan Brown (Kilmarnock and Loudoun) (SNP)
As a chartered civil engineer, I welcome the principle of the construction sector deal. On protecting the supply chain, the Government must deal with two key issues: the elimination of cash retentions; and, as the Minister knows from his previous role, the effect that multi-employer pensions are having on subcontractors, particularly plumbers. Will the Minister review the Multi-employer Pension Schemes Bill—my private Member’s Bill—and have a word with the Under-Secretary of State for Work and Pensions, the hon. Member for Hexham (Guy Opperman), to ask him to take on board the measures in my Bill?
Richard Harrington
We are currently considering the entire policy on retentions, as I am sure that the hon. Gentleman knows. We are reviewing the responses to our consultation and considering the options for future policy.
Maggie Throup (Erewash) (Con)
When we consider construction, we often think about only what we see above ground. Saint-Gobain and Stanton Bonna in my constituency make pressed concrete and cast pipework. Can the Minister reassure the House that his statement on the construction sector deal will benefit all aspects of construction, whether invisible or visible?
Richard Harrington
Absolutely; I can reassure my hon. Friend on that point.
Mr Philip Hollobone (Kettering) (Con)
What is there in the construction sector deal to encourage small builders in Kettering?
Richard Harrington
My hon. Friend, as always, speaks up for Kettering, and he does so well. Kettering is typical of many places in the country where small businesses are the core of the construction industry. The sector deal is not silent about that. [Interruption.] The shadow Minister is chuntering that he made that point—he did, and he is absolutely right.
Small businesses are the core of the construction industry. On every visit I have made to the tier 1 large contractors, they have been very conscious that small businesses are part of the industry. We have to make sure that those small businesses get their share of the expenditure on apprenticeships, as they are getting, and make it easier for them to get apprentices, which we are doing. The training board and the industry bodies we work with are conscious of that.
Amesbury Incident
(6 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for the Home Department (Sajid Javid)
With permission, Mr Speaker, I would like to make a statement regarding the events that have been unfolding in Amesbury and Salisbury. This morning, I chaired a meeting of the Government’s emergency committee, Cobra, covering the ongoing investigation in Amesbury. I have been separately briefed by the security services and by counter-terrorism police.
As many Members will now know, a 45-year-old man and a 44-year-old woman were found to be unwell at a property at Muggleton Road in Amesbury on Saturday—both are British citizens. Paramedics attended the scene and admitted the pair to the accident and emergency department at Salisbury District Hospital, where they were treated for exposure to an unknown substance. Further testing by expert scientists in chemical warfare at the Porton Down laboratory confirmed this to be the nerve agent of the type known as Novichok. This has been identified as the same nerve agent that contaminated both Yulia and Sergei Skripal.
The pair are currently in a critical condition, and I am sure the whole House will want to join me in wishing them a full and swift recovery. I would also like to express my sincere thanks to the emergency services and staff at the Salisbury District Hospital for their tireless professionalism and for the dedicated care they are providing. I understand that there will be some concerns about what this incident means for public safety. In particular, I recognise that some local Wiltshire residents will be feeling very anxious. Let me reassure everyone that public safety is of paramount importance. Public Health England’s latest assessment is that based on the number of casualties affected, there is no significant risk to the wider public. Its advice is informed by scientists and the police as the facts evolve. Dame Sally Davies, the chief medical officer, has confirmed that the risk to the public remains low, and has asked that the public follow the advice of Public Health England and the police. She has also advised that people who have visited the areas that have been recently cordoned off should wash their clothes and wipe down any items they may have been carrying at the time. She has also urged people not to pick up any unknown or already dangerous objects such as needles and syringes. That is not new advice and it follows on from what was said in March. We have a well-established response to these types of incidents and clear processes to follow.
I also want to add that all the sites that have been decontaminated following the attempted murder of Sergei and Yulia Skripal are safe. All sites that have been reopened have undergone rigorous testing, and any items that may have harboured residual amounts of the agent were safely removed for disposal. We have taken a very robust approach to decontamination, and there is no evidence that either the man or the woman in hospital visited any of the places that were visited by the Skripals. Our strong working assumption is that the couple came into contact with the nerve agent in a different location from the sites that have been part of the original clean-up operation. The police have also set up two dedicated phone numbers for anyone with concerns relating to this incident. Salisbury District Hospital remains open as usual and is advising people to attend routine operations unless they are contacted and told otherwise.
We are taking this incident incredibly seriously and are working around the clock to discover precisely what has happened, where and why. Be assured that we have world-leading scientists, intelligence officers and police on this case. Local residents can expect to see an increased police presence in and around Amesbury and Salisbury. All six sites that were visited by the pair before they collapsed have been cordoned off and are being securely guarded as a precaution. An investigation has started to work out how these two individuals came into contact with the nerve agent. About 100 detectives from the counter-terrorism policing network are working to support this investigation, alongside colleagues from Wiltshire police.
Obviously, this incident will invoke memories of the reckless attempted murder of Sergei and Yulia Skripal earlier this year, given the similarities. I know that many Members will question whether this incident is linked to that one. That is clearly the main line of inquiry. However, we must not jump to conclusions and we must give the police the space and time to carry out their investigations—the police’s work will take time. But we are ready to respond as and when new evidence comes to light and the situation becomes clearer.
Following the events in Salisbury earlier this year, we rapidly worked with international partners at the Organisation for the Prohibition of Chemical Weapons to confirm our identification of the nerve agent used. Through a process of extensive, impartial testing and analysis, our findings were confirmed correct beyond doubt. The use of chemical weapons anywhere is barbaric and inhumane. The decision taken by the Russian Government to deploy them in Salisbury on 4 March was reckless and callous. There is no plausible alternative explanation to explain the events in March other than that the Russian state was responsible, and we acted accordingly. The British Government and the international community immediately and robustly condemned this inhuman action. In the light of this attack, the UK expelled 23 Russian diplomats from our shores, and we were joined by 28 of our closest international allies in this action, ranging from the United States to Ukraine, who expelled more than 150 of the Russian state’s diplomats.
We have already seen multiple explanations from state-sponsored Russian media regarding this latest incident. We can anticipate further disinformation from the Kremlin, as we saw following the Salisbury attack. As we did before, we will be consulting our international partners and allies following these latest developments. The eyes of the world are currently on Russia, not least because of the World cup. It is now time that the Russian state comes forward and explains exactly what has gone on. Let me be clear: we do not have a quarrel with the Russian people. Rather, it is the actions of the Russian Government that continue to undermine our security and that of the international community. We will stand up to actions that threaten our security and the security of our partners. It is completely unacceptable for our people to be either deliberate or accidental targets, or for our streets, parks or towns to be dumping grounds for poison. We will continue our investigations as a matter of urgency, and I will keep the House and the public updated on any significant developments. I commend this statement to the House.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
I thank the Home Secretary for making his statement to this House and for giving me prior sight of it. The whole House appreciates that he came here directly from a Cobra meeting. As he said, the first duty of any Government is to secure the safety and security of their people and all those resident in this country. No Government can allow the poisoning of their citizens or residents as they go about their daily lives, by state actors or others. As he has said, the use of chemical weapons is both barbaric and inhumane. Our thoughts and best wishes go out to Dawn Sturgess and Charlie Rowley, and we wish them a speedy and complete recovery. I would also like to place on the record the admiration and support we on this side of the House have for the work of the emergency services, the security services and the vital public servants at Porton Down.
The Home Secretary will appreciate how alarmed the public, particularly the people of Wiltshire, must be at this second incident involving the nerve agent Novichok in four months. This incident has occurred long after local people had been assured that there had been a thorough clean-up of the area. We understood that numerous areas across Salisbury had been decontaminated, at great expense and with great thoroughness. It is still not clear whether this is a wholly separate incident or the fall-out from the original incident but with effects being felt months apart.
The Home Secretary will appreciate that if there are connections, other than the type of nerve agent involved, between this latest incident and the Skripal case, the House and the general public will obviously want to know as soon as possible. The House has not received an update on the Skripal case for some time; the Home Secretary may wish to take this opportunity to update the House and the general public about ongoing work on the Skripal case. The House and the public at large will want reassurance, but they will want it to be based on facts. I agree with the Home Secretary that we should not jump to conclusions. We need the facts on this serious matter, and no doubt Members from all parties will resist the temptation to engage in wild speculation or to offer their own guesswork as informed opinion.
Members from all parties, along with the general public, will eventually want to understand how this incident could have occurred. The public will also be concerned about other issues. Do the local police have the resources that they need? Will the Government be providing them and the local authority with additional emergency funding for the enormous drain on resources that this investigation and the securing of various sites will inevitably involve? As well as causing great public concern, this second incident will be a blow to business and retail in the area. Local businesses were just recovering from the Salisbury fallout; what support will they be given? Will the Secretary of State assure the public that this new clean-up and decontamination effort will be exemplary in its thoroughness?
There are some matters that the Secretary of State might usefully raise with his colleagues in the Department of Health and Social Care. Do all relevant emergency workers and health professionals have sufficient information to recognise the symptoms of this type of poisoning? Do they have advice on how to respond to suspected cases? The public will have noted that although Dawn Sturgess and Charlie Rowley took ill on Saturday night and were taken to exactly the same hospital as the Skripals, it apparently took two days to refer the case to Porton Down.
As the Home Secretary said, the eyes of the world are on Russia. We will all have seen the very warm and enthusiastic response of the Russian people to people coming from all over the world for the World cup. The Opposition supported the expulsion of the 23 Russian diplomats and the other related actions that Her Majesty’s Government took in the wake of the Salisbury incident, and we will support any action that the Government take that will keep our people safe. We cannot allow the streets of ordinary British towns and communities to become killing fields for state actors.
Sajid Javid
I thank the right hon. Lady for her support and her comments and join her in stating again that the whole House wishes the victims a very speedy recovery. I very much welcome her questions, which I shall try to respond to in turn.
The right hon. Lady asked, perfectly correctly, for reassurance that this incident is not connected in any way to the areas that were decontaminated after the original incident back in March. We are very comfortable that that is not the case—and that is not just the view of Ministers on their own; it is the view of experts, especially the decontamination experts. They are clear that the decontamination exercise was successful, as is Dame Sally Davies, the chief medical officer, and we are happy to say that those areas are all safe. We are also comfortable that, from what we know, in this particular incident neither individual contracted or came into contact with the nerve agent at any of the decontaminated areas. That is our belief.
The right hon. Lady asked whether there was any more information on the connection between this incident and the original incident. That is of course the main line of inquiry for the police, for obvious reasons, but as she alluded to—it is worth restating—none of us should rush to prejudge the outcome of the investigation. As more evidence and any information comes out, we will of course share that with Members and with the wider public.
The right hon. Lady rightly raised the issue of resources, and I can reassure her on that. In fact, one of the main things that we discussed at the Cobra meeting earlier was ensuring that all the necessary resources are made available, as they were back in March. We wanted to make sure that that applied to everyone involved in dealing with this incident, but particularly local police, CT policing and the security services. I am comfortable that any resources required will be provided and any further requests will be met. That will be a priority for us.
The right hon. Lady mentioned the impact on the local area, and she was right to do so. People local to the area were heroic in their response to the original attack and have united, together as a community, and sent a clear message of support for each other. At the time of the original incident, there was a lot of support from the local council, Wiltshire Council, and from local political leaders, including my hon. Friend the Member for Salisbury (John Glen), who contacted me at the moment he knew about the incident to ask about further support. We are looking at what more can be done. We will meet the leader of the local council, Baroness Jane Scott, and talk about precisely that, and we will also talk about, as the right hon. Lady mentioned, local businesses, many of which were just starting to recover. Whether they are high street shops or part of the local tourist trade, we want to make sure that their business is as unaffected as possible, so we are looking at what further support we can provide to them. The right hon. Lady was absolutely right to raise that point.
The right hon. Lady asked about local health expertise. The Department of Health and Social Care is of course making sure that if any extra resources are required, they will be provided to the health services. It is particularly important that, given that it is where the victims are, Salisbury District Hospital has all the support needed. My current understanding is that in respect of the two victims in this case, the health professionals in the hospital were able to use some of the experience that they gained from March’s incident in their approach, which meant that the right type of medical support was provided earlier than it perhaps would have been otherwise. There is considerable local expertise, but of course if more needs to be provided, it will be.
Lastly, the right hon. Lady asked me about an update on the police investigation into the original case. That investigation is of course ongoing and involves CT policing, local police and the security services, but it would be inappropriate for me to say anything further on that at this point.
Richard Benyon (Newbury) (Con)
We can be sure that this incident will be used by Russian state misinformation campaigns to try further to obfuscate what happened in March. Does my right hon. Friend agree that it is vital that we counter that through a steady drumbeat of telling the truth about what happened in March and of giving as much information about this incident as we can, when we can?
Sajid Javid
My right hon. Friend is absolutely right to make that point. He will know that the Russian disinformation campaign has already begun. As soon as this news was made public yesterday, we saw that, certainly on social media. For that reason and many more, it is important that, as more evidence of what happened emerges, the UK, together with our international allies, presents that to the public and makes it very clear and very factual.
Tommy Sheppard (Edinburgh East) (SNP)
I thank the Home Secretary for advance sight of his statement. As others have said, our immediate thoughts are with Charlie Rowley and Dawn Sturgess, whom we wish a very speedy and full recovery. They are completely innocent victims in this whole affair. I endorse the statements that have been made about our support for the emergency services; we can only wonder about the concern that they themselves must feel for their own personal safety when they cope with matters of this kind.
I particularly welcome the Home Secretary’s statement in two regards. First, it is important to reassure the public that there is no generalised threat to the wider community and dampen down irresponsible speculation that might be to the contrary. I also welcome the fact that he draws a distinction between the Russian people and the Russian state, particularly at this time. We should try hard to make sure that that message resonates within Russia itself, particularly given the events that are happening there at the moment.
I wish to press the Home Secretary in two respects. First, he says that people will naturally be concerned to understand the link, if any, between this incident and the Skripal case. Is it possible for him to identify whether the Novichok in this instance is from the same batch as was used in the Skripal case, or will that not be possible, and will he therefore not be able to say whether there is a direct link? Secondly, he has updated the House on the expulsion of diplomats, but, of course, there was a great range of other measures discussed as well in response to the incident on 4 March. If he is not able to do this now, can he say when he will be in a position to update the House on other matters, particularly with regard to the seizure of Russian state assets and to improving checks at our borders?
Sajid Javid
I thank the hon. Gentleman for his response. Again, he has made a number of important points. I join him in commending the work of the emergency services; their response has been absolutely exceptional both back in March and, from what we have seen, in the past few days. He is also right to emphasise the distinction between the Russian people and the Russian state. Our quarrel is with the Russian state, not with the Russian people. In the World cup so far, the Russian people’s response and welcome to British fans and to the British team has been very nice to see, which emphasises the point that he has made.
The hon. Gentleman asked two questions: one about the nerve agent and the second about Russian action. On the nerve agent, scientists from Porton Down are absolutely clear that this is the exact same type of nerve agent from the Novichok family of nerve agents that was used in the March attack, so we are very clear on that. He asked specifically about the batch. We cannot attribute this to the same batch at this point, but scientists will be looking into that. I have been told that that may not even be possible because of a number of factors, but we cannot rule out, of course, that it was from the same batch. Although we are comfortable that it is the exact same nerve agent, we cannot at this point say that it is from the exact same batch.
The hon. Gentleman also asked about any further action against Russia. I think that I said in the statement that, as we continue with the investigation and as evidence emerges, we will respond accordingly.
Sir David Evennett (Bexleyheath and Crayford) (Con)
I strongly support my right hon. Friend’s statement today and the information that he has given us. Obviously, local people will need maximum reassurance. Will he reaffirm that the risk to the general public is very low and that the Government’s top priority is the safety and wellbeing of local residents?
Sajid Javid
I am very happy to reaffirm that. The statements made yesterday by the chief medical officer and Public Health England were very reassuring; the risk to the public remains low. There is advice from the chief medical officer for those whom I mentioned briefly in my statement—those who believe that they may have been in some of the same areas that are now cordoned off to take some precautionary action. That kind of belt and braces approach is very appropriate, but the risk to the public remains very low.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
I welcome the Home Secretary’s statement. Our police, intelligence officers and medical staff are among the best in the world, and I know that they will be doing everything possible to keep people safe and to pursue this vile crime against this couple and the original Skripal attack. Can he confirm that he has had no co-operation from the Russian Government, which would be both revealing and shocking in itself? Will he also say a little bit more about Novichok and whether or how it degrades or deteriorates and how easy it is to detect, as he will be aware that there is already conflicting information and, potentially, misinformation being circulated on this?
Sajid Javid
I thank the right hon. Lady for her question. First, I can confirm that we have had no co-operation from the Russian Government, but given their responsibility for the original attack and their campaign of disinformation, no one in the House should be surprised about that. I have made it clear today that, if the Russians wanted to respond in a positive way and provide more information—for example, on Novichok and on how they disposed of the nerve agent, if they did—they could, but they have clearly chosen not to. I have no doubt that, in the coming days and weeks, we will see an increased campaign of disinformation from the Russian state.
The right hon. Lady specifically asks about Novichok and that type of nerve agent. Like all nerve agents, it will deteriorate over some time, but my understanding is that, in the case of this type of nerve agent, that some time could be months and months. Therefore, it is scientifically perfectly possible that this nerve agent came from the same batch; it could well be the exact same nerve agent that was used in March because it would not have had enough time to deteriorate in any meaningful way.
The right hon. Lady also asks about detecting a nerve agent. It is not easy to detect at all. Detection equipment is available for radioactive substances, but detecting a nerve agent is a very different matter and there is no easy way at all to detect it. There are some ways to help find it, but it is hard to detect. That said, the considerable experience that we built up back in March will help us in responding to this incident, too.
Several hon. Members rose—
Mr Speaker
Order. Understandably, a significant number of Members wish to participate in these exchanges and to question the Home Secretary. There is a debate to follow on proxy voting, which is well subscribed and which risks having very little time left for it. If that were to transpire, it would be open to the Government to reschedule that debate on another occasion so that Members were not disappointed, but, in the meantime, if people could ask short questions and the Home Secretary could provide short replies that would help.
Helen Whately (Faversham and Mid Kent) (Con)
It is quite extraordinary and shocking to hear the statements that are already coming out of Russia. Does my right hon. Friend agree that it is really important that we work with our international allies to counter the fake news and the disinformation coming from Russia and others?
Sajid Javid
Yes, I very much agree with my hon. Friend. That is exactly what we have been doing, especially since the incident in March. This recent incident is a reminder that there is more to do.
Sir Edward Davey (Kingston and Surbiton) (LD)
I thank the Home Secretary for his excellent statement and join others in celebrating his distinction between our condemnation of the Russian Government and our support for the Russian people. His careful phrasing today and his diplomatic sensitivity is vital. Will he reassure the House that all Ministers will follow his lead and his calm strength?
Mr Philip Hollobone (Kettering) (Con)
May I stress the need to support local organisations? Budgeting in an annual budget cycle for an international chemical weapons attack simply does not happen, so the local council, the local hospital, the local police force and local businesses need financial support from central Government, and they need it quickly.
Sajid Javid
My hon. Friend is absolutely right on that point. He will recall that, when the previous incident happened, I was the Local Government Secretary and was very much aware of that. We provided support then, and we will certainly be providing support again this time.
Mr Pat McFadden (Wolverhampton South East) (Lab)
The Home Secretary referred in his statement to the strong solidarity that Britain’s allies had shown to us in the wake of the Skripal incident a few months ago. Is he confident that we can maintain strong solidarity in the wake of this incident among liberal democracies, and does he agree that that is essential when the forces of nationalism are on the rise in a number of countries?
Sajid Javid
I very much agree with the right hon. Gentleman. Having that unity among freedom-loving nations is very important in the face of this type of incident. There are a number of important multilateral events coming up: the western Balkans summit, the NATO summit and the visit to the UK by the President of America. Those are all fresh opportunities to build on that solidarity.
Victoria Prentis (Banbury) (Con)
When does the Home Secretary expect the police to be able to update the public?
Sajid Javid
I understand that people will want to hear from the police investigation as soon as possible, but from what I heard from the police in the briefing I received this morning, it will take some time. We need to give them that time, but I assure my hon. Friend that as we get more information we will bring it to this House immediately.
John Woodcock (Barrow and Furness) (Ind)
If and when the Government come to the conclusion that Russia was responsible for this attack—whether through targeting or by accident—will the Government pursue further co-ordinated action with our allies in response?
Sajid Javid
We absolutely need to keep all options open. I think that the hon. Gentleman would understand that the focus right here and now—certainly in today’s Cobra meeting—is very much on public safety, the police investigation and supporting the victims. I am sure that we will be considering other options as more information comes to light.
Craig Tracey (North Warwickshire) (Con)
Obviously, this situation is distressing and it is being monitored by many of our constituents all around the country. Will my right hon. Friend reassure the House that the incident is being treated with the utmost seriousness and that the Government are being regularly updated on developments?
Sajid Javid
I can give my hon. Friend that assurance. From the moment we knew about the incident, we have responded in that way—and not just the Government, but, just as importantly, local emergency services, the local council, local police and counter-terrorism police. We will keep treating the situation as an absolute priority.
Diana Johnson (Kingston upon Hull North) (Lab)
What more can the Government do to tackle the misinformation coming out from the Russian state about this issue?
Sajid Javid
The hon. Lady asks another important question. There are no easy ways. Since the March incident we—not just the Government, but the wider responsible media, Members of Parliament and others—have learnt to call out misinformation whenever we see it. This misinformation is often directed not only at us or the British public, but at a wider international audience, so working with our international allies can also help.
Maggie Throup (Erewash) (Con)
From the statement today and statements after the March incident, it is quite clear that our agencies are world-leading and well recognised as being so throughout the world. Will the Secretary of State reassure the House that those agencies will have all the resources that they need to get to the bottom of this situation?
Sajid Javid
Yes. As my hon. Friend will know, a number of agencies and organisations are involved in addressing this incident—to deal not only with the criminal investigation, but the health issues—and I can give my hon. Friend that assurance.
Mike Gapes (Ilford South) (Lab/Co-op)
The St Petersburg troll factories and the RT propaganda channel are already gearing up to spread misinformation. Could we not at least do a little bit more to expose this? In particular, would Members of all parties in this House not appear on Putin’s propaganda television channel?
Sajid Javid
The hon. Gentleman is absolutely right to raise this issue. There have been far too many incidents when Members have sadly supported the Russia propaganda regime, and RT is one way in which they have done so. If any Member has an ounce of common sense, they will realise—especially after this second incident—that the British public will not support any of them if they support President Putin.
John Howell (Henley) (Con)
The Croatian Prime Minister told me last week at the Council of Europe that the evidence that made him expel a Russian diplomat had been absolutely compelling. Will the Home Secretary ensure that the evidence that he produces will be just as compelling in this case?
Sajid Javid
This is an opportunity to highlight just how seriously we take evidence and the facts. Already our world-leading scientists have been involved in the identification of the nerve agent in this incident, and that is exactly how we will proceed. As we gather that evidence, of course we will discuss it with our international allies.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
The Home Secretary is right to draw a distinction between the Russian Government and the Russian people. With a potential clash between Russia and England in the World cup, what conversations has he had with the Foreign Secretary to ensure that English fans in Russia are being kept up to date through regularly updated Foreign Office travel advice?
Sajid Javid
Even before the World cup started, a robust and well-thought-through plan was put in place after work between my Department, the police and others to support British fans in Russia. In the light of this incident, we will certainly be reviewing that information. There is nothing at this point to indicate that the risk to fans in Russia has changed in any way, but we want to keep that under review.
Huw Merriman (Bexhill and Battle) (Con)
Novichok was developed by the Soviet Union in the ’70s and ’80s. It is down to the Russians to fill in the gaps. If they cannot do so, the assumption has to be made as it has been. Will the Home Secretary absolutely assure us that—notwithstanding our success going into the World cup and the way in which we have warmed towards the Russian people—we will not let up on the Russian state, which stands accused of attempting to murder our citizens?
Sajid Javid
I can absolutely give my hon. Friend that assurance. He will understand that although this incident has a leading line of inquiry—the connection with the previous incident—we do not want to jump to conclusions. If it is established that the Russian state is entirely responsible for this incident as well, of course we will consider what further action we can take.
Tom Brake (Carshalton and Wallington) (LD)
Russia is receiving lots of positive coverage at the moment because of the World cup. Therefore, tackling the disinformation issue is that much more important. Has the Home Secretary or anyone else called in the Russian ambassador to hold him to account for this incident and to say that the level of disinformation that Russia is propagating is completely unacceptable and will be challenged?
Sajid Javid
At this point, we have not called in the Russian ambassador. We will want to consider what further action we can take as this investigation develops, and that may well include speaking to the Russian ambassador.
Michelle Donelan (Chippenham) (Con)
The Amesbury incident is shocking, and I wish the pair affected a swift recovery. I am deeply concerned for Salisbury’s local economy and community. Will my right hon. Friend commit to the necessary support for Wiltshire to get through this? Will he also stress again that the Government’s priority is the safety of residents and that the risk to Wiltshire residents remains low?
Sajid Javid
My hon. Friend is right to raise this point. As a local MP, she will be concerned and will be hearing concerns from her constituents. I can give her that commitment: we will support the local economy, local businesses and local people in every way that we can. I discussed the matter this morning with the Communities Secretary, who shares that desire to help in every way that we can.
Andrew Jones (Harrogate and Knaresborough) (Con)
I commend my right hon. Friend for his statement. This must, understandably, be a time of great anxiety for local residents. Will he confirm that they are receiving all the public health advice that we can provide?
Sajid Javid
Yes, I can confirm that. There will obviously be more advice to come, as we learn more from the chief medical officer and Public Health England. The police and other agencies are working closely with the health authorities to ensure that the public health advice is updated at all times. Let me reiterate that the advice from the chief medical officer and Public Health England is that the risk to the public remains low.
Vicky Ford (Chelmsford) (Con)
The Salisbury attack and Russian disinformation shows how important it is to continue saying our side of the story. I understand that the BBC World Service is considering a considerable uplift in its broadcasting activities in the Balkans, eastern Europe and on the borders of Russia. Will the Home Secretary consider giving his support to the BBC World Service at this time, because it is clearly crucial to our safety at home?
Sajid Javid
My hon. Friend raises an important point. It is right that we look at how we can counter much of the disinformation out there that is coming from Russia, and the BBC World Service can play an important role in doing so.
Mary Robinson (Cheadle) (Con)
There will be a great temptation to engage in speculation following this latest incident. Does my right hon. Friend agree that the police must be given the space that they need to be able to fully investigate the facts and establish exactly what happened?
Sajid Javid
I can give my hon. Friend that assurance. As she will know, the police investigation has already begun. From the moment that this was declared a major incident, it has involved not just local policing but substantial support from counter-terrorism policing. Over 100 officers from counter-terrorism policing are already involved in this new incident. We will continue to make sure that they get the resources that are needed and are given the time to complete their work.
Chris Skidmore (Kingswood) (Con)
On Sunday, I drove through Salisbury on my way to the excellent Chalk valley history festival, also attended by my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs. Driving through the city, one cannot but be struck by the historic beauty of Salisbury, particularly its cathedral. Obviously, Salisbury’s local economy is highly dependent on international tourism. Will the Home Secretary send out a message to those people intending to visit Salisbury and nearby Stonehenge that they must continue to do so against the threat of what is effectively terrorism? They should attend Stonehenge, go to Salisbury and enjoy the wonderful historic sites.
Mr Speaker
The hon. Gentleman is himself a distinguished historian. I trust that he was not merely attending the festival but orating at it.
Sajid Javid
I very much agree with my hon. Friend. Obviously, Salisbury is one of the most beautiful places in our country—[Interruption.] My hon. Friend the Member for Salisbury (John Glen) shouts, “On earth.” I think we will have to agree with him on that. Whether by visiting Salisbury itself, nearby towns and villages or Stonehenge, this is a very good way that we can show our support. I would not only encourage members of the public to continue with their plans, but suggest that perhaps it is time to give ourselves an extra reason to make such a plan and be more determined to make a specific, special visit.
Points of Order
(6 years, 5 months ago)
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Dame Cheryl Gillan (Chesham and Amersham) (Con)
On a point of order, Mr Speaker. I seek your advice on a matter that has caused me some concern. While I was out of the country representing the United Kingdom at the Council of Europe, I received an email from an organisation called Global Justice Now. It told me that I would have received emails over the weekend from my constituents with the subject, “MPs not border guards”. It said that owing to a filtering system failure in its organisation, constituents would be thanking me for signing a pledge, which in fact I had not done, nor am I aware that I had even been asked to do so. This pledge apparently said that if anybody visited a constituency surgery of mine who was an illegal immigrant, I would undertake not to report them to the authorities.
I am really concerned, Mr Speaker, that an unaccountable organisation can actually send out information to my constituents about activities in my constituency surgery, effectively telling lies about me, and I have no opportunity to correct it. I appreciate that I am putting this on the record with you now, but could you perhaps take it away and look at how Members of Parliament can protect themselves against this sort of misinformation about their activities, because it is highly damaging and these organisations are not accountable?
Mr Speaker
I can well understand why the right hon. Lady is very perturbed about the matter. On hearing her explanation of the sequence of events, I rather imagine that other Members listening will be similarly concerned for her, and potentially for themselves. As she says, this organisation is not accountable. I have to admit that it is not an organisation of which I have previously heard, but I have now done so. The matter certainly warrants some thought, and I will give it that thought, including speaking about it to the Parliamentary Security Director on the right hon. Lady’s and others’ behalf. As and when I have anything to disclose to her or to the House, she or the House—possibly both—will hear it.
Dame Cheryl Gillan
Further to that point of order, Mr Speaker. I will arrange for my office to send you the email trail so that you have the evidence of what was sent to me. I am grateful for your undertaking to look into this matter.
Mr Speaker
I look forward to the receipt of that email trail. Well, I do not know whether I look forward to it or not, but I know that I can expect to receive it. I think that would be helpful to all concerned.
Mr Speaker
I will come to the hon. Gentleman, but it would be a pity to squander him too early.
Alex Burghart (Brentwood and Ongar) (Con)
On a point of order, Mr Speaker. I want to raise with you an issue that I have encountered in recent days. The pedestrian entrance at Carriage Gates has relatively new card-swipe machines that are quite glitchy, and there have been a couple of occasions when I have struggled to get in— fortunately not at a time when I was coming in for a vote. However, as someone who often cuts things quite fine in getting to the Chamber to vote, I would not want to find that I, or indeed other hon. Members, could not get through Carriage Gates in a hurry and that that affected our business in the Chamber. To whom should I report this concern, and what is the procedure for trying to address it?
Mr Speaker
The hon. Gentleman could inform the Serjeant at Arms about the matter, or if he wishes to raise it with Eric Hepburn, the Parliamentary Security Director, it is open to him to do so. I think it is a fairly safe bet, though, that the Parliamentary Security Director will come to learn of the point that the hon. Gentleman has made. Clearly, it is very important that these glitches should be reduced to a minimum and that the system should be operationally efficient sooner rather than later.
Andrew Bowie (West Aberdeenshire and Kincardine) (Con)
On a point of order, Mr Speaker. I have just come from a sitting of the Counter-Terrorism and Border Security Bill Committee. To say that temperatures in Committee Room 12 are bordering on stifling would be an understatement. We—Members—and officials are luckily at liberty to remove our jackets, but it was brought to my attention that the same courtesy is not extended to the Doorkeepers, who have to remain in full rig throughout, no matter what the temperature. Might you offer guidance on how action might be taken to allow our hard-working and dedicated Doorkeepers the same rights as ourselves in relation to making their workplace conditions as comfortable as possible in the current conditions?
Mr Speaker
Personally, I very much agree with that. It is not a matter that has been raised with me before. I remember that when I used to sit on the Panel of Chairs before my fortunate election to the office of Speaker, I was one of those who always took the view that in hot conditions Members should be able to take off their jackets. It was not a view universally held by Chairs. There were Chairs emanating from both sides of the House who took what I thought was an excessively trad view of the matter. However, the point that the hon. Gentleman makes is an important one. That which we make available to ourselves should be made more widely available. I would not want dedicated, hard-working, conscientious staff to be working in conditions of extreme discomfort, so I hope that that point can be registered. I think it is probably a matter of discretion for the Chair. If it is not, it should be, and if it is, they should know how to exercise that discretion in a way that would commend itself to the hon. Gentleman and, I suspect, to Members across the House.
Mr Charles Walker (Broxbourne) (Con)
On a point of order, Mr Speaker. I understand that due to pressures of time, the Government have pulled the next debate on the principle of proxy voting in the House of Commons. That is of course a great shame, although I understand that there are pressing matters of state in play at the moment. On 1 February, we passed a motion in this House to look at proxy voting. The Procedure Committee, which I chair, published its report on 15 May. We are some two months from that point and five months- plus from 1 February. I am a man of great patience, Mr Speaker, but babies are not as patient as I am. A number of colleagues who are expecting to give birth in the next few weeks were rather hoping that we would get on to this business, if not today, then perhaps next week.
Mrs Maria Miller (Basingstoke) (Con)
Further to that point of order, Mr Speaker. We talk a lot about efficiency in this place, and we demand efficiency of business. I have to say that I do not see today as being a great example of efficiency when it comes to looking at the issue of baby leave. It is clear that we have to discuss issues that arise, such as the dreadful incident in Amesbury, but I urge the Government to look at rescheduling the baby leave debate as soon as possible. Time waits for no pregnant woman, and I can see a bump over there that is significantly bigger than it was five months ago when we first debated this issue.
Mr Speaker
I will respond to those points of order, but as I think it is on the same theme, I would like to hear from the shadow Leader of the House.
Valerie Vaz (Walsall South) (Lab)
Further to that point of order, Mr Speaker. In support of what my colleagues have said, can we have an indication of when we are likely to get the debate back? It is quite urgent.
Emma Reynolds (Wolverhampton North East) (Lab)
Further to that point of order, Mr Speaker. The biological clock is ticking. Last year I took maternity leave, and I suffered reputational damage due to one of the newspapers branding me a lazy MP who was not here for a lot of the time. Three of our colleagues are expecting babies in the next few months, and the hon. Member for East Dunbartonshire (Jo Swinson) has recently had her baby. I hope we can get proxy voting in place for the recess, in time for those hon. Members during their maternity leave.
Alison Thewliss (Glasgow Central) (SNP)
Further to that point of order, Mr Speaker. This is absolutely ridiculous. People have come here in good faith to debate baby leave, which is very important. As we have heard, time is pressing. Can the Government give us a date for when the debate will happen? Will it happen before recess? How many more babies have to be born to Members of the House before we get some modern practices in place to take care of those women and their babies?
Mr Speaker
I will respond to all these points at the end, but I may as well take the remaining points of order.
Vicky Ford (Chelmsford) (Con)
Further to that point of order, Mr Speaker. If there is to be a delay to the debate on proxy voting, can we at least ensure that in the meantime, the pairing system operated by the Whips is giving our pregnant colleagues the flexibility that they need?
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Further to that point of order, Mr Speaker. May I impress upon you and Members of the House, including members of the Government who might be listening, that it was many months ago that we debated this issue and Members on both sides of the House made urgent and eloquent contributions about how important this was? That was in advance of us knowing how many colleagues might be affected, and now we are at a juncture at which many of our colleagues will be affected. The reputational issues for many of us who have previously been in this situation were extensive, and we do not know what is around the corner in terms of future elections. For a variety of reasons, it is critical that the Government respond.
Sir Christopher Chope (Christchurch) (Con)
Further to that point of order, Mr Speaker. The motion on the Order Paper was just for a general debate. Perhaps matters could be shortened if the Government were now to table a substantive motion that could be debated next week. We could then reach a decision on this, because we were not going to be able to reach a decision today anyway.
Nic Dakin (Scunthorpe) (Lab)
Further to that point of order, Mr Speaker. I rise to support the Chair of the Procedure Committee, the hon. Member for Broxbourne (Mr Walker). Our Committee did this work at an accelerated pace and published a report some time ago, as he said. There is no reason whatsoever for this delay. As I said to the Leader of the House in business questions last week, we need to get on with this. I agree very much with the hon. Member for Christchurch (Sir Christopher Chope) that it would be a good idea to move to a vote on the recommendation of the Procedure Committee, which has diligently done its job under its excellent Chair.
Helen Whately (Faversham and Mid Kent) (Con)
Further to that point of order, Mr Speaker. Many Members have mentioned the bumps and the time pressure. There will also be expectant fathers, so to speak, who are feeling the time pressure.
David Linden (Glasgow East) (SNP)
Further to that point of order, Mr Speaker. On that very theme, this is a picture of my daughter who will be born in the autumn, so I am particularly keen to see this measure put in place as soon as possible.
On a serious point, where is the Leader of the House? The Government have just unilaterally changed the business of the House this afternoon. I am the acting Whip for the Scottish National party today, and I found out by a rumour that this had happened. It is a gross discourtesy to the House, and the Leader of the House should have come to the Dispatch Box and made an announcement.
Dame Cheryl Gillan (Chesham and Amersham) (Con)
Further to that point of order, Mr Speaker. I am not expecting a baby any time soon, but I have great sympathy for my colleagues on both sides of the House and fathers who are expecting. Would it be helpful to reassure colleagues that this House stands firmly behind expectant mothers and mothers who take leave from the House that they are not in dereliction of their duty and that no female Member should be traduced in this way? Would it also be helpful to confirm that the pairing system is alive and well and working, so that even if this excellent recommendation is not passed into the Standing Orders, people who are expecting babies or have to take maternity or paternity leave will be paired by our Whips Offices?
Mike Gapes (Ilford South) (Lab/Co-op)
Further to that point of order, Mr Speaker. I was in a position 25 years ago where I was told by the Chief Whip, “I’d be very happy for you to be there when your daughter is born, but be here on Monday night because we’ve got an important vote on Maastricht.” The birth of my child was therefore going to determine whether I was breaking the whip or not. Pairing is not satisfactory in those circumstances. We have to have proxy voting.
Bob Blackman (Harrow East) (Con)
Further to that point of order, Mr Speaker. I am a member of the Procedure Committee, and we looked at this issue in great detail. Colleagues have spoken about pairing, but of course, pairing does not apply at the moment to Members from the Scottish National party. May I urge that similar arrangements be made for our SNP colleagues, to allow them to experience the same facility as Opposition or Government Members?
Mr Speaker
I am grateful to colleagues for all their points of order. Let me emphasise that I understand completely how very disappointed and, indeed, aggrieved many Members are that the debate that had been scheduled will not now take place today. In fairness, I think it only reasonable to point out that from the Government’s point of view, it was a choice between having an extremely truncated debate of less than an hour or choosing not to move the motion. When the hon. Member for Glasgow East (David Linden) understandably complains that the debate was summarily withdrawn, he has a point, but the response to that is that of course, there was a motion for a general debate. The motion was to be moved by the Leader of the House, and if a motion is not moved, by definition, the debate cannot take place. I would not want to impugn anyone’s motives in this matter.
Mr Speaker
Of course I will come to the Leader of the House.
I want simply to say at this stage the following. First, this matter has been considered over some period. I want to join the tributes to the excellent and indefatigable Chair of the Procedure Committee, the hon. Member for Broxbourne (Mr Walker), whose Committee did treat of this matter in some detail. Indeed, as is not uncommon in relation to procedural matters, the Committee asked me whether I would be willing to give evidence to it, which I did. It is no secret whatsoever that I expressed support for the principle and practice of proxy voting in circumstances where people were enjoying or seeking to enjoy maternity or paternity leave. That was my very firm view. I appreciate that there may be a mixture of views on this matter, but that was my very firm view. [Interruption.] What has caused the amusement?
Vicky Ford
The “enjoyment” of maternity leave—it is very hard work, Mr Speaker.
Mr Speaker
Perhaps I should have used a more neutral term.
Secondly, I think it is not a secret that the support for this idea is not universal, and it is not specifically a party matter. There are people on both sides of the House—particularly those who are accustomed to operating through the usual channels—whose enthusiasm for the idea of proxy voting is, shall we say, not unalloyed. Whether that has anything to do with the way events have transpired today, I have no way of knowing. To be fair, the Home Secretary’s statement was very important, and that statement did have to be made. The Home Secretary was earlier, as he said, chairing Cobra and could not make his statement until he got here.
The Government’s rationale for choosing to have a statement on the industrial strategy is a matter for the Government. The Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Watford (Richard Harrington), addressed us with his usual charm and courtesy. He displayed no little knowledge of the matters under discussion, and was widely questioned. Whether that statement had to be made today was a judgment for the Government to make.
As people have asked about when the debate might be rescheduled, I would say that I asked the Deputy Chief Whip, who courteously came to the Chair to inform me that the debate would not go ahead today, whether it would soon be rescheduled. He said that the Government would look to reschedule the debate, but that it would have to be done by agreement through the usual channels.
My own very firm view, having heard what colleagues have said, is that the debate, preferably on a substantive motion—to go back to the point made by the hon. Member for Christchurch (Sir Christopher Chope)—so that the House can decide whether to proceed with proxy voting, should take place before the summer recess. It would be perfectly possible for that to happen, but it is for others to determine whether it shall. It would be my preference, but it is not to be decided by the Chair.
The Leader has come into the Chamber, and we appreciate that. She has also signalled that she wants to say something on this matter, and I think it is important that we hear from her.
Andrea Leadsom
Further to that point of order, Mr Speaker. May I say that nobody is more disappointed than I am that we have not been able to carry on with this debate? I have always made absolutely clear my 100% commitment to the vital importance of a secure early bond between parents and their babies. It is something for which I have had an absolute passion for 20 years, so nobody should be in any doubt about that.
I have had a number of meetings with colleagues. In fact, last November, when this issue was first raised with me, I asked the Chairman of the Procedure Committee whether the Committee would be so good as to look into how to provide proxy voting arrangements for baby leave. He was kind enough to do so, and I pay tribute to him and to all members of the Procedure Committee for their very well-considered report.
The purpose of today’s debate was to open up the discussion about what would actually be quite a significant change to the conventions of the House. My speech, were I delivering it, would have asked Members open questions about how they believe this could best be handled, whether there are alternatives and, indeed, whether there might be unintended consequences. My intention was to facilitate such a debate.
You are absolutely right, Mr Speaker, that the events in Wiltshire meant that the Home Secretary could not get to the House to make his statement until after the end of Cobra. Unfortunately, that has led to our having insufficient time to air the issues under discussion properly today. It is absolutely my intention to bring back that debate as soon as possible.
Mr Speaker
I am very grateful to the Leader of the House for what she has said. Colleagues, I think we have all put our cards on the table, and we need to leave the issue there for today. However, knowing the perspicacity of my colleagues and the strength of feeling that exists among them—not least the Chairs of the Procedure and the Women and Equalities Committees, to name but two—there is no way on earth that this issue will go away, even if anybody in the House, and I know the Leader of the House does not want it to do so, thought that it could be pushed into the long grass. Thinking that would be a triumph of optimism and self-delusion over reality and common sense, and no one would want knowingly to be guilty of that.
Backbench Business
Transforming Care Programme
(6 years, 5 months ago)
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Mr Speaker
We now come to the Back-Bench motion on the future of the transforming care programme. I am pleased to say that the Member who is due to move the motion is in the Chamber. This is not a laughing matter, but, sadly, not many Members wish to speak in the debate, so it could finish early. Alternatively, the sheer breadth and depth of the learning of the right hon. Member for North Norfolk (Norman Lamb), together with his capacity to expatiate with great eloquence on it, could lead to a very full debate.
Norman Lamb (North Norfolk) (LD)
I beg to move,
That this House is concerned at the slow progress made under the Transforming Care programme, which was set up to improve the care and quality of life of children and adults with a learning disability and/or autism who display behaviour that challenges; recognises that a substantial number of people with learning disabilities remain trapped in, and continue to be inappropriately admitted to, Assessment and Treatment Units rather than living with support in the community; is further concerned at the lack of capacity within community services; notes evidence of the neglect, abuse, poor care, and premature deaths of people with learning disabilities; believes that the Transforming Care programme is unlikely to realise the ambitions set out in the Building the Right Support strategy before it ends in March 2019; calls on the Government to establish, prioritise, and adequately resource a successor programme that delivers a shift away from institutional care by investing in community services across education, health and social care; and further calls on the Government to ensure that such a programme is based on lifelong support that protects people’s human rights and promotes their independence and wellbeing.
May I thank the Backbench Business Committee for facilitating this important debate? Although the number of Members who have indicated a desire to speak is low, this incredibly important issue deserves to be debated in the House. I thank the hon. Member for Dulwich and West Norwood (Helen Hayes), together with other Members, for joining me in making the application for the debate. I have worked very closely with her on this issue, which we both care very much about.
I thank a number of voluntary sector organisations that have been incredibly helpful in preparing for this debate. I particularly want to mention the Challenging Behaviour Foundation, which is led by the very impressive Viv Cooper, as well as Mencap, the National Autistic Society, the Voluntary Organisations Disability Group and Shared Lives Plus.
It is perhaps sobering that we are debating this issue on the 70th anniversary of the NHS. I say that as someone who is a very strong supporter of the NHS, but for the people we are talking about in this debate, the record has not been a good one. The system has let down too many individuals and too many families. On this very significant day, it is important to recognise that the NHS has a lot of work to do to repair the damage that has been done to so many people, and to treat them properly.
The origins of the transforming care programme lie in the horror of the Winterbourne View scandal, which Members will remember. In that private hospital, people with learning disabilities and autism were abused and assaulted behind locked doors over a sustained period, and that was only revealed by brave whistleblowers. In the aftermath of that horror, I invited the families of those who had been patients in Winterbourne View to come to the Department of Health—I became a Health Minister in September 2012—to talk to me about their concerns.
I clearly remember a father called Steve Sollars, who talked to me about how he had watched his son become, in his words, increasingly zombie-like as he was pumped full of anti-psychotic drugs. Steve described how he tried to complain to the local authority and the primary care trust, as it was in those days, and said that he was just completely ignored. It really struck home when he said, “I felt guilty that I couldn’t do anything for my son.” I was left thinking how dreadful it was that we had got to a position in which state agencies had left an individual—a father—feeling guilty because they were ignoring his pleas for something to be done.
In the following months and years, I met some other parents of individuals trapped in hospital—sometimes in unattractive institutions—for long periods, all of whom felt that no one was listening to them. I refer in particular to Phill Wills, who campaigned brilliantly on behalf of his son Josh, who was stuck in a hospital in Birmingham for more than two years. The family live in Cornwall, so they had to make an incredible journey just to maintain contact with their little son.
I also met Shahana Hussein, the aunt of a girl called Fauzia, who was in St Andrew’s in Northampton. She talked to me about her fears of how her niece appeared to be trapped there. She was anxious that that might be her life course, and that she would never emerge from that place. I met Lynne McCarrick, whose son Chris had been stuck in Calderstones undergoing inappropriate treatment for a very long time, and Lorna and Sid, the parents of Simone, who is still stuck in hospital nine years after her first admission. For much of that time, she has been a long distance away from home, therefore making it impossible for her parents to visit, which is shocking in this day and age. Many of those families are present for today’s debate, and they remain extremely concerned about their loved ones and others who remain trapped in institutions.
The conclusion that I reached at that time, which I still hold, is that individuals’ human rights are routinely ignored and breached in serious ways. Someone who is convicted of a criminal offence and then sent to prison—other than the cohort who have received indeterminate sentences—generally knows the date of their release. However, people who go into institutions and their families do not know a release date, and many people stay in those institutions for much of their lives, which is shocking. To put it bluntly, they are treated as second-class citizens. I said that at the time, and I still say it now, because not enough has changed for any of us to be comfortable with the situation.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
I congratulate the right hon. Gentleman and my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on the leadership they have shown by securing this debate through the Backbench Business Committee. The right hon. Gentleman said that this programme came out of the Winterbourne View scandal, which was back in 2011. Does he share my concern that we are discussing this issue seven years later in 2018 and yet thousands of people in our country—thousands!—are still in institutional care? It is an absolute disgrace that we find ourselves discussing this issue.
Norman Lamb
I completely agree. That sense of complete injustice and the denial of human rights still exists. Nothing much has changed, which is why the debate is so important, and I share the hon. Lady’s view that we should not tolerate this scandal. What makes the situation even worse is that this is not a demand for vast amounts of extra public money; it is about how public money is spent. Our demand is that money is spent in a way that respects people’s human rights and gives them the chance of a good, happy life in the community, with the support of care workers, friends and family, rather than being trapped in institutions. It is shocking that the situation for very many people has remained exactly the same as it was all those years ago.
Mr Jim Cunningham (Coventry South) (Lab)
As my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) said, it is shocking that it has taken seven years for us to get even this far. I have noticed that although on the one hand the national health service encourages whistleblowers, on the other hand it sometimes litigates to stop whistleblowers, so there is a contradiction. Does the right hon. Gentleman agree that if people had taken notice of whistleblowers, some of these things might never have happened?
Norman Lamb
I do agree, and that is another big subject that I will be pursuing further in the light of the Gosport inquiry, which I established when I was a Minister. In that case, brave nurses tried to blow the whistle in 1991, but they were shut down by management and unable to pursue their concerns. More than 456 people lost their lives as a result of the inappropriate prescribing of opioids, and that was because whistleblowers—brave staff members—were not listened to. In every part of our health service, we must ensure that people feel able to speak up and that they have the legal rights to do so.
The outcome of our deliberations in the Department was to establish the transforming care programme, which was published in December 2012. Interestingly, it was pursued as a concordat and an agreed programme of action. It was supported by an amazing array of organisations, all of whose logos appeared in the document, including—critically—NHS England. Every organisation that signed up to the programme committed to
“working together, with individuals and their families—
note the phrase “with individuals and their families”—
and with the groups that represent them, to deliver real change.”
That was in December 2012.
These organisations that had committed “to deliver real change” also stated:
“Our shared objective is to see the health and care system get to grips with past failings by listening to this very vulnerable group of people and their families, meeting their needs and working together to commission the range of support which will enable them to lead fulfilling and safe lives in their communities.”
To put it bluntly, there has been a shameful failure on that commitment to change, which simply has not happened for the majority of people involved.
At that time we were operating in a fog. No data had been collected historically on the numbers of people in beds in institutions, so we had to rely on periodic censuses to find out whether anything was changing. When we conducted a census about 18 months after the start of the programme, it was shocking to discover that there had effectively been no change—it was business as usual. The really disturbing thing was that many private sector organisations were making substantial investments in new facilities and delivering the wrong model of care. Why did those organisations have the confidence to make major million-pound investments in inappropriate care? It seems to me that to justify such investment, they must have had reassurance from somewhere in the system that things would carry on as they were. It was shocking to discover the extent to which it was simply business as usual.
Luciana Berger
I apologise if the right hon. Gentleman is going to come on to this, but I want to reflect on the reports commissioned by NHS England and Sir Stephen Bubb. Back in 2014, Sir Stephen was commissioned to write a report entitled “Winterbourne View – Time for Change”, yet nothing happened in the wake of that report, other than a closure programme that was published back in 2015, on which we have seen little progress. In February 2016, Sir Stephen Bubb published another report entitled “Time for Change – The Challenge Ahead”, which again demanded urgent action. Does the right hon. Gentleman share my concern that although those reports were commissioned, there was very little response or action taken?
Norman Lamb
Again, I entirely share the hon. Lady’s view. I work closely with Sir Stephen Bubb and we have exactly the same view about this. He and I attended a meeting about a year ago with NHS England to discuss progress, or the lack of it. The hon. Lady is right to say that there is a culture of looking at things again and again, and then doing nothing about the conclusions reached, which is wholly unacceptable.
At that time, three issues stood out, and they involved perverse incentives that acted to prevent change from happening. First—this is extraordinary—the person who was making the critical decision about whether an individual should stay in a bed or be discharged was, and still is, the clinician employed by the provider organisation that makes money out of the person staying in the bed. That total conflict of interest has never been confronted. As Minister, I kept asking NHS England to act to address that issue, but it has not yet been resolved. If a private sector organisation is earning £4,000 or £5,000 every week from someone being in a bed, there is a strong incentive to keep them in that bed. There is also an incentive for public sector organisations that want to maintain their existence, and that conflict of interest has never been confronted.
Secondly, there is a complete failure to invest properly in community provision. This is all about the need to shift resources from institutional care to community support; in other words, shifting money from NHS England to local authorities. The original transforming care concordat made it clear that there should be a pooling of resources between specialist commissioning, clinical commissioning groups and local authorities. As the hon. Member for Liverpool, Wavertree said, seven years on we are still waiting for a proper pooling of resources so that the money can actually shift and investment can be made in community resources.
The third insight I had at that time was the most extraordinary and wholly unacceptable exclusion of families and individuals from any decisions that were being made about their care. This, I am afraid, continues today. It is very far from the personalised care that the NHS and the Government say they are committed to. In the light of what I saw as our complete collective failure to deliver that change—this was the thing that caused me most distress as Minister—I decided that we had to come up with new proposals for new legal rights, so that families and individuals could challenge decisions that were being made behind their backs about where they would be cared for and treated.
Shortly before the 2015 general election, we published a Green Paper, I think in March 2015, called, “No Voice Unheard, No Right Ignored”. It has an important title, but I am afraid that those rights and those voices are still unheard and ignored because it has never been implemented. Nothing proposed in the Green Paper has been taken forward by the Government. We now have a review of the Mental Health Act 1983, so there is another opportunity to address the scandalous lack of rights for individuals, but the time it will take before there is any legislation will be very long—I doubt whether it will be in this Parliament—and families will just be left waiting.
At that time I worked with Sara Ryan, a remarkable woman and the mother of Connor Sparrowhawk, known as Laughing Boy. He was a young man in the “care” of Southern Health who lost his life while he was within its institution. He drowned in a bath because of neglect. The Health and Safety Executive had decided not to investigate the case. I intervened and asked it to reconsider. It then decided that it could investigate and eventually, years later, prosecutions and convictions followed. The result of the tragedy that struck that family was that Sara Ryan and an amazing group of people worked together to produce a Bill that would have strengthened the rights of individuals. We worked closely with them in the production of that Green Paper.
Because no progress was being made following the 2015 general election, the Government and NHS England embarked on a new process. In October 2015, they published a document called “Building the Right Support”. The plan was to close between 35% and 50% of in-patient beds and, critically, ensure that local areas developed the right community support by—this is the critical date—March next year. The plan involved the creation of 48 transforming care partnerships covering the whole country. These partnerships between NHS England specialist regional commissioners, local authorities and CCGs were to facilitate the shift of money from NHS England to local authorities, so that people could be cared for in the community.
There was a plan for people who had already been in in-patient care for more than five years at April 2016 to be given a dowry to facilitate their transfer into community support. When campaigners asked how many dowries had been provided, NHS England said it did not know because it did not have any records on that. What kind of implementation of a national programme is it when we do not even know, and have no way of telling, how many dowries have been delivered? And why was it just for that one cohort of people? Surely every person stuck in a hospital or institution has the right to have the money go with them on their journey back into the community. I want to know from the Government how many dowries have been delivered so far and whether they will become part of the programme in the future.
As I said, the programme ends in March next year, along with other work on learning disabilities which campaigners are concerned will continue—I will come back to that at the end—including the learning disabilities mortality review. There has already been a lot of concern expressed about how the annual report was slipped out the day after the local election at the beginning of May. The report contained pretty shocking findings, with life expectancy falling massively short of the rest of us—for men by about 22 years; for women, by 29 years—without any clear justification. Some 13% of the cohort of people looked at in the mortality review were cases where the person’s health had been adversely affected by delays in care or treatment, gaps in services or organisational dysfunction, neglect or abuse. Those findings are shocking and concerning. The question for the Government, which I will come back to, is what happens with the findings of mortality reviews. We can all express concern when they are published, but unless there is a plan of action to address the failings identified in them then nothing will change.
The nine principles in the “Building the Right Support” document are very good. They are all focused on personalised care and getting people into the community, which we all agree must happen.
Luciana Berger
I normally would not make so many interventions and I hope the right hon. Gentleman is happy to take them—I thank him greatly. I just want to reflect a bit more on the learning disabilities mortality review. The title is quite technical, but it comes back to what he opened his speech with: we are discussing thousands of the most vulnerable people in our country and we have a responsibility to do everything we can to compensate for the fact that they are so vulnerable. The mortality review, launched in May of the previous year, found that one in eight of the deaths reviewed showed there had been abuse, neglect, delays in treatment or gaps in care. Today we celebrate the 70th anniversary of the NHS. Is it not a sad reflection that, amidst all the positivity, we need to do something about this issue so urgently?
Norman Lamb
I totally agree. It is, as I said at the start, sobering. In a way, all of us who strongly support the NHS must not laud it as a perfect institution with nothing to complain about. As far as this group of people are concerned, they have been very badly let down. Fundamentally, in many cases they have died early through neglect. That is intolerable in this day and age.
The nine principles, which are positive and empowering, are really good. I sign up to them completely. It is the implementation that is lacking and has largely failed. I say to the Minister that she is very fortunate to be in her wonderful job. My great frustration is that this programme came early in my time as Minister, but I learned, as I did the job, just how critically important implementation is. You think that by establishing good principles and getting everyone to agree to implement them those organisations will do what they have committed to do. It was probably naïve to think that. The reality was that nothing changed and it still has not changed. One critically important lesson to learn from that failure is to have a total, obsessive focus on implementation and national leadership.
Sandy Martin (Ipswich) (Lab)
Does the right hon. Gentleman agree that to achieve transformation in care, investment needs to be put into alternatives in the community before it is possible to free vulnerable people from these institutions, and that far too often, the public sector tries to make savings before it has made the investment in the things that will achieve the same?
Norman Lamb
The hon. Gentleman makes a really important point, and I totally agree. I said at the start that this is not a great demand for a whole load more money. However, some up-front investment is needed, not only in establishing the facilities in the community, but in training people in the community, and I will come back to that in a little while.
Dame Cheryl Gillan (Chesham and Amersham) (Con)
I add my voice to others in the Chamber in saying that I am very grateful to the right hon. Gentleman for securing the debate, and I hope to catch the Chair’s eye to make a contribution on autism. Does the right hon. Gentleman agree that when it comes to financing and co-ordination, a lot can be learnt from the National Audit Office report from 2017 that looked specifically at progress in the transforming care programme? Does he also agree that it is quite worrying that the NAO said that it was concerned about the programme’s overall progress and whether it would achieve value for money? One of the problems that it pointed out was that some of the local partnerships were
“struggling to put in place appropriate accommodation quickly enough”,
which had led to delays in people coming out of hospital and perhaps not the correct co-ordination to provide the services that are so desperately required by this vulnerable group of people.
Norman Lamb
I thank the right hon. Lady for her intervention, although it was a bit freaky, because I was about to come on to the National Audit Office report. She is absolutely right in identifying the criticism that it made of progress on this programme.
Let me deal with the numbers involved. As I said, the commitment was to close between 35% and 50% of in-patient learning disability and autism beds and to provide alternative arrangements in the community by March next year. The document, “Building the Right Support”, mentioned getting 2,600 beds down to between 1,300 and 1,700 beds, which is a very significant drop. Hitting the minimum drop that the Government committed to of 35% would involve the closure of 922 beds. Of that total, 531 still need to be closed in what is now a very short space of time.
The latest data, from the end of May, shows that there are still 2,400 people in institutions, 41% of whom are over 50 km away from home. I ask hon. Members to think about what that means. Many of those families are not wealthy, and some people are themselves disabled. If their loved one—their child—is put in an institution a long way from home, it can sometimes be impossible to maintain contact. Just imagine—all of us—what that must mean to people to lose touch with their vulnerable child. It is not acceptable, but it persists today, and according to that latest data from the end of May, the length of stay is still over five years. There has been very little change in the length of stay. Perhaps most troubling of all from that latest data is that the number of children in in-patient beds has more than doubled. For goodness’ sake, this programme is about moving away from institutional care, yet between March 2015 and May 2018, we have doubled the number of children in institutions. This is intolerable and in a little while, I will come back to why that is not necessary if things are done properly.
I find myself in a horrible position of expressing anxiety about closing the rest of those beds by March next year, but it is important for the Minister to note that there is a real fear on the part of families and the organisations that represent them about a big risk in a head-long dash to close beds by the deadline in cases where many people have complex needs. Some people in units that have been earmarked either for closure or reductions in beds, apparently defined as “impacted sites” in the system, will not be going home but will have to be shunted somewhere else in the country. Of course, a move for someone who has very complex needs can be massively destabilising. If this is done in a hurry to meet a target because there has been a failure of the programme to date to prepare community resources, it will be a disaster for the individuals involved. For those able to live in the community who are still in institutional care, there is a massive concern that not enough has been done to develop community services or train the workforce. We have to avoid the risk of discharging people only to readmit them weeks or months later.
I mention the really shocking case of a young lad called Eden. He has been failed throughout his life, from childhood into adulthood. He has been in hospital for more than 10 years. His mother, Deb, is desperate. She constantly fights against the system, which does not listen to her. He is in a hospital in Norfolk, and they live in London. She has long journeys—a 10-hour round trip or something of that sort—to visit him. She is not wealthy. Eventually—I visited Eden in that hospital—she got him home to a facility near their home in west London, but because arrangements had not been made properly by the local authority to have the proper support services in place, within weeks he was back in that institution again. That individual has been horribly failed by the NHS—by the system—and it is wholly unacceptable.
The consequences of the failure to get people out of institutions include, as I said, the loss of contact with family. Care behind closed doors often involves unacceptable practices, hidden from view. I mentioned Fauzia earlier, who was admitted to St Andrew’s hospital in Northampton—she was a child of 15 at the time. Her family asked me to go and visit her. It is an unusual thing for a Minister to do, but I decided to go at the invitation not of the institution, but of the family. I went to see her and she was living in what I would describe as “a cell”. This is a 15-year-old girl. She suffered from the constant use of force—restraint—and she was being put into seclusion in another room that was completely bare, with concrete walls. She had a tiny exercise yard. This girl was in there for over two years. It was really shocking—a total abuse of her human rights. She had no life at all, yet from the day that she was discharged, when we finally got a review undertaken, there has been no more restraint. She went to a brilliant place called Alderwood, also in Northamptonshire. The people who work there have never had to use restraint against her, because they have been trained, crucially—the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) will know about this—in how autism affects the individual, which so often does not happen in big institutions.
I visited Fauzia at Alderwood. She has a very happy life. She is outdoors much of the time, happy and contented—still very complex, but not in the horribly alien environment that she was in in St Andrew’s. St Andrew’s is receiving a fortune in Government money—taxpayers’ money—in many cases to treat people using the wrong model of care, trapping them in this institution. It has invested in a very substantial new unit. It may be smart—I am told that it is—but why are we making this investment in new in-patient facilities when children should not be going into hospital, unless there is an absolutely exceptional circumstance?
I also visited Josh, who I mentioned earlier. He had been in a hospital in Birmingham that had cared for him well, but he was far away from home. He has now made a substantial improvement and is developing brilliantly. He has a life again, and he is happy with his family. It is inspiring to see what people are doing to support individuals in those community settings.
What have the Government done to assess the progress of this programme? The Department of Health commissioned an independent review of transforming care partnerships, allocated £1 million to it and put it out to tender, but I am told that it has now been pulled and will not go ahead. Why? I understand that it might be because NHS England is also, bizarrely, commissioning an independent review, but we have only had provisional results from that. When will we know more? Those provisional results are disturbing. They show that, in quarter 3 of 2017-18, only 35 of the 48 transforming care partnerships had intensive support services to look after adults 24/7 in their own homes across the whole area of the partnership. Those services are required by the Government’s document, and they are critical to ensuring that people can be safe at home, yet only 35 out of 48 partnerships have them in place.
Only 23—less than half—of the partnerships had intensive support services for children and young people, so it is little wonder that we have seen a doubling of the number of children going into institutions. Only 19 had adult community forensics services across the whole area, and only 14 had children and young people’s community forensics services across the area. There is no detail at all yet about what the services that are in place actually consist of. All we have is a tick-box exercise to show whether there is a service in place. As the hon. Member for Ipswich (Sandy Martin) rightly identified, there is so much missing from community support that would enable people to be safely discharged and return home.
The National Audit Office report, to which the right hon. Member for Chesham and Amersham referred, made a pretty damning assessment in 2017. It questioned the credibility of the transforming care partnership plans and highlighted the fact that care and treatment reviews were not taking place as promised. Those reviews are supposed to be carried out for every individual in in-patient care every six months, yet, as of May this year, only 54% had had one in the past six months, and 390 patients—16% of the total—had not had one for more than a year. Why not? If the programme is being properly implemented, with proper national leadership, surely those reviews should happen in every case, every six months.
The NAO made the case that money was not transferring quickly enough from hospitals to the community and that there was still no effective mechanism to guarantee that that would happen. It identified an absence of workforce plans for community provision and found that most transforming care partnerships did not intend to produce such plans until 2019. Well, how the hell are they going to meet the target of this dramatic reduction in beds by March 2019 if they do not produce workforce plans until that time? That is completely the wrong way round.
Dame Cheryl Gillan
I happen to agree with the right hon. Gentleman. Does he expect the Minister to be able to tell us what has happened to the extra £2 billion of investment that the Government have made in social care services since March last year? It seems to me that something is not quite right about the co-ordination in this area, because the money is going in but the outcomes are not coming out at the other end.
Norman Lamb
I agree, and I suspect that the social care system as a whole is under considerable strain. The Government have chosen to produce a Green Paper only on the older people element of social care. They are not looking at the position of younger adults with disability. The right hon. Lady is absolutely right to say that we are not seeing the outcomes that we absolutely need to see.
Importantly, the NAO focused on the proportion of people with learning disabilities who are in paid employment. We need to take a holistic view. This is not just about whether someone is in a hospital bed or in the community. We need to empower people, as far as possible, to live the kind of lives that the rest of us take for granted. The report highlights the fact that only 5.8% of people with a learning disability are in paid employment. However, some local authorities have up to 20% employment rates in that area, which shows what is possible. [Interruption.] Madam Deputy Speaker, I am moving towards the end of my speech. I heard a cough, and I note the point that you are trying to make.
Before I finish, however, I want to highlight the fact that there are good things going on. I want to ask the Minister a number of questions. Some areas of the country do this really well. They include Salford, Hertfordshire, Ealing and Bristol, and there is a brilliant community service in my own county of Norfolk, which is run by an immensely inspiring woman called Melanie Bruce. She previously worked in institutions, but now takes the view that very few children ever need to go into hospital and that, if they do need to do so, it should be for only a very short time. The community service is called Starfish, and I have written to Simon Stevens saying that that model should be applied everywhere. In the past year, among the group of people in the Starfish programme, there has not been a single admission to hospital. That shows what is possible, rather than the doubling of the numbers that we are seeing elsewhere. I also want to mention Shared Lives Plus, a scheme in which someone with a learning disability or with mental ill health goes to live in a family. The families are paid for the support that they give, but the scheme treats the person as a human being and an equal citizen, rather than putting them in an institution. That is what is so important.
I will end by asking the Minister some questions. What will happen after March 2019? Will she commit to an improved successor programme that learns lessons from the last seven years and actually fulfils the promise of the transforming care programme, with a focus on implementation and inspiring effective national leadership? Will she confirm that those other programmes in NHS England, which are vital for people with learning disability, will continue and that the same national focus will be maintained or indeed enhanced? What assurances can she give that this programme of work will continue as an absolute priority beyond March next year?
Given the slow progress to date on closing beds and the stated plan to close 922 beds by March, what evidence does the Minister have that new community support is available to support the safe discharge of those people? Can she guarantee that there will be a close focus on every single case, to avoid the risk of neglect? Will the Government establish a new workforce development fund to ensure that there are enough staff with the skills to deliver the right care in the community?
What actions will the Minister take to guarantee the pooling of money and the shift of resource from hospitals to the community? Will she address the conflict of interest of clinicians making decisions when they are employed by organisations that earn their money from keeping beds occupied? How will the Government ensure that all in-patients receive a care and treatment review every six months, instead of the failure of delivery that we have at the moment? What steps are the Government taking to improve data on in-patient numbers so that we can bring to an end the two unreconciled data sets that we still have, years on from when the NAO complained about this in the first place?
How will the Minister ensure that progress is robustly and independently monitored and scrutinised? When will the independent evaluation be published in full? How do the Government intend to learn from the areas of really good practice to deliver an approach based on early intervention and crisis prevention? Will she ensure that, from here on, children will be central to the Government’s programme? If we can prevent children from going into institutions in the first place, we can change their lives completely. We can rescue them from a life in an institution.
Finally, will the Minister discuss with the Prime Minister the case for a cross-departmental ministerial taskforce to drive progress and show that all parts of Government are doing their bit to meet people’s full range of needs, given the importance not only of where they are but of employment, housing, education and the criminal justice system? This is a story of the awful neglect of people’s human rights, and of people in this country here and now being treated as second-class citizens. This really does have to end, and we owe it to the families sitting in the Public Gallery today and their loved ones to do far better by them in the future.
Dame Cheryl Gillan (Chesham and Amersham) (Con)
Once again, I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this debate, but I regret that more of our colleagues are not in the Chamber for what I consider to be a very important debate.
I hope that the right hon. Gentleman and the House will forgive me if I come at this purely from the angle of autism, but, having the privilege of chairing the all-party group on autism, I tend to refer to it on every occasion, as many of my colleagues know. I have just come from a lunchtime event in the other place with the Baroness Browning, Angela Browning, who entered the House in the same year as I did and who was the original inspiration behind the Autism Act 2009, a private Member’s Bill that I took through the House. She was entertaining a group of people from an organisation called Fixers. I appreciate that we are not allowed prompts in the Chamber, but its report, “Feel Happy on the Spectrum: Young Autistic People Speak Out”, has already left an impression on me. Two very impressive young people, Jenny and Gabriel, talked us through their experiences.
As the right hon. Gentleman talked about employment, I had a look at the recommendations in the report, and of course they include something we would all like to see: more education on autism in the workplace. It contains testimony that I thought would be interesting to read into the record from a young person who has obviously found an employer who is understanding and welcoming of their autism. They wrote:
“Civil Service fast-stream is really good for people with autism. They go out of their way to accommodate your autism in their entrance exams with things like extra time and they don’t discriminate if you disclose”.
That is a positive note on which to start my remarks in a debate that is partly a reflection of the very sad and disturbing stories that came out of Winterbourne View care home. The transforming care programme was developed in response to that atrocious scandal. No one could have failed to be moved by the shocking abuse of adults with learning disabilities and autism in that private hospital, which was supposed to be an assessment and treatment unit—it most certainly was not a treatment unit; it was a maltreatment unit. Following that, the Government committed to moving about 3,000 adults with learning disabilities and autism out of in-patient settings and into community-based support by next April.
Although we have seen a small reduction in the number of people in in-patient settings, about 2,500 people are still in hospital, as the right hon. Gentleman said. Some 10% of those patients are under 18—that number has more than doubled since 2015; 61% have been in hospital for over two years and some, sadly, for over 10 years; and 46% have not had a care treatment review in the past six months, as mandated. As he also told us, and as I also understand from an excellent organisation called Dimensions, which provides personalised social care services to people with learning disabilities and autism, more than 22% of people are placed more than 100 km from home. So although there has been a reduction in the number of people living in hospital and some real success in moving people into community support, too many people are still being admitted or readmitted to hospital, and there remain obstacles to moving some of the original cohort considered under the programme into real homes.
The success of the programme relies on the right support being available in the community to prevent people from being admitted in the first place or to help them move out of hospital. The number of autistic people recorded in in-patient units has increased by over a third in the three years since data collection began in March 2015. That is a phenomenal increase. According to the latest figures, almost 48% of people covered by the transforming care programme are in fact autistic. While some of this increase may be put down to better identification of autism, it still displays a concerning over-reliance on hospitals rather than homes. Put simply, if transforming care does not work for autistic people, I am afraid that it will not work. If the programme is to continue, all mental health staff will require better training on and understanding of autism and the right community support will have to be made available.
It is crucial that we hear from the Minister what plans there are beyond March 2019 to ensure that any progress made is not lost and that there is a focus on areas where better progress needs to be made, specifically in supporting autistic people.
Jim Shannon (Strangford) (DUP)
I am sorry I was not here earlier, but I was in a one-hour Westminster Hall debate. I commend the right hon. Lady for the hard work she does on autism across the United Kingdom. As she will know, Northern Ireland has an autism strategy that leads the United Kingdom. It is similar to the programme in Wales, but we are leading the way. Will she kindly suggest to the Minister that the Government look at the plan in Northern Ireland, along with the one in Wales, as a good way of proceeding?
Dame Cheryl Gillan
Yes, it is very important that we look at what arrangements the devolved countries make for people with autism. Certainly a few years ago, Wales was well in advance with its plans for autism, which I found most commendable, but I think it now needs to revisit and update its plans, because none of these plans must be left to one side; they need to be constantly reviewed and updated.
I am pleased that next year we will have the opportunity to conduct a 10-year review of the Autism Act. I hope the right hon. Gentleman will contribute to the work that many Members are doing on both sides of the House in various areas, from education to employment, healthcare and even the over-representation of people with autism in the criminal justice system, so that we can put down a marker for the Government after 10 years on what progress has been made and how much further we have to go. If the hon. Member for Strangford (Jim Shannon) would be good enough to send me a link to the plans in Northern Ireland, or point me in the right direction, I am sure they will be taken into consideration as we carry out the review.
I am pleased to see the Minister in her place, as she obviously has a lead role, but I think that all relevant Departments need to play their part. I still have a feeling that we need a cross-departmental ministerial taskforce to cover the areas that I have just been highlighting, such as health, education, housing, and justice, all of which we will include in the APPG’s summary and presentation to the Government next year. Let me put down a marker for the Government. I want to know what plans the Minister has for the future of transforming care, whether she will establish that cross-departmental taskforce to lead the process, and what steps she will take to reduce the number of admissions of autistic people and improve the community services that should support them.
I work closely with many autism charities, and in particular with the National Autistic Society. Alongside Mencap and the Challenging Behaviour Foundation, it has been leading research on the experience of families who have been affected by the transforming care programme. It wanted to look into exactly how relatives came to be in mental health hospitals, and what was getting in the way of their being discharged back into the community. I commend to the Minister the report “Transforming Care: our stories”. It contains the very powerful stories of 13 families, and I think that she will find it very useful, if she or her officials have not yet been able to read it.
The report found that, despite the existence of a national programme, five areas needed real focus to make the programme successful. The first is
“Making sure the right services are available in the community”.
I think we have covered that. The second is involving and listening to individual families, and helping them to be heard through advocacy if necessary. The third is improving the quality of in-patient care. The fourth is
“Making plans for discharge and sticking to them”.
The fifth is providing specialist support from trained and understanding staff. For me, that last one is key. When we have met someone with autism, we have met just one person with autism. Everyone is different. Staff really need to understand that, and to be trained to understand people with autism.
Sandy Martin
Does the right hon. Lady agree that one of the most important aspects of support for the families of children and young people with autism is the availability of respite care, to enable them to cope with the very great additional duties that they have?
Dame Cheryl Gillan
Absolutely. I know from my constituency casework—as, I think, will every MP—that providing a safe home and a safe environment for a family member who has autism can be a very intense, demanding and challenging process, and respite care plays an important part in giving family members a breathing space.
The report includes some remarks from someone called Anna, the mother of Catherine, who is autistic and has a learning disability and obsessive-compulsive disorder.
“Anna told us, ‘she’s not getting any treatment, it’s just a holding pen because staff [in the unit] don’t have the right skills, expertise or mindset…Everything is about seclusion, never about trying to prevent incidents happening in the first place.”
That demonstrates to me that there is a lack of training, and that much more emphasis should be put on that.
The report goes on to outline recommendations made from people and organisations at every level, from individual professionals to NHS England and the Government. In particular, it suggests that a cultural shift is needed to ensure that individuals and their families are listened to in a way that can reduce the number of adversarial relationships that sometimes arise. The importance of a good understanding of both autism and learning disabilities, as a comorbidity, should be emphasised more than it is at present.
One of the parents of an autistic man with mental health problems said:
““Stephen just falls between the gaps and no one takes ultimate responsibility for his case… Where is the pressure to get Stephen back into the community?”
That is a cry for help from a father who wants to see his son go out into the community and have the quality of life that everyone deserves to be able to achieve.
The report also highlights a lack of accountability throughout the system, particularly when it comes to meeting the needs of autistic people. At a national level, in NHS England, leadership for autism falls into the gap between established learning disability and mental health teams. The appointment of a new strategy lead for autism in NHS England is considered to be a very positive step, but I need to be reassured that, in the future, NHS England will focus on the needs of autistic people in order to meet the Government’s requirement for a reduction in their health inequality, which is a commitment in the NHS mandate. I hope that the Minister will tell us what steps she will take to ensure that NHS England allocates appropriate resources to the needs of autistic people, and to ensure that the issues set out in “Transforming Care: our stories”—I am going to give her a copy—are addressed.
Autism charities regularly hear that autistic people struggle to find mental health support that meets their needs, and in the worst cases, if this is not available, people hit crisis and are admitted to hospital. Traditional mental health interventions might need changing, for example by using clear, non-metaphorical language or communicating with someone who does not speak. That, again, requires a good understanding of autism.
In 2016 NHS England published its mental health “Five Year Forward View” outlining how it plans to improve mental health services in England. It includes a number of proposals for new care pathways to help people access the right support and, importantly, it proposes a care pathway for autism. Work on designing this pathway is due to start this year, but I have not seen any detail on what it will include. It is vital that it covers the following for children, young people and adults on the autism spectrum: timely access to autism diagnosis, autism training for all mental health staff, and the ability to make reasonable adjustments for mental health treatments so that if autistic people need mental health support, they can get the right help from services. I hope that the Minister will also address how the autism care pathway will be developed and that it will cover diagnosis, access to tailored mental health support and autism training.
Another contributory factor to the number of autistic people in mental health hospitals is the inclusion of autism in the Mental Health Act 1983 definition of mental disorder, meaning that autistic people can be sectioned without a diagnosed mental health problem. The independent review of the Mental Health Act is very important and has been welcomed by the autism charities. They believe it is important to create a legal regime around mental health support that properly meets the needs of autistic people and their families. The status quo fails to do this, and that has resulted in autistic people being inappropriately detained under the Act and far too often subjected to damaging over-medication. The NHS digital data show that autistic people are not benefiting entirely from the NHS England transforming care programme, because the in-patient numbers are failing to meaningfully reduce and in some cases are rising. The review’s interim report has identified this definition of autism as a mental disorder as a key question to be addressed in the final report, and I strongly urge that the review must address the inequality for autistic people at the heart of the Mental Health Act. I hope the Minister addresses that in her closing remarks.
I have spoken for some time, and I hope I have added to the debate initiated by the right hon. Member for North Norfolk, although I appreciate that I have, inevitably, repeated some of the points he made. In conclusion, I go back to something I said earlier about the transforming care programme that I think summarises the situation. Put simply, if transforming care does not work for autistic people, it will not work. We want transforming care to work; we want it to succeed. It has made a start: it is not an all-good start, but it is not an all-bad start. The Minister and the Government have a golden opportunity to turn what is a visionary programme into something that can reflect the success of the care with which we look after people in our community with learning disabilities and autism. I look forward to hearing the Minister’s response.
Helen Hayes (Dulwich and West Norwood) (Lab)
I am grateful to the Backbench Business Committee for allocating time for the debate and to the right hon. Member for North Norfolk (Norman Lamb) for securing it. I am also grateful for his commitment to this issue over many years. It is a pleasure to follow the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan). I am grateful, too, for her deep commitment to, and knowledge of, the subject of autism.
The treatment of residents at Winterbourne View was a national disgrace. That any human being should be subjected to such terrifying physical and emotional abuse in their own home setting is utterly abhorrent, and that those people should be among the most vulnerable and least able to speak out or defend themselves simply defies belief. The way in which we treat our most vulnerable residents is a mark of our civilisation, and Winterbourne View was a failure of the most basic measure of human decency. It was therefore absolutely right that the public outcry that followed Winterbourne View led to a firm commitment from the Government and to the transforming care programme.
However, the transforming care programme has failed to live up to its name. It has not substantially transformed the care and support that many people with autism and/or a learning disability are receiving. There are still far too many people living in hospitals such as Winterbourne View instead of homes. There are still far too many examples of families who have to fight each week to ensure their relatives’ safety and security, and even the basics of care, and too many people are still not receiving the support they need to live healthy, secure and fulfilled lives. We are now eight months away from the end of the transforming care programme and urgent action is needed to deliver a genuine transformation in the quality of care for thousands of people living with learning disability and autism in the UK.
In December 2012, 3,400 people were in NHS-funded learning disability in-patient beds, with around 1,200 in assessment and treatment units. The original Department of Health report following Winterbourne View found that the main reason for referral was the management of a crisis, suggesting that the failure in service provision had often started long before the person was admitted to hospital. The failure often involved a lack of support in other areas of health, social care and education provision, often leading to behaviour and mental health deteriorating over time and then reaching a crisis point. The report’s conclusion suggested six key changes, and I want to restate them because, in the experience of too many of my constituents, those changes have not yet been implemented or become a reality.
The first recommendation was that the information made available by councils, health bodies and care providers should be transparent and of good quality. The second was that community-based mental health services should offer assertive outreach, 24-hour crisis resolution and general support. The third recommendation was that small-scale residential care should be available to those in greatest need. The fourth was that employment or daytime activities should be offered. The fifth was that health and social care commissioners should start to plan from day one of admission to in-patient services for the move back to the community. The final recommendation was that the Care Quality Commission should monitor whether services are meeting essential standards, take enforcement action if a provider is not compliant, and monitor the operation of the Mental Health Act 1983.
Those recommendations bring me to the case of my constituent Matthew Garnett. Matthew’s mother Isabelle is in the Public Gallery today, and I am grateful to the Minister for taking the time to meet me and Isabelle recently. I have spoken of Matthew’s situation in the Chamber several times, but I make no apologies for raising it again today because his case illustrates exactly how little progress has been made in implementing the Department of Health’s original recommendations in response to Winterbourne View.
Matthew is approaching his 18th birthday. He is a tall young man whose absolute passion is football, particularly Liverpool FC. Matthew has autism. I first met Matthew’s mum at the start of 2016 when she came to my surgery following a deterioration in Matthew’s mental health and behaviour at home. Matthew had been admitted to a mental health unit under section. At that time, Matthew’s parents were concerned that the assessment unit that he was in had no specialism in autism and that he had been there for far too long without appropriate clinical support. They had been recommended a hospital in Northampton, St Andrew’s, as a place with the right expertise for Matthew to be able to get well and come home. I supported their battle to get access to a bed for Matthew at St Andrew’s, and we celebrated when he was allocated a bed.
After Matthew had been at St Andrew’s for just a few weeks, his parents came to see me again. They were concerned that Matthew seemed to be taking part in very few activities, that he was losing weight, that he had become more withdrawn and that they had noticed signs of anxiety in his behaviour. They were concerned that there was no discharge plan and that staff seemed reluctant even to talk about one. Matthew’s situation deteriorated rapidly at St Andrew’s. He suffered a broken wrist and bruising. His parents found excrement in his shoes. He lost a catastrophic amount of weight. His parents became gravely concerned that he would die, so we fought again. They found alternative community-based provision not far from the hospital. They contacted Alderwood, which the right hon. Member for North Norfolk has already mentioned, and discovered that it had a place for Matthew, so he moved in.
Matthew is now flourishing. He volunteers at the local football club and in the village where his home is located. He takes part in a wide range of activities—from film nights to canoeing and trips to the seaside—and he is able to play and watch lots of football. Matthew is well and living life to the full. The care and support he is receiving costs considerably less than the £12,000 a week spent by the NHS on a private hospital bed in which his health was deteriorating and from which there was no plan to discharge him.
Norman Lamb
The hon. Lady is making a powerful case. Does she agree that the Care Quality Commission should do far more to challenge how these units often define themselves as specialist units? The care given to Matthew and Fouzia at St Andrew’s in Northampton was very far from specialist; it was inappropriate and it damaged them massively.
Helen Hayes
I thank the right hon. Gentleman for his intervention. I also visited St Andrew’s and, when I returned, I looked at how it was advertising its services and compared that with what I saw. I would go so far as to say that, in any consumer environment, a good case could be made that St Andrew’s was contravening the Trade Descriptions Act 1968 in how it was advertising itself, given the expertise the staff actually had in relation to autism. In my view, that is certainly a matter for the CQC.
Matthew’s case is important, because it demonstrates clearly that all the failures that led to Winterbourne View are still possible. Matthew’s family did not receive the support they needed for Matthew at any stage prior to his admission to hospital. It was that lack of support that led to his behaviour deteriorating in the first place. There was no assertive outreach or 24-hour crisis resolution support; there was just the local police force when things got too much. That was four years after the Department of Health report on Winterbourne View.
The small-scale residential setting in which Matthew is now living is brilliant, but there is far too little of that type of provision and none of it close to home. Matthew’s parents live in my south London constituency, and Matthew is currently living in Northamptonshire. I met the providers of his care at Alderwood, and they told me that what they provide is easily scalable. It is about training staff in effective communication techniques, paying staff properly and providing a good career structure so that providers can retain a stable team, and being able to access funding for the places they provide. It is not rocket science. It just needs a proper commitment to invest in settings that deliver the best possible care.
At St Andrew’s, Matthew was not participating in any meaningful activities on a day-to-day basis; the emphasis was on managing and containing his behaviour through medication rather than engaging him in recovery. In his new home at Alderwood, Matthew is on very low levels of medication. He takes part in meaningful activities that add value to his life and make a real contribution to his community on a daily basis.
There was no discharge planning while Matthew was at St Andrew’s. In fact, his parents were told they were being far too optimistic even to raise discharge with his clinicians. St Andrew’s is a private hospital that is largely funded by the NHS. The Government must look seriously and urgently at the perverse incentives at work in a system that is so reliant on the private sector because of the lack of NHS provision. Private hospitals currently have no incentive to discharge when they are being paid a rate of £12,000 a week by the NHS.
There was very little scrutiny of the effectiveness of the treatment Matthew was receiving in return for such large amounts of NHS funding, and no regard was given to the concerns of his family, who had to fight to get a second opinion, which was itself dismissed by staff at St Andrew’s.
Transforming care can never be fully implemented while such perverse incentives apply and while profit-making organisations are relied on to substitute for a lack of proper funding for NHS and social care provision. Private hospitals too often remain holding pens for patients, rather than the secure and supported homes that they need. No learning disabled or autistic person should be living in a hospital for the long term. We need homes not hospitals.
Too many of my constituents whose family members, including children, have a learning disability and/or autism still tell me that when they express concerns about the care their loved one is receiving, their views are not taken seriously and they have to battle to have their concerns addressed. Again, we cannot begin to see a system that delivers the care that vulnerable people need without proper processes for accountability through which family members can raise concerns.
I am concerned about the Government’s tracking of the progress of the implementation of transforming care. In response to a written question tabled by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), the Minister for Care highlighted, in her answer on 4 June, the plan to decommission 900 beds in mental health hospitals. Assuring transformation data provides figures on the number of people with learning disabilities and/or autism admitted and discharged. In the 2017-18 period, there were 330 more discharges than admissions, but it should be noted that that applies not to individual people, but to the individual instance of an admission or discharge, so there is no way to tell to what extent some people are caught in a revolving door. The dataset does not directly identify whether an admission is from the community or a transfer from another hospital setting. Similarly, the data does not directly identify whether the end of an episode of care is a discharge to the community or a transfer to another hospital setting. Thus, although 330 discharges might sound like progress, the Department of Health and Social Care has not so far provided figures for individual cases. In the light of the target of closing 900 beds, this cannot be seen in any way as a victory for either the Government or, more importantly, those vulnerable individuals whom transforming care is intended to safeguard.
I am also concerned that the Government's focus for the final few months of transforming care is far too much on hospital bed closures. Bed closures should be a consequence of the provision of properly funded, high-quality community settings, and the by-product of achieving better outcomes for people currently in long-term hospital provision. Instead, the Government continually refer to bed closures as the headline target and measure for transforming care. Without high-quality, properly resourced alternative provision, bed closures, in themselves, will simply result in further pressures on the NHS, as people who are discharged without sufficient support will end up readmitted, via A&E, to a situation where fewer in-patient beds are available. It is almost impossible to find any meaningful data on the funding and level of community provision for people with autism and learning disabilities, and I urge the Government to switch their focus from bed closures to community provision for the final eight months of transforming care in its current form.
I also want to highlight the regulatory gap that still exists. A constituent contacted me recently on behalf of her brother, who is an adult with autism living in a supported housing provision, paid for through his personal budget. He needs a high level of support and his personal budget is considerable, but his sister has raised concerns about his treatment in the community provision over a period of months. The provision involves a high level of care, but is technically supported housing, which means that it is not regulated by the CQC. The recent report by the Housing, Communities and Local Government Committee and the Work and Pensions Committee on supported housing highlighted this gap in regulation and called on the Government to take action to address it, and I want to do so again today. There is great urgency that we make progress on transforming care, but discharging vulnerable people from hospital into settings that are not regulated creates a risk that they will be failed yet again.
Finally, I wish to highlight the wider gap in awareness and support, particularly in the area of autism. In schools and in the NHS, the experience of far too many of my constituents is that the support needed so that autistic people, particularly children, are able to thrive is simply not there. This continued failure to properly equip teachers and healthcare professionals to understand autism and the support that their students and patients need has long-term consequences through an increased level of care that people need later in life and an increased likelihood of crisis. I urge the Minister to work with her colleagues, particularly those in the Department for Education, to accelerate and bring forward training in autism for teachers, and not just new teachers coming through the education system now but existing teachers who are working day in, day out, without the knowledge that they need to serve autistic students well.
There is no way around the fact that the transforming care programme has failed significantly to date. We need a renewed focus on care and support for people with learning disabilities and autism. In every community throughout the country they should be living well, close to family and friends and properly supported, not locked away receiving over-medicalised care, with no one monitoring how effective that care is or what the public purse receives by way of high-quality provision in return for the expenditure. We need homes not hospitals, and we need everybody living with autism and a learning disability in this country to be able to live life to the full, with dignity, in community settings that are close to home.
Ronnie Cowan (Inverclyde) (SNP)
Thank you very much, Madam Deputy Speaker; it was like Hobson’s choice there, but I eventually got to my feet.
I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this important debate. I echo the sentiments of the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) about there being lamentably few Members present to take part; it makes my job of summarising the debate a lot easier, but I am sure that all 650 MPs have constituency cases relating to the issues we are discussing.
The right hon. Member for North Norfolk correctly pointed out in his opening remarks that the input from charitable organisations in the sector is absolutely paramount. Where would we be without the organisations that turn out in numbers to raise money for and give help and support to people in care throughout our society? Their commitment and support of the caring community is quite extraordinary. He also brought a humane touch to the debate, detailing some distressing individual cases, and highlighted the risk that individuals can be trapped in the very system that is supposed to be there to aid them.
The right hon. Gentleman also encouraged whistle- blowers, saying that they should be listened to and not shut down. He offered strong support for the nine principles on getting the right support, describing them as positive and empowering, but unfortunately had to lament the fact that they have not actually been implemented yet. He spoke passionately about keeping children out of institutions and hospitals wherever possible and caring for them in our communities.
Once again, the right hon. Member for Chesham and Amersham educated the House on matters regarding autism, and she has no need to apologise for that. Several organisations in Inverclyde, my constituency, support children and young adults across the spectrum, and at least two of them were started because parents could not find the help and support for their loved ones that they were looking for. They got up and did it themselves. The right hon. Lady expressed concern that there is still an overriding reliance on hospital care and spoke about the need for a cross-departmental taskforce, because the issues cover a range of Departments. She also highlighted how inappropriate it is to detain people with autism under the Mental Health Act 1983.
The hon. Member for Dulwich and West Norwood (Helen Hayes) was highly critical of the transforming care programme and expressed concerns that many people with learning disabilities and autism are not properly supported. She forensically analysed the case of Matthew Garnett, thereby identifying the failings in the system. That was a timely reminder that behind the statistics are individuals and their families. Thankfully, Matthew is now flourishing at Alderwood, and it is notable that the care there costs less than institutional care.
I have absolutely no desire whatsoever to turn this speech into a party political broadcast but, as the hon. Member for Strangford (Jim Shannon) said, there are examples out there from throughout the United Kingdom that can be learned from, and I hope that the UK Government will look to improve the care that they provide.
I am proud to be a member of the Scottish National party. In our 2016 manifesto, we made the following pledge:
“Our services will be designed to support people living longer, often with complex conditions. Our aim is to deliver care as close to home as possible. We will build on health and social care integration by ensuring that our NHS develops as a Community Health Service.”
The Scottish Government are continuing to work on and review our strategy, and that is key: we have to work on and review our strategies; we cannot sit back on our laurels at any point and decide that we have this matter under control. It is about learning and re-learning as we go forward.
The Keys to Life, published in 2013, is a 10-year strategy, with a focus on health issues, to improve the quality of life for people with learning disabilities. With £7.7 million of investment, we are improving learning disability services in Scotland. The strategy’s implementation plan sets out four strategic outcomes: a healthy life; choice and control; independence; and active citizenship. The delivery of the strategy is being taken forward with a wide range of partners in the statutory and third sectors, and is focused on phased priorities targeted at each of the four outcomes. The Scottish Government have been working since 2017 on reviewing progress and identifying priorities for the next phase of implementation. Reducing the stark health inequalities that people with learning disabilities face is a key priority within the strategy. Without good health, people with learning disabilities are unable to contribute to, or participate in, their communities.
Ultimately, sometimes these things do come down to money. There will never be a time when we look at the healthcare that we are provided with and say, “Well, that’s good enough.” We always want better for our friends, our family and our loved ones. The Scottish Government are committed to the twin approach of investment and reform in our national health and care services. In 2018-19, the health resource budget will increase by more than £400 million to £13.1 billion— £360 million more than the inflation-only increases since 2016-17. By the end of the current Holyrood term, we will have increased the health resource budget by £2 billion.
I have grave concern with regard to the people providing these services. Although we all seek to improve care across our communities, Brexit and the UK Government’s hesitation in guaranteeing EU national rights for those in the UK means that we face a massive threat to the NHS workforce. As a result, we face losing valued and respected workers in the care sector and beyond. The free movement of people and the mutual recognition of qualifications allow skilled and experienced health professionals from the EU and the European economic area to work in our NHS. Without that, our ability to continue to provide high-quality health and social care services for the people of Scotland will suffer, particularly for the people in Scotland’s remote and rural communities, and that will be echoed throughout the United Kingdom.
I always take great pleasure in engaging in the local carers’ week in my community. It has happened in the past three years that I have been an MP. It is a learning process. Attending such events means that we can meet some of the best people in our communities. I learn from them on an ongoing basis, and I look forward to doing so. I ask this Government to take a serious long-term look at how to fund the service, where to get the people from and how to roll out the correct and appropriate training to help some of the most vulnerable people in our society.
Paula Sherriff (Dewsbury) (Lab)
Let me start by congratulating and thanking the right hon. Member for North Norfolk (Norman Lamb) for securing this debate and the Backbench Business Committee for granting the time on this very important issue. As the motion today notes, the transforming care programme was created with the stated intention of improving quality of care and quality of life for children and adults with a learning disability or autism who display challenging behaviours.
As we have heard from Members today, people with learning disabilities too often suffer from neglect, abuse, poor care and even premature death. Unfortunately, as the right hon. Gentleman set out, the transforming care programme simply is not delivering the promised improvements in their lives. Instead, too many are wrongly admitted to assessment and treatment units, in which they remain trapped, rather than living independently where they can be with their families and friends and, of course, the support network that comes with them. The community services that should be part of that support network are themselves underfunded and simply do not have the capacity that is needed. As it stands, the transforming care programme is unlikely even to come close to the ambitions rightly set out in the “Building the Right Support” strategy by March 2019, when it is due to conclude. Let us take, for example, the target to decommission 900 learning disability beds in conventional hospitals. The Minister admitted just this week, in an answer to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), that the Government have not even come close to meeting the halfway point to that target.
Seven years after Winterbourne View and more than two years on from the start of “Building the Right Support” strategy, there has been a startling lack of progress in key areas. There has been little reduction in the number of people in in-patient units and in the number of admissions. Indeed, the most recent data, from May 2018, shows that there are 2,400 people with a learning disability and/or autism in in-patient units, which is an increase since the last monthly data was released. It should be of great concern that the number of children in in-patient units has also increased. The latest NHS Digital data shows there are 250 children in these units, more than double the number of children—110—who were reported as being in in-patient units in March 2015. There are 465 young people aged between 18 and 24 in in-patient units, and this age group makes up a significant proportion of the whole transforming care in-patient cohort. This data suggests that the transition from child to adult services is the point at which people with learning disabilities are particularly at risk of admission, as Dame Christine Lenehan pointed out in her review last year.
As we have already heard this afternoon, the average length of stay in in-patient units has stayed largely the same, at approximately 5.4 years. Similarly, in answers to my hon. Friends Ministers have admitted that discharges into the community actually went down in the last year, and quite significantly so for those with learning disabilities. It is clear that transforming care is not delivering the promised outcomes at this time. Unfortunately, this failure fits the wider picture of neglect for people with learning disabilities and the services on which they rely.
The recent learning disabilities mortality review came seven years after Winterbourne View and nearly three years since the death of Connor Sparrowhawk, which in part prompted it. Its findings show the scant regard with which people with learning disabilities are treated.
Mark Tami (Alyn and Deeside) (Lab)
The fact that the risk of people with learning disabilities dying before the age of 50 is 58 times higher than the rest of the population is scandalous in itself.
Paula Sherriff
My hon. Friend makes a very valid point. Everybody here this afternoon could not fail to be shocked and horrified by the case outlined by my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) regarding her young constituent, Matthew, and the quality of care that he received on an in-patient unit.
Some 1,311 cases were passed for review between July 2016 and November 2017, but only 103—that is 8%—have finished so far. The report cited a lack of local capacity to review cases, inadequate training for people completing mortality reviews and insufficient staff capacity to complete a mortality review. Will the Minister update the House on when the remaining cases will be finalised and what the Department is doing to ensure that these barriers are tackled? In 13% of cases reviewed, the person’s health had been adversely affected by delays in care or treatment, gaps in service provision, organisational dysfunction, neglect or abuse.
Just how many more deaths must occur before the Government tackle the unjust treatment of people with learning disabilities? Dr Ryan, Connor Sparrowhawk’s mother, was also damning in her assessment. She said that too many agencies had shown “systematic disregard” for some people with learning disabilities and she felt that certain people “simply don’t count” in the eyes of the authorities. We must do better, and we must show that every single life matters. But our fear is that, without some fundamental changes in the Government’s approach, the problem is set to get worse, not better.
Take the NHS workforce, for example. The latest figures from Health Education England show that the number of learning disability nurses working in the NHS has gone down by a third over five years. HEE data from March 2017 shows that learning disability nursing had the highest proportion of vacancies, at 16.3%, compared with all other fields of nursing. Will the Minister tell us how the Government plan to tackle this?
It is bad enough that the failures of transforming care have left too many people inappropriately in hospital settings, but the lack of trained staff when they are there makes that failure all the more stark.
Dame Cheryl Gillan
I am with the hon. Lady in her criticisms, and in wanting some constructive developments and improvements, but I would not want her to stay at the Dispatch Box and paint a picture that is completely negative. There are some inspirational stories about people coming out of these settings and institutions after being dealt with by a caring team, who have put a particular emphasis on communications and turned lives around. Some of the case studies published by Dimensions show that that really is one of the ways forward, and that is what we should seek. It is possible to take an aggressive individual out of an in-patient setting and give them the quality of life and meaning to life that we would all want and expect.
Paula Sherriff
I thank the right hon. Lady for her intervention. I absolutely agree. There are some incredible examples around the country of excellent work that is being done, but that makes it all the more important that we share that good practice so that it is disseminated more widely. Particularly on this very special day of the NHS’s 70th anniversary, I pay tribute to all those people who are involved in being innovative, and not just doing exactly what they have to and no more.
It is bad enough that the failure of transforming care has left too many people inappropriately in hospital settings, but the lack of trained staff when they are there makes that failure all the more stark. It is also a matter of great concern that the Government are not including people with learning disabilities, or working-age people with disabilities, in the social care Green Paper, but are instead having a “parallel workstream”. Once again, the care needs of people with learning disabilities seem to have been put in second place.
If this catalogue of failure were not enough, the issue around sleep-ins threatens to make it even worse. It has been woefully mishandled thus far. Having admitted that earlier guidance on pay was misleading both for providers and commissioners, Ministers are now playing for time rather than finding a solution, ignoring warnings from care providers, charities, and the Local Government Association. The consequences for people with learning disabilities and autism could be disastrous. Some 70% of learning disability providers have warned that they will no longer be viable. It could drastically reduce the number of providers available to provide community services. For people with learning disabilities, autism or challenging behaviour who are personal budget-holders in receipt of funding from local authorities to pay care staff themselves, this crisis could lead to difficulty in paying their personal back-pay bill and, in turn, having to reduce their level of support to cover costs.
Let me be clear, as a former healthcare worker and trade unionist, that the care workers affected should receive historic back pay for national minimum wage sleep-in shifts rather than paying the price for underfunding of social care. Given the state of the sector, without imminent investment we run the risk of a systemic failure that could leave thousands of people without the care that they desperately need. That is why we continue to call for the Government to reveal the full scale of financial liability and to increase funding for social care so that care providers can continue to deliver services to vulnerable people in need of care and workers can receive the pay to which they are entitled.
A Labour Government would provide care workers with paid travel time, access to training, and an option to choose regular hours. That, of course, comes in the context of proper investment, increasing social care budgets by £8 billion over the next Parliament, including an additional £1 billion for the first year to ease the Tory social care crisis. We have made our alternative crystal clear. Our policy will include all people with care needs, with the aim of ensuring that they can live independently and, most crucially, with dignity.
The question that the Minister must now answer is whether and how this Government can work towards that goal. Will there be a successor programme to transforming care? How will the shift to early intervention, prevention and community care be prioritised and properly resourced, given that what we have now is clearly not sufficient? In the end, this is a question of how we value human lives.
The Minister for Care (Caroline Dinenage)
I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this really important debate. I thank him for his continuing hard work and commitment, both within this place and outside, in championing the interests of people with a learning disability. As a Minister in the coalition, he was a driving force on this issue, particularly following the Winterbourne View scandal.
On a personal note, I also thank the right hon. Gentleman for the work that he did in commissioning an investigation into the tragedies at Gosport War Memorial Hospital. As a Health Minister, I have had to recuse myself from speaking about that because I am also the local Member of Parliament, but I want to put on record my gratitude to him for the work that he did. In many ways, there are parallels with what we are talking about today: families whose voices have not been heard; families who do not necessarily feel that they have been listened to. We all have to look at how we can learn the lessons from cases like Winterbourne View and how we stop other families suffering in the same way.
I thank other Members from across the House for participating in the debate. I am so sorry that there are not more of them, because this is a really important issue. I have met many of the Members here today to discuss their concerns. I will always be available to do that at another point if they would wish me to do so. They have asked me lots of questions. I will do my best to answer as many of them as I can in the time that you have permitted me, Madam Deputy Speaker. If I fail to do that, I will write to the Members concerned.
Madam Deputy Speaker (Dame Eleanor Laing)
For the sake of clarity, I should say to the Minister that I cannot limit her time, nor would I try to. In the current circumstances, she actually has an enormous amount of time, but I know that she will not try the patience of the House. I agree with her that a great many important questions have been raised, and I am sure she will wish, assiduously as ever, to answer them all. I will not interfere with the time that it takes her to do so.
Caroline Dinenage
That truly is good news, Madam Deputy Speaker. I will try not to go on, as my husband tells me I have a propensity to do. I will answer as many questions as I can. I may have misinterpreted some of them, and I may not be able to read the copious notes I have written, but I will write to Members if I do not get to their points.
We can all agree that people with a learning disability and/or autism have the right to the same opportunities as everyone else to live satisfying and valued lives and to be treated with dignity and respect; that goes for their families, too. As good and as necessary as in-patient care can be—we have heard examples of how it has changed people’s lives—we know that people with a learning disability should have the opportunity to live at home, to develop and maintain relationships and to get the support they need to live healthy, safe and rewarding lives in their own local communities.
The mandate to NHS England—the list of “must dos” for the NHS—set by the Government every year includes the following clear objective:
“We expect NHS England to strive to reduce the health gap between people with mental health problems, learning disabilities and autism and the population as a whole, and support them to live full, healthy and independent lives.”
The transforming care programme is at the heart of that commitment. It is a partnership across local government and the NHS to transform the care, support and treatment available to enable people with a learning disability, autism or both to lead the lives of their choosing with and in their local community.
Through the national transformation plan, “Building the Right Support”, we have an ambitious and comprehensive plan to bring councils and clinical commissioning groups together in transforming care partnerships to plan and provide services across their areas; to use funding in new ways, including through pooling budgets, which I will talk about in a moment; and to ensure that people and their families have a clear idea of what they should expect from those agencies through the national service model. Key to all that has been building the right support in the community so that people do not need to go to hospital in the first place and those who are already there can move out.
Members have raised concerns today about the progress made under the transforming care programme. I can reassure them that progress continues to be made, but I will commit to take forward most seriously all the concerns raised today. The number of in-patients continues to decrease, and it is down to 2,400. NHS England has been clear that it is fully committed to meeting the ambition to reduce the number of in-patients by at least 35% by next March. It has talked about the intention to close around 900 learning disability beds. I entirely take the point made by the hon. Member for Dulwich and West Norwood (Helen Hayes) that focusing on the number of beds misses the point, and that it must be about ensuring that community provision and support are available to enable people to make that move, rather than the fact that beds are closing.
Norman Lamb
I appreciate the Minister being willing to write to us after the debate with anything she is not able to cover. Does she understand the concern that a headlong rush to meet the target because we are getting close to the deadline without proper arrangements in place could be disastrous for individuals? If the target is not achieved, that is better than a complete failure, with readmissions after failed discharges. The focus on detail in every case is critical.
Caroline Dinenage
I completely agree with the right hon. Gentleman. I do not want to have concerns about safe discharge, and that is why we look at that in care and treatment reviews. More than 7,000 of those reviews have been carried out, to reduce the time that people stay in hospital and improve the quality of care they receive while in hospital. Essentially, they are a step towards ensuring that community provision is available before people are allowed to leave hospital. The latest data show that the proportion of in-patients reported as never having had a care and treatment review was 8%, down from 47% in January 2016.
Caroline Dinenage
Absolutely, it should be 0%. As the right hon. Gentleman knows, that is what we are working towards.
Dame Cheryl Gillan
I appreciate that this is quite a complex area, but I have looked at some of the transition times. Dimensions—I mentioned it earlier—has estimated that its average transition time per patient is 12.5 months, which I believe is below the usual transition time. Does the Minister feel that this length of time will inhibit her from reaching her targets in 2019? Is there anything we can do to reduce the time, or does that length of time need to be taken?
Caroline Dinenage
My right hon. Friend makes an excellent point. NHS England says it is confident of hitting these targets and it will be doing all it can to ensure that that happens, but that must not be at the cost of treating people with the right levels of care or of having the right provision in place. This is also about keeping people out of the hospital setting in the first place.
The number of people receiving community or pre-admission care, education and treatment reviews also continues to improve, with 42% more undertaken in 2017-18 than in the previous year, of which 79% led to a decision not to admit somebody to in-patient care.
Dame Cheryl Gillan
I do not know whether the Minister will accept this, but I would have thought that everybody involved in this debate actually preferred us not to aim for a target that might not be reachable, because it is the quality of the outcomes and successful transitions that we are looking for. Will she be flexible enough to say, on looking at this again, that if we cannot achieve the targets by 2019, she will allow the timeframe to drop out of the picture? It is more important to have a successful transition, with the right length of time for somebody to transition, than to hit what might be an unattainable target.
Caroline Dinenage
I agree with my right hon. Friend that there is absolutely no point in having arbitrary targets that do not actually deliver the quality we are aiming for. As we all know from political history, targets for the sake of it have not always necessarily worked out in the way intended.
It is worth emphasising that this is a really special programme for people with very complex needs who require a very particular type of support. They also need to have their care reviewed and to have a bespoke package put in place, tailored to their needs, to allow them to live in the community. There is no one single intervention and no template for what care is needed because every person is different.
Caroline Dinenage
If I may make a little progress, I will definitely answer the right hon. Gentleman’s questions a bit later.
Care must be personalised, and it must be enduring. This can never be a case of rolling out a particular model of care across the country or seen as kicking off some kind of universal service.
To further accelerate discharge and the community service necessary to provide it, NHS England has transferred £50 million to clinical commissioning groups that are closing hospital beds so that they can invest in community alternatives. In addition, between 2015 and the end of the programme, NHS England will have invested over £50 million in transformation funding to support transforming care partnerships in putting in place the critical components of community support. This support includes community forensic teams, crisis prevention teams and teams focused on supporting children in the community.
Additionally, the Department of Health and Social Care has provided capital grants of over £23 million, which has been spent on housing to support people to return to live in the community or to prevent an admission to hospital. NHS England has a pipeline of further investments that it plans to deliver over the next year to support housing projects, to accelerate bed decommissioning and discharges and, most specifically and importantly, to develop community teams.
Members have expressed concern that once the transforming care programme ends in March 2019, action to support those with a learning disability and the most complex needs will also end, but I stress emphatically that that is not the case. NHS organisations and local authorities have come together to build on existing practice, and they have engaged with families and organisations to develop innovative plans to suit their areas. That must not stop. We are closing those beds permanently, and ensuring good-quality community provision is more important than ever. We should be crystal clear that the principles of building the right support will endure beyond March 2019. The philosophy is to change the way that we support people with learning disabilities for good.
Caroline Dinenage
Perhaps I can make a bit of progress and then I will come back to the right hon. Gentleman. We are not moving people from a hospital, where their outcomes are poor, into the community, just for them to be replaced in hospital by others. The transformation must be permanent, and we must consider what central support local areas need to ensure that that happens.
Hon. Members have been tempting me to talk about what will happen beyond March 2019, and to give a commitment on how the future of transforming care will look beyond that point. All delivery partners share a commitment to support the progress made by local partnerships to transform the choices available for local people, and to ensure that they are supported to lead fuller and more independent lives in their local communities. Plans are currently under way, and we will provide hon. Members with further updates once they have been finalised.
Transforming care is not the only area in which we seek to support those with a learning disability, and we are driving work to improve health and care outcomes across the board. It is an uncomfortable truth that mortality rates for people with a learning disability can be a measure of how well their care needs are being met. Following the publication of the report “Confidential Inquiry into premature deaths of people with learning disabilities” in 2013, we know that those with a learning disability die much earlier than those without, and too often for completely avoidable reasons. That is unforgivable.
In order to tackle that issue, in 2015 we established the learning disabilities mortality review programme, which requires consistent, local scrutiny across England into the deaths of anyone with a learning disability, so that action can be taken based on those findings. Like me, hon. Members will have been deeply concerned by the recent report from the University of Bristol, which leads that programme. The report highlights the persistence of inequalities faced by people with learning disabilities in their health and care. People with learning disabilities are still dying prematurely, and I was particularly alarmed and distressed to note that neglect, abuse, delays in treatment, and gaps in service provision played a part in one in eight of the deaths reviewed, which is unacceptable. The situation described in the report must change, and the Government will soon respond to its national recommendations in full. I am pleased, however, that we are not waiting for that publication to ensure that action is taken, and significant remedial actions are already under way.
I agree with the right hon. Gentleman that as well as implementation we must embed change and ensure that we never revert back—that is key and something I am determined to focus on. We need a relentless focus on improvement, and I am convinced that training is a key part of that. Local commissioners must use that learning and take appropriate remedial action in their own areas.
The NHS improvement learning disability standards published in June specify that an NHS trust should measure the service it provides against clearly defined standards, so as to identify improvements. We will collect information on every trust centrally, to monitor how well the needs of people with learning disabilities are being met.
Hon. Members mentioned workforce and training, and on 9 May we announced a £10 million fund for incentives for postgraduate students to go on to work in the fields of mental health and learning disabilities, as well as for those who go on to work in community nursing roles. We are considering the most effective way to implement an incentive scheme. Our response to the LeDeR report will address its clear recommendations on workforce training.
The right hon. Gentleman spoke about how we improve data. Clearly, with monthly data published on progress we are aiming for transparency. NHS Digital is working with the transforming care partnerships to make sure that we have high-quality data. The aim is for the mental health services dataset to be the main dataset in the future.
I was pleased that Members spoke with positivity about some of the outcomes for their constituents, albeit in some cases way too late. I am very grateful to my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) for talking about some of the transformational results of the work so far. We clearly need to see more of it. The right hon. Member for North Norfolk talked about what an incredible difference the Shared Lives scheme can make. My self-appointed best friend, an adult from my constituency with learning disabilities who sadly passed away last year, lived in a Shared Lives home. I saw what an incredible relationship she had with the family she lived with.
Norman Lamb
I am very grateful to the Minister for giving way. On that specific point, she will probably be aware that the development of Shared Lives is quite variable around the country. There are some regions where it has developed quite well and other regions where there is virtually nothing. The Government could give more resource to expand the programme, because that is the way that we really change lives, getting people out of institutions and giving them a fulfilling life.
Caroline Dinenage
I am very glad the right hon. Gentleman said that because as part of the Department of Health and Social Care legacy scheme we are providing £70,000 in this year for that sort of intermediate and reablement provision which Share Lives would come under. We should definitely be investing more in that.
I take very seriously the right hon. Gentleman’s point on conflicts of interest. We have to look at that very carefully, because it might imply that any clinician would be conflicted in making a clinical decision because they are employed by a trust. Providers are monitored by the CQC and doctors are of course subject to extremely rigorous professional registration, but I take what he says very seriously and I will look more closely at his concerns. I am very happy to meet him to discuss this issue further if he would like me to do so.
The right hon. Gentleman spoke about pooling resources. There are now formal mechanisms for that to take place, such as section 75 and the ways in which CCGs and local authorities can work together. That is the point of having transforming care partnerships’ commissioners working together.
The right hon. Gentleman spoke about the exclusion of families from decisions. That really upsets me and it really should not happen. There are legal duties, under the Mental Capacity Act 2005 and the Mental Health Act 2007, to have independent mental health advocates. I would be very keen to speak to him further about what more we can do to make sure that the legislation is having the desired effect.
My right hon. Friend the Member for Chesham and Amersham knows I am a massive fan of hers. She has probably done more to further the cause of individuals with autism and their families than anybody else in the history of this building. She spoke with great knowledge about autism and was absolutely right to point out that transforming care is not only about learning disabilities but people with autism. In Think Autism, the adult autism strategy, we set a programme of action across Government to support autistic people to lead fulfilling and independent lives where possible. We have recently refreshed the governance arrangements that will achieve greater traction and delivery of the required outcomes, better supporting autistic people to live healthy independent lives and participate in their local communities.
My right hon. Friend spoke about autism care pathways. NHS England is developing a framework of adult community mental health services which will include care for adults with comorbid neurodevelopmental disorders and/or learning disabilities, rather than the pathways planned and set out in the “Five Year Forward View” implementation plan. NHS England’s care pathway programme has evolved to take account of the current operational context and expert service user advice. The pathway is linear about discrete episodes of care, so is more appropriate for specific interventions undertaken by specialist teams.
My right hon. Friend spoke about the barriers that autistic people face in accessing mental health services. Trusts should already be ensuring that services are accessible to people with autism and that they have made reasonable adjustments to care pathways to ensure that people with learning disabilities and autism can access the highly personalised care and achieve the equality of outcome that we all want.
The hon. Member for Dulwich and West Norwood spoke about her constituent, Matthew Garnett. It was a great pleasure to meet the hon. Lady and Matthew’s mum, Isabelle, recently. I was very shocked to hear of Matthew’s experience and deeply upset to see the pictures of him at his lowest ebb, when he was suffering from the neglect that she spoke of. It was very distressing. I am pleased that the NHS is learning from this. The Marsh review into Matthew’s care has helped to shape a much more focused approach to the needs of children and young people who are at risk of slipping into the sort of crisis that she mentioned. The operational delivery group allows stakeholders, including young people, to shape policy.
Helen Hayes
The right hon. Member for North Norfolk (Norman Lamb) raised the issue of St Andrew’s in Northampton having been able to expand so significantly with the benefit of NHS funding—I cannot remember the exact percentage, but the percentage of funding that comes from the NHS for St Andrew’s is up in the eighties and nineties. Does she agree that this is not the right model and will she commit to looking at limiting the further expansion of private in-patient beds, when they are not what is needed for treating young people with autism and learning disability?
Caroline Dinenage
We can certainly look at what the hon. Lady suggests. I am pleased that the operational delivery group, which I just mentioned, allows stakeholders to shape policy and it is really good news that Isabelle Garnett, Matthew’s mum, is a major contributor to this and liaises with NHS England directly on its programme around children either in hospital or at risk of being admitted.
The right hon. Member for North Norfolk asked why the evaluation was cancelled. As he knows, an evaluation sponsored by NHS England is already under way, and the Department, having invited bids for its evaluation, was not satisfied that the proposals received were what was needed. That does not mean that we are not absolutely determined to critically review progress, particularly working with stakeholders and users.
The right hon. Gentleman spoke about the “No voice unheard, no right ignored” Green Paper. Although I am always ready to bow to his incredible knowledge in this field, it is not entirely true to say that the Green Paper went unheeded. Some of the recommendations were overtaken by changes in Government policy, and indeed, in Governments, but we have taken forward work such as the named social worker pilot and a review of the Mental Health Act. We have asked Professor Sir Simon Wessely, the chair of the independent review, to listen to people with direct experience of the Mental Health Act and this, of course, includes autistic people and their carers. He published his interim report to update the Government on his progress, which sets out specific issues that we must explore to look at how we can improve the scope of the Act.
The hon. Member for Dulwich and West Norwood also spoke about training for teachers in autism. The Department for Education has funded training and support for teachers through the Autism Education Trust. That is in early years, schools and further education, and so far, 175,000 staff have been trained.
Dame Cheryl Gillan
Does my hon. Friend also welcome the fact that from September this year in initial teacher training, the possibility of having a module on autism will now be included? It is something that we worked very hard for and the Department for Education responded. This is about not just the historical training, which is so important, but the future training that is coming on-stream from September this year.
Caroline Dinenage
My right hon. Friend is absolutely right to raise that, and I am sure that its introduction is in no small part down to her incredible work.
Society has failed people with learning disabilities for too many years. Our aim is to put things right. People are at the heart of the transforming care delivery programme. The priority is to provide safe, high-quality care that is appropriate for everyone. We will continue to work with our partners to ensure that people with learning disabilities have the opportunity to live as full and independent lives as possible.
Norman Lamb
I think I can safely say that the debate this afternoon has reflected quality rather than quantity. I am not referring to my own contribution, of course. We have focused on an important issue, and I am grateful that the Minister has treated it with the seriousness it deserves. I want quickly to highlight the key things that I think she needs to focus on, and I would be delighted to meet her to discuss them, perhaps together with the key organisations that I referred to at the start.
The Minister did not particularly focus on children in her response. If we are to have a system that works in a sustainable way in the long term, keeping children out of institutions will be key to solving the problem, particularly given that the numbers have doubled in the past few years and that we are going in the wrong direction. I particularly commend to her the brilliantly led Starfish programme in Norfolk as an exemplar of what can be done to keep people out of institutions.
On workforce training, I was pleased to hear about the money—£10 million, I think—for postgrads, but we also need training for the frontline staff in community settings who make the return to the community possible. A really important point was made about Alderwood and the experience of the constituents of the hon. Member for Dulwich and West Norwood (Helen Hayes). I also talked about Fauzia in this context. Training is needed in how autism affects individuals. It is not just about training in autism generally. Understanding the impact on an individual is what is so important, as is wider community training.
The Minister said that mechanisms were now in place to shift money across. What I do not understand is why that does not appear to be working effectively enough. If it is there, why is it not happening routinely? Why cannot the money just shift to a local authority to facilitate a much-needed community place? I am reassured that the work will continue after March next year, but it needs a national programme. I am afraid that it cannot just be left to localities. We know that there are some great places around the country doing amazing work, but others are falling well behind. There needs to be an inspiring national drive and the sense of an imperative that things have to change, wherever people live.
On the cross-departmental work and the taskforce to which the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) referred, we must recognise the importance of employment opportunities. So many people can work and can be paid in work, and that of course relieves the burden on the statutory services. Understanding that, and recognising that housing plays a vital part in this—
Norman Lamb
Am I allowed to give way, Madam Deputy Speaker? I am coming to the end of my response very soon—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Technically, no. The right hon. Gentleman has a strict two minutes to sum up at the end. However, I recognise that really important issues are being discussed here, and the Minister clearly has something to add. I am not creating a precedent here, but I am, unusually, allowing her to intervene.
Caroline Dinenage
I am grateful to you, Madam Deputy Speaker. My lack of understanding of the rules is clearly shining through quite beautifully here. I completely forgot to say earlier that we have an inter-ministerial group on disability in society which met for the first time yesterday, and I hope that it will go some way towards achieving some of the improvements that the right hon. Gentleman wants to see.
Norman Lamb
I am very glad to hear that. I was unaware that I had only two minutes, so I am really sorry, but I am pleased that you are so chilled out this afternoon, Madam Deputy Speaker. I applaud you for that.
I am pleased that the Minister has said that we must learn the lessons from the mortality review. Also, we must recognise the critical importance of involving the individual and the family in the decision making and in shaping the programme, in every case. This is about human rights, and human rights are routinely being abused and ignored. That must end. I am grateful to everyone who has spoken in the debate to highlight the critical issues involved in giving people the chance of a good life.
Question put and agreed to.
Resolved,
That this House is concerned at the slow progress made under the Transforming Care programme, which was set up to improve the care and quality of life of children and adults with a learning disability and/or autism who display behaviour that challenges; recognises that a substantial number of people with learning disabilities remain trapped in, and continue to be inappropriately admitted to, Assessment and Treatment Units rather than living with support in the community; is further concerned at the lack of capacity within community services; notes evidence of the neglect, abuse, poor care, and premature deaths of people with learning disabilities; believes that the Transforming Care programme is unlikely to realise the ambitions set out in the Building the Right Support strategy before it ends in March 2019; calls on the Government to establish, prioritise, and adequately resource a successor programme that delivers a shift away from institutional care by investing in community services across education, health and social care; and further calls on the Government to ensure that such a programme is based on lifelong support that protects people’s human rights and promotes their independence and wellbeing.
Alison Thewliss (Glasgow Central) (SNP)
On a point of order, Madam Deputy Speaker. Is there a means of putting it on record that the House’s business has finished just after 4 o’clock, collapsing an hour early, even though our important debate on baby leave in the House got pulled because of insufficient time? I understand that both this afternoon’s Westminster Hall debates also finished early. Do you agree that there ought to be a better way of organising business in the House so that important issues that need to be discussed have the time they need for discussion when other business falls short?
Madam Deputy Speaker (Dame Eleanor Laing)
I understand the hon. Lady’s point and her frustration that the debate on proxy voting, which we were all looking forward to, has not taken place, but she will understand that time had to be given in today’s proceedings for the Home Secretary to come to the House and address an urgent and important matter that arose only yesterday and which no one could have predicted. I am also aware that the timetabling of today’s business was so arranged, with a 2.30 pm cut-off for the first debate, because the Government were anxious to protect the time for the important matter we have just discussed in Back-Bench time. In saying that, I hope that those observing our proceedings will appreciate that the lack of Members in the Chamber did not reflect the importance the House attaches to this matter. It is extremely important; some of us have been debating these matters here for decades and are finally beginning to make progress. So while I take her point—it is well made—the fact is that sometimes the House has to adjust to events in the world outside, and that was why the Home Secretary needed time this afternoon.
Planning Application: Chelveston-cum-Caldecott
Mr Peter Bone (Wellingborough) (Con)
I am grateful that my hon. Friend the Member for Corby (Tom Pursglove) is in the Chamber because this petition affects his constituency as much as mine. I have presented many petitions in this House, but this is probably the one I am most concerned about. It refers to a planning application in my constituency for what is called a recycling plant, but is something that will create dioxins and other dangerous chemicals. There is no similar plant in this country. I do not want, in a few years, to find out that babies born in my constituency are deformed. The lead petitioners are Kaye Pentland, Tony Dawson and Martin Izzard, who are all members of RAID—Residents Against Inappropriate Development—which is the community group opposing the planning application. The petition has been signed by several hundred of my constituents.
The petition states:
The Humble Petition of Chelveston-cum-Caldecott and the surrounding areas,
Sheweth,
That the Petitioners believe that the proposed development by Energy Roots Ltd planning application No. 18/00006/WASFUL for a Construction of a Plastic Recycling and Recovery Facility, should be refused on the grounds of the great cost to the environment, agricultural land, and residents with harmful emissions from the plant. Hazardous emissions will include Nitrogen Dioxide, Sulphur Dioxide, Nitric Acid, Hydrogen Chloride, Ammonia, Particulate matter, Dioxins and Furans.
Wherefore your Petitioners pray that your Honourable House urges the Department for Environment, Food and Rural Affairs, the Department for Communities and Local Government, Northamptonshire County Council and East Northamptonshire Council to take in account the concerns of petitioners and refuse to grant the planning application for a Plastic Recycling and Recovery Facility to Energy Roots Ltd.
And your Petitioners, as in duty bound, will ever pray, &c.
[P002173]
Paupers' Funerals
(6 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr John Hayes (South Holland and The Deepings) (Con)
Losing a loved one is heartbreaking. Almost everyone in this House will have suffered the loss of a loved one: a parent, a grandparent, a friend, or even—the worst nightmare of all—a child. Funerals provide the chance of a final goodbye. They allow us to grieve, as a family or as friends, sharing the loss of someone close. The ability to say goodbye at a funeral is a necessary part of the grieving process, a staging post in loss. Funerals can change moods. They can lift hearts. Sharing stories and reflecting on memories keep the spirit of the one we have lost alive in our hearts, minds and memories. It is because of the importance of the shared experience of grief that the character of the last parting matters so very much.
Public health funerals, or national assistance funerals as they are called in Scotland, occur when a family cannot, or in a minority of cases refuses to, pay the cost of the funeral of a departed relative or other loved one. As we would and should expect in a civilised and compassionate country, the state, in the form of local councils, steps in to cover the cost of a basic funeral. However, recent press and media coverage has revealed the shocking reality of public health funerals, which are sometimes callous, careless or even cruel. Dubbed “paupers’ funerals”, they can be occasions on which, as an official from Bracknell Forest Council has put it:
“There’s no attendees, no keeping of the ashes. Nobody’s invited; you don’t have any say over the funeral at all…It’s literally as basic as basic can get”.
That is what modern paupers’ funerals are: the reduction of a human life to something that is
“as basic as basic can get”.
As a Christian country, we surely believe that every life has intrinsic value. I follow, or at least try to follow, the commandment to treat others as I would wish to be treated. There can be no pretence that these public health funerals fulfil our Christian duty. They are the very antithesis of what Christ taught us.
In the 1860s, Charles Dickens wrote of that ultimate manifestation of the cruel neglect at the rotten core of liberal utilitarianism, the Poor Law—which included the original scourge of paupers’ funerals—that it was
“to degrade a Christian’s duty into a charlatan’s trick”.
To the shame of our age, Dickens’s words remain an apt description of modern public health funerals.
The hon. Member for Swansea East (Carolyn Harris) moved us all when she recounted the heartbreaking story of losing her son. She has already succeeded in changing Government policy on children’s funerals, and now I hope that I can play a part in changing it on public health funerals. There are two things that the Government can do to bring about change and to relive the pressure of funeral poverty. First, they can carry out an urgent review of the 15-year-old cap on funeral expenses payments. In April 2003, a £700 cap was imposed, and it has since remained in place. The payment is combined with help that is intended to cover some of the cost of a burial plot, cremation fees, travel, the moving of a body and death certificates. However, a maximum of £700 is hardly sufficient, even with those supplements.
The policy is simply no longer fit for purpose. When the cap was introduced in 2003, the average cost of a funeral was £1,920. Since then, the price of funerals has increased by 112%. That means that the £700 of assistance offered would, on average, cover about 17% of the cost of a funeral, compared with 36% in 2003. Given that, it is hardly surprising that the number of public health funerals has increased by more than 200% since 1997. The Government should examine whether more can be done to alleviate the financial burden of funerals. The Minister will know that the Department for Work and Pensions began to help last year by allowing recipients of funeral payments to receive additional contributions without deductions, by extending the application period for a claim from three to six months, by clarifying that the funeral payments will cover the cost of a burial with or without exclusive rights of burial, and with the ability to submit evidence electronically. Nevertheless, it is time to do more.
The heart of reform must be an urgent examination of the appalling way in which some public health funerals are routinely conducted. The right hon. Member for Birkenhead (Frank Field) was surely right to say that
“the idea that because you are poor you should have no tangible means through which to remember and pay your respects for a loved one is appalling.”
The Government should issue statutory guidance to every relevant local authority describing in detail best practice in the conduct of public health funerals.
In the absence of such guidance, bad practice has persisted. According to The Sunday Times, a number of councils, including Glasgow and Bracknell Forest, imposed bans on family and friends attending these funerals and denied the bereaved the remains of their deceased loved ones. Who could possibly believe that grieving families should be forbidden from saying a last goodbye to those lost to the grave? I am pleased to say that my own council, South Holland, always ensures that family members can attend and are made aware of the date of the funeral, with the proper dignity and respect that such an occasion deserves. Furthermore, authorities must without any quibbling make the ashes of the deceased available to loved ones. A Glasgow City Council official was recorded telling a reporter:
“It’s us having to pay for it, so, as I say, she will not get his ashes back.”
That is appalling. Local authorities should have a duty to surrender the remains to the family; the ashes, just like the memories, belong to those who loved the departed. I understand that in some local authorities, such as mine, it is less expensive to bury someone than to cremate them. The problem seems to be centred on those places where cremation is the cheapest option.
Finally, it is the comforting delusion of those who regard the past with disdain—perhaps from misplaced guilt, or because they know little or nothing of it—that our age is at the apex of accomplishment. The more thoughtful here know that many things were once better. For now, in our time, paupers’ funerals ban children from mothers’ gravesides. Now, in our kingdom, some public officials refuse to inform children of their father’s cremation. Now, in this age, parents who have loved and lost cannot keep their child’s ashes to scatter or retain. This outrage must end, and the Government must make it happen.
The Parliamentary Under-Secretary of State for Justice (Edward Argar)
It is a pleasure to be responding to my first debate at the Dispatch Box with you, Madam Deputy Speaker, in the Chair, who were presiding when I made my maiden speech, and to be responding to my right hon. Friend, and indeed my friend, the Member for South Holland and The Deepings (Mr Hayes).
My right hon. Friend spoke with his famed eloquence and passion, but also with typical compassion, on a hugely important issue about which, in our compassionate and decent society, we should all care. As he said, a funeral plays a huge part in helping all of us, at one of the most difficult points in our lives, come to terms with loss and grief. This issue was also more broadly raised in a debate in Westminster Hall last October by the hon. Member for Mitcham and Morden (Siobhain McDonagh).
Public health funerals are likely to become necessary when either, sadly, a deceased person dies alone with no family or friends to organise a funeral or because the bereaved family does not, or is for various reasons unable to, make funeral arrangements. In either situation, the relevant local authority has a statutory duty under section 46 of the Public Health (Control of Disease) Act 1984 to make arrangements for the disposal of the body. To respond to my right hon. Friend’s points, it is important to highlight that the 1984 Act contains no statutory requirement for the local authority to make any arrangements beyond that, nor is it prescriptive of how they deliver on their obligation nor does it contain provision for regulations for statutory guidance or instruction on how they must do so. However, I hear my right hon. Friend’s point, and I have asked my Department to clarify and confirm that my understanding of that position is correct.
In a humane and civilised society, it is reasonable, and indeed proper, to expect that the deceased person and, where they can be involved, their bereaved family are treated with the dignity and compassion they deserve. I am sure that that is what happens in many local authority areas. For example, I have recently heard of a council where officials routinely attend public health funerals themselves—I believe that this is the case in the City of Westminster, among many others—to ensure that the deceased person is not alone in that final act.
However, the Government and I, like my right hon. Friend, are deeply concerned at the alleged practices of some local authorities, such as refusing to tell bereaved families where and when the funeral is taking place or refusing to return their loved one’s remains following cremation. Media reports—my right hon. Friend alluded to the report in The Sunday Times in May—suggest that that may be an attempt to deter future reliance on the local authority’s obligation to step in if other arrangements cannot be made. We all appreciate that local authorities should be mindful of public money, providing a decent funeral but ensuring that care is taken with that public money, but the key thing is that word “decent”. I am deeply concerned that, if true, the reports suggest completely unacceptable behaviour that would be putting bereaved families through unnecessary additional stress and insensitive treatment at an already extremely difficult time in their lives and when they are, in many cases, already managing on a low income. This is about sensitivity, decency and doing the right thing, and that should permeate the approach. I urge all local authorities to reflect on those words.
The legislation and lack of centralised control and powers to mandate is a reflection of the fact that public health funerals are a cross-cutting issue, that local authorities are best placed to determine local priorities and that this matter has sat with local authorities for many decades. It is a pleasure to be here answering on the behalf of the Ministry of Justice today, but colleagues in the Department for Work and Pensions, the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government all have a role to play. Historically, the Government have not centrally collated information on the number and cost of the public health funerals that councils manage annually. However, a series of freedom of information requests in recent years appear to show a consistent rise in both elements. The most recent of these requests, published by ITV News last month, was based on responses from 300 councils across the UK. It indicated that there has been a 70% increase in the number of public health funerals in the past three years, to around 15,000 last year, at a cost to local authorities of around £4 million in the last financial year.
As I have alluded to, local authorities are independent from central Government in providing their services and are responsible to their own electors and for managing their budgets in line with local priorities. That is how it should be and, as a former councillor, I recognise the importance of that local accountability and local decision making. However, that does not obviate the need for those local authorities to reflect on their obligations with the moneys they have given to them to ensure that this area is not neglected. It is absolutely right that local priorities should determine local spending, but I urge local authorities to reflect on my words about decency.
As my right hon. Friend alluded to, the Government have acted to address the financial pressures that death and bereavement can put on both families and local authorities. On 1 April, my right hon. Friend the Prime Minister announced her intention to establish a children’s funeral fund for England, which all Members would warmly welcome, with the intention that, at such an incredibly difficult and distressing time in their lives, bereaved parents will not have to worry about the essential costs of burying or cremating their child. As the House will know, arrangements for similar funding have already been put in place by the Welsh Assembly Government, and the Scottish Government have recently announced their intention to do the same.
This difficult but important issue has, of course, been championed by the hon. Member for Swansea East (Carolyn Harris). Although she is not in her place today, I take the opportunity to pay tribute to her for her work, for her tenacity and for her courage in doing so in the light of her own tragic experience. She is an hon. Lady of great decency, commitment and compassion. This House is the better for her presence, and her constituents are lucky to have her representing their interests.
The hon. Lady has continued in her work to support those for whom death and bereavement bring unmanageable financial pressure. On 8 June she co-ordinated and sent a cross-party letter to the Prime Minister, supported by a significant number of hon. Members, calling for the establishment of minimum standards in the provision of public health funerals by local authorities. This action was prompted by concern about the media reports that gave rise to today’s debate, and I understand my right hon. Friend the Prime Minister is responding to that letter.
Public health funerals are not needed in the vast majority of deaths. I have mentioned the figure of 15,000 public health funerals a year, which represents around 3% of the total annual number of deaths in the UK. It is right that, where a family are in a position to take responsibility for the cost of funeral arrangements, they should do so. However, there are times when state support is appropriate and necessary, and we are committed to supporting vulnerable people going through bereavement who, depending on their situation, may need to draw on different elements of support.
That support, as my right hon. Friend the Member for South Holland and The Deepings alluded to, includes the provision of funeral expenses payments to help people on qualifying benefits with the cost of arranging a funeral. Such payments make a significant contribution to the cost of a simple, respectful, decent funeral, covering the necessary costs of burial or cremation and in addition up to £700 for other funeral expenses.
Mr Hayes
I am sure the Minister is just about to announce it, and I do not want to steal his thunder because he is a fine new member of the Government, but I called for the cap to be lifted. He may want to make that announcement now and make a big impact, or he might want to reflect and write to me about it very soon.
Edward Argar
My right hon. Friend is typically beguiling in attempting to persuade me to announce changes to policy from the Dispatch Box. However, the funding offered from the funeral expenses payments scheme and the social fund budgeting loan—he has referred to other measures taken by the Government, such as changing the rules so that additional contributions may be received without deductions being necessary from that fund—provides a level of support while, crucially, maintaining a fiscally viable fund.
I hear my right hon. Friend’s comments about the 2003 cap on that second element, and I will ensure that the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for North West Hampshire (Kit Malthouse)—the Department for Work and Pensions administers the fund—is made aware of my right hon. Friend’s comments and of the case he has made today. I sense my ministerial colleague may well be writing to him in response to that specific point.
In conclusion, I wish to thank my right hon. Friend for providing this hugely valuable opportunity to discuss, once again, such an important and sensitive issue. It is of course a truism that death touches us all. For many of us, the funeral arrangements are something that can be planned for and managed, but for some they are something for which the local authority and local government must take on responsibility, in a sense representing the local community. I believe that many councils do so honourably and carry out their duties with utmost respect for the dignity of the deceased person and their family. However, as I have said, it is of deep concern that some allegedly do not. I conclude by exhorting those few to show the compassion and sensitivity any of us would wish to be shown were we to find ourselves in those circumstances. I also reiterate the clear commitment of the Prime Minister, this Government and myself, as a Minister, to work with colleagues to ensure that the system of public health funerals continues to provide that decency and decent send-off we would all wish for.
Question put and agreed to.
Ministerial Corrections
(6 years, 5 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text
Home Department
(6 years, 5 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Caroline Nokes
We are on track to resettle 20,000 refugees from Syria and a further 30,000 children and families from the wider middle east and north Africa—MENA—region.
[Official Report, 21 June 2018, Vol. 643, c. 553.]
Letter of correction from Caroline Nokes:
An error has been identified in the response I made to the debate on Refugee Family Reunion.
The correct response should have been:
Caroline Nokes
We are on track to resettle 20,000 refugees from Syria and a further 3,000 children and families from the wider middle east and north Africa—MENA—region.
Defence
(6 years, 5 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Julian Lewis (New Forest East) (Con)
Does the Secretary of State accept that our principal allies on the ground in Syria have been Kurdish-led? Does he share my concern that, having helped to supress and eliminate Daesh in Syria, those Kurdish-led forces may now find themselves under attack by Turkey, a country with an ambivalent record toward both Islamist extremism on the one hand and Russia on the other? What will we do if we find our Kurdish allies are attacked by our so-called NATO ally?
Gavin Williamson
We have worked incredibly closely with the Syrian defence forces over a period of time, as have other coalition allies. We are working closely with the United States and France to get a dialogue going between the Syrian defence forces and Turkey to ensure that there is no conflict of the form that my right hon. Friend raises. [Official Report, 3 July 2018, Vol. 644, c. 196.]
Letter of correction from Gavin Williamson:
An error has been identified in the response I gave to my right hon. Friend the Member for New Forest East (Dr Lewis).
The correct response should have been:
Gavin Williamson
We have worked incredibly closely with the Syrian democratic forces over a period of time, as have other coalition allies. We are working closely with the United States and France to get a dialogue going between the Syrian democratic forces and Turkey to ensure that there is no conflict of the form that my right hon. Friend raises.
The following is a further extract from questions on a statement by the Secretary of State for Defence on 3 July 2018.
Sandy Martin (Ipswich) (Lab)
The Kurdish people fought with some of the most bravery and effect to defend their local populations against the cruelties of Daesh. What are the UK Government now doing to protect the Kurdish people of Iraq and Syria from being attacked by the Governments of those two countries and, indeed, by the Government of Turkey?
Gavin Williamson
We continue to work very closely with, especially, the Iraqi Government and the Turkish Government to make sure that we have sensible and pragmatic solutions. We have always had a very strong relationship with the Kurds, especially in Afghanistan. We have a very good relationship with the SDF, which is both Kurdish and Arab. We will continue to work to try to ensure, especially in Syria, that the SDF is an integral part of the solution for that country going forward. [Official Report, 3 July 2018, Vol. 644, c. 201.]
Letter of correction from Gavin Williamson:
An error has been identified in the response I gave to the hon. Member for Ipswich (Sandy Martin).
The correct response should have been:
Gavin Williamson
We continue to work very closely with, especially, the Iraqi Government and the Turkish Government to make sure that we have sensible and pragmatic solutions. We have always had a very strong relationship with the Kurds, especially in Iraq. We have a very good relationship with the SDF, which is both Kurdish and Arab. We will continue to work to try to ensure, especially in Syria, that the SDF is an integral part of the solution for that country going forward.
Petitions
Home Education: draft guidance and the consultation
Counter-Terrorism and Border Security Bill (Sixth sitting)
Thursday 5th July 2018
(6 years, 5 months ago)
Public Bill CommitteesRead Full debate Counter-Terrorism and Border Security Act 2019 View all Counter-Terrorism and Border Security Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 5 July 2018 - (5 Jul 2018)
The Chair
Good morning, everyone. The selection list for today’s sitting is available in the Committee Room. The amendment paper printed for today’s sitting contains, in error, some amendments that we have already considered. Please turn to page 7, where we shall begin with amendment 26 to clause 19. Copies of the written evidence received by the Committee are also here.
Clause 19
Terrorism reinsurance
Neil Coyle (Bermondsey and Old Southwark) (Lab)
I beg to move amendment 26, in clause 19, page 19, line 27, at end insert—
“(4) Where an event occurs which the Secretary of State has grounds to believe may be an act of terrorism for the purposes of terrorism reinsurance, the Secretary of State must within three days of the event make a statement that—
(a) the event is or is not an act of terrorism for the purposes of terrorism reinsurance; or
(b) there is not yet enough evidence to make a statement under paragraph (a) and set a timeframe for when it is expected that such a statement is likely to be made.”
This amendment would require the Secretary of State to make a statement in relation to whether an event is an act of terrorism within three days of the event occurring, or else provide a statement of when such a statement is likely to be made.
It is a great pleasure to serve with you in the Chair, Ms Ryan. I hope the amendment is self-explanatory, so I shall keep my comments to a minimum. Under the Reinsurance (Acts of Terrorism) Act 1993, the Treasury holds responsibility for providing certificates of classification for acts of terror. Members might think that that duty would more sensibly sit under the Home Office, given its wider responsibilities for policing and security. The Bill is the chance to update that obvious discrepancy and to speed up classification to better help those affected when terror attacks occur. The Government and the security services tell us that the threat remains severe so, sadly, further attacks will come.
Under existing arrangements, the Treasury is supposed to classify within 21 days, but in practice that varies widely. There is also a contrast with individual Ministers, who often state on the day or the next day after an attack occurs that it was terrorism, but official certification takes longer. Ministerial comment should act as a guide to insurers and others involved, but the practical experience at London Bridge and Borough market in my constituency has taught me that that does not always happen, leaving those distraught after an attack with further problems just knowing how and when those with insurance can claim back losses.
I believe that the Westminster attack took 11 days to classify, and the London Bridge and Borough market one took far too long to declare: that happened 21 days after the attack, and only following pressure as a result of an Evening Standard intervention on behalf of classification. Those delays have consequences. The amendment aims to tackle situations in which businesses hit by terrorists are then held up by a convoluted process in moving on with their lives and their business.
As mentioned on Tuesday, claiming on insurance after attacks is tough enough. One insurer told a business affected by the Borough market attack that it was not covered for terror attacks, and the same insurer told another firm—one with terror insurance—that the Borough market attack had not been classified and that no payment could be made. That is simply not good enough, and the amendment would end that bad practice.
The amendment would allow for swifter declaration, in line with ministerial statements, and would protect businesses further and better. The uncertainty and delay over London Bridge and Borough market caused more anxiety for those affected at an already difficult time. It is unnecessary and unhelpful to experience delays in accessing the support that is supposed to be there in very tough circumstances, with businesses already badly damaged.
Ministers have claimed previously that London Bridge and Borough market took longer to classify due to the involvement of three police forces: the British Transport police, the Met and the City of London police. Blaming police forces that did so much to end the attack so swiftly and to help all those affected is simply distasteful. The amendment could provide a swifter process, to prevent police officers from being blamed for delays to classification.
Members may have concerns that a three-day limit is too short a timeframe in more complex incidents, but the amendment is designed not to be overly prescriptive—I thank the Clerks for helping me draft it. Cyber-attacks, by their very nature, can take more time to identify—months, in some cases—and any return to planting bombs around buildings or infrastructure without the involvement of suicidal attackers might also take more time to investigate to confirm motives. The amendment would allow for that.
The three-day process is designed for the more obvious attacks, such as that in my constituency last year. Ministers and the Prime Minister stated on the day that it was a terror attack—weeks before formal classification. However, the amendment includes a means of deferring formal declaration for more complex attacks. It would make a helpful, practical difference to employers affected by terror in the immediate aftermath. For attacks that take longer to classify, the amendment allows a statement to be made indicating what that time might be. At the time of any event, and in the face of all the facts, which may or may not be in the public domain, it would be entirely up to Ministers to make that statement and give direction, without that being burdensome.
The proposal would allow insurers and Pool Reinsurance to step in more swiftly to support those affected by any future attack. I hope that the amendment is welcomed by the Government, and I look forward to the Minister’s reply.
The Minister for Security and Economic Crime (Mr Ben Wallace)
It is nice to serve under your chairmanship, Ms Ryan.
As the hon. Member for Bermondsey and Old Southwark (Neil Coyle) explained, the intention behind the amendment is to ensure that the Government make a public statement three days after an incident about whether it is an act of terrorism as defined by the Reinsurance (Acts of Terrorism) Act 1993. If that is not possible within three days, the amendment would require the Government to provide an estimate of when they will be able to make such a statement.
The amendment would significantly alter the current process, and would introduce uncertainty for businesses and insurers during what is already a stressful and challenging time, following a terrorist attack. The 1993 Act requires that reinsurance and guarantee arrangements can be extended only for losses related to acts of terrorism, as defined by the Act. There is an established contractual process, under which an incident is certified as an act of terror in accordance with the 1993 Act. That important process is designed to give the insurance industry certainty about whether an incident is within those reinsurance or guarantee arrangements.
In the case of the Government-backed terrorism insurer, Pool Re, Her Majesty’s Treasury has an agreed deadline to certify whether an incident is an act of terrorism. It must do so within 21 days of receiving a certification request from Pool Re. It is worth clarifying that Pool Re’s formal certification request may not necessarily arrive on the day of the terror event, as it is driven by whether any of its members have received a claim.
The Treasury treats certification as a priority, to ensure that Pool Re and its members can proceed with the claim process. That means that businesses can get the financial protection they have paid for through insurance contracts. The Westminster, Manchester and London Bridge attacks in 2017 were all certified within 21 days. For example, the Manchester Arena attack was certified within five business days of the certification request being received from Pool Re.
Once such a request has been received, Treasury officials consult the police and the Home Office before giving advice to the Chancellor of the Exchequer, who makes a final decision about whether an event should be certified as an attack. That certification process properly sits with the Treasury, as the Chancellor’s approval is ultimately required to authorise any financial support required for Pool Re.
Pool Re is not the only underwriter of terrorism risk in the country. Many businesses across the UK are insured via contracts with different terms, conditions and certification processes. That means that if the Government were to make a public statement about the status of the certification process, as it related to Pool Re, it would risk confusing those businesses about the status of their own claims.
I know that the hon. Member for Bermondsey and Old Southwark is particularly concerned about the length of time it took for the horrific terrorist attack in his constituency in June last year to be certified, and I am very conscious of the impact that any delays can have on businesses. I have therefore asked that our officials look at why the process is not quicker after a Pool Re certification request comes to the Treasury, given that, as Security Minister, I sometimes know within minutes or hours whether an attack is a terrorist offence. Indeed, the head of counter-terrorism often makes a public statement to that effect within hours, not days.
I have taken the essence of the hon. Gentleman’s amendment and his constituents’ concerns and sought to follow up to see why it takes so long when a request enters the Government system—I cannot do much about how long it takes for claimants to submit a claim. The clock starts not once the event happens but once a claimant makes a claim to an insurer, and then the insurer triggers the Pool Re request. That could take time, depending on loss adjustment and that end of the process.
I assure the hon. Gentleman that I will seek to improve the performance of the process and to find out why it takes so long once the Government formally receive a request. His point is well meant, and I do not disagree with it. I cannot see why the process takes so long in some cases. I assure him that I will follow that up. I hope my assurances, which I will keep the hon. Gentleman updated on, are enough to persuade him to withdraw his amendment.
Neil Coyle
I thank the Minister for his response. The difficulty is that he wants a reactive system, whereby insurers wait for someone to get in touch with them, but I think we should have a more proactive approach. Insurers should step in as soon as a Minister makes it clear that a terror incident has occurred. However, on the basis that the Minister is seeking further advice before the Bill progresses any further, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Neil Coyle
I beg to move amendment 27, in clause 19, page 19, line 27, at end insert—
“(4) After section 2 of the Reinsurance (Acts of Terrorism) Act 1993 (Reinsurance arrangements to which this Act applies) insert—
‘2A Duty to advise on terrorism insurance
(1) Where the conditions in subsection (2) are met, an insurance provider has a duty to advise on the available insurance related to losses sustained as a result of acts of terrorism.
(2) The conditions referred to in subsection (1) are—
(a) that a person asks the insurance provider for advice in relation to insurance (whether related to terrorism or not); and
(b) that it seems to the insurance provider that the person may benefit from insurance in relation to a loss which is covered by terrorism reinsurance arrangements under this Act.
(3) In this section, “insurance provider” means—
(a) a person regulated by the Financial Conduct Authority or the Prudential Regulation Authority who sells insurance, or underwrites the risk of such insurance, or
(b) the agent of such a person.’”
This amendment would require insurance providers to advise on the insurance available in relation to losses sustained as a result of acts of terrorism.
I thank insurers and brokers for all their help since last June, including the Association of British Insurers and the British Insurance Brokers’ Association. The amendment would require insurance providers to advise on the insurance available in relation to losses sustained as a result of acts of terrorism.
The Government have been commended for belatedly acting to better extend the Pool Reinsurance model to cover contemporary forms of terrorism. Having seen my constituency attacked without the adequate protection that could have been available, I am slightly more reticent to congratulate them. However, covering non-physical damage and allowing employers to be covered for all business interruption issues arising from a terror attack is a significant step forward for people and firms who might be affected by future attacks.
There were firms at London Bridge and Borough market that were affected by physical damage from the vehicle that was used initially in the attack on the bridge. The vehicle ended its journey on the edge of the bridge, damaging the Barrowboy and Banker and the London Bridge Experience. Some buildings incurred other damage during the attack, including bullet holes from the swift police response to end the brutal rampage. However, most of the damage was non-physical, as we discussed on Tuesday. The closure of premises; the lack of access to stock; the loss of stock; the inability to contact customers; lost bookings; lost contracts; and employees leaving, with the associated recruitment costs, are all forms of business interruption, as highlighted on Tuesday. Extending coverage for those matters as standard in future attacks is welcome.
The Government tell us the threat remains severe, so it is likely we will witness more atrocities, sadly. The Government are taking one step towards better cover, but they need to recognise the broader issue of coverage. Even when the Bill is enacted and implemented, coverage will have another limitation: terror insurance will still need to be held. “Market penetration” is the term the sector uses. The Minister spoke on Tuesday about insurers and brokers upping their game. In effect, the amendment would help to ensure that they do and that more firms take out protection through better awareness of the offer when advised by insurers and brokers.
The British Insurance Brokers’ Association estimates that less than 2.5% of 5 million UK businesses have terror insurance. That leaves vast swathes of employers and jobs at risk under the severe threat that the Government tell us exists of another attack. The amendment is designed to help tackle that issue and increase take-up.
There are options. The Government could compel Pool Reinsurance to advertise, but have never done so. Pool Re has been left alone, with the consequence that coverage has been inadequate in terms of what is protected and who has bought into the system. My personal preference would be to compel larger employers and firms with higher turnover to hold terror insurance. That could be done alongside compelling some form of direct marketing of terror insurance and Pool Reinsurance to businesses, especially in areas known to be at greater risk. I appreciate that that is not the Government’s approach, so my amendment is designed to find a means of promoting coverage that is not onerous, that facilitates choice for all firms, that reflects the level of risk in different areas and that has a means of delivery that is not burdensome on those involved.
The amendment would compel insurance providers and brokers of insurance to offer terror insurance and to advise on the merits of terror insurance and the risks of not having it. Individual businesses would still be able to make their choice based on circumstances, including location, but the offer must be made, and advice must be given on the pros and cons and risks involved.
I am aware that Pool Reinsurance has adapted its package and support, and now offers a £30 arrangement to cover up to £500,000 in damages. The costs of taking up support are not massive for most firms. The amendment facilitates better awareness of the package and helps build resilience in the pool through greater coverage and protection for more businesses. The amendment would obviously work most easily in terms of direct sales with firms and drawing up new contracts, but it goes further.
In discussions with insurers and brokers’ representatives, I am aware that a lot of insurance is bought online in standard packages. The amendment would not alter that. Firms offering those deals would simply need to consider adding terror insurance to those them, or to add an automated trigger system to ensure follow-up correspondence advising on terror insurance and its benefits. That’s it—it’s simple.
Under existing packages and arrangements, insurers and brokers could also go back to customers to flag up their new requirement to offer terror insurance—a responsibility that is on them and not on customers, who have only to consider their advice. I acknowledge that there are costs to put that in place, and those are costs for the insurers, who have overseen the very low record of take-up, which puts more firms, jobs and revenue for the Treasury at risk in the event of further terror atrocities. Ignoring the massive gap should not be an option. It is not in UK plc’s interest to perpetuate the current lack of take-up.
Borough market is an example of where, even when terror insurance was offered, it was so basic that some firms declined to take it up because it was limited to physical damage only. Traders felt they were unlikely to have their stalls blown up. However, they have lost considerably because of the attack last June—£2 million, as discussed on Tuesday. They needed to have better coverage in place and to have been made better aware of what coverage was possible. If terror insurance had—the Bill addresses this—covered business interruption, and they had been advised on it, more take-up would have occurred. It should not be an either/or scenario. The Government are making the business interruption changes, but they are not focusing enough on how to drive up the coverage, which is also essential.
This amendment comes from the practical experience of Borough market and a desire to ensure that other areas are not so badly affected in the event of future attacks. I hope that it will receive Government support as our consideration of the Bill progresses. I would welcome discussion of it now and an indication of the Minister’s position.
Mr Wallace
I am very conscious of the wider impacts of terrorist attacks on surrounding communities and businesses. However, I am afraid that there are several issues with the proposed amendment and its objective. Most prominent among those is the increased regulatory burden that would arise from the amendment. That would be likely to lead to an increase in the cost of insurance for people across the UK, as the hon. Gentleman has said, as well as for businesses being sold terrorism insurance instead of other insurance products that might better suit their needs.
The amendment would also impinge on the existing regulatory protection provided by the Financial Conduct Authority. The FCA’s “Insurance: Conduct of Business” sourcebook sets out the regulatory framework for the conduct of insurers and brokers in the United Kingdom. It aims to ensure that customers are treated fairly and given clear and fair information when they are sold insurance. These rules already include an obligation on firms involved in selling or providing advice on insurance to make sure their customers have sufficient information to make an informed purchase. In practice, that would mean that if terrorism is excluded from a business interruption product that is being purchased by a business, the broker should tell them, so that different businesses can consider whether a different product might better suit their needs.
If a customer feels that they were not provided with advice that met that requirement, they can ask for a review by the Financial Ombudsman Service. That service is open to individuals as well as to small and medium-sized enterprises with less than 10 staff and an annual turnover of up to €2 million. Larger businesses can take their insurer to court.
The amendment would also reduce the flexibility of the existing regulatory framework and potentially stifle innovation. That is because further primary legislation would be required to adjust the statutory duty in the future if necessary, unlike with the rest of the FCA’s rules, which can be updated quickly in line with trends in the insurance sector.
By imposing a specific statutory duty outside the FCA’s regulatory framework, the amendment would also risk significant additional consumer detriment. It would require any firm involved in providing advice on insurance products or selling insurance products to consider whether terrorism insurance was relevant to every one of their customers. In practice, that would mean that such firms would have to consider whether individuals and businesses would benefit from terrorism insurance when they are looking to purchase other insurance products, such as home insurance, mobile phone insurance, travel insurance and motor insurance.
This prescriptive approach would likely result in cases of mis-selling and an increase in the cost of insurance. That would be driven by firms that are more concerned about avoiding penalties for breaching a new requirement cost than the interests of their customers, as well as by firms introducing new processes to ensure they are compliant with the amendment.
The amendment might also result in those firms over-prioritising the sale of terrorism insurance relative to other risks, which might be a greater threat to an individual business. There are over 5.7 million SMEs in the UK. It is not generally the Government’s role to prescribe to those businesses the risks against which they should be insured.
Officials at the Home Office, the Treasury and the Department for Business, Energy and Industrial Strategy are working on options to improve take-up of insurance by businesses and by SMEs in particular. This is part of an holistic approach, looking at insurance as one of the many steps that an SME can take to improve its resilience to financial shocks.
Given the steps that are already under way to improve take-up, the existing protections already available through the UK’s regulatory framework, and the potential for significant additional costs to consumers—
Neil Coyle
On that specific point about increasing take-up, will the Minister explain how take-up is being encouraged and what level he expects it to be at within, say, three years of implementation of the Bill?
Mr Wallace
The Association of British Insurers and the insurance broker trade industry do great amounts of marketing and promotion to get people to buy insurance and be protected and covered. The biggest threat to us all in the insurance space is inappropriately covered people, whether that is in terms of terrorism or anything else. That is a constant challenge to the industry, often because a number of its risks are mutually pooled, as we were talking about when considering a previous amendment on motor insurance. Therefore, it would be in the interests of the insurers to ensure that people have appropriate insurance for their risk; that is quite important.
The Government can play a role in highlighting awareness of the threat of terrorism. Everyone here will be very aware of the shift in terrorism over the last 18 months; it has been top of the news most weeks. Probably like everyone else, I will look at whether my travel insurance for my summer holiday covers terrorism—well, I am going to Wales, but if I was not, I would check that. The difference between me and the hon. Member for Bermondsey and Old Southwark is that he wants the Government to direct the insurance industry to tell people about that insurance. The position of the Government is that the FCA should use its regulations and advice to be more responsive, and we should not use primary legislation.
Members on the Government side of the House would also say that there is some onus on the customer to seek the most appropriate cover from their insurers to match the threat that they face. That is where we differ, and it is why I urge the hon. Gentleman to help us seek a way to improve take-up through the building up of marketing and promotional material on getting the right insurance, and indeed through regulations, rather than primary legislation. A project is under way to improve take-up, and I will write to him with further details if he would like me to. I urge him to withdraw his amendment.
Neil Coyle
I think the Minister has slightly misinterpreted my suggestion. I did not suggest placing an obligation on customers to purchase insurance—merely that insurers advise on its availability. On Tuesday the Minister talked about insurance market failure in some areas, and this will be a missed opportunity to correct that failure. However, on the basis that the Minister will outline the awareness-raising activities that the Government will undertake, and in the hope that doing so will allow a discussion before the Bill goes to the Lords, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Question proposed, That the clause stand part of the Bill.
The Chair
With this it will convenient to consider New Clause 4—Review of the changing nature of terrorism reinsurance requirements—
“(1) The Pool Reinsurance Company Limited must provide an annual report to the Secretary of State setting out—
(a) an assessment of the nature of terrorism reinsurance requirements; and
(b) any recommendations on how terrorism reinsurance arrangements should be amended to address terrorism reinsurance requirements.
(2) The Secretary of State must lay the report and any recommendations made under subsection (1) before the House of Commons within three months of receipt.
(3) The laying of the report and recommendations under subsection (2) must be accompanied by a statement by the Secretary of State responding to each recommendation made under subsection (1)(b).”.
This new clause would ensure that terrorism reinsurance arrangements are kept under annual review by Pool Re and would require the Secretary of State to respond to Pool Re’s recommendations in relation to terrorism reinsurance.
Nick Thomas-Symonds (Torfaen) (Lab)
I raised this issue on Second Reading. I generally welcome the clause. The original provision in section 2 of the Reinsurance (Acts of Terrorism) Act 1993 restricted the loss that could be claimed for loss of, or damage to, property and for consequential loss, which I am afraid therefore excluded business interruption in situations in which there was no direct damage to property. The clause solves that problem and will explicitly insert business interruption as a form of loss in that section of the 1993 Act. That is welcome, because it recognises that the terrible acts of terrorism that we see have an impact on the wider community and have a financial impact on businesses in terms of lost trade.
However, I want to set out the concern about businesses that have suffered losses in the past. I pay tribute to the work of my hon. Friend the Member for Bermondsey and Old Southwark, who has campaigned tirelessly for his constituents on this issue after the terrible atrocity that occurred at London Bridge and Borough market in his constituency. He eloquently put the case today and last week for dealing with these iniquities in the system.
I hear what the Minister says about looking into the past. Wherever a line is drawn, it will, of course, lead to further unfairness because of the events that would fall on the wrong side of it. However, will the Minister at least undertake to look at whether anything can be done with respect to some of the losses occurring through business interruption in Borough market and elsewhere, so that no stone is left unturned as to whether any form of help can be provided? I would be very grateful for that reassurance from him.
Neil Coyle
I rise to speak to new clause 4. I have nicknamed this “the resilience clause”, and I hope it will be adopted to protect UK firms. I will speak as briefly as possible, but I will touch more generally on clause 19, for which I have been campaigning for the last year, and I am grateful to see it emerge now. Had it been in place before last year, it would have made a huge difference to those affected by the terror attacks at Borough market and London Bridge last June. I have been seeking this through Westminster Hall debates, so I am pleased to see it. I am disappointed that, as my hon. Friend the Member for Torfaen just said, the Government are yet to offer any form of compensation—a single penny—for the damage felt and caused at Borough market and London Bridge last year. I will keep campaigning for that.
New clause 4 would ensure that terrorism reinsurance arrangements are kept under annual review by Pool Reinsurance, and would require the Secretary of State to respond to Pool Reinsurance recommendations in relation to terrorism reinsurance. The clause is designed to prevent the Government-backed system from falling behind terrorist methods and their future impact. It would help to build resilience in our anti-terror structures overall. The clause would require Pool Reinsurance to provide an annual report on the nature of terrorism and any need to improve the systems designed to protect UK citizens and businesses from the form of terrorism we currently face, and to advise on how it is changing and what we might expect in future.
If that system had been in place from the introduction of Pool Reinsurance in the 1990s, it could have ensured that as the Provisional IRA threat of physical damage to economic infrastructure diminished and as terrorism morphed into the deliberate targeting of innocent civilians with knives and vehicles, the pool would have adapted accordingly over time, or at least have had the potential to do so. The Provisional IRA targeted buildings—physical economic infrastructure—not civilians. The pool was designed for that early 1990s threat, after the devastating Canary Wharf and Manchester Arndale attacks. Sadly, the system has not been updated properly over time as the nature of the threat has changed and, with it, the impact on businesses and employers’ insurance needs.
As discussed on Tuesday, Pool Reinsurance, despite warnings dating back to at least February 2016, has not been updated swiftly enough by the Government to cover the brutal attacks against innocent people, such as those enjoying Borough market on Saturday 3 June last year. That should have been possible, and the new clause will ensure that it will be going forward. The pool should never be left to slip behind again. The duty would ensure an annual appraisal of the nature of terror threats and their potential impact on businesses in particular, and would ensure that advice and recommendations are provided on how to adapt to better protect under-insurance systems from contemporary systems, and who or what terrorists target.
The duty would be on Pool Reinsurance, but the clause is not prescriptive regarding how it would work in practice. The pool could involve a range of stakeholders, including Government Departments, ABI, BIBA and business representatives. The wording is kept simple enough to prevent too onerous a system, or too rigid a structure, from developing. The duty is on Pool, because Pool is obviously in a strong position to provide overview from a tactically strategic position, and at no new cost. Pool already provides a quarterly terrorism frequency report, which could form the basis of any future annual reporting of risks and the UK’s ability both to prevent companies from losing out and to protect employers and employees from job losses as a result of insufficient coverage.
I believe that Pool would welcome the role. It has already sought to improve its insurance coverage in terms of packaged costs, awareness of cover and extending the support offered after different forms of attack, including both cyber and business interruption. However, Pool’s work has not always been swiftly acted on by Ministers, creating the gap that so badly affected London Bridge and Borough market in my constituency last year, and that the Bill is aimed at addressing.
Pool Reinsurance would report, and make recommendations, to the Secretary of State, who would be obliged to reply. That obligation is not massively onerous, especially given the huge range of responsibilities, and the clause suggests an ample three-month timeframe. I hope that the proposed new clause will have the backing of the Minister, and I would welcome an indication of whether the Government will pursue it in the Bill’s later stages.
Mr Wallace
I understand what the hon. Gentleman is trying to do, which is, in order to ensure that we do not miss the impact—in terms of how victims of terrorism are dealt with—of the changing threat, to have a review of that to ensure that all the holes in cover are plugged in future. The only point on which I differ from him is in understanding what Pool Re is.
Neil Coyle
Is the Minister suggesting that Pool Re is seeking to extend its role beyond where it should? Is he suggesting that the Government and Ministers are in a better position to judge the impact—bearing in mind that the overall clause is about terror insurance—and to advise on what should be covered than Pool Re, which is already there doing the job and has sought to have cyber-attacks, and the kind of non-physical damage we have seen mentioned in this clause, brought into coverage? I would slightly disagree.
Mr Wallace
We have to be careful. Pool Re is, first of all, not the only organisation in the marketplace. The Government have a duty to all the insurers, including Pool Re, to indicate where risk, certainly in the security space, is developing or currently stands. We must be minded that it is not a stand-alone organisation. It should be the Government who indicate risk in security. It is our JTAC, the joint terrorism analysis centre, that indicates, independently of Ministers, what the latest analysis shows about where a security threat is developing. We raise severe threat levels and so on.
It is not the Government’s job to tell people how to do the insurance, and we would not seek to tell Pool Re how to carry out or issue insurance policies, but it is the role of Government—because the Government are independent of that vested interest—to be the owners of understanding where the threat is going and being able to pull together all those experiences. It is from the hon. Gentleman’s experience as a constituency MP that he has learned about his businesses in Borough Market. The police will have their experiences, as will the ambulance service and so on.
If we are to really get to grips with understanding the vulnerabilities, it requires someone who is set aside from the insurance industry. I do not think it would involve the Government producing a report saying, “You must insure this, and this is how you do it.” I think it would be the Government saying, periodically, “Let’s have a look at what has happened, what has been missed out, what the public need to be aware of and what action they need to take.” That is where I would sit; that is the issue I have with the start point of the hon. Gentleman’s new clause. Again, his meaning is not misplaced and nobody in the Committee disagrees with his determination to improve his constituents’ opportunities to get insurance, but I see it as a question of how we will get there.
Neil Coyle
My concern is that an expert body already exists specifically with this focus of terrorism reinsurance—a body that could do this job and in part does it already through the advice it offers. The new clause would formalise that role. Instead of taking that approach, the Minister seems to want to take on an even bigger Government, a bigger state and more civil servants. I thought we were meant to be the party of big Government, not the Conservatives, so I am confused.
Mr Wallace
The hon. Gentleman’s question would basically mean asking an insurer “Whom should we insure?”. As to the role of Government, they have secret intelligence at their fingertips, and have numerous reviews. After the Manchester attack, dozens of reviews took place over the past year; we have all of that. Some of it is secret, and some is not. That can help us understand and be better informed. We have no interest in the outcome of that.
Neil Coyle
Has Pool Reinsurance ever asked the Government to cover something that is not now covered—be it business interruption or cyber? Has that ever happened? That is what the Minister seems to be suggesting. Under the new clause the Minister would respond to recommendations. That is where the points that he makes would come in.
Mr Wallace
We have lots of discussions with Pool Re and many other insurers, and it has asked about cyber, as the hon. Gentleman has suggested. I have met its representatives several times, being the Security Minister. It has asked to do cyber, and we then take that into the process and go to the Treasury.
Mr Wallace
We are not going to agree: I view the role of the Government in this space as being able to review an incident, take input from communities, police, ambulance services and everyone else who has dealt with damage, add that to the secret intelligence they have on emerging threat, and come up with a position.
When we do such reviews they are significant. In the case of Manchester attack, the operational improvement review alone was 1,300 pages. Every detail was examined. That is where that type of advice to the market, including Pool Re, should come from. Clearly we are not going to agree on that. It is not that Pool Re is not a great organisation; but it is owned by its members and is a reinsurance company. Call it big state, if you like, but I think that the role of the Government of the day is to be able to direct it. That is the right place for it to sit, so I urge the hon. Gentleman to withdraw the new clause.
The Chair
Order. May I make it clear that we are on the clause stand part debate? Although we are discussing new clause 4 within the debate, it will not be formally moved or voted on until we reach new clauses at the end.
Nick Thomas-Symonds
I asked for reassurance from the Minister about leaving no stone unturned in the matter of past compensation. I do not think he responded to that when he was responding to the new clause, and I wonder if he would do so.
Mr Wallace
We want Pool Re to be dynamic and we want it to stimulate other insurers to meet the growing threat. The issue relates to a point I have made on numerous occasions—the number of travel insurances that have slowly, over the years, dropped terrorist insurance. It is not just about increasing insurance cover; it is important to keep an eye out for areas that are losing it. One of the lessons of last year is that we must be very much in touch with the affected communities—and it is about not only the human beings, but other aspects—to understand what has not been covered, and what more we can do.
Nick Thomas-Symonds
I am grateful to the Minister for covering those issues. Last week he argued against compensation for past events—because a line would have to be drawn somewhere. He said there could be additional unfairness because if the past period was set at 12 months, as my hon. Friend the Member for Bermondsey and Old Southwark suggested, something that happened two years ago would not attract the benefit, but something that happened six months ago would. The Minister said that that would create a new unfairness. I seek assurances that he will leave no stone unturned to find out whether anything can be done in relation to some of those past events, including the one at Borough market.
Mr Wallace
The hon. Gentleman makes an important point. I spoke to the hon. Member for Bermondsey and Old Southwark after the Committee sitting last week. After last year’s attacks, mayors and local authorities got together and produced requests of Government, which we met, with £23 million or £24 million in Manchester. We also met a request from Salisbury.
I said to the hon. Gentleman, “Let’s meet and speak with the local authority that covers Borough market and put together an ask.” I did not receive a reply from the Mayor of London on that, but we did receive replies from the Mayor of Manchester and the Salisbury council leader. I am happy to sit down and see what we can do. We gave an extra £1 million to the NHS to deal with some of it, but in comparison, for the Manchester package—the hon. Member for Manchester Central (Lucy Powell) was involved in that—we gave in response to a big long list of everything, from a marketing budget—to help that great city attract people back—to help with infrastructure and so on.
I am happy to meet the hon. Gentleman and his local authority and say, “Okay, come on—what is it you seek?” whether it be business rate relief or whatever. The Treasury will go mad at me for suggesting that. The point is, I have not received such a request, but I am happy to help stimulate it and will also work with the Mayor of London to do so.
Neil Coyle
I will certainly take the Minister up on that offer. Those who have been affected and are trying to rebuild their businesses—some are still in combat with insurance companies—have put further effort, while their businesses have suffered, into a request. That was put to a BEIS Minister, who came to the Borough Market Trust and met those directly affected. It was also put to a Treasury Minister here in Westminster when traders came to talk about their experience and ask for help. Those requests for support have been made, but to date they have not been acknowledged.
The Prime Minister visited the site and came back for the commemorative service. She was obviously welcome to do so, but she was aware of what had happened, its direct impact, the lack of insurance cover and costs involved for some, including microbusinesses, who could have gone under without public support. It is a little unfair to suggest that a request has not been made, but I will look to draw up something more comprehensive with the leader of the council, Peter John, and the Mayor of London and come back to the Minister with that. I thank him for the offer.
Question put and agreed to.
Clause 19 accordingly ordered to stand part of the Bill.
Clause 20
Border security
Question proposed, That the clause stand part of the Bill.
Mr Wallace
The clause simply introduces schedule 3, which confers powers exercisable at ports and borders in connection with the questioning and detention of persons for the purpose of determining whether they are or have been engaged in hostile activity. It fulfils a mechanistic function; the new powers will be best discussed when we debate schedule 3.
Question put and agreed to.
Clause 20 accordingly ordered to stand part of the Bill.
Schedule 3
Border security
Nick Thomas-Symonds
I beg to move amendment 44, in schedule 3, page 35, line 37, leave out “whether or not there are” and insert “where there are reasonable”.
The Chair
With this it will be convenient to discuss new clause 2—Threshold for port and border control powers—
“(1) Schedule 7 to the Terrorism Act 2000 is amended as follows.
(2) In paragraph 5 before ‘A person who is questioned’ insert ‘Subject to paragraph 9A,’.
(3) After paragraph 6A(2) insert—
‘(2A) A person questioned under paragraph 2 or 3 may not be detained under paragraph 6 unless the examining officer has reasonable grounds to suspect that he is a person falling within section 40(1)(b).’
(4) In paragraph 8(1) before ‘An examining officer’ insert ‘Subject to paragraph 9A below,’.
(5) In paragraph 9(1) before ‘An examining officer’ insert ‘Subject to paragraph 9A below,’.
(6) After paragraph 9 insert—
‘Data stored on electronic devices
9A (1) For the purposes of this Schedule—
(a) the information or documents which a person can be required to give the examining officer under paragraph 5,
(b) the things which may be searched under paragraph 8, and
(c) the property which may be examined under paragraph 9 do not include data stored on personal electronic devices unless the person is detained under paragraph 6.
(2) “Personal electronic device” includes a mobile phone, a personal computer and any other portable electronic device on which personal information is stored.’”
This new clause would implement the recommendations of Parliament’s Joint Committee on Human Rights and would require an officer to have reasonable grounds for suspecting an individual is or has been concerned in the commission, preparation or instigation of acts of terrorism before she could detain an individual for up to 6 hours under Schedule 7.
Nick Thomas-Symonds
I tabled the amendment in the hope of further exposition and assurances from the Minister. The shadow Home Secretary and I set out on Second Reading that, in the light of the events of recent months—with nerve agents on the streets of Britain—it is right that the Government should look at our border security. Therefore, while I will not stray out of order and discuss our other amendments, in generality they are designed to introduce further safeguards into the various powers available.
Amendment 44 would deal specifically with the non-suspicion power, if I may put it that way, in schedule 3, part 1, paragraph 1(4) on page 35. In regard to the power to stop, question and detain at the border, it states:
“An examining officer may exercise the powers under this paragraph whether or not there are grounds for suspecting that a person is or has been engaged in hostile activity.”
I am pressing the Minister specifically on whether or not there are grounds for suspecting. Clearly, in our criminal law there would usually be a reasonable suspicion of an individual. This power clearly goes beyond that, to suspicion that is not linked to the individual who can be stopped.
In previous debates and exchanges with the Minister on this matter, he has given me two explanations. The first was with regard to the nature of the intelligence provided; an example would be a flight where perhaps there is a suspicion about someone or people travelling on that flight, but the intelligence does not necessarily narrow down who that is. Therefore, anyone coming off that flight may be stopped. Secondly, with regard to the nature of the intelligence, when there are reasonable grounds for suspicion, those grounds may come about because of intelligence that, in itself, cannot be declassified or go into the public realm.
I am well aware of the arguments for the non-suspicion power; however, I would be grateful if the Minister could set out some of the situations in which this power would be used. Secondly, will the Minister indicate how frequently he would expect them to be used? I know it is not an exact science—we cannot predict the future—but I hope the Minister would at least have some sense of how he might expect it to be used and how frequently. Thirdly, there is concern because this power is different from so many other aspects of our criminal law where there has to be reasonable suspicion. Why does he think it is so vital for our national security that this be in schedule 3?
Gavin Newlands (Paisley and Renfrewshire North) (SNP)
It is a pleasure to see you in the Chair again, Ms Ryan. I shall speak in support of new clause 2 and amendment 44.
The new clause would largely do similar things, with an addition in our case. It would implement the recommendations of the Joint Committee on Human Rights and would require an officer to have reasonable grounds for suspecting that an individual is or has been concerned in the commission, preparation or instigation of acts of terrorism before they could detain an individual for up to six hours under Schedule 7. In addition, it would institute safeguards with regard to electronic devices.
The issues concerning this schedule are topical, given that some of it has been drawn in response to the Skripal incident in Salisbury in March. Obviously, in recent days there has been another incident, which is under investigation. The Bill was introduced with the intention of
“giving the police new powers to investigate hostile state activity at the border.”
The press release that accompanied the Bill stated:
“Using the new power, the police or designated immigration or customs officer will be able to stop, question, search and detail an individual at a port, airport or border area to determine whether he or she is, or has been engaged in hostile activity.”
On the face of it, there is little to disagree with in terms of the sentiment. Obviously, it is right and proper that we are able to take action on those who look to enter our country to do our country or its citizens harm. The authorities that do that do an incredibly important job and we should be grateful to them and ensure they have the necessary powers, but as drafted, these powers are concerning due to the lack of a reasonable grounds test for suspecting that an individual may be entering the UK to cause harm. They are therefore open to abuse and there is not enough assurance for officers working at our borders.
In addition, the Bill fails to protect any individual who has been designated a suspect. The arguments against these search and detail powers have been rehearsed over the years, but we should not dismiss the concerns that have been raised about racial profiling and how these powers allow for an element of discrimination in our society.
New clause 2 would implement the sensible recommendation of the Joint Committee on Human Rights and would require an officer to have reasonable grounds for suspecting an individual. It would provide greater clarity on when someone should be detained and would eliminate the chances of an individual’s personal belongings being searched and retained. It would therefore protect any individuals suspected of carrying out such an offence and also offers protection to the relevant officer on the border by providing greater clarity as to when they should detain a potential suspect. I urge the Minister to give new clause 2 and amendment 44 due consideration.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
The Minister and I discussed some of these powers privately, and I welcome the chance to discuss them again. He is aware of a number of cases that I am concerned about regarding detention or stopping and searching at borders. I make it absolutely clear that, when needed to protect public safety—whether from hostile state activity or from those travelling abroad or entering this country to commit acts of terrorism—the powers must absolutely be there to enable searching, detention and other necessary processes to deal with that and to keep the public safe.
However, there are two crucial points. The first is that, wherever possible, action should be taken before we have to detain or search or interdict somebody at a border, particularly if that person is leaving the UK. We should, if possible, detain them at their home or interview them elsewhere—voluntarily or otherwise—because if we get to the stage at which somebody attempts to board a plane or a ship or a Eurostar or whatever, there will be a risk both to public safety and of unnecessarily detaining or disrupting the travel of individuals who are not guilty of any offence.
The second point, which the Minister is aware of, is that we need to be aware that individuals may travel with family members or other individuals who are in no way connected and should not be under the reasonable suspicion that may be directed at that individual. What steps are being taken to ensure that information and processes are being shared to ensure that such detentions, searches and interdictions take place at the earliest possible opportunity? What arrangements are there to ensure that relevant information is shared, wherever possible, between airlines or other forms of transport, the Border Force, the Passport Office, the security services, the police and others to ensure that those things I mentioned are done at the earliest stage? I will move amendments on that issue later.
Afzal Khan (Manchester, Gorton) (Lab)
I shall be brief. I would like the Minister to take a couple of my questions into account when answering those raised by other Members. It is clear that this whole area gives a lot of power to officers, and that the term “hostile activity” risks casting an extremely wide net; in essence, anyone could be subject to the Bill’s invasive powers. Will the Minister explain how any confidential material obtained at the border will be protected? How do the Government intend to ensure that these powers will not lead to ethnic and religious profiling? In view of these broad powers, will the Minister also clarify whether any training will be given to officers?
Mr Wallace
First, the use of, effectively, no-suspicion stops on our border is not new. In fact, as we heard from those giving evidence to the Committee last week, lots of stops happen on our border, because borders are particularly vulnerable spaces. There are screening stops, in which people are asked questions about where they are coming from or going. There are also customs and excise stops, which go beyond that, and in which people are stopped and their bags and luggage are properly searched, perhaps in a side room. That is detaining, in a sense. It is not for a long period of time; it is certainly not as long as some of the scheduled stops that we will talk about.
Until someone is arrested, their access to legal advice and so on is different, because our vulnerability at a border, and our need to establish who, what and when, is really important for our national security. That is why many of those stops, in different guises—whether customs or identity screening—have been in place, sometimes, for hundreds of years. This is a development of that. In the Terrorism Act 2000, passed by the last Labour Government, the feeling was that, given our vulnerability at the border in a fast-moving world of millions of passengers, it was important to give our Border Force and our law enforcement community the ability to establish that information.
Some 89% of all stops at the border are done in under an hour. The vast majority are inward not outward, but to the point made by the hon. Member for Cardiff South and Penarth, I also have a constituent who was stopped when outward bound. My constituent was held up, and a family holiday and lots of money were effectively lost. Having met the hon. Gentleman, we have started a piece of work to look at exactly what we can do to minimise that. A good example would be asking whether it is really necessary to stop someone on the way out; they could perhaps be stopped only on the way back in. If we do not think they are going to travel to fight in Syria, but we think they might be going to do something else, we could just wait until they come back, and people are much less likely to suffer financial risk if they are done.
In answer to the question by the hon. Member for Manchester, Gorton, only officers who are specially trained are allowed to conduct a stop, search and detail. I think it would be illegal, and it would certainly be against the powers, to do it for arbitrary or discriminatory reasons. That would cover doing it on the basis of race or anything else. The no-suspicion power has been incredibly useful and has caught a significant number of terrorists, predominantly due to the fact that they have been stopped and data or biometrics has been seized. We have seen a number of cases. There was a guy from Wembley, I think, who was convicted of murder based on material recovered from a stop.
There will be safeguards in this new power. Our terrorism stops are reviewed by the Independent Reviewer of Terrorism Legislation. I have asked the Judicial Commissioner, Lord Justice Fulford, to review the use of the hostile state power on an annual basis. One of the reasons why we have introduced this is that the Independent Reviewer of Terrorism Legislation had serious concerns that in the past we were using a counter-terrorism power to stop people on a national security or hostile state concern. This is our response to what I think was David Anderson’s recommendation to take that forward.
The hon. Member for Torfaen and the Scottish National party have spoken about no-suspicion and the fact that we should have reasonable grounds. The biggest challenge is that the way our intelligence is presented to us can often be very broad. It can be based on a method, on a threat on a date, or on a plane, rather than on a person. The Government’s reading of the law is that if we had to have reasonable grounds, it would be too narrow for us to be able to respond to some of that intelligence threat.
It may even be that we have gone to a state of “critical”, where an attack is imminent but we do not know from which direction. I have personal experience, doing this job, of where we had some “reliable” intelligence about an attack in one part of the country, but in fact an attack happened in an entirely different place at another end of the country. The information was enough to consider raising the threat level, but not enough to know exactly where it was happening. I remember having rather an uncomfortable night, going out and having in the back of my head what I had been told might happen; while I was pleased that it did not happen, something else then happened elsewhere. It is a challenge; it is a difficulty. It is the way our intelligence is often presented to us, and that is why we need a no-suspicion stop.
There are protections for journalistic material and legal privilege. Because the seizing at this stop would not be under suspicion, the examining officer would have to apply to the Judicial Commissioner for that to be further examined, and the Judicial Commissioner could say no. We have included protections for journalists, lawyers and so on, to ensure that that happens, because we do not want the power abused, especially when we are talking about a hostile state rather than terrorism. Of course, hostile states are pretty clever at how they try to penetrate or come into the country.
Stephen Doughty
Obviously I do not expect the Minister to share any information here if it would be inappropriate to do so, but he mentioned the clever way in which hostile states may attempt to penetrate this country and undertake acts, whether that is the Skripal poisoning or other activities. Could he reassure us about measures in place at, for example, general aviation airports, smaller seaports and so on? Obviously, a lot of our focus is understandably on major locations such as Heathrow or Eurostar terminals and so on, but hostile states are well known for using alternative routes or, indeed, diplomatic channels to bring in individuals who conduct serious offences.
Mr Wallace
The hon. Gentleman makes an interesting point. Again, it goes to the reason we have the no-suspicion stop. They are most likely to be trained, capable agents of a country, not amateurs, or they may be disguised using amateurs. Look at the history of the cold war. That is why we sometimes have to respond to more general intelligence specifics. Let us say we had intelligence that a hostile state was seeking to use a minor port, a west coast port or a private air strip. That is all we would have, but if the threat was significant enough we would then have to—and we do—deploy individual police and Border Force officers from each region to cover that. However, that is quite wide. It is not, “Ben Wallace is coming in on flight X, Y or Z”; perhaps it is our responding to a flight plan. It is sometimes that simple.
I have come from a Cobra meeting this morning where we have seen the consequences of some really hostile state activity, which has put two innocent British citizens, who are very seriously ill, in hospital. We are being taken advantage of as an open country. I am afraid that there is far too much intelligence officer activity, not always under diplomatic cover in this country, from some of our adversaries, and we have to make our border a bit harder for them. Diplomats will not be covered by that—we will still be obliged under the diplomatic conventions—but their families may be. It goes back to the question on suspicion. I might have a suspicion that X is doing it, and they are a diplomat, but they may say, “Well, I’m not carrying that in; I’m not risking myself, but I’ll get someone else in the wider party who doesn’t have diplomatic cover to do it.”
I am afraid that is why it is really important for us. It is why the last Labour Government thought it was important on the terrorism issue. The Law Society of England and Wales witness said in his evidence that he had no concern about the suspicion part of the powers. He had some concerns about legal privilege, and I listened with interest to that part of his submission. That is why I think it would set us back in our national security and counter-terrorism work if we lost the power to do that. I am afraid the Government will therefore resist the amendment, and I ask colleagues on both sides of the Committee to reflect on that, and hopefully the hon. Gentleman will withdraw the amendment.
Nick Thomas-Symonds
I am grateful to the Minister for that explanation and exposition, and for the promise of the annual review under Lord Justice Fulford, which I think will be extremely useful. On that basis, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Nick Thomas-Symonds
I beg to move amendment 37, in schedule 3, page 36, line 7, at end insert—
“(6A) The Investigatory Powers Commissioner (‘the Commissioner’) must be informed when a person is stopped under the provisions of this paragraph.
(6B) The Commissioner must make an annual report on the use of powers under this paragraph.”
The Chair
With this it will be convenient to discuss amendment 36, in schedule 3, page 40, line 31, at end insert—
“(2A) The person who owns or was carrying or transporting an article which is retained under paragraph 11(2)(d) or (e) must be notified by the examining officer when the Commissioner is informed that the article has been retained.”
Nick Thomas-Symonds
I will be quite brief, because these amendments simply insert some further safeguards. They do not detract from the central aims of what the Government are seeking to do, but provide additional protections.
Amendment 37 relates to the power to stop, question and detain, which obviously we have been discussing in relation to my previous amendment. The amendment would simply allow the Investigatory Powers Commissioner to be informed when a person is stopped, and to make an annual report on the use of the power, which seems a perfectly reasonable request in the circumstances.
I will deal with amendment 35 in due course. Amendment 36 is simply about the commissioner being informed about the retention of property. The person who owned the article, or who was carrying or transporting it, will be notified by the examining officer when the commissioner is informed that it has been retained. These two amendments are not major interferences with the power, or with the aims of the Bill, but I suggest to the Minister that they are sensible safeguards.
Mr Wallace
As the hon. Gentleman has explained, the two amendments seek to enhance the oversight of the powers in schedule 3 by the Investigatory Powers Commissioner. I entirely agree that we need effective oversight, but I hope to persuade him that the Bill already provides for that.
Amendment 37 would require that when a person is stopped and examined under schedule 3, the commissioner must be informed. It would also require the commissioner to make an annual report on the use of those powers. As to the duty to prepare an annual report, I refer the hon. Gentleman to part 6 of schedule 3, which already sets out the duty on the commissioner to keep under review the operation of the provisions in the schedule and to make an annual report to the Secretary of State about the outcome of that review.
The mechanism outlined in part 6 mirrors the well-established reporting apparatus of the independent reviewer of terrorism legislation in relation to counter-terrorism powers. In his annual report, the independent reviewer reviews the operation of the equivalent port and border power in schedule 7 to the Terrorism Act 2000, and in doing so highlights any issues that have arisen through the exercise of those powers, provides a statistical breakdown of how they are used and makes recommendations for their future operation.
Amendment 36 would require that the examining officer informs the owner of an article that has been retained under paragraph 11(2)(d) or (e) of schedule 3 once the Investigatory Powers Commissioner has been notified of its retention. An examining officer may retain an article under paragraph 11 (2)(d) when
“the officer believes that it could be used in connection with the carrying out of a hostile act”,
or under paragraph 11(2)(e)
“for the purpose of preventing death or significant injury.”
Although I appreciate the amendment’s intent, it would place an unnecessary burden on the examining officer.
My officials are working with the Investigatory Powers Commissioner’s Office to determine the precise mechanism for keeping the individual informed of the fate of their property, including the appeal process and notice of any decision made. That will be set out in greater detail in the schedule 3 code of practice that we aim to publish in draft this autumn. Let me reassure the Committee that no individual will be left guessing as to what has happened. I agree wholeheartedly that the process should be governed appropriately and transparently. Given that the issues are already addressed in the Bill, or will be in the code of practice, I invite the hon. Gentleman to withdraw his amendment.
Nick Thomas-Symonds
I am grateful for those reassurances. I ask the Minister to comment on a further issue that relates to what I said previously. When the commissioner is carrying out the review process and producing the report that the Minister has referred to, will they be aware of every stop that has taken place?
Mr Wallace
Yes. As for the counter-terrorism stops that exist, the total numbers will be in the annual transparency report. Although the commissioner will not be informed every time someone is stopped, the numbers will all be recorded, and he will have the power, in the same way as the reviewer of terrorism legislation does, to investigate those stops while doing the review. It will not just be, “Are these the numbers? Have they complied?”
The reviewer of terrorism legislation can investigate intelligence agencies issues, police issues and the things that lay behind the stops, and that is what we expect them to do. That is why I want a judicial commissioner to do that for hostile states, so if we see it being abused or not being right, he will spot it—not us. He will spot where police officers are not being properly trained or are not doing it correctly, or if it is being overused with no results. I assure the hon. Gentleman that in that scenario the independent commissioners will not take it at face value.
Nick Thomas-Symonds
I am grateful for those reassurances. In those circumstances, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Nick Thomas-Symonds
I beg to move amendment 35, in schedule 3, page 40, line 27, at end insert—
“11A(1) This paragraph applies where—
(a) an examining officer intends to retain an article under paragraph (2); and
(b) the person who owns or was carrying or transporting the article alleges that the article contains confidential material.
(2) Where sub-paragraph (1) applies, the examining officer—
(a) may not examine the article; and
(b) must immediately provide the article to the Investigatory Powers Commissioner (the ‘Commissioner’).
(3) On receiving an article under sub-paragraph (2), the Commissioner must determine whether or not the article contains confidential material.
(4) Where the Commissioner determines the article contains confidential material, the Commissioner may authorise the examination and retention of material in accordance with the provisions of paragraph 12(5).
(5) Where the Commissioner determines the article does not contain confidential material, the Commissioner must return the article to the examining officer to determine whether the material should be retained under paragraph 11(2).”
The amendment relates purely to the protection of confidential material. I have based it squarely on what was said by the Master of the Rolls, one of our most senior judges, in the Miranda judgment, with which I am sure the Minister is familiar. The Court of Appeal judgment is dated 19 January 2016. The Master of the Rolls, who gave the leading judgment—this is from paragraph 119 of the judgment—said:
“But in disagreement with the Divisional Court, I would declare that the stop power conferred by para 2(1) of Schedule 7”—
to the Terrorism Act 2000—
“is incompatible with article 10 of the Convention”—
the European convention—
“in relation to journalistic material in that it is not subject to adequate safeguards against its arbitrary exercise and I would, therefore, allow the appeal in relation to that issue. It will be for Parliament to provide such protection. The most obvious safeguard would be some form of judicial or other independent and impartial scrutiny conducted in such a way as to protect the confidentiality in the material.”
It is important to protect the confidential material, as the Minister is aware. I have simply taken what one of our country’s most senior judges has said and tried to construct a protection that is in line with what he has asked Parliament to do. It would work through the oversight of the Investigatory Powers Commissioner.
The commissioner could determine whether an article contains confidential material and could then give powers in those circumstances where it can still be examined and retained, but there has to be that protection and that distinction given by the commissioner. Where there is a determination that the article does not contain confidential material, it could be returned to the examining officer. That is a sensible suggestion to deal with the lack of a safeguard that has been highlighted by one of our most senior judges.
Mr Wallace
I am grateful to the hon. Gentleman for explaining his amendment. I want to start by reaffirming the Government’s strong conviction that confidential material should always be handled with the utmost care and consideration. We have sought to provide for that in schedule 3. The Bill provides that the Investigatory Powers Commissioner must be the one who authorises the retention and use of an article that consists of or includes confidential material, subject to meeting the requirements of paragraph 12(5). Beyond the point at which the examining officer comes to hold a reasonable belief that an article contains confidential material, the officer will not be able to examine that article until further authorisation has been granted by the commissioner.
However, it would be improper to impose a restriction on the examining officer such that they were unable to establish their own belief that the article does in fact consist of confidential material. The police have a statutory obligation to protect our citizens and prevent crime. They cannot be expected always to take at face value the word of someone they are examining, who in some cases will be motivated to lie. If an individual being examined claims that an article consists of confidential material, the examining officer should be within their rights to verify that if they feel that is appropriate. Having verified that the article does indeed consist of confidential material, the examining officer should stop the examination and, if they wish to retain the article, seek the commissioner’s authorisation to examine it.
The point about face value is important. Bona fide people will usually be able to identify themselves as bona fide lawyers or journalists pretty quickly. If someone turned up with no law degree or legal background and said, “I’m a lawyer, so you cannot look at my devices,” it would be fair for the officer not to be able to examine the whole documentation or device, but to seek to establish the fact before they then take the next step and go to the judicial commissioner with a request to examine the material. Until the request is granted, the judicial commissioner can say, “No, you can’t. You have to destroy it.” They can direct them.
The difference between me and the hon. Gentleman is the extent to which we want face value to be established before it goes to the judicial commissioner. I stress that under this schedule the examining officer can seek to retain that material only if they believe that the article could be used
“in connection with the carrying out of a hostile act”,
or if they believe that retaining the article could prevent “death or significant injury”. Although it is not in the Bill, I assure the hon. Gentleman that it will be in the code of practice that is provided for in part 4 of schedule 3. If the commissioner concludes that the article could not be used in connection with the carrying out of a hostile act, or could not cause death or significant injury, they will direct the article to be returned to the person from whom it was taken.
I assure the hon. Gentleman that we are working with the police and the Investigatory Powers Commissioner on how those provisions will be implemented in practice. The mechanics will be set out in the schedule 3 code of practice that we aim to publish in draft in the autumn. I hope that I have persuaded him that that is the right approach and he will accordingly be content to withdraw his amendment.
Nick Thomas-Symonds
I am grateful that the Minister has set out the position regarding the proposed code of practice. If he would undertake to keep me updated on how discussions go leading up to that publication in the autumn, I would be very grateful and willing to withdraw the amendment.
Mr Wallace
To reassure the hon. Gentleman, it will be a statutory code, so it will go through the full process.
Nick Thomas-Symonds
In that case, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Gavin Newlands
I beg to move amendment 21, in schedule 3, page 46, line 17, leave out “and 26”.
The Chair
With this it will be convenient to discuss the following:
Amendment 22, in schedule 3, page 46, line 26, leave out sub-paragraph (3).
Amendment 38, in schedule 3, page 46, line 27, leave out from “would” to the end of line 28 and insert
“create an immediate risk of physical injury to any person or persons.”
Amendment 40, in schedule 3, page 46, line 28, at end insert—
“(3A) Where the examining officer believes that there is an immediate risk of physical injury to any person or persons under subparagraph (3), they must allow the detainee to consult a solicitor by telephone.”
Amendment 23, in schedule 3, page 46, line 33, leave out sub-paragraph (6) and insert—
“(6) Sub-paragraph (5) does not apply if the examining officer reasonably believes that the time it would take to consult a solicitor in person would create an immediate risk of physical injury to any person.”
Amendment 39, in schedule 3, page 46, line 34, leave out from “would” to the end of line 35 and insert
“create an immediate risk of physical injury to any person or persons.”
Amendment 41, in schedule 3, page 46, line 35, at end insert—
“(6A) Where the examining officer believes that there is an immediate risk of physical injury to any person or persons under subparagraph (6), they must allow the detainee to consult a solicitor by telephone.”
New clause 3—Access to a solicitor—
“(1) Schedule 8 of the Terrorism Act 2000 is amended as follows.
(2) In paragraph 7 leave out ‘Subject to paragraphs 8 and 9’.
(3) In paragraph 7A—
(a) leave out sub-paragraph (3),
(b) leave out sub-paragraph (6) and insert—
‘(6) Sub-paragraph (5) does not apply if the examining officer reasonably believes that the time it would take to consult a solicitor in person would create an immediate risk of physical injury to any person.’
(c) in sub-paragraph (7) at end insert ‘provided that the person is at all times able to consult with a solicitor in private.’
(d) leave out subparagraph (8).
(4) Leave out paragraph 9.”
This amendment would delete provisions in the Terrorism Act 2000 which restrict access to a lawyer for those detained under Schedule 7.
Gavin Newlands
The amendments would delete the provisions that restrict access to a lawyer for those detained under schedule 3 for the purpose of assessing whether they have engaged in hostile activity. However, in doing so, the amendments would add an important safeguard that would ensure that that would not apply if the examining officer reasonably believed that the time it would take to consult a solicitor in person would create an immediate risk of physical injury to any person.
In addition, new clause 3 would amend schedule 8 of the Terrorism Act 2000 with regards to access to a lawyer. It acts on the concerns that have been expressed to us by many different organisations and respected individuals. As we have heard, this section of the Bill would allow an individual to be detained for a significant period of time without reasonable grounds.
Notwithstanding the Minister’s points about the varied forms of intelligence that are received, the amendments are not about constraining the powers of the men and women who work at our borders, but acting on the concerns that have been expressed to ensure that correct and proper due process is followed. During the evidence session, we heard from Richard Atkinson that the schedule was of “great concern” to him as
“It fundamentally undermines what I would consider to be a cornerstone of our justice system—legal professional privilege.”––[Official Report, Counter-Terrorism and Border Security Public Bill Committee, 26 June 2018; c. 26, Q55.]
We will come on to that in more detail in the next set of amendments.
In addition, during the oral evidence, Abigail Bright of the Criminal Bar Association also had concerns about
“having no access to a lawyer, on the face of it for no good reason”
and
“why the rights of a suspect, who is potentially an accused person, should be diminished”.––[Official Report, Counter-Terrorism and Border Security Public Bill Committee, 26 June 2018; c. 58, Q128.]
I suspect that the schedule has been drafted as a result of concerns that lawyers and legal advisers could be exploited and manipulated in some way, as has been outlined. However, as was pointed out, that is not unknown to our criminal justice system and we already have powers in place to deal with such occasions. For example, in code H of the Police and Criminal Evidence Act 1984, which deals with counter-terrorism cases, if there is a concern about an individual lawyer, there is provision for the suspect to have the consultation with that lawyer delayed but to be offered the services of another lawyer in the meantime, so the suspect is not devoid of legal advice.
Access to legal advice is a cornerstone of the British justice system—as a Scottish National politician, I should say the English and Welsh justice system and the Scottish justice system, before I get chided—and one that we should protect at all costs. I accept the Government propose the changes with the best of intentions to keep us safe but, as we have pointed out, there are ways that that can be done without eliminating or infringing on the basic principle of the rule of law.
The amendments provide a degree of flexibility to the authorities while ensuring that individuals can still access and make use of proper legal representation. Specifically, amendment 23 would, as I have outlined, provide that an individual can be prevented from consulting a lawyer in person only where the officer reasonably believes that the time it would take to secure a solicitor’s presence would create an immediate risk of physical injury to an individual or group of people. Those are important safeguards when there is valid suspicion about waiting for a lawyer to meet a client. Public harm can be caused by the wait, but at the same time there is an issue in the majority of circumstances of protecting someone’s basic right of access to a lawyer.
New clause 3 would amend schedule 8 to the Terrorism Act 2000. It would delete provisions restricting the access to a lawyer of people detained under schedule 7 to the same Act. I respect the concerns that the Minister has outlined, but I think that they were alleviated in the oral evidence given by Max Hill a couple of weeks ago. By tabling the amendments and new clause I am trying simply to maintain access to justice.
Nick Thomas-Symonds
I support the amendments tabled by the hon. Member for Paisley and Renfrewshire North; I also want to speak to amendments 38 to 41, which I tabled. They follow the same general tenor as the hon. Gentleman’s amendments, in that they are practical suggestions for maintaining the right to access to a lawyer. Amendment 41 is about consultation via telephone.
I will not discuss the amendments in the next group now. They have far more to do with the right to consult a solicitor in private. None the less, that issue is also at the heart of the amendments in the group we are now considering. The hon. Member for Paisley and Renfrewshire North has already referred to the evidence given by Max Hill, and I commend the evidence of Richard Atkinson, too. He chairs the criminal law committee of the Law Society, and I am sure that the Minister recalls a conversation with him on this very issue.
The Minister put the practical point to Mr Atkinson about whether access to a lawyer would be requested on every stop at the border. However, that is not what is at the heart of the amendments. The Minister asked Mr Atkinson whether he thought
“that when a Border Force person, a customs person, seeks to detain you for an hour or however long to examine and question you further, they, too, should have access to a lawyer”––[Official Report, Counter-Terrorism and Border Security Public Bill Committee, 26 June 2018; c. 29, Q66.]
That was about when the stage of being questioned was reached. The Minister mentioned a series of stages—whether it was a screening stop or another type of stop; but what I am talking about applies when questioning starts, when legal advice would be a necessity. We are not talking about the thousands of stops that are made. We are talking about particular circumstances that would be analogous to the position in the Police and Criminal Evidence Act 1984.
I also commend Mr Atkinson’s evidence in terms of seeking practical solutions to deal with the Government’s concerns and still maintain our cherished right of legal professional privilege. As I have said, Ms Ryan, I will not talk about that in principle now, as I will do so on the next group of amendments. However, Mr Atkinson suggested several ways in which the balance could be maintained. He said the consultation could be delayed; if there were concerns about a particular lawyer, the services of a different one could be offered; and advice could still be given within the sight of examining officers without necessarily being given within their hearing.
I recognise the issue of immediate physical threat, as well. However, I urge the Minister to look at the matter practically, and not to sacrifice legal professional privilege but to take note of the practical solutions by which we could deal with concerns about individuals abusing the right to consult a lawyer by, for example, consulting someone who is not a lawyer or passing on information. I accept that there is a risk and I accept what the Government say, but we should turn our minds to finding a practical solution that maintains legal professional privilege.
Mr Wallace
I commend the spirit of the amendments tabled by the hon. Members for Paisley and Renfrewshire North and for Torfaen. It is important that as we strengthen our powers to tackle hostile state activity, we ensure that appropriate safeguards are in place to govern the exercise of those powers. The amendments seek to ensure that if an individual has been detained under schedule 3 to the Bill, and schedules 7 and 8 to the Terrorism Act 2000, the examining officer must postpone questioning until the examinee has consulted a solicitor in private. The amendments, and those in the next group, would remove almost all restrictions on that right, which allow police officers to impose conditions on its exercise. The Government’s case against the amendments applies equally to those in the next group, so I ask for your indulgence, Ms Ryan, if I touch on the issues raised by amendments 24, 25 and 42. It may be that when we come to the next group, we will find that we have already covered much of the ground.
The powers under schedule 3 to this Bill and schedule 8 to the 2000 Act would afford any person who is formally detained the right to consult a solicitor privately, if they request to do so, subject to exceptional powers of delay, which I will explain further. I agree with Opposition Members that where an individual has been detained under those schedules and has requested to consult a solicitor, they should have the right to do so privately. In the vast majority of cases, there will be no reason to question that right. On rare occasions, there might be a need for the examining officer or a more senior police officer to impose certain restrictions.
I want to be clear that the restrictions in schedule 3 are not new or novel. Indeed, they are modelled on existing restrictions and conditions that are available now to police officers in schedule 8 to the 2000 Act and in the PACE codes governing the detention rights of those arrested under non-terrorist arrest powers. They are designed to be available only in specific and serious circumstances, namely where those detained seek to frustrate an examination, cause evidence to be interfered with or alert others who are in some way involved in an indictable offence.
Nick Thomas-Symonds
If there were, just as there would be in a police station, a list of duty solicitors—or a list of approved lawyers where, if there were concerns, those lawyers could be removed from the list—why would there be a concern about an individual speaking to one of those lawyers in private, if that control were in place?
Mr Wallace
In the PACE codes, we already have that small ability to reflect that concern, if there is a concern. It can be done already in such a situation.
Nick Thomas-Symonds
There can certainly be restrictions. There could be a restriction that an individual can consult a lawyer within sight of an examining officer—no issue with that. The issue is where the Bill goes further and provides that it must also be within the officer’s hearing. The justification given for that, as I understand it, is a worry that the individual will abuse that right and pass on information to someone, saying they have been picked up or whatever it might be. Why would that be a problem if there was an approved list of lawyers, which we were monitoring all the time, where we know that they are bona fide lawyers and there is not a concern?
Mr Wallace
I will address that issue later in my speech. I can inform the hon. Member for Torfaen that at the moment, if an individual is detained on a customs stop for an hour, they only have a right to a lawyer in that environment once they have been arrested, not while they are being detained. That is currently the practice.
In the vast majority of cases there will be no reason to question the right, but on rare occasions, there may be a need for the examining officer or a more senior police officer to impose certain restrictions. As I have already stated, these conditions are available now to police officers in schedule 8 to the 2000 Act and in the PACE codes. It is mainly about a situation where those detained seek to frustrate an examination or in some way alert others who might be themselves subject to an indictable offence. That might be where prior intelligence indicates that the individual might seek to obstruct an examination, either because they have a history of doing so or they have been trained to bypass, frustrate or subvert police examinations. The officer might also witness interactions between the individual and their solicitor, which alerts the officer to the possibility that they are conspiring to obstruct an examination or interfere with evidence.
Nick Thomas-Symonds
Clearly, the professional code of conduct that lawyers have would prevent them in engaging in any illegal activity, so that would be covered in any event. If there were, say, four or five approved lawyers who were completely regulated and we knew who they were, why would there be a risk of them passing information on to other people?
Mr Wallace
Let me proceed. When it comes to a person’s right to have access to a lawyer, no one currently prescribes in law that they may have only certain lawyers, except in Special Immigration Appeals Commission hearings. I would be interested in what the Law Society in Wales would say if we tried to set out that they could see only vetted lawyers.
Nick Thomas-Symonds
Police stations have duty solicitor rotas, and that has been in existence for decades.
Mr Wallace
I understand that, but that does not restrict arrested people in a police station to choosing only from those lawyers. They can say, “I don’t want any of those five. I want the one I want.” I understand the hon. Gentleman’s point about a lawyer being trustworthy or effectively selected not specifically by the person detained but from an approved list. However, it would be difficult to go down the path of trying to approve people.
Nick Thomas-Symonds
But that is already the case in Police and Criminal Evidence Act 1984 code H. Richard Atkinson said that
“where there is concern about an individual lawyer”—
let us take the example of a person who asks to ring someone we are not entirely sure about—
“there is provision for the suspect to have the consultation with that lawyer delayed but to be offered the services of another lawyer in the meantime.”––[Official Report, Counter-Terrorism and Border Security Public Bill Committee, 26 June 2018; c. 27, Q55.]
Why do we not take the equivalent of that to the border? We could offer the services of those on our duty list—problem solved.
Mr Wallace
I understand the hon. Gentleman’s point. All such schemes, including his, restrict people’s right to a lawyer, one way or another. They either say, “I don’t trust your lawyer, so you can have my lawyer,” or—this is how the Government are doing it—“We have exceptional grounds, authorised by a chief officer, because we are suspicious of something”.
The hon. Gentleman makes a point about police stations, but many of these examinations are about establishing who, what, where and when. We should remember that in the port stops power, to balance the removal of some rights, these verbal discussions are not admissible in court as evidence, unlike in a police station, where everything said can be taken down in evidence and used. We give that protection, as my hon. Friend the Member for Cheltenham (Alex Chalk) pointed out.
Afzal Khan
I accept what the Minister says about trying to balance rights by not allowing such conversations to be used as evidence, but would it not be better and in the wider interest to allow the use of solicitors from a pool and be able to use those conversations as evidence?
Mr Wallace
If I were to propose such a restriction on which lawyers could be consulted, I would find difficulty in the House of Lords. Let me proceed.
Accepting the amendments would in effect offer an opportunity to those engaged in activity of such severity to frustrate and obstruct an examination. Let me address the key point raised—the evidence we heard last week on restriction of the right to consult a solicitor in private. We must be clear that schedule 3 would allow use of the power only when an officer at least of the rank of commander or assistant chief constable has reasonable grounds for believing that allowing the examinee to exercise his or her right to consult a solicitor privately will have certain serious consequences.
The provisions are largely modelled on similar provisions in PACE: namely, where there are reasonable grounds to believe that private consultation will result in interference, injury to another person or hindering the recovery of property. Due to the potential severity of an act of terrorism, schedule 8 to the 2000 Act outlines additional consequences that might justify allowing the legal consultation to take place only within the sight and hearing of a qualified officer. Those include interference with information-gathering relating to an act of terrorism, alerting a person and making it more difficult to prevent an act of terrorism.
Schedule 3 to the Bill contains a similar consequence as a ground for allowing non-private legal consultations, namely the consequence of interference with information gathering about
“a person’s engagement in hostile activity.”
The need for the restriction is clear. It is there to disrupt and deter a detainee who seeks to use their right to a solicitor to pass on instructions to a third party. It already exists in legislation in schedule 8 to the 2000 Act, which the Bill seeks to replicate. In giving evidence to the Committee, the chair of the Law Society’s criminal law committee questioned why this restriction went beyond the equivalent provisions in PACE code H, which relate to a situation where an individual has been arrested on suspicion of a terrorism offence. PACE code H provides that:
“Authority to delay a detainee’s right to consult privately with a solicitor may be given only if the authorising officer has reasonable grounds to believe the solicitor the detainee wants to consult will, inadvertently or otherwise, pass on a message from the detainee or act in some other way which will have any of the consequences specified under paragraph 8 of Schedule 8 to the Terrorism Act 2000.”
Those consequences include harming others or tipping off terrorism suspects. In such circumstances,
“the detainee must be allowed to choose another solicitor.”
We have considered that carefully, but there are two main reasons why it is not feasible from an operational standpoint. First, in the circumstances described, where the police are concerned that an individual will use their solicitor to pass on instructions, allowing them access to a different solicitor in private will not prevent that possibility. The solicitor might be completely oblivious to the fact that their client is using them to pass on instructions to a third party. For instance, a detainee might ask the solicitor to contact someone and pass on a specific message, such as the fact that they are being detained and their location, with the solicitor unaware that the message will trigger some prearranged activity.
Secondly, inviting the detainee to choose another solicitor is not as straightforward at a UK port as it is at a police station. Unlike a detention under PACE, where there is time and access to a duty solicitor, it might take a substantial amount of time for an alternative solicitor to arrive at a UK port. To offer that option up front to the detainee, who is already presenting reasons to believe they are up to no good, provides another means for them to obstruct and frustrate the examination against a ticking detention clock.
Despite those reservations, I draw the Committee’s attention to two important safeguards that govern the exercise of such a direction. The first will ensure that a direction may be given only by an officer of the rank of assistant chief constable. The second will ensure that the officer present during the detainee’s legal consultation must not be connected with the detainee’s case. I reassure the Committee that the safeguards to the schedules have been carefully considered, following lessons learned through the exercise of the equivalent police powers, the work of the independent reviewers of terrorism legislation and our engagement with the public in respect of the existing powers for counter-terrorism purposes.
In relation to the amendments before us today, I stress that we should not hinder the ability of our law enforcement professionals to disrupt and deter those who present a threat to this country due to their involvement in terrorism or hostile state activity. Accordingly, I invite the hon. Member for Paisley and Renfrewshire North to withdraw his amendment.
Nick Thomas-Symonds
I do not propose to take this particular group of amendments to a vote at this stage, but I say to the Security Minister that the first of the two explanations given—that somehow solicitors bound by a code of conduct would be unwilling and unaware stooges passing on information to third parties—is not particularly credible. I do not think the distinction between a police station and a border security stop is particularly strong either, and I urge the Minister to look again at the practical steps around this. However, it is not my intention to push the amendments to a vote at this stage.
Gavin Newlands
I have to say that I remain somewhat unconvinced by the Minister’s arguments, and we may choose to revisit some of these amendments on Report, but at this stage I will keep my powder dry until the next group of amendments. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Ordered, That further consideration be now adjourned. —(Paul Maynard.)
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Universal Health Coverage
(6 years, 5 months ago)
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Jim Shannon (Strangford) (DUP)
I beg to move,
That this House has considered the role of universal health coverage in tackling preventable and treatable diseases.
I would first like to thank the Backbench Business Committee for granting this debate. I have been lobbied fairly heavily on the subject and a number of organisations asked me to approach the Committee and request a debate. I am pleased to see the Minister in his place. He and I have discussed the matter before. It is probably one of those issues that involves not only the Department of Health but perhaps the Department for International Development. He once told me that he took part in a debate that covered five different Departments—I suppose he is a man of many talents—so he will be able to answer wisely for the Departments covered in this debate. I thank hon. Members for coming along to Westminster Hall on such a warm day, and given the almost end-of-season approach we seem to have to matters now.
I wish to begin, as we approach the 70th anniversary of our NHS, by thanking all those who have made that institution all that it is. I have said that in other places, but I wanted to say it publicly now in Westminster Hall. Many political parties have had the opportunity to be part of the creation of our great NHS, and many of us have had the opportunity to be cared for by it, both surgically—in operations—and through the care that nurses provide in hospitals, which I personally have had on three occasions over the past year. I am thankful to every person involved in the NHS, from the porter to the paediatric consultant, from the occupational therapist to the oncologist, from the scrub nurse to the surgeon, from the auxiliary nurse to the audiology clinician, and all people in between. I thank them all very much for all that they do for us as patients, but also for us as a nation. I want to put that on the record.
I thank NHS staff for making the NHS work in situations that often seem unworkable, due to stress and pressure. As the Democratic Unionist party’s spokesperson on health, I am frequently contacted by those who need more than the service has to offer. A great many times we focus on the problems of the NHS and where we are—that is the way life is—but we also need to reflect on how good it is and how much we owe it.
People often come to us with their problems; they do not necessarily come to us to tell us how good a job we are doing. Perhaps half a dozen people will call in a week to say what a good a job we are doing, but hundreds of others will come to us with their complaints. That is the nature of the job. It is not about complaining; it is part of the job. I believe that I must highlight where we are going wrong, or perhaps where we can do things better. We must see if we can do things along those lines.
Today it is my desire to thank all those who work in the NHS so tirelessly, who do not always get the recognition they deserve. The NHS is our nation’s greatest asset. A Member said in the main Chamber today during business questions that the NHS was probably our nation’s greatest accomplishment. I tend to agree, as I am sure would many others. The NHS embodies our British values of compassion and fairness. It represents our nation’s strong sense of justice and the desire to help those in need. With its quality of care and pioneering scientific research, it is a world-leading institution.
Across the whole of the United Kingdom of Great Britain and Northern Ireland, the NHS works in partnership with many universities and private companies on research and development for drugs that can help save lives. Queen’s University Belfast is one of those universities, and I know that because it is one of the institutions that I would call in on. Indeed, just three months ago I visited its cancer research team to see the scientific work they are doing. They were over here this week, along with staff from breast cancer charities, in the Attlee suite in Portcullis House, and we had a chance to catch up. What they are doing to try to find cures for cancer at all levels is incredible. There is also the complexity of breast cancer treatment to consider, because many people have different variations, so the drugs they take must be just as varied.
The NHS is the type of British export that can help underpin the UK’s global Britain vision, which I believe we lead the world on and which we can be the forerunners for. Health for all, which is the bedrock of this most beloved institution, is a principle that the UK originated in 1948, when it first embarked on the altruistic duty of creating a national health system to provide care to everyone, everywhere, without their having to experience financial hardship.
Tulip Siddiq (Hampstead and Kilburn) (Lab)
I agree with everything the hon. Gentleman has said so far about the NHS. I saw its merits at first hand when I had a baby two years ago. However, I wish to make a point about the current shortage in the NHS of the BCG vaccine, which is used to treat tuberculosis. My constituent, Hussein, is 11 months old. He was born in Lebanon but is a British citizen. His parents have told me that their GP said that Hussein cannot have the BCG vaccine on the NHS because he was born outside the UK. Does the hon. Gentleman agree that although our NHS has a fantastic track record in tackling diseases and providing care, in order for it to have a successful future every British citizen must be entitled to the preventive medicines on offer?
Jim Shannon
I thank the hon. Lady for that intervention. I know that the Minister, like me, listened carefully to what she said. If there is clearly the anomaly that she outlines, the NHS should reply and make the vaccine available. I am quite incredulous that someone who is a citizen of the United Kingdom of Great Britain and Northern Ireland cannot have it. That is almost impossible to understand. I am sure that the hon. Lady will receive a response from the Minister in whatever time is left at the end of the debate.
The NHS is the purest and simplest definition of universal health coverage, and it is the world’s oldest and most successful model. The World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that 100 million people are pushed into extreme poverty by healthcare expenses. We have problems as well. I get frustrated sometimes when constituents come to me. I am referring to Northern Ireland, where health is a devolved matter and therefore not the Minister’s responsibility, but I believe that these cases illustrate some of the issues. A constituent told me this week that a consultant had said to them, “Well, you’re going to have to wait maybe 53 weeks for an operation.” If people want to have an operation through private healthcare, however, they are told that it could maybe be done before the end of the month. As always, if someone can pay for something, they can have it done. We have these problems within the NHS in Northern Ireland and, I suspect, across the rest of the United Kingdom.
As I said, the World Health Organisation estimates that half the world’s population lack access to essential healthcare services and that some 100 million people are pushed into extreme poverty by healthcare expenses. Behind these horrifying statistics are tragic human stories of unnecessary loss and suffering. My parliamentary aide, who does a lot of speech writing and research for me, has travelled to Africa to work every summer, usually in Swaziland but also in Zimbabwe over the past couple of years. That is through Elim Missions, which is a church group in my constituency. She used to visit Africa every summer, during the recess, but she now has two young girls and has not been for a few years. When she came home each year, the tales she would tell about the hospitals she visited would break your heart.
Let me tie together these two stories: first, our NHS; and secondly—perhaps this is for DFID—the responsibility that I believe we have to reach out and help other countries. I referred to that in my earlier discussion with the Minister. My aide’s stories would really have broken your heart. The children’s ward was full of the cast-offs from hospitals in the UK. I do not mean that disrespectfully, because we do that in Northern Ireland—Elim Missions and many other groups do it. We fill containers with second-hand hospital apparatus that might need repairs and we send it out to Zimbabwe, Swaziland and other countries around the world. The equipment can still be used, but sometimes it is worse for wear. We would not put our children anywhere near some of those conditions, but the staff we met made use of all that apparatus and all those materials.
Children in orphanages went without basic medical care until nurses from the UK gave up years of their lives to provide medical training to local communities, for example on the importance of sterilisation. Sometimes the issues can be small, but necessary, such as the simple effect of drops. The hon. Member for Stafford (Jeremy Lefroy) and I were talking this morning about some other things. He said that when he was in Africa his son was taken very ill with pneumonia at eight months old. They did not have the small antibiotic drops that were needed, but once his son got them he became much better and got over the illness. That shows how small things can make a difference and how important it is that we do them.
The Luke Commission is a charity that has been operating since 2005. It takes free healthcare and hope to the most isolated populations in Swaziland. Mobile hospital outreach sites are set up in the remotest parts of that small country. The population is scattered and dispersed. Patients are tested, counselled and linked to treatment for HIV/AIDS. Swaziland has some of the highest levels of HIV in the whole world, and the whole of Africa in particular. Those suspected of having TB are X-rayed and started on medication. Voluntary male circumcisions are performed in an on-site 11-bed operating room, as studies have shown that the rate of HIV transmission is cut by 60% in circumcised males. Those are practical actions that can be taken to change things. More and more evidence indicates that lack of male circumcision is one of the primary reasons why the HIV prevalence rate is so high. These actions can reduce that. Nurses travel back to rural communities to check on newly circumcised men to ensure that they are healing, to answer questions and to provide HIV prevention education.
At the mobile hospital sites, schoolchildren are treated for skin and intestinal problems. Young people are fitted with new shoes. Those are practical, small things that can make a difference. I put on record my thanks to the Elim church charity and to the many other charities and churches across my constituency that gather products, whether clothes, shoes, medication or hospital apparatus—whatever it may be—to help fit out some of these places in Swaziland, Zimbabwe and further afield.
Handicapped people are analysed by Luke Commission medical personnel and given bush wheelchairs—they need a wheelchair that is practical. Follow-up treatment for patients with HIV, chronic disease, complex medical disease and various cancers is offered. Those with poor eyesight receive vision services and glasses, if needed. There is an ophthalmic surgical programme primarily focused on the removal of cataracts, which are a serious issue in parts of Africa. Those practical changes can be made easily. They do not need a lot of money or investment, but they can change lives. Can you imagine, Mr McCabe, not having your eyesight? Of all the things in the world that you would never want to lose, it would be your eyesight. I say that as someone who has worn glasses since I was eight. I understand the importance.
Packets of medication are distributed by the thousands every day, each prescribed by a doctor with instructions on usage in the mother tongue so that they are understood. Psychosocial and grief counselling is available, too. The pain and the tears they have are no less than the pain and tears we have. Some of the things that happen to them happen because they do not have medical treatment available. The Luke Commission team of nearly 100 people treated more than 61,000 patients in 2015. We can do a lot more with small things, but how many more could we affect?
Most recently, a young lady from my constituency gave up her time during her summer to help the Luke Commission. So many others from the UK give up their time to make a difference. Would the Minister be so kind as to outline the initiatives that are in place? I understand his remit may not stretch to that, but it would be helpful if he could give us some idea. What initiatives are in place to encourage our knowledge and skills to be shared worldwide, like the schemes of Doctors Without Borders and the Luke Commission? How are the Government sharing and disseminating the expertise and learning generated from the NHS with Health Minsters in developing countries?
We have great partnerships and the wonderful NHS. We are celebrating the NHS’s 70 years of tremendous work, but we should be trying to show other countries what we can do. Will the Minister give us some idea of how we can help developing countries? I believe that is our duty, and I would like to better understand how we can fulfil it. We need to take up the mantle and do more in our constituencies. We are doing practical, physical and financial things through churches and other charities that directly help in Africa and other countries across the world.
Countries in the developing world are already showcasing their ingenuity and political will in delivering universal healthcare. For example, Bangladesh has achieved wonders in national health in the last 25 years. More than 95% of Bangladeshi children are now fully immunised—that is tremendous. There have been other massive improvements: breastfeeding is near universal, and the level of stunting in children under five declined from 51% in 2004 to 36% in 2014—a significant decrease, showing what we can do if we influence and help both physically and practically. Community outreach by a skilled cadre of female community workers was instrumental in achieving almost universal immunisation coverage, the world’s highest coverage of oral rehydration solution, greater uptake of family planning, and innovative solutions for community-based management of sick newborn babies and severe and acute malnutrition.
Bangladesh is a world leader in reducing child mortality, but pneumonia remains a major challenge for policy makers. Sadly, childhood pneumonia is prevalent across many countries. The stats are alarming: every minute of every day, including today, two young lives are lost to pneumonia; in 2016, it claimed nearly a million children under the age of five in developing countries—more than HIV, TB and malaria combined. If we had the antibiotics available, we could tackle a lot of those problems. Pneumonia is a killer that leaves children gasping for breath and fighting for their lives, but it is also a disease that we have the power to prevent, diagnose and treat. We can do that, so how can we do it better to save those million children’s lives?
We know that an accessible and free health system is the most effective way of treating pneumonia. A fully integrated universal healthcare model can care for a child from the moment they are born until they reach adulthood. That will prevent deaths from pneumonia, which is the biggest killer. We are here today to find out what more can be done to provide UHC in countries around the world, including those in Africa and the middle east, India, Pakistan, Bangladesh and other countries where these problems occur. Millions of people around the world are denied their most basic rights of access to healthcare. We have UHC in this country, and I would like to think that one day we will be able to make it available across the world. As beneficiaries of the NHS, everyone in this room must believe we want everyone to have what we have: a system that is fair and free. We must therefore take steps to change things.
Pneumonia is a prevalent issue within the Commonwealth, too. Save the Children has calculated that children under the age of five living in Commonwealth countries are two and a half times more likely to die from pneumonia than children living in non-Commonwealth countries. When we hear those stats, we realise how big the difference is that we have to try to reduce. Will the UK Government raise the subject at the next Commonwealth Health Ministers meeting? If the Minister is in a position to use that power, I ask him to do so. He should certainly contact the relevant Department to ensure that it happens. What leadership role can the UK Government play, given that the UK is the chair of the Commonwealth for the next two years? I would like to think we can use that influential role. I know we will, but perhaps we should be reminded that we have that opportunity. We should try hard to make things happen.
I am incredibly pleased to have one of the world’s foremost research and medical centres in the wonderful Queen’s University. The steps taken in improving healthcare worldwide have been tremendous, including the most recent breakthrough regarding the targeting of antibiotics for pneumonia using groundbreaking cancer treatment technology. I mentioned Queen’s at the beginning of my speech, but I mention it again, because it is at the coalface of breakthrough technology. I asked Queen’s for a little more in-depth information regarding the breakthrough. That information is certainly something to be proud of. The Queen’s research team indicated that our struggle against infectious diseases is far from over, but they, with other universities, research and development bodies and private companies, are doing their best to make things happen. Globalisation has increased the risk of pandemics, which we get regularly, reminding us that whenever we accomplish something, another disease and pandemic comes along, and sometimes existing drugs are useless.
Unsurprisingly, antimicrobial resistance—AMR—is included in the recently released UK Government national risk register of civil emergencies that may directly affect the UK over the next five years. Our Government have been instrumental in assisting and responding, and it is always good that they do that. More than 80,000 deaths in the UK are estimated if there is a widespread outbreak of a resistant microbe. Far from being an apocalyptic fantasy, a post-antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century. We can never rest on our laurels with what we have done. We need to step forward and be more aware of what we need to do in the time ahead. New diseases are always developing, and there is always a need to match them. We should pay respect and give credit to organisations that do that well.
The O’Neill review on AMR sets out the global threat by highlighting that drug-resistant infections already kill hundreds of thousands of people a year globally. By 2050, it could be as many as 10 million—one person every three seconds. If we needed a reminder of the importance of the issue, that would be the figure. I am not sure if anybody in the Chamber will be around in 2050—I certainly will not be—but those who are could well face one of the debilitating diseases that we need to research now.
Of particular concern is the mounting prevalence of infections caused by multi-drug-resistant gram-negative bacteria, in particular Klebsiella pneumoniae. That pathogen has been singled out as an urgent threat to human health by the UK Government, the US Centres for Disease Control and Prevention, and the World Health Organisation due to extremely drug-resistant strains. Notably, Klebsiella infections have increased by 12% in the UK alone over the last five years. That tells us how things are developing, and that we need to be prepared.
Professor Chris Scott, the interim director of the Centre for Cancer Research and Cell Biology, is an expert in nanotechnology. In June, he teamed up with Professor Jose Bengoechea, director of the Wellcome-Wolfson Institute for Experimental Medicine, who is a world expert on infections by multi-drug-resistant pathogens, chiefly Klebsiella pneumoniae. Professor Bengoechea’s team discovered that it is possible to use the nanotechnology approaches that Professor Scott is developing for cancer to try to treat the bacteria that reside inside human cells and combat that pathogen. We have to listen to the experts and ask them to take things forward in the right way.
Although there is clearly a need for new antibiotic drugs, which must be the Government’s main focus in tackling the potential tsunami of antimicrobial resistance that we face, Queen’s research shows that with effective delivery of antibiotics we will gain a better therapeutic effect against a main protagonist of pneumonia. The complex scientific work that Queen’s is doing should make a difference. Patients may need to take an inhaler of particles containing antibiotics, as opposed to a simple tablet, in the specific case of pneumonia. It is possible that an advanced formulation of drugs could slow resistance developing in some instances and generate better outcomes for patients. It may also mean that we could extend the useful lifespan of some of our current antibiotics. To take that to patients, we need to prepare clinical grade material, but advanced formulations such as nanomedicine are difficult to manufacture. Life is never straightforward, but when we are given a challenge we have to take it on.
Investment is needed in the UK to provide facilities that can advance these excellent therapeutic strategies before they can be tested on humans. We have a process to go through and we must walk along those lines. When we come to the end of the road, we want to ensure that the medication is appropriate and safe. Additional funding needs to be allocated to new approaches to treat infections. Again, the Minister may wish to tell us how the Government are working through the Department of Health and Social Care with universities, companies and research and development on how that process can work, and perhaps how it can work better.
By thinking outside the box, as exemplified by the Queen’s University Belfast research, we will find much-needed new therapeutics. Several projects at Queen’s University Belfast are reaching the pre-clinical stage and are being stalled by the lack of investment, since pharma are still not interested in supporting this essential work. There are ways of going forward, but we need a wee bit of security as well. The lady from Queen’s University who was here this week talking about breast cancer research was funded through one of the Government Departments in Northern Ireland. Queen’s University also gave her a position, which brought her a bit of income. That meant that she could do her research here in the UK, and we in the UK can get the advantage and try to advance that as well. Other UK Government schemes, such as those supported by Innovate UK, also fall short in supporting pre-clinical work because there is still no commitment from pharma. I ask the Minister to consider standing in the breach, if that is possible, and supplying the necessary support and funding for Queen’s and other research centres to help us to do better.
It is expected that by 2035 more than 500,000 people in the UK will be diagnosed with cancer each year. To ensure that our health service can meet future demand, action to prevent cancer and other diseases must be at the forefront of any approach. We have heard today some of the figures, certainly on the mainland in relation to cancer and some of the delays. There are many problems in the NHS, but we are here to help the Minister and to encourage him and the Department of Health to move forward.
The Government must train and employ more staff to diagnose and treat cancers earlier. We can be proud of what the UK Government—our Government—do on healthcare, but we strive to do more, and the Minister strives to do more. The Department of Health is already looking across the world to see how it can share expertise. The Department for International Development is helping countries to strengthen their healthcare systems. What else could we achieve if we joined up the dots and worked together more on implementing universal healthcare?
We should encourage countries to raise their own domestic resources for healthcare, which could have a transformative impact. DFID has been fantastic at supporting the health system to strengthen, but that is not always free, which leaves behind the poorest and most marginalised. I referred earlier to those who are unable to get their operation through the NHS, but are offered the opportunity to pay for it. I am very unhappy with that system; it suits some people, but not everyone. We have to be ever mindful that some of the poorest and most marginalised people in countries across the world are at the bottom rung of the healthcare ladder. We should share our expertise on domestic funding for the NHS with Governments around the world, encouraging Governments to spend more on healthcare.
From 2011 to 2015 there was a cross-Government strategy on global healthcare. An update strategy could include recommendations on domestic resource mobilisation. I understand that the Department of Health has a global health team. It would be helpful to know the remit of that team and how they co-ordinate with DFID on global health issues. What is the connection? Do they have any input to the policy, strategy and the way forward? Do they have regular meetings?
In February 2014, the world watched in horror as Ebola swept across many parts of Africa. We in this country did our bit immediately to respond. We sent our service personnel, our experts and our medication. We were not found wanting, and we never will be. The horror turned to pride as we saw that role that UK aid and our healthcare professionals played in stopping Ebola and saving lives. We should be immensely proud of what our people did, and what our Government did and continue to do. That was the UK Government at their best. They co-ordinated the response to a major global health crisis and supported a country’s health system. How well that was done! We owe thanks to those personnel and to our Government for leading the way. We would never wish for Ebola or something similar to return. What can be done to implement that sort of cross-Government approach to supporting health systems?
I thank hon. Members for coming along to support me, and the Minister for coming along to respond. I thank hon. Members for their time. How does the Minister believe we can excel, improve and achieve an even higher level of global care?
Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)
It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. It is a thoughtful and appropriate way to mark NHS70. I pay tribute to him for his typically expert and heartfelt speech.
Whatever the difference between our parties and the Governments of the UK on the details of health policy, we all agree about the extraordinary benefits that the national health service brings as a universal healthcare service, and about its immense contribution in tackling preventable and communicable diseases in this country, not just through treatment but through immunisation and other public health measures. I pay tribute to all NHS staff for their immense dedication and service. Like other hon. Members, I have benefited from the NHS’s care on many occasions, and I will forever be grateful for that.
As the hon. Gentleman said, that is not to say that the job is done. There are things to improve, but we are fortunate to have been born in a country with such a system, given that so many others are not. In the absence of universal health coverage in some countries, many are excluded from the healthcare they need, sometimes including the most basic care. As the hon. Gentleman pointed out, as recently as December 2017, it was reported that at least half the world’s population cannot access essential health services, and almost 100 million people are forced to live in extreme poverty simply because of the expenses associated with healthcare.
It is not just a question of finance and infrastructure; it is also about the barriers caused by culture, prejudice and even draconian and inhumane laws. The hon. Gentleman set out some of the tragic consequences for the affected individuals. For example, the terrible incidence of pneumonia among children in certain countries is a tragedy for individuals, for family after family and for community after community. It is also a disaster for those countries’ economies and public finances. In short, it is a circle of despair.
That is exactly why the goal of universal health coverage is enshrined in sustainable development goal 3—“health for all”—and is a global priority for the World Health Organisation and other international organisations. In simple terms, that means we need to work towards ensuring access to skilled medical professionals in good-quality facilities. We still have a long way to go even in that regard, particularly in the poorest countries and the remotest areas, where even the most basic of issues, such as access to safe water, sanitation and hygiene, remain challenging. Without those things in place, facilities cannot function effectively.
That is not an end to the matter. The goal of universal health coverage will not be realised unless good-quality care is provided without discrimination. There is no point in having facilities and doctors if absence rates among healthcare staff are 60%, as sometimes happens in certain countries. The goal is fatally undermined if discrimination against the most marginalised people, some of whom are the most in need of healthcare, means that they cannot access its full benefits or that they receive substandard treatment. In short, the goal is not simply universal health coverage but effective universal health coverage.
Disease-specific programmes continue to have a vital role to play, but ultimately diseases such as malaria, HIV/AIDS and many others can be eradicated only by establishing universal health coverage, which we sometimes take for granted in our country. That also means ensuring that HIV services are part of a universal health coverage system. People with HIV can often be among the most marginalised in a country—for example, sex workers and men who have sex with men. That can mean that their ability to pay for treatment is even more limited, and they face additional hurdles, such as culture, prejudice and inhumane criminal laws.
I am not slow to criticise the UK Government when they get it wrong, so it is only fair that I praise them when they get it right. I will do that in a moment. The goal of extending universal health coverage around the world will not be assisted by poorly planned and abrupt withdrawals by the Department for International Development from countries without a proper transition. The Independent Commission for Aid Impact gave an amber-red warning to DFID’s transition programmes. The Government have responded to that warning, but it is vital that, as that work is taken forward, DFID ensures that its transition programmes promote UHC and prioritise access to services for the most marginalised communities before it makes its exit.
I recognise that the UK has been a key global leader on this issue in years gone by, and long may that continue. This Government, and any Government, will have our support if they continue to pursue the goals in the universal health coverage 2030 partnership. We need to use the NHS’s expertise and experience to help shape new universal systems in other countries. We should continue to use DFID to put other Governments in a position to support such systems and end reliance on charges and out-of-pocket spending. We want the Foreign Office to be used fully to argue for an increase in health spending and an end to draconian criminal laws that marginalise communities and make access to healthcare difficult. We should continue to support efforts to better measure progress on who has access to universal healthcare and the quality of care they are receiving, so that we can check, for example, that HIV treatment is reaching marginalised communities.
We should continue to support non-governmental organisations and civil society in helping people to access healthcare and hold their national Governments to account. We should continue to be a leader in research and development. The hon. Member for Strangford rightly highlighted the work at Queen’s University, but universities across the United Kingdom play a pivotal role in researching diseases that affect low and middle-income countries.
We need to work with other countries and the World Health Organisation to create a global road map on access to medicines, and to end what is sometimes a medicines rip-off. That means encouraging the de-linking of research and development costs from medicine prices, and defending the use of so-called TRIPs flexibilities—those under the agreement on trade-related aspects of intellectual property rights—by low-income countries seeking to access medicines. It would be particularly helpful to hear a bit from the Government about their commitment to pushing for protecting such flexibilities in the outcome document from the forthcoming high-level meeting on tuberculosis, which I understand is to take place in September.
If all that helps to achieve the universal health coverage goal for 2030, then the NHS’s 82nd birthday will be an even more significant and happier occasion than its 70th.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
It is a pleasure to serve under your chairmanship, Mr McCabe, on this historic day—the 70th anniversary of the founding of the NHS. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate and for his passionate speech. I also thank my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq) and the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) for their contributions. Finally, I thank the Backbench Business Committee for granting time for this debate, especially on the NHS’s 70th birthday.
It is an honour to be here to speak about our NHS and the example it has set for the rest of the world. When introducing the National Health Service Bill to the House of Commons, Bevan said:
“I believe it will lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering…It will be a great contribution towards the wellbeing of the common people of Great Britain.”—[Official Report, 30 April 1946; Vol. 422, c. 63.]
Seventy years on, those words still ring true in the UK. That is why the Labour party will always defend our NHS from Government funding cuts and from ever-increasing marketisation, which opens the door to unwanted privatisation. We remain committed to defending our NHS so that it continues to be the fairest and best healthcare system in the entire world. While we celebrate today, however, it is easy to forget that across the world, as we heard from the hon. Member for Strangford, some of the poorest and most vulnerable people are being denied the basic right to health services that we enjoy and indeed take for granted.
In December 2017 the World Health Organisation reported that at least half of the world’s population did not have access to essential health services. It also found that 800 million people spent at least 10% of their household budget on health expenses for themselves, a sick child or other family member, and that for almost 100 million people, the expenses associated with healthcare meant that they were forced to live in poverty.
That widespread lack of access to healthcare contributes to the global epidemic of vaccine-preventable diseases, widespread malnutrition and other health-related problems. Following on from the hon. Gentleman, I shall add some examples to the debate. Globally, 2.6 million children died in the first month of life in 2016, largely due to lack of quality care at birth or skilled care and treatment after birth. More than 20% of births throughout the world still take place without the presence of a skilled birth attendant, and in sub-Saharan Africa that figure rises to more than 40%.
Pneumonia is now the biggest infectious killer of children, claiming nearly 1 million lives each year, or two children every minute. Pneumonia is preventable and treatable; that so many children are dying because of it is shameful. Globally, only 4% of HIV-positive people who inject drugs have access to HIV treatment, and that also increases the risk of HIV transmission among those who use drugs. Behind such awful statistics are tragic human stories of unnecessary loss and suffering. When we invest in health, we invest in people, no matter where they are in the world.
Universal health coverage means that everyone can receive the healthcare services that they need without the worry of suffering financial hardship. It can therefore protect countries from epidemics, reduce poverty and the risk of hunger, create jobs—as we know, the NHS is the biggest employer in the country—drive economic growth and enhance gender equality. Given the world-class reputation of our NHS, the UK Government have a huge part to play in encouraging other countries to establish universal health coverage, and we should be proud that we have such a prestigious role in leading the way on health.
I am pleased that the Government are committed to delivering the UN’s sustainable development goals, which include universal health coverage. Indeed, we should all be committed to ensuring that people live healthy lives, no matter where they live. Will the Minister tell us whether his Department has worked with other Governments from around the world to promote universal healthcare coverage? Which countries has he worked with on that?
Public Health England has developed a global health strategy to look into building public health capacity, particularly in low and middle-income countries, as well as sharing excellence by working in partnership and building on the UK’s strengths. Does the Department of Health have any plans to develop a global health strategy with a specific focus on universal healthcare coverage? Does the Department have regular conversations with Public Health England and colleagues in the Department for International Development to discuss universal healthcare coverage and how to promote it around the world?
Seventy years ago everyone in the UK was granted access to free healthcare, regardless of how much they earned or where they lived. Sadly, millions around the world are still missing out on access to such a basic human right, and people are dying because of it. It should be the ambition of us all on this special day to ensure that that right is enjoyed by everyone around the world. I support the Government on any aims that they might have to do that.
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
I am sorry for my musical chairs during the debate, Mr McCabe, but I could not hear everyone from the end of the Chamber—I think it is my age and the heat. I thank the hon. Member for Strangford (Jim Shannon) for, as always, an interesting speech. I congratulate him, especially today—birthday day—on securing the debate in his residence of Westminster Hall. He mentioned that he might still be here in 2050—I would almost hazard a wager with the hon. Gentleman about that one, but I hope we shall all still be here.
Was not 5 July 1948 a pivotal day for our country, with the inauguration of healthcare free at the point of use for all our citizens? Seven decades later, the NHS remains one of our nation’s most loved institutions. The NHS is often described as the closest thing we have to a national religion, and this lunchtime a service in Westminster Abbey proved the point. The NHS is one of our country’s crowning achievements, possibly the crowning achievement—along with the English football team, of course—and it is the envy of people across the globe. When I travel around the world in this job, people are fascinated by and envious of the NHS in equal measure.
As has been said by my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), and everyone else who has spoken today, the NHS is of course nothing without its fantastic staff, who show such a level of Christian compassion—some without even knowing it—day in, day out. More than 1.5 million people work each day to provide the best possible care for our constituents.
The questions that the hon. Member for Strangford asked are important. We are the proud owners of an excellent universal healthcare system, albeit one we continually strive to strengthen, as we must—the best friends are prepared to criticise, and the NHS is not above criticism in our struggle to make it better—but he asked what we are doing to share our experiences. I shall certainly be able to cover that point.
The health of UK citizens is not dependent only on action in the UK. Diseases do not respect borders, and we need to act internationally to protect ourselves as well as to help others. Not only is that relevant when an outbreak hits—recently we had an Ebola outbreak, which I have monitored closely—but we must keep working with other nations to strengthen their capacity to prevent, detect and respond to diseases. UHC is critical to that. Threats such as that of antimicrobial resistance, which the hon. Gentleman mentioned in his opening remarks, can be tackled only through global action.
There is much that we can learn from each other. The NHS has evolved a huge amount since the late 1940s, and the next 70 years will require ongoing adaptation and innovation as we deal with the challenges of 1 million more over-70s—the ageing population—and further reap the rewards of scientific advancements, which have been so central to the NHS in its first 70 years. Other countries develop innovative approaches that we may not yet have considered—it is not all about the great empire of Britain, telling the rest of the world how things shall be—and there are plenty of challenges that no one has yet cracked. We should work together, and we do. It is right that we support others who have not yet achieved universal health coverage to do so, including by sharing our experiences.
We are committed to delivering the sustainable development goals, which the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) mentioned, including SDG 3. That is crucial to tackling many other health challenges, including the improvement of maternal, newborn and child health, as he said, and specific diseases such as TB, HIV, malaria and—everyone rightly mentioned this—pneumonia, the single largest infectious cause of death in children worldwide.
Universal health coverage is a goal, not a blueprint. Country needs, plans and perspectives are central to our work, and we have no interest in imposing an NHS model. It is crucial for each country to find its own path to UHC, which may entail greater private sector involvement, if that is what the country wishes, or a national health insurance scheme if that is what the politicians are brave enough to do. That is not our choice, but it is the choice in some parts of the world. We cannot just go with our judgment in trying to help other countries achieve universal health coverage.
Poorer, marginalised populations must achieve better access to good-quality essential services without the risk of financial hardship, as we choose in our NHS. Support for UHC must also involve helping countries to achieve sustainable funding mechanisms for their system, whichever they choose. The countries in greatest need deserve our financial support, but the ultimate goal must remain to transition to domestic funding, so that countries can maintain health systems in the long term.
The UK engages on UHC in a number of international forums. We strongly support the World Health Organisation’s focus on UHC through its new general programme of work, and we provide funding through a number of DFID programmes. We engage on this topic at governing body meetings and our annual UK-WHO strategic dialogue. I have a good, open and direct relationship with the head of the WHO, as part of my responsibility for international health at the Department of Health and Social Care. Underpinning the WHO’s success is a strong and effective organisation, and the UK continues to promote reform of the WHO so that it is the best it can be. As the second largest donor to the WHO, we are in a very strong position in that regard.
We promote UHC as a priority in other forums such as the G20 and the G7; I attended the G7 Health Ministers meeting last year in Milan. We were pleased to see strong commitments on health in the recent Commonwealth Heads of Government meeting, including on eye care, which I am passionate about. We will continue to follow up with the Commonwealth secretariat on the implementation of everything that was agreed in London. The high-level meeting on UHC at the UN General Assembly in 2019 will be an important opportunity to share experiences and to drive greater collective action. I will pass on the hon. Gentleman’s request, which I agree with, for us to use our chairmanship of the Commonwealth to further the UHC agenda that we all believe is so important.
My Department has rightly taken on a global leadership role on patient safety, along with our German and Japanese counterparts, to whom I spoke directly at the G7 Health Ministers meeting last year. Hon. Members will know that patient safety is the central mission of the Secretary of State. It is crucial to universal healthcare—as the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East rightly says, the aim cannot just be universal healthcare but must be good-quality and safe universal healthcare. Providing access but not quality care is not truly delivering on the sustainable development goals. We hosted the first global ministerial summit on patient safety in 2016, bringing together political leaders and experts to galvanise action on this crucial issue. Subsequent summits in Germany and Japan have continued that legacy.
Another key but often overlooked facet of universal health coverage is addressing mental as well as physical health. Again, my Department is taking an international role: we will host the first global ministerial mental health summit in October. The summit will bring together political leaders, experts by experience, policy makers and civil society to share innovative and effective approaches to mental health care, which the Prime Minister has rightly said is one of her main priorities. The Department of Health and Social Care frequently receives ministerial and official delegations from overseas to look at topics as diverse as childhood obesity, on which we lead the world; emergency response, as we often send people around the world; and elderly care.
The international team, which the hon. Member for Strangford mentioned and which I look after, manages the Department’s bilateral and multilateral engagement, working closely with colleagues at DFID and across Government. The team also leads on co-ordinating global health strategy across Government and on the health implications of trade and of the UK leaving the European Union.
The hon. Gentleman asked about our support for low and middle-income countries. The UK has a number of programmes with those countries. They are largely led by DFID, although a number draw on my Department, the NHS and Public Health England, for which I have ministerial responsibility. The UK supports the aim of countries working towards universal health coverage, with priority given to ensuring that poorer, harder to reach populations achieve better access to good-quality essential services without risk of financial hardship.
We apply a health systems strengthening approach to all health investments. That includes addressing global health security issues such as antimicrobial resistance; scaling up nutrition interventions, which are about building up country resilience; improving reproductive, maternal, newborn and child health; and targeting specific diseases such as HIV, TB and neglected tropical diseases. One of the first things I was able to do in that space was to speak at the family planning summit organised by DFID over the road at County Hall, which was backed by Bill and Melinda Gates, about our record in driving down the teenage pregnancy rate in this country. Of course, getting reproductive health right often helps developing countries to make their health systems more robust and sustainable.
The hon. Gentleman mentioned the delicate subject of male circumcisions and HIV. He is right to say that circumcision is practised across many parts of Africa to prevent HIV. The WHO and the UN consider male circumcision to be effective in HIV prevention, where there are heterosexual epidemics and high HIV and low male circumcision prevalence. However, the practice provides only partial protection. The procedure should not be seen as a green light to risky behaviour; it should be one element of a comprehensive HIV protection package. It would be remiss of me not to mention that I get a lot of letters on this subject. A number of campaign groups in this country and around the world make arguments about the human rights elements of the matter, especially when children undergo circumcision surgery, and its impact later in life. It is important to recognise all those facts, but the hon. Gentleman is right to mention it as part of the toolkit used in certain countries, Tanzania being one of the most prevalent.
We provide support directly to countries, work through the WHO and scale up targeted, cost-effective preventive and treatment interventions through global initiatives such as the global health fund, Gavi and the global financing facility. We are the largest donor to Gavi, which provides developing countries with pneumococcal vaccine to protect against the main cause of pneumonia. Between 2010 and 2016, 109 million children received the vaccine; we estimate that saved about 760,000 lives.
The health partnership scheme is another good example of how the UK can use our expertise overseas. Since 2011, we have trained 84,000 health workers across 31 countries. The scheme relies on volunteers from the NHS who help to support the training of staff overseas and benefit themselves through gaining new skills and motivation. Last October, the Minister of State, Department for International Development, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), who I work closely with across Government, announced the new £30 million programme with the catchy title “Stronger Health Partnerships for Stronger Health Systems”. It will run for five years from 2019 and will support partnerships between leading UK institutions and those in developing countries.
One of the benefits of being the Minister in these debates is that sometimes I can mention the good things that happen in my constituency. Hampshire Hospitals NHS Foundation Trust, which covers the Royal Hampshire County Hospital in Winchester and the Basingstoke and North Hampshire Hospital, has two very good international links, including with Yei in South Sudan, where a number of medical professionals from that trust have worked on antibiotic resistance studies, looking at the bacteria that can cause pneumonia. In collaboration with the Rotary Club in Winchester and the Brickworks, which is a Winchester-based charity, it has secured funding for textbooks to repopulate a midwifery and lab training institution and funding to build schools for South Sudanese refugees in Uganda, so that refugee children can continue their primary and secondary education. There will be examples in the constituencies of Members throughout the House of health professionals using such expertise as part of their upskilling, but also to help those less fortunate than us.
The UK offers development opportunities for the medical workforce globally. The medical training initiative allows overseas medical specialists to train in the UK for up to two years, to see our system close up, so that they can return to their home country and apply their skills and knowledge to the benefit of their population. Of course, that benefits the NHS by providing extra staff, who we desperately need, and enhances the clinical capacities of health systems in low and middle-income countries. We estimate that just over 3,300 overseas doctors have taken part since 2009. I know the House will be interested in that positive programme.
We are passionate about tackling AMR, and we are committed to doing so. My Department is working across Government with a wide range of stakeholders to refresh our AMR strategy, which rightly gets a lot of attention in the House, with a view to republishing it at the end of 2018. I know that the hon. Member for Strangford will be interested in that. One of the ambitions we set out in response to Lord O’Neill’s independent review of AMR, which was established by George Osborne when he was at the Treasury, was to halve healthcare-associated gram-negative bloodstream infections. We are focusing on E. coli infections this year, but we are also collecting data on Klebsiella and Pseudomona pathogens.
I think there will be a lot of interest among Members in the refreshed AMR strategy. Health Question Time seldom goes by without AMR being mentioned. AMR is important. As the chief medical officer, who is busy in other ways today, has said, it is one of the greatest threats, if not the greatest threat, that our world—not just our healthcare world—faces.
We welcome all new research that contributes to our work to tackle AMR—especially great research such as that produced by Queen’s University Belfast, which the hon. Gentleman mentioned. There are a number of funding opportunities, and high-quality proposals are always welcomed. He rightly mentioned that people from Queen’s were at the House yesterday. He and I met them together—we had our photo taken with them—at an excellent Breast Cancer Now event, which was a great chance to hear about some of the incredible research that is being done on that disease in our United Kingdom.
Great research projects often start with relatively small grants from charities such as Breast Cancer Now, which act as the building block for other researchers to jump on board and get with the plan. That is very important. This is not all about the Government starting research projects; it is about institutions such as Queen’s being world-renowned. The lady I met yesterday was clearly on top of her game. She deserves great credit, and I thank her and all her colleagues at Queen’s for the work they do for our country.
We have strong join-up across Government. My Department, DFID, Public Health England and the Foreign Office in particular take a “one HMG” approach to global health, which was recently praised by the Independent Commission for Aid Impact. That includes regular meetings between Ministers, and a co-ordination group of senior officials meets very regularly to look strategically at our international activity and some of the programmes I mentioned. It includes joint delegations to WHO meetings and daily contact between our officials. It also includes joint working on projects such as the UK public health rapid support team. That is a partnership between the Department of Health and Social Care, Public Health England and the London School of Hygiene and Tropical Medicine that, at countries’ request, deploys people rapidly to some of the poorest parts of the world to investigate significant disease outbreaks and support capacity building. I mentioned examples of times when that has been invaluable, such as during the Ebola crisis.
In concluding, let me return to the incredible achievements of our NHS over the past 70 years, during which time life expectancy has leapt. Its staff work tirelessly to ensure that it remains the best in the world. We are committed to ensuring that it provides universal health coverage in the UK for generations to come, but we do not keep it all to ourselves—we are desperately keen to go on sharing our knowledge to help other countries do the same, so that people around the world can benefit from the incredible privileges we have in this country.
Steve McCabe (in the Chair)
Mr Shannon, would you like to make some concluding remarks?
Jim Shannon
I certainly would, Mr McCabe. I thank you for chairing the debate so well. I also thank the hon. Members for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald)—my pronunciation is probably all wrong—and for Washington and Sunderland West (Mrs Hodgson), whose contributions were immense. The hon. Member for Hampstead and Kilburn (Tulip Siddiq) highlighted important issues with the BCG vaccine.
I thank the Minister for his comprehensive response. He always says that he is pleased to be in his position because he has a deep interest in the subject, and that was illustrated by his responses to everyone who spoke. He was right to say that we are celebrating the 70th anniversary of the NHS and its excellent work, and to focus on what we can do both here and around the world. I am glad he mentioned the importance of remembering, whenever we think about diseases and healthcare in this country, that we also have to prepare for the diseases that come into the country from outside. We have a joint approach, in which the NHS delivers great healthcare here and we share that healthcare around the world. For that, we are eternally grateful.
Question put and agreed to.
Resolved,
That this House has considered the role of universal health coverage in tackling preventable and treatable diseases.
Equal Franchise Act 1928
(6 years, 5 months ago)
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Rosie Duffield (Canterbury) (Lab)
I beg to move,
That this House has considered the 90th anniversary of the Equal Franchise Act 1928.
It is a pleasure to serve under your chairmanship, Ms Buck. I rise to mark an important date in British history: 90 years ago, on 2 July, this House ratified the Representation of the People (Equal Franchise) Act 1928. For the first time ever, women were afforded equal rights to men in formal political participation; for the first time ever, women over the age of 21 and women who did not meet arbitrary property qualifications were eligible to vote; and for the first time ever, women made up the majority of the British electorate.
According to the Electoral Commission, in 2017 women were four times more likely than men to cite people fighting to win them the right to vote as a motivation for casting their ballot. Three quarters of women say that they always vote in general elections. This year we rightly celebrate that it is 100 years since some women, through tireless sacrifice and struggle, attained suffrage in the UK, but it would be wrong to forget that many other women—around a third—had to wait another decade to participate fully in this country’s democracy.
During that decade, feminists made advances in their campaign for gender equality across different sectors of British society. On 1 December 1919, Lady Astor became the first woman to take her seat in Parliament. On 23 December 1919, women successfully lobbied Parliament to enact the Sex Disqualification (Removal) Act 1919, which prohibited women’s exclusion from most forms of employment and allowed them to obtain professional employment in any civil or judicial office. In 1920, women were finally afforded the privilege of being able to obtain a formal degree from the University of Oxford, despite having already contributed to its structures and studies for decades.
However, most working-class women did not have the opportunity to stand for political office or to seek professional employment in the judiciary or other such posts, and they certainly did not have the resources to study at any university, let alone Oxford. In fact, during the early 20th century the working class had few opportunities indeed. For that reason, the last century saw the intensification and politicisation of workers’ rights and the growth of the trade union and socialist movements whose values form the very foundations of my party.
Even by the time Ramsay MacDonald became, albeit briefly, the first ever Labour Prime Minister in January 1924, working-class women could still not vote. It pains me to imagine how much more could have been permanently achieved if more than one third of our population had not been disenfranchised for so long and at such a crucial time in the history of the British working class. Would we be further along the march to true equality? Would I still have needed to hold this debate?
Because of the hesitant start to the full enfranchisement of women and the working class, even today many of us in this room will have experienced, from a young age, a world that has not always been particularly inclusive or fair to women, minorities, the working class or, broadly speaking, those deemed to be “others” in society.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
I congratulate my hon. Friend on securing this important debate to mark the 90th anniversary of women attaining equal voting rights to men. Unfortunately, there are still some women who, because of their circumstances, feel unable to vote. One example is survivors of domestic abuse who feel unable to register because they do not want to risk their safety. They may not be aware that, thanks to the Electoral Commission, they can register anonymously. Does my hon. Friend agree that we should pay tribute to the charities, groups and organisations—including the Dash Charity and Hestia in my constituency—that work for women’s empowerment and support victims of domestic abuse?
Rosie Duffield
Absolutely. I am a champion of Hestia, so I know of its brilliant work. The Electoral Commission is making sure that women know that their vote is theirs alone.
While on this important date we note the lost potential and the pain caused by sexism and injustice, we also celebrate the tenacity, bravery and resolve of those who fought tooth and nail against the status quo to reverse the injustices of patriarchy, classism and all forms of discrimination. We must also look at what more needs to be done in the struggle for equality. Working-class women may have attained the vote, but many barriers remain to equal political participation and representation, and equality in all aspects of modern life.
This year has seen a number of cross-party initiatives launched to combat the gender pay gap, seeking to remedy an age-old economic injustice faced by women, much like the political disenfranchisement faced by the suffragettes. However, similar to the disparity faced by working-class women in the 1920s, working-class women and minority ethnic women are far more affected by the inequality of the gender pay gap than their middle-class counterparts. Recent Library research shows that women as a whole bear 86% of the costs of austerity, with working class, disabled and minority ethnic women disproportionately affected by cuts to public services and welfare.
I do not say that to create a rift among different groups of women or to sour the mood on this landmark date, but to remind us that it is our duty as parliamentarians to ensure that all women are adequately represented, both in this place and across the UK. On that note, I have learned since my arrival here a year ago, which I have really taken to heart, that those of us privileged enough to be in this place really are women first and partisan politicians second. We need—indeed, want—to work together to improve women’s lives and the future for girls growing up in this country.
It would not be right to celebrate without recognising that we still have a long way to go in our fight for equality. For example, we know that almost 52% of the UK population is female, yet we still make up only one third of all Members. As a representative of the excellent campaign group 50:50 Parliament, which was started by my brilliant friend, Frances Scott, I understand only too well how far we still have to go to achieve a true representation—or simply an accurate picture—of our nation’s population.
Jo Stevens (Cardiff Central) (Lab)
I congratulate my hon. Friend on securing the debate. The first general election in which women could stand as candidates was in 1918; then, one female stood in Wales. Last year, 66 candidates in Wales were women, but only 11 of Wales’ 40 MPs are women. Does she agree that we still have a long way to go to achieve parity with our male colleagues?
Rosie Duffield
Absolutely. I am sure that the Welsh Government are doing their bit.
When the debate is reported and shared on social media, I know for certain the comments that will be made, because they always are. Men will type, “Why can women only be represented by women?”, “Why do we need more women?” or, “What difference does it make?” as well as other rude comments that I cannot say. I will tell them why. Do we really think that debates leading to legislation and policy change that focus on issues only or mostly affecting women would be on the Order Paper at all without the growing number of us here? Issues brought to the House by my colleagues in recent years include period poverty, the provision of affordable childcare, maternity leave, the gender pay gap, abortion rights, domestic violence, stalking and sexual harassment to name just a few. Could we really have left those issues in the hope that hundreds of male Members would one day stumble upon them and take them forward on our behalf? No.
Alex Sobel (Leeds North West) (Lab/Co-op)
Does my hon. Friend agree that another example of that is the campaign of the Women Against State Pension Inequality? Without those women having the franchise and being able to raise their voices electorally, and without all the women MPs in Parliament, that issue would not be in the public domain in the way that it is.
Rosie Duffield
Absolutely. I was happy to meet some of my local WASPI activists yesterday on Parliament Square.
We know that men would not have taken those issues forward because they did not in the hundreds of years that they had this place to themselves, so we came here and did it ourselves. A recent and important Bill on upskirting was almost totally stopped in its tracks. It was tabled by a female MP, the hon. Member for Bath (Wera Hobhouse), and was talked out by a male MP, the hon. Member for Christchurch (Sir Christopher Chope), who frankly made a mockery of our Parliament and completely shamed himself. A female Minister is now taking the Bill through the House as the Voyeurism (Offences) (No. 2) Bill, in a Bill Committee made up mostly of women.
Sadly, women still often face societal discrimination and sexism in their everyday lives. Misogyny is rife and in full health. Rather than being consigned to history, it sits at the heart of even current legislation. One particularly disgusting example that is never far from my mind is the so-called two child policy: the epitome and very definition of sexist, disempowering, discriminatory and degrading prejudice towards ordinary working women who are, unlike most people here who get to create the policies, struggling to just get by. That particular policy would not have seemed so out of place 90 or 100 years ago before we marched, starved ourselves, chained ourselves to fences, broke the law, fought back and refused to give in until we got the right to vote.
Although many things have changed, and mostly for the better, so many other things really have not. We have to make sure that the change is not simply on the surface. Women must continue to fight for our rights, for equality, for a seat at the table and a voice in the decision-making processes—not only white, wealthy and middle-class women but working women, disabled women, black and minority ethnic women, lesbian, gay, bisexual and transgender women; women from all cultures, all religious faiths and every financial background. We must support each other, encourage one another and keep looking around the table to see if we are all represented.
One way in which we can practically commit to that aim is through cross-party solidarity on enacting and fully implementing section 106 of the Equality Act 2010. Section 106 would ensure that all political parties adequately report on the diversity of their candidates, allowing us to scrutinise discriminatory practices and hold parties to account when they fall short of what is necessary for real and true equality. This is an initiative recommended by the Women and Equalities Select Committee, the Labour party’s shadow Secretary of State for Women and Equalities, my hon. Friend the Member for Brent Central (Dawn Butler), the Fawcett Society, CARE International and many more.
Today in the Chamber we were due to debate proxy voting. Two weeks ago, a few of our women MPs, one seriously ill and two very heavily pregnant, were forced to go through the crowded voting Lobbies, which caused them considerable physical discomfort as well as being an extremely unpleasant experience. My hon. Friend the Member for Bradford West (Naz Shah) describes it in an article in today’s Guardian as,
“degrading, humiliating and downright horrible.”
I agree with her when she says,
“It should never have happened.”
That practice needs to change as soon as possible, and proxy voting is one option that would put an end to such practices. We need and want to encourage more women to come to this place, and some women have babies.
If we are serious about women’s representation and about celebrating the legacy of those fearless women who so vociferously fought for our right to stand here today, we must do our bit to ensure that those who wish to stand here do not face the barriers that many of us have had to. Ninety years ago, working women like my grandmother and great-aunts and their peers who served, cooked and laundered for the local landowners got to have their say. Our job here is to speak for those who are still not here but need to be, and to hold the doors of Parliament wide open to welcome them in to take their rightful place beside us.
Lyn Brown (West Ham) (Lab)
It is an absolute pleasure to see you in the Chair this afternoon, Ms Buck, and to speak under your chairmanship. I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate and giving us all the opportunity to talk about this issue today. She treated us to a really excellent contribution, which I look forward to reading in Hansard, because she touched on so many salient and important current political points.
I want to talk about the history of all women in this year of feminist anniversaries. The centenary of partial suffrage for women is important, but the centenary that means most to me will come in 10 years’ time. The women of my family were unable to vote in 1918, 1922, ’23 or ’24 because they were working class—they did not own property and they were not married to a man who owned property. As my hon. Friend has said, more than half the adult women in the UK were denied suffrage for a decade longer.
My family were proud of the right that they won. I was told at a really early age that they did not care who I voted for—as if!—but I had to vote. Only by voting would I respect the fight and the sacrifices made to secure my franchise. We sometimes forget that the story of suffrage is not just middle-class and white. Suffrage fighters were black, Indian, and disabled, like May Billinghurst, who once used her wheelchair as a battering ram to escape a police cordon when she had been trapped by a group of men.
Lyn Brown
I am grateful to my hon. Friend for mentioning Sophia Duleep Singh. She was indeed a doughty fighter, and all too often women like her have been written out of our history. He does us a great service by bringing her name into the debate.
Above all, for me, suffrage fighters were working-class. The first branch of the Women’s Social and Political Union was opened in my constituency in Canning Town, where my family lived. It was opened by Sylvia Pankhurst, but equally by the working-class women Minnie Baldock and Annie Kenney, who was a mill worker. It is fair to say that the Women’s Social and Political Union had become quite autocratic over time and the leadership appeared increasingly intimidated by the strength of the heavily working-class branches of east London, so those branches were expelled, along with Sylvia Pankhurst, and they formed the new East London Federation of Suffragettes.
The success of the group was massive. They organised among workers, including more than 5 million women who worked in factories during the first world war. They fought against deprivation in working-class communities, opening free milk depots for mums with young children and canteens that served affordable, nutritious food. That was so important then—and sadly now. They even opened a co-operative toy factory that paid a living wage. It included a crèche and, unsurprisingly, it recognised the needs of working mothers. At the time, working women were generally on poverty wages in munitions factories or they were sewing uniforms at home. However, the east London suffragettes stepped up their support for working communities and refused to allow the war to stop their campaign, continuing to build momentum for genuinely universal suffrage when others had, frankly, given up.
It is true that Sylvia Pankhurst’s socialist convictions were important to the movement but, as she recognised herself, it was the working-class women who were key. She said that working-class women were:
“not merely the argument of more fortunate people, but...fighters on their own account, despising mere platitudes...and demanding for themselves and their families a full share of the benefits of civilisation and progress.”
She was proved right. After she had been imprisoned and was weak from force-feeding, it was the women of the east of London who offered her protection.
Jo Stevens
Does my hon. Friend share my view that although it is brilliant to see the statue of Millicent Fawcett in Parliament Square, it would be as good to see a statue of Sylvia on Clerkenwell Green?
Lyn Brown
I certainly do, and perhaps we could do something about the Payne family, who took Sylvia in when she was weak. The Payne family came from Old Ford, which is kind of Hackney, kind of Tower Hamlets, and kind of Stratford—so that makes it mine—and they were shoemakers. Police officers tried to surround the house that Sylvia was in, but they were confronted by really strong women who simply stood firm and resolute and refused to move. Special branch officers attempted to bribe the women to withdraw and to allow them to use their rooms for surveillance. They offered decent money, but every single woman and family, I am proud to say, stood firm and refused to accept the bribes. They refused to move. I believe that, if the East London Federation had not put working-class women first, the anniversary that we are celebrating today would have taken much longer to achieve.
Those women stood on the shoulders of the match women who went on strike. They were from the same area and of the same stock. History is clear: the match women’s success in organising for themselves and fighting for their rights inspired London’s east end dockers to do the same. Those women were the wives, daughters, sisters and mothers of the dockers who went on strike the year after. The match women did not plead for inclusion in the labour movement, because they created it. They organised, fought and won against massive odds. They were instrumental in founding a political labour movement that continues to fight for fair pay and conditions for all Britain’s workers today.
I am happy that people know about those events through the wonderful work of the amazing historian Dr Louise Raw, whose sixth successful annual match women’s festival took place last Saturday. Louise and I have been campaigning for a proper memorial for the match women at the Bryant and May factory site in Bow where they worked. Progress is slow, but I am glad to tell the sisters present—and the brothers—that I reckon we will make it within the next 12 months. We have strong support from residents, historians and activists.
We are making some progress with recognition of our history as working-class women. However, Members will agree that we have a way to go, because in the east of London we have a Jack the Ripper museum that glamorises misogynist murders and turns the working-class women victims into mere props. At the same time, one of the victims, Annie Chapman, is buried in a pauper’s grave in Newham, and one of the match women’s leaders, Sarah Chapman—no relation, as it happens—is buried just a few metres away. Those are the stories that we need to tell and remember. Those are the people we need to memorialise—not a sad, sick man.
Why do we have a Jack the Ripper museum? The building was originally supposed to be a celebration of east end women but, according to newspaper reports, the developers lied. The travesty of the Ripper museum in Cable Street, of all places, may have a positive outcome yet, because the campaign for an east end women’s museum is stronger than ever. The campaigners aim to secure a permanent home for their exhibitions, which they expect to open in 2020. They are still talking about putting the museum in Barking—but I still have my dreams.
Learning about our history is important, because unless we know where we come from and who we are, it is hard to know where we can go. The history we talk about today can play a part in inspiring a new generation. Remembering our past helps us to understand our present and imagine our future. If more people knew about the true contribution of working-class women to the suffrage and labour movements, and the rights and prosperity in this society today, they would be less likely to overlook the amazing women who do that same work now. The potential that my working-class sisters have is enormous. They need the recognition and the space to achieve it.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate. She is a woman I am proud of, as I know many Members are.
It is vital in such a debate not only to celebrate the achievement of the 1928 Act, but to remember the stories of the women and fighters who campaigned for it and who won the battle for electoral reform, suffrage and equality. It is 100 years since some women got the right to vote—not all of them, but some. It was a good step forward. People often get confused between the different Representation of the People Acts. Were it not for the fantastic Voice & Vote exhibition in Westminster Hall, it would be easy for Members of Parliament, too, to be confused about when each piece of legislation was passed, and what it meant.
In 1918 the vote was given to some women—only those at the top of society. The 1928 Act gave the vote to all women over 21, rather than those over 30 who were landowners. That was a huge step forward, and it meant that 52.5% of the electorate in the 1929 general election were women. That was transformative. The fact that it took 10 years—two whole Parliaments—fully to extend the franchise shows just how scared the establishment was of giving proper representation to women and the working class across the UK.
I pay tribute to the incredible campaigners who continued to make the case for the legislation. Many gave up their freedom, faced imprisonment or went on hunger strikes. Many, such as Emily Davison, gave their lives for the cause, but the campaigners never gave up. They are an inspiration to all of us in this House and we pledge ourselves to further their cause. The story is often overlooked.
In Plymouth we are proud to be part of the suffragette story, and of the fact that the suffragette movement there was not just one of rich women campaigning for the vote. The women took things into their own hands. Members may be familiar with the beautiful Smeaton’s Tower on Plymouth Hoe. That lighthouse still stands proudly, but the suffragettes put a bomb in it and tried to blow it up. They wanted to attract attention to their cause. I am glad that the lighthouse still stands, but the story of how local women in Plymouth resorted to those means to try to gain attention and credibility for their cause should continue to be talked about.
I want to talk now about Nancy Astor. As my hon. Friend the Member for Canterbury said, the story of how we reached the point where only a third of our Parliament are women started with Nancy Astor taking her seat in 1919. She represented Plymouth Sutton and was introduced to the House of Commons flanked by Balfour and Lloyd George. It will be the 100th anniversary of her election—and of Plymouth’s voting for a woman—in November 2019. She and I would disagree fundamentally on nearly everything. She stood for many things that I could not stomach, countenance or go along with, and I am sure that that would be the case for nearly every Member. We would not share her views on slavery, anti-Semitism, fascism and LGBT equality, but her story, the fact that she was the first woman to take her seat in this place, and the fact that Plymouth was the first place to elect a woman who took her seat means we are intimately entwined in the story, which we must keep telling.
There are far too many girls and young women in schools in Plymouth and across the country who do not know about Nancy Astor. I do not want her political views to be advocated; I want the story of brave women, many of them standing alone, doing brave things and pushing the boundaries for women in general. She was initially known as the Member of Parliament for women, and we should talk about her role. There should be debate about the good and bad sides of all politicians. The first step that she took is important. It may seem odd for me as a Labour MP to speak here about a Conservative MP—especially one I fundamentally disagree with—but we need to tell the story. It frustrates me that the story of women in our politics is not told. We hear about men, and occasionally about the women standing behind them. We need to break that, and we can do so only when we—men in particular—start to tell the story. We cannot leave it to women to tell the story of women in politics. It is for all Members of Parliament, male and female, to talk up the role of women in Parliament.
Mr Dhesi
My hon. Friend is making an excellent speech. As to women pushing boundaries, does he agree that women, and especially those from ethnic minorities, are often not given much credit for their accomplishments? The first black lady mayor in the country, Lydia Simmons, was elected in Slough. She was an inspiration for many, yet often such individuals do not get the credit they deserve.
Luke Pollard
My hon. Friend has proved my point precisely that we need male MPs speaking up as well as female MPs, and I thank him for taking the advice so quickly.
I recently visited the superb Voice & Vote exhibition in Westminster Hall. I pay tribute to the House authorities for putting it on. It really is a superb exhibition, and hon. Members who have not visited need to take the time to do so. They will notice that one exhibit is Nancy Astor’s dress, on loan from Plymouth museum. She picked the dress because it looked like a man’s suit; it looks like a double-breasted suit. Beside it is a little plaque explaining that she chose it because she wanted people to judge her by what she said and not for what she wore. It is therefore somewhat ironic that 99 years later I stand here, as one of her successors, talking about her dress and disagreeing with all her words, but perhaps those are the joys of democracy.
Parliament was a very different place when Nancy Astor became a Member. Voice & Vote tells us the story of a system that did not welcome women to Parliament. It did not afford them the equality and credibility that they deserved by virtue of their election. We can see that in the fact that in 1929 there was only one coat hook in the Lady Members’ Room for eight female MPs. That was simply unacceptable. However, there is still far too much that the women at that time, Nancy Astor included, were fighting for that we are still fighting for today.
Nancy Astor was not afraid to stand up for herself as a woman, even in the face of power. She had an incredibly canny sense of humour, and people who have spent time in Plymouth will know many stories about her. I will touch on just a few. In particular, I want to touch on her relationship with Winston Churchill. Many hon. Members will know one story about it, but there were so many glorious clashes between them. Apparently, Churchill once told Nancy Astor that having a woman in Parliament was like having one intrude on him in the bathroom, to which she retorted, “You’re not handsome enough to have such fears.” She is also said to have responded to a question from Churchill about what disguise he should wear to a masquerade ball by saying, “Why don’t you come sober, Prime Minister?” But perhaps the most famous exchange, which I am sure all hon. Members will know of, is the one in which Nancy Astor said, “Mr. Churchill, if you were my husband, I would poison your tea,” to which Churchill replied, “Madam, if you were my wife, I would drink it.”
So many stories are told about Nancy Astor, but so few are told about many of the other fantastic female MPs for Plymouth. I want to single out Lucy Middleton, who was the MP from 1945 to 1951 and a real tower of strength in the trade union movement. She is not remembered enough by my party in Plymouth, or by all of us here. Sadly, she lost her seat, to a male member of the Astor dynasty, Jakie Astor, in 1951, but it is good to see her name on the wall of female MPs in the Voice & Vote exhibition, because there is so much more that needs to be said in that respect.
One thing that frustrates me every time I come to Parliament—and that helps keep alive in me the fire so that I do not become accustomed to or cushioned by this place—is looking around the rooms in which we have our meetings and seeing all the old white men in wigs staring down at me. This place has a problem, because nearly every room—except, perhaps, this one—has too many pictures of men, too many pictures of old men, and too many pictures of old, white, rich men on the walls. Where are the women? Every single one of these rooms should have 50:50 representation. If there are not the paintings of women from our political history, commission them or borrow them and put them up. Take down those images of old white men, so that when young children from Plymouth come to visit Parliament they see pictures of people who look like them. Let us also ensure that there is not just male and female representation. Let us ensure that we have on our walls LGBT heroes, black, Asian and minority ethnic heroes, and disabled heroes. This place looks far too much like the old stale white male club that it sometimes was in the past.
We can change that. We need to do it by speaking up about equality. We need to continue to be restless about it to ensure that we keep fighting the misogyny that we see in our politics, in our parties and in our society. We need to give a voice to the single parents, to the WASPI women and to those people who are standing up for equality and want a fair day’s pay for a fair day’s work. That is what we all need to do. We can all do our bit to ensure that we get there by telling the story of women in politics, and the 1928 Act is a really important part of that. I look forward to my hon. Friend the Member for Canterbury still being in this place in 10 years’ time to lead the debate on the 100th anniversary of that Act.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for securing the debate. I will start my contribution by remembering Margaret Bondfield. Margaret was a shop worker and union official from Brighton who was foundational in extending the franchise to working-class women. She was the first woman Minister and the first woman Privy Counsellor, and she was a Labour MP.
As a campaigner for women’s suffrage, Margaret was part of a broader labour movement with other working-class suffragettes, fighting for all women to have equal rights with men. This year, of course, marks 90 years of the equal franchise, but it is also the centenary of the unequal franchise for women—that is probably what we should call it. Ten years previously, the Representation of the People Act 1918 was passed to give middle-class and upper-class women the vote. For Margaret and the millions of other working-class women, that meant one rule for the rich and another for the poor. A third of the least well-off women could not vote.
We cannot look at gender separately from class. The fight for suffrage and equality is a difficult journey. Margaret, after years of condemnation and even imprisonment because of trade union activities, understood that the struggles of unionisation and feminism went hand in hand. Let us be clear: it is thanks to the many sacrifices made by Margaret and fellow suffragettes that the struggle for gender equality has been transformed into law. Change can happen only when ordinary people organise together to fight to shape their future. We must remember those women who fought to shape their future, and in doing so helped others. We cannot forget either those who stood in solidarity with the suffragettes. Of course, male Labour MPs such as Keir Hardie and George Lansbury resigned their positions and faced imprisonment on this issue as well.
The struggle for gender equality has not yet been won elsewhere in the world, and sometimes the fight takes place vociferously on the streets as well as in parliamentary chambers. Earlier this year, I went to northern Syria, where I met the People’s Protection Units, the YPG, and the YPJ, the Women’s Protection Units, of the Kurdish fighters. They are not only fighting the Islamic State in the middle east, but building a feminist revolution, in which all positions are held jointly by women and men. Women hold 50% of all the positions in their organisation—that is better than we do in the UK. There is still a lot to learn. We must remember and show solidarity with the YPJ fighters and other feminist fighters around the world. Those women take up not only the torch against persecution and disenfranchisement, but the fight for a global humanity and against the fascism of ISIS. They remind us that each battle takes us a step closer to equality.
This year, of course, we have seen erected in Parliament Square the statue of Millicent Fawcett, who lived in Brighton and whose husband was the first non-Conservative Member of Parliament in Brighton. On the plinth are 58 names, but there are many more names that we must remember. Today, however, some of their greatest achievements of progress are being rolled back—progress not just for women, but for those with disabilities, LGBT people and BAME people. Severe cuts have landed disproportionately on women and ethnic minorities. Since 2010, 86% of the money raised from Conservative tax and social security changes has come straight out of women’s pockets. And of course the introduction of voter ID harms working-class women of colour the most.
The Young Women’s Trust found that young women are especially likely to be on low pay and in insecure jobs. One sixth of young women have been on less than the minimum wage, and almost half are worried about job security. The Office for National Statistics says that half a million young women are workless. Despite most wanting jobs, they cannot afford to work because of lack of childcare, direct discrimination, and lack of support to find jobs.
We cannot stop fighting for women, especially when, I believe, this Government are not doing enough; nor can we ignore the central role of working people in demanding social change. These rights are hard-won not by asking nicely, but by feminists’ and working class people’s continued commitment to equality. A campaign of equality will always find its home in the Labour movement.
When Margaret Bondfield and fellow suffragettes joined the labour movement to fight for equality, they found a home in the Labour party. Sewing machinists such as Rose Boland and Sheila Douglas, who fought for what became the Equal Pay Act 1970, found their home in the Labour party. Today, women make up half of our shadow Cabinet. A third of Labour Members are women—more than any other political party. Labour has always led the way in guaranteeing women’s representation through our party structures, but it still needs to do more internally, and I think other parties do, too.
We will always welcome those demanding social change for what they believe in. Equality fighters will always have a home in the Labour party. In Brighton we have a campaign to commemorate Liberal and Labour party women on blue plaques around our city this year. We hope to have a statue of the first suffragette to die, who was from Brighton, erected in Brighton. I believe every town should have a statue of a woman, because, as my hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard) said, there are far too many representations of men, not only in Parliament, but in our communities. Those struggles and fights will have a home in the Labour party. I hope that local Labour parties and other parties will fight for that across the country.
Tommy Sheppard (Edinburgh East) (SNP)
It is a pleasure to serve under your chairmanship, Ms Buck. I thank the hon. Member for Canterbury (Rosie Duffield) for bringing this debate to the House and giving me the opportunity to speak on the subject today.
We have spent a lot of time this year marking the anniversaries of universal suffrage. Every time I think about this, what I find remarkable is not how long ago it was, but how recent. The beginning of the 20th century was an age of modernity—there were motorcars, aeroplanes, radios and televisions; there were new advances in thinking in science and technology; there was an avant-garde movement in the arts, architecture and music. Yet while all that was happening, half—in fact, more than half—of our population were denied the basic political rights given to the other half. On reflection, that is a monstrous injustice, and the fact that it could have existed for so long while our modern constitution was being shaped is a source of great shame, and a black mark on our collective history.
Universal suffrage had been a long time coming when it happened. I have spent some time recently looking at the political agitation of the late 18th century, from Thomas Muir in Scotland to Thomas Paine here and Wolfe Tone in Ireland. They were agitating for universal suffrage—basic political suffrage—in an age when there was none. The role of women was alive and present in those debates. Since we have time, I want to read for the record the opening lines of a poem by Robert Burns, written in 1792:
“While Europe's eye is fix’d on mighty things,
The fate of Empires and the fall of Kings;
While quacks of State must each produce his plan,
And even children lisp the Rights of Man;
Amid this mighty fuss just let me mention,
The Rights of Woman merit some attention.”
That shows that in 1792 there was a live discussion about the political rights distributed among men and women.
The exhibition just outside this Chamber in Westminster Hall shows that throughout the 19th century there was agitation, in the Reform Acts of the 1830s and driving on throughout that century. People were asking for reforms for a very long time. It is hard to imagine now the political organisation of men in this country and the degree to which that patriarchy practised misogyny and exclusion. It is quite phenomenal that it took so long—decades and generations—for these most basic of reforms to be achieved.
Having the right to vote is an end in itself, but increasing the franchise and bringing women into the electorate and then into Parliament achieved many other great ends. In particular, it overcame much exclusion, inequality and discrimination that pervaded every aspect of social policy. Even in the period 1918 to 1939, there were many advances in social and economic legislation, to the betterment of women and our society, and the task continues today. It is sad that we have to admit this, but it is a fact that there is a correlation between the involvement of women in the rules that govern our society and the effect those rules have on sexual inequality.
I hope we are nearing the end of this process. I hope we are getting to a situation where we have genuine equality and where our public policy is genuinely equal, but as colleagues have said, we are still at it. Government policy today still has a worse effect on women in our society than on men. The welfare cuts fall mainly on women. The rape clause means that women now have to prove that they have been raped to get child benefit for their third child. The WASPI inequality—I think that all of us would agree that men and women should have equal pension rights—was brought in in a ham-fisted way. The denial and breaking of an obligation and guarantee given to so many born in the 1950s is a monstrous act of Government policy. Those things are still with us today.
Luke Pollard
The mistakes made with the WASPI women—not informing people about changes—are still happening today with the change in universal credit. If women transitioning with their families on to universal credit have more than two children, they are not being told that they will lose the benefit after the two-child cut-off. The opportunity of WASPI is to learn the lessons and to help women with three children especially to understand that cuts are coming for them. That is not being done by Government at the moment.
Tommy Sheppard
Indeed. It would probably be unfair to expect the Cabinet Office Minister to respond to that point on behalf of the Government, but perhaps she will commit to take it back to discuss with colleagues.
It would be remiss of me to speak on behalf of the Scottish National party without saying something about the many great women who have contributed much to the politics not just of Scotland but of the United Kingdom as a whole. I shall mention only three: in 1967 Winnie Ewing tore the establishment apart by winning the Hamilton by-election, surprising everyone in British politics and beginning 51 years of unbroken representation by my party in this place; in the following decade Margo MacDonald did the same in not one but two by-elections, upturning the political firmament and in many ways creating the conditions that have led to the modern political dynamic in Scotland now; and of course Nicola Sturgeon, our First Minister in Scotland, who has been a beacon, an inspiration and a role model for young women in Scotland and throughout Europe and the modern world.
Nicola Sturgeon presides over one of the few Cabinets among Governments that is gender-balanced, made up half of women and half of men. It has been praised as a role model by the United Nations. The Scottish Government are also moving forward in many other respects to improve the representation of women in public life, setting targets and quotas for representation in our public board rooms, hoping to encourage the private sector to follow suit.
There has been a big debate about quotas—whether they are a right and proper thing and whether they genuinely advance women or are in some ways unnecessary or patronising to women. My experience is clear: quotas are a way of breaking the inertia and stasis that surround the existing system. It is a way of asking and answering a question about whether women are capable of doing the job. When given the chance, they are not just capable but in my view more capable than their male counterparts. That is the experience of the Scottish Government in action, which the rest of the United Kingdom might choose to learn from.
Jo Stevens
The Labour party has the highest proportion of female MPs, which has been achieved through all-women shortlists—a mechanism that was put in place to make that change. Does the hon. Gentleman agree that similar mechanisms should be put in place across all political parties?
Tommy Sheppard
Yes. I am not saying that we should necessarily copy the Labour party rulebook, but a similar objective and similar mechanisms should certainly be put in place. We have something similar in my party, although not for every seat. Many seats that we do not hold are designated as all-women shortlists so a female candidate is selected. In Scotland, that has resulted in 43% of the governing party, my party, being women—still not 50%, but further forward than many other parties can boast of. Those policies have obsolescence built in, because once they have achieved the desired effect, they are no longer necessary.
As we reflect on the 90th anniversary of universal suffrage and the 100th anniversary of the beginning of votes for women, we should also consider what we can do across the globe as an international player. In many countries, the rights of women resemble what they were in this country 90 years or 100 years ago. That needs to be built into our foreign policy much more—again, I do not expect the Cabinet Minister to respond to that—so that our relationship with other countries is conditioned and qualified by the way in which they treat their citizens and particularly women in their societies. We should not have beneficial relations, roll out the red carpet or sign arms deals, or whatever, with countries that manifestly practise discrimination within their own borders. That would bring long-overdue principle into politics and Government policy and, as we look forward on this anniversary, it would be a practical contribution that we could make to celebrate the gains already made and recognise how much still needs to be done throughout the world.
Dawn Butler (Brent Central) (Lab)
It is a pleasure to serve under your chairship, Ms Buck. I congratulate my hon. Friend the Member for Canterbury (Rosie Duffield) on securing this important debate. It has been great to listen to all these names, which are now in Hansard in perpetuity, and know that we have done our bit to recognise working-class women who have been, and are still, often ignored.
In history, working-class women, the poorer suffragettes, were referred to as “women quite unknown”. My hon. Friend mentioned how few opportunities there were for working-class women. She talked about inequality and the gender pay gap, and the way that they are still poorer female citizens. She also mentioned 50:50 Parliament, which we campaign on with Frances Scott, who is here today. We need to ensure that upskirting and revenge porn become sexual offences so that women who suffer do not have to make themselves publicly known.
How can we achieve all that in this day and age? We can all play our part. We can use inclusion riders, like actors who say, “I will not star in a film if it does not involve diversity in its pipeline and creation.” We have also talked about various sections of the Equality Act 2010. I hope that when the Minister responds, she might be tempted to announce that the Government will enact section 1 of the Act, which would force public bodies to take into account socioeconomic disadvantage when making policy decisions. If we had more consideration of that when policies were being developed, we would see fewer policies like the third-child policy, and fewer policies like those under which 86% of cuts fall on the shoulders of women and black, Asian and minority ethnic women suffer more than any other group.
My hon. Friend also mentioned my hon. Friend the Member for Bradford West (Naz Shah), who is recovering. The proxy vote debate, which was supposed to be today, has been postponed. I had hoped that all the women MPs who were ready and poised to speak would come to this debate to at least listen or even make their speeches, because then they would not have been wasted.
There were many great contributions to the debate, and I will touch on a few. My hon. Friend the Member for West Ham (Lyn Brown) flew the flag for working-class women, the different types of women and the strength of east London women, which I can obviously attest to. She gave a voice to the match women and talked about the leaders of those times, who were buried in paupers’ graves after all their struggles.
My hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard) talked about Nancy Astor and how we have to talk about the journeys of women, even those we disagree with. Of course, I often talk about women I disagree with and the policies they make. Their story deserves to be told, just like everybody else’s. It is important that we stand up for other people’s rights. Let us imagine how quickly we would move towards equality if all men spoke about the rights of women, all white people spoke about the equality of black people, and all straight people spoke about LGBT+ people. We must all play our part in speaking up for equality, because we all play a part in each other’s journey. As Martin Luther King said:
“I can never be what I ought to be until you are what you ought to be. This is the interrelated structure of reality.”
My hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) spoke about Margaret Bondfield, the first female Minister under Labour, which made me think about all the firsts that Labour has achieved. I would like to read them out, but there are so many that it would take at least an hour, and I do not have that much time. Some of them are to be celebrated: we have had the first black female MP, the first lesbian Minister and the first black female Minister—that is me. There are also some sad firsts, such as Maureen Colquhoun, a Labour MP who was born in 1928, who was gay and outed by the Daily Mail, which still happens today. Newspapers still think that that is okay, which shows how far we have to go.
We also heard some great interventions about 1950s women. I thank my hon. Friend the Member for Slough (Mr Dhesi), who is no longer in his place, for wearing the colours of the suffragettes in his turban. He talked about Princess Sophia Duleep Singh and the hidden histories that have been ignored or forgotten, which this debate has shined a light on.
Poorer women were treated worse than middle-class women. They were treated more brutally by the police, prison wardens and magistrates. As I said, I am pleased that we are recognising them. To remember them and their struggle is to remember our own struggle and to adopt their struggle as our own.
As has been said, alongside the growing women’s suffrage movement was the women’s labour movement, which included groups such as the Women’s Protective and Provident League, the Co-operative Women’s Guild, the Women’s Trade Union Association and women in the young Independent Labour party, which would probably be known as Momentum today. Those women were referred to as “radical suffragists”. I cannot see what was radical about them, apart from wanting equality. However, those “radical suffragists” included people such as Sarah Reddish, Ada Nield Chew, Helen Silcock and Selina Cooper. Those women mobilised other women in the trade union movement—in fact, they mobilised almost 30,000 people to sign a suffrage petition, and that was without the internet, Twitter, Facebook, mobile phones and WhatsApp.
Ada Nield Chew said that if the National Union of Women’s Suffrage Societies’ request had been granted in 1884,
“the entire class of wealthy women would be enfranchised” ,
but, as she added,
“the great body of working women, married or single, would be voteless still”.
That message rings true with me. The radical suffragists, as they were known, began to move away from the NUWSS, as my hon. Friend the Member for West Ham spoke about. That reminded me of something that I did recently. I was a member of a women’s WhatsApp group, but I became so frustrated with trying to get members of that group to understand and consider the intersectionality of women that in the end I left the group, and I was not the only one to do so. It did not feel radical to leave that group; it obviously just entailed the click of a button. However, it reminded me of those powerful working-class women and it made me realise that the fight for recognition of, and equality for, all women is a constant struggle. We have to talk about it and fight for it constantly, otherwise we will be dragged backwards. That is really a stark realisation, because I would have hoped that we would have progressed.
I cannot confirm or deny whether I joined a new radical women’s WhatsApp group, but those working-class women broke away and formed “Womanhood Suffrage”, or the Women’s Social and Political Union. The WSPU’s strapline and objective was:
“A vote for every adult woman, regardless of whether she owned property.”
When working-class women fight, they fight for everybody; they do not just fight for a select group. That is a lesson that truly still needs to be learned in some feminist circles. What those women were fighting for sounds really simple now; it does not sound radical to me at all. As my hon. Friend the Member for Canterbury asked, if all women had received the vote earlier, how far towards equality would we be now? We might not even be having this debate.
As we have heard, the first march was from east London, and it included trade unionists such as Minnie Baldock, Sylvia Pankhurst and Dora Montefiore, who were working-class women using their non-working day to march. They worked six days a week and on the one day that they were not working they marched to Westminster and back. In a way, it can be said that working-class women committed more, in that they sacrificed more. They had the daily struggles of life. They had no home help; when they left to march on that one day off, they had to go back home afterwards and do everything else that they needed to. They had less time, less money and less formal education than many others, yet still they fought, and fought for everybody. They fought for food, they fought for their rights, they fought for dignity and respect, and they fought for every woman’s rights. And they were known as radical—I really do not get it.
Later, the WSPU was taken over by wealthy women, and it moved away from its roots in the labour movement and the trade union movement. It became ineffective and it was too far removed from its roots; some people would say that has been repeated in some circles. However, Sylvia Pankhurst reclaimed the movement, and I agree with my hon. Friend the Member for Canterbury that we should perhaps see a statue of Sylvia Pankhurst. Not all women were up for the fight. Some women described the working-class women’s movement in this way:
“A working women’s movement was of no value—working women were the weakest portion of the sex...their lives were too hard, their education too meagre to equip them for the contest.”
That was an insult, but let us hope that we are moving forward.
The fact is that the Representation of the People Act 1918 enabled the representation of less than half the adult women in the UK. However, the Equal Franchise Act 1928 was literally equal. Women fought not only for the right to vote but for economic and social rights, through the labour movement and the trade union movement. We are still fighting for those rights today, as we have heard from many hon. Members.
To forget the place of working-class women, disabled women and black women in history is to be complicit in the misogynistic class war, and to forget the interconnectivity of the Labour party and the labour movement in that is to do a disservice to the truth. In this day and age of fake news, the truth has never been so important, so it is vital that we correct the record and put on the record the names of these working-class women at each and every opportunity that we get.
This year saw the first statue of a woman in Parliament Square, and I am thankful to the Mayor of London for making that happen. There are about 58 or so names of women, mainly those of working-class women, around the plinth. However, I would like to see a statue of Sarah Parker Remond, the only black woman known to have signed the Representation of the People Act 1918. I am pleased to say that the Mayor of London and his team are meeting me to discuss that proposal. While I am there, I might even put in a plug for a little statue of Sylvia Pankhurst, as my hon. Friend the Member for Cardiff Central (Jo Stevens) suggested.
Our job here in Parliament is to give a voice to the voiceless.
Luke Pollard
When I first got into Parliament, I tabled a question to the Department for Digital, Culture, Media and Sport, asking what the official figures were for the number of men and the number of women represented in statues and other public art. However, the UK Government do not keep those statistics. I think we should. Does my hon. Friend agree that we should encourage Ministers to start recording equality in our public art, so that we understand the scale of the challenge ahead of us?
Dawn Butler
I thank my hon. Friend for that intervention and I absolutely agree, because only then will we be able to measure how far we have come and what still needs to be done.
Lyn Brown
While my hon. Friend is advocating on behalf of the statues that we could build, maybe we could have a statue that had some of the working-class women around it, such as Minnie Baldock and Annie Kenney; maybe they could stand shoulder to shoulder with the other women she wants on the plinth. Maybe we could have a really big platform with lots of women from the suffrage movement standing tall.
Dawn Butler
How amazing would it be to walk around different parts of London and the country, and see statues of women, and learn about their history, and know that we have made that happen? People always bang on about Britain having had two female Prime Ministers. Well, we have a female Prime Minister—I am not saying that I want statues of the female Prime Minister going up all around the place, but I am saying that the female Prime Minister can make the decision. She can say, “Right, I will give the money for this to happen, so that we can embrace our rich and colourful and socialist history”, because our job is to give a voice to the voiceless and to uncover the hidden stories. Should I have missed out the word “socialist” there? [Laughter.] Our job is to put a name to “A.N. Other” and to “Anonymous”, to ensure that history becomes herstory, and that herstory paints a true picture of a moment in time.
Working-class women fought for all women, so when women of today fight for the select, privileged few, I find it hard to refer to them as feminists, and when they use their voice to amplify their privilege and ignore the cries of the less fortunate, I find it hard to support the cause wholeheartedly. I hope that in time people will use their power and privilege for progress. People often talk about the legacy that they will leave behind; I think that we need to talk about the foundation that we will leave behind. Women who are on the ladder of success should leave behind them the foundation for an escalator, and the women who are on the escalator of success should leave behind them the foundation for a lift, so that those women who come behind us get to that destination, quicker and more smoothly.
The Parliamentary Secretary, Cabinet Office (Chloe Smith)
May I say how pleased I am to have you presiding over us today, Ms Buck? I will make a few remarks before ensuring that the hon. Member for Canterbury (Rosie Duffield) can wrap up the debate. I begin by thanking her for bringing forward this debate on the 90th anniversary of the Equal Franchise Act 1928. I am delighted to play my part in recognising that milestone. I will set out some of the work that the Government are undertaking to mark the anniversary and our plans for ensuring that all citizens feel empowered to be part of democracy as we enjoy it in this country.
Chloe Smith
Perhaps the hon. Lady should give me a chance to get started, but go on—make it good.
Jo Stevens
The Minister specifically mentioned allowing people to participate in democracy. Would it not be a wonderful thing on this anniversary to give 16 and 17-year-olds the right to vote?
Chloe Smith
The hon. Lady will need to wait for another 90 minutes in another Westminster Hall debate for the full discussion on that.
I thank the hon. Member for Canterbury for her commitment to equality for all members of our society. I am aware of the work she does with the 50:50 Parliament campaign, and I pay tribute to it. I am glad she shares my view and the Government’s view that no one in our society is more important than anyone else. Every individual, no matter their gender or background, has an equal role and, in relation to my particular brief, an equal right to vote.
As a fellow female parliamentarian, it is important to acknowledge the efforts of the brilliant women who paved the way for us to be here today. I thank the hon. Member for West Ham (Lyn Brown) for beginning the Back-Bench contributions with an exposition of the history that is at play here. It is important to think about the past as we consider our present and our future. Without the tireless efforts of those women and the men who championed their cause, perhaps most of us in this room would not have a voice in society, let alone in this place. I am proud to be part of the present, when we have the most diverse Parliament in British history, but there is a lot more to do.
We all welcome such initiatives as the 50:50 campaign, the #AskHerToStand campaign and Parliament’s own Vote 100 project, which make the goal of gender balance a long-needed reality. I thank the hon. Member for Edinburgh East (Tommy Sheppard) for reminding us that progress needs to be encouraged and supported internationally.
This week is National Democracy Week, which has been timed to coincide with Monday’s important anniversary. Many of the events happening up and down the country will be highlighting the role played by those who fought for equal voting rights, which included women from a diverse range of backgrounds. Our goal in running National Democracy Week has been to reach out to citizens from all backgrounds, especially those from groups less likely to be registered to vote. I am very passionate about that.
I understand, respect and acknowledge the arguments that have been made today about the difference between 1918 and 1928. In this year of suffrage, which encompasses both those anniversaries, it is valid and important that we test those concepts and have that debate. I would like to acknowledge that in my remarks.
The Equal Franchise Act 1928, which is what we are here to discuss, is as significant today as it was then. It cemented in law that no matter whether someone was a woman or a man, they had the right to vote on equal terms. We are celebrating that 90th anniversary in a number of ways, including the National Democracy Week awards, which were held in Manchester on Monday. They kicked off the week and were a fantastic way of recognising the exceptional work of individuals and organisations helping others to be involved in democracy. Just today, a “Women in Politics Hackathon”, supported by the Leader of the House and run by Shout Out UK, brought girls and young women to Parliament to work on creative ideas to get more women into politics.
This year the Government Equalities Office has provided £1.5 million for the women’s vote centenary grant scheme, which has already provided funds to 140 projects across the country. As a Minister at the Cabinet Office, I am delivering projects under the “Educate” theme of the suffrage centenary programme. The projects are being developed to increase knowledge of UK democracy and its importance among young people in particular, but not exclusively. It includes those from ethnic minorities and under-registered groups, so as to widen democratic participation.
Increasing participation has been facilitated by the Government’s commitment to making registering to vote more straightforward than ever before. In 2014 we introduced individual electoral registration alongside a digital service, and as a result we have seen record numbers on our electoral register, which reached 46.8 million people before the 2017 general election. I wonder what that might have looked like to someone looking ahead from 1928.
We are committed to making the service more accessible. For example, I am pleased to say that we are working with Mencap on an easy-read guide. Historically—I say this as a passing point of interest—figures suggest that women have been more likely to be registered to vote than men, with recent research on completeness of registers suggesting a 2% difference in the rates for women and men.
Last December, the Government published their democratic engagement plan, which sets out the ways in which we will tackle further barriers to democratic inclusion. I was pleased that the hon. Member for Canterbury widened her argument at the start and set the tone for the debate, because in many ways the issue goes beyond just gender. That gives me the chance to note that we have set up an accessibility of elections working group along with Mencap, Scope, the Royal National Institute of Blind People and many others, through which we are working on how we can make our registration and electoral systems and processes as smooth and secure as possible for people with specific conditions or disabilities.
The hon. Member for Slough (Mr Dhesi), who is no longer in his place, was right to reassure people that our recent changes to the anonymous registration system have made it easier for victims of domestic abuse to register to vote while protecting their right to remain anonymous. Those changes, which of course were welcomed by Women’s Aid and many others, will make it easier for an estimated 12,000 survivors of domestic abuse to register to vote without their name or address appearing on the roll and without the fear of former partners finding their address. I would like the message to go out loud and clear that that has been done, and I hope it is already making victims’ lives easier.
I was struck by some of the words the hon. Member for Canterbury used about the grotesque abuse that may follow her introducing the debate. She was right to draw that point out. I will shortly launch a consultation on intimidation in public life, which, as the Committee on Standards in Public Life noted, is directed disproportionately at female candidates for public service. I hope we can work together to improve the way our electoral law protects debate and welcomes everyone into democracy.
The hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) reminded us in his helpful remarks outlining the life and times of Nancy Astor that we should respect difference. I am delighted that hon. Members spoke so well about their political traditions, and I shall take the licence the hon. Gentleman offered me to speak about mine. I remind hon. Members that the first woman to sit in the House of Commons was indeed that Conservative, Nancy Astor, and we were the first party in the western world to elect a female Prime Minister. Here we are on our second, while the party in opposition is yet to have a female leader.
Chloe Smith
Is the hon. Lady the next leader of the Labour party? I hope so.
Dawn Butler
I am not, but let me correct the Minister. We have not had a female Prime Minister, but my right hon. Friend the Member for Derby South (Margaret Beckett) was a female leader of the Labour party.
Chloe Smith
I am happy to stand corrected, but I still raise the hon. Lady two Prime Ministers to one Leader of the Opposition. I also raise her the Prime Minister who passed the Equal Franchise Act 1928—the Conservative Stanley Baldwin—and pay credit to Emmeline Pankhurst, who, had she not passed away before the election, would have contested a parliamentary seat for the Conservative party.
Turning to other matters in women’s lives, under this Conservative Government there are more women in work than ever before. The female employment rate is at a record high of 70.9%. Under the last Labour Government, female unemployment rose by 25%. Let us not forget that that represents nearly 1 million women. We are encouraging all companies to do more to eliminate the gender pay gap by publishing their data, improving their pipeline to ensure progress on female representation at senior levels, and making flexible working a reality for all employees. We introduced shared parental leave—my husband and I took it ourselves, and we agree that it is extremely important. I would love to see others taking it up as well.
Other political points were made that neglected to give the entire picture, so let me make a few more economic points before concluding. In Government, we have introduced tax-free childcare, providing working families with up to £2,000 per child per year. We have introduced universal credit, and increased support to 85% of childcare costs, 15 hours of free childcare a week for families with disadvantaged two-year-olds, and an additional 15 hours of free childcare every week to working parents of three and four-year-olds. We will be investing around £6 billion in childcare every year by 2020—more than ever before. That is the Conservative reality.
Furthermore, the increase in the national living wage in April from £7.50 to £7.83, with more to come, represents an increase in a full-time minimum wage worker’s annual earnings of more than £600. We all know that a higher proportion of women than men are expected to benefit from that increase, so there is no glass ceiling in the Government’s approach to improving the lives of all women in society. We practise what we preach—improving female representation and creating equal opportunities in the workplace.
I will leave time for the hon. Member for Canterbury to wind up. I thank her again for securing the debate on this important anniversary. We should use such opportunities to promote participation and work together, combining our traditions and interests and coming together to use our powerful positions in this place to deliver a democracy that is more accessible, inclusive and representative.
Rosie Duffield
Thank you, Ms Buck, for allowing me to lead today’s debate and for chairing it so brilliantly. I thank all hon. Members who stayed here on a horrible hot Thursday afternoon instead of going back to their constituencies. It is great to hear the Minister pledge to do so much for democracy, and to hear about the Government’s plans. Obviously Opposition Members will keep a close eye on those things.
I thank all Members who made contributions. I have learned a lot about the east end women. I share the view of my hon. Friend the Member for West Ham (Lyn Brown) that the Jack the Ripper museum is abhorrent. I cannot wait for us to find a space where we can celebrate the lives of the east end women permanently, rather than having to shift about all the time. It would be nice to have the money behind that that this horrible other place seems to have.
Dawn Butler
Does my hon. Friend have any comments about women who are on zero-hours contracts, the gig economy and the rise in women among the working poor?
Rosie Duffield
Absolutely. Under the last Labour Government I was able to work and bring up my children as a single mum. Without tax credits, I would have had no hope. I would have been living with my parents, with my children in one room, unable to feed them easily. The last Labour Government made the lives of women a lot easier and a lot better, and introduced childcare and all sorts of things that get forgotten and overlooked. Yes, a lot more people are in work, but a lot of them are working for companies such as Deliveroo and McDonald’s on a very low wage. The childcare issue is a huge and growing problem, and nurseries are having to close.
It is worth saying that there is not equality. Working women are still the working poor, as the shadow Minister just mentioned. Zero-hours contracts do not help anybody, so there is still much to do to get equality. As some Members have said, we also must not forget our sisters around the world. Although we think we have done equality and feminism, we have not. We need to keep going, look around us, and do as much as we can for everyone.
Question put and agreed to.
Resolved,
That this House has considered the 90th anniversary of the Equal Franchise Act 1928.
Written Statements
(6 years, 5 months ago)
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Industrial Strategy
(6 years, 5 months ago)
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The Secretary of State for Business, Energy and Industrial Strategy (Greg Clark)
As part of the industrial strategy, the Government committed to making the most of the UK’s strengths, so we can be at the forefront of new technologies and emerging industries in the years ahead. The construction sector is fundamental to our economy as we invest in our future; building the homes and infrastructure we rely on.
The construction sector deal aims to drive a substantial improvement in the productivity growth of the sector in the coming years, by increasing the use of digital and offsite manufacturing technologies, creating new jobs and training the workforce in new skills, and supporting UK firms to exploit export opportunities in a rapidly expanding global construction market. The deal will support the development of affordable, easy to construct homes, schools and other buildings which can be quickly and sustainably manufactured offsite and then assembled when and where needed. The deal will boost the delivery of the Government’s ambition to build 1.5 million new homes by 2022.
The construction sector deal will deliver:
£420 million of investment to transform construction through developing and commercialising new digital and offsite manufacturing technologies for construction, which will aim to reduce the cost of new buildings by a third, and halve the time taken to deliver them;
Cheaper energy bills for families and businesses—supporting the industrial strategy clean growth mission to halve the energy use of new builds by 2030;
25,000 construction apprenticeship starts and 1,000 construction T-level placements; and
Supporting the UK construction sector to compete in the global market for infrastructure which is worth US $2.5 trillion a year.
With almost half of the economy reliant on the built environment and the services it enables, this deal brings together the construction, manufacturing, energy and digital sectors to deliver innovative approaches that improve productivity in the construction sector and accelerate a shift to building more efficient, safer, healthier and more affordable places to live, work and learn.
Sector deals, where industries are invited to come forward with plans for their future, embody the ethos of our collaborative approach. They show how industry and the Government, working in partnership, can boost the productivity and earning power of specific sectors. We have already struck ambitious deals with the artificial intelligence, life sciences, automotive and creative industries sectors with the nuclear sector deal announced last week, and we look forward to building on this in the months ahead.
I am placing a copy of the “Construction Sector Deal” in the Libraries of both Houses.
[HCWS831]
General Affairs Council: 26 June 2018
(6 years, 5 months ago)
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The Parliamentary Under-Secretary of State for Exiting the European Union (Mr Robin Walker)
Lord Callanan, Minister of State for Exiting the European Union, has made the following statement:
I represented the UK at the General Affairs Council (GAC) meeting in Luxembourg on 26 June. A provisional report of the meeting and the conclusions adopted can be found on the Council of the European Union’s website at:
http://www.consilium.europa.eu/en/meetings/gac/ 2018/06/26/
Enlargement and stabilisation and association process
Ministers agreed Council conclusions on enlargement policy and the stabilisation and association process. Subject to progress on rule of law reform, the Council set out the path towards opening accession negotiations in June 2019 with Albania and Macedonia, which I supported.
Preparation of the European Council on 28 and 29 June 2018
Ministers prepared June European Council by discussing the draft conclusions issued on 25 June. On migration, Ministers exchanged views on internal and external migration, the reform of the common European asylum system and measures to strengthen the EU’s external borders.
On security and defence, Ministers discussed EU-NATO co-operation, permanent structured co-operation (PESCO) and the European defence industrial development programme. I supported the draft conclusions on chemical, biological, radiological and nuclear threats which were issued as part of the response to the attack on Sergei and Yulia Skripal in Salisbury on 4 March. I also welcomed the inclusion of language in the draft conclusions on measures to counter malign cyber-activity.
In discussions on jobs, growth and competitiveness, I highlighted the UK’s concerns surrounding proposals on investment screening. On the response to the US decision to impose tariffs on the EU for aluminium and steel imports, I supported the measures that had been taken and welcomed calls to avoid the further escalation of this situation.
Ministers also debated digital and innovation matters, external relations and the multiannual financial framework.
European semester
In accordance with the European semester process, Ministers approved country-specific recommendations (CSR) on the economic and social outcomes which member states will work towards over the course of the following year. The Council is expected to formally adopt the CSRs in July.
Interinstitutional agreement implementation
Ministers reviewed the implementation of the interinstitutional agreement on better law-making (IIA BLM) and considered the work that has been carried out during the first half of 2018.
Rule of law in Poland/article 7 (1) TEU reasoned proposal
The Council held a hearing under article 7 (1) treaty on European Union. The Commission set out its concerns on the judicial reforms enacted by the Polish authorities. In response, Poland provided a detailed presentation which set out the context and content of the reforms and highlighted the political sensitivities. Thirteen member states asked Poland questions and Poland responded. The presidency confirmed that Ministers would return to this matter at future meetings of the GAC.
[HCWS833]
Foreign Affairs Council: 25 June 2018
(6 years, 5 months ago)
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The Minister for Europe and the Americas (Sir Alan Duncan)
My noble Friend the Minister of State for Defence, the right hon. Earl Howe, and I attended the Joint Foreign Affairs Council (FAC). I also attended a meeting of the FAC for Foreign Ministers only. The Council was chaired by the High Representative and Vice-President of the European Union (EU) for Foreign Affairs and Security Policy (HRVP), Federica Mogherini. The meeting was held in Luxembourg.
Security and defence co-operation
Foreign and Defence Ministers discussed EU security and defence co-operation, permanent structured co-operation (PESCO), military mobility, the European defence fund, the European peace facility, the fight against hybrid threats, and the importance of strengthening the EU’s resilience to such threats and civilian capability development.
The Council adopted conclusions on security and defence. It also adopted a decision setting out governance rules for projects undertaken under PESCO, and approved the overarching high-level part of the military requirements for military mobility within and beyond the EU.
EU-NATO co-operation
Ahead of the NATO summit on 11 and 12 July, Foreign and Defence Ministers exchanged views on EU-NATO co-operation with NATO Secretary-General Jens Stoltenberg. Against the background of challenges in the transatlantic relationship, Ministers underlined the continuing good collaboration on security and defence between the EU and NATO. Ministers also highlighted the important progress made on the 74 concrete actions implementing the July 2016 joint declaration between the President of the European Council, the President of the European Commission and the NATO Secretary-General. Ministers encouraged further co-operation, in particular on military mobility and on countering hybrid threats.
Yemen
Ministers discussed Yemen with the United Nations (UN) Special Envoy Martin Griffiths, who briefed them on his peace plan. Ministers exchanged views on ongoing EU efforts and explored ways to strengthen the UN-led process. The Council adopted conclusions on Yemen.
Horn of Africa and the Red sea
The Council discussed and adopted conclusions on the horn of Africa and the Red sea. Ministers highlighted the strategic importance of the region for the EU. They expressed their support to efforts aimed at the creation of an organised and inclusive regional forum for dialogue and co-operation around the Red sea.
EU global strategy
The Council reviewed the implementation of the EU global strategy based on the second implementation progress report. Ministers welcomed the important progress made.
Jordan
The HRVP reported back on her recent visit to Jordan. Ministers expressed their strong support for Jordan as one of the countries most affected by the crisis in Syria. Ministers took stock of EU-Jordanian relations including socioeconomic co-operation under the EU-Jordan partnership. They expressed the importance of maintaining a high level of support to Jordan which faces a critical time both politically and economically and highlighted the importance of supporting the new Government to continue economic and social reforms.
The Council also agreed a number of measures without discussion:
The Council adopted the EU priorities at the UN and 73rd UN General Assembly;
The Council adopted conclusions on Sahel/Mali;
The Council adopted the decision on the signing and provisional application of a protocol to the Euro-Mediterranean agreement establishing an association between the EU and Israel to take account of the accession of the Republic of Croatia to the EU;
The Council placed seven individuals under restrictive measures in light of the situation in Myanmar/Burma;
The Council extended the mandates of six EU special representatives for Bosnia and Herzegovina, central Asia, horn of Africa, Kosovo, Sahel and the south Caucasus, and the crisis in Georgia;
The Council decided to put 11 individuals holding official positions under restrictive measures who are responsible for human rights violations and for undermining democracy and the rule of law in Venezuela;
The Council approved the progress catalogue 2018;
The Council adopted conclusions on EU co-operation with cities and local authorities in third countries.
[HCWS832]
House of Lords
Introduction: Lord Garnier
NHS: Equitable Access
(6 years, 5 months ago)
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Baroness Thornton
To ask Her Majesty’s Government what steps they will take to ensure that National Health Service patients have equitable access to the benefits of (1) artificial intelligence, (2) genomic medicine, (3) new drugs, and (4) innovative treatments.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)
My Lords, the NHS was founded on the principle of universal access and we are committed to making sure that that remains. To achieve this we are establishing a genomic medicine service to provide equitable access to testing across the NHS. We have commissioned the Topol review so that our staff can maximise patient benefits from technological advances and we are accelerating access to innovation across the country by expanding the role of academic health science networks.
Baroness Thornton
I thank the Minister for his detailed Answer. My Question concerns the future in the next 70 years. One of the key barriers to ensuring that NHS patients have equitable access to genomic medicine, new drugs and innovative treatment is the pressure on the workforce and lack of protected time for the workforce to develop research and to translate new research into practice. Some 25% of medics do research in their own time. This suggests a welcome hunger for innovation, but only 0.1% of NHS money is set aside for the adoption and spread of innovation. That seems modest. With the new funding agreement and the 10-year plan in preparation, will the Government support and enable our research base and ensure the continuation of clinical trials across the EU post Brexit?
Lord O'Shaughnessy
I thank the noble Baroness for her Question and join the whole House in wishing many happy returns to the NHS on its 70th birthday. She asked an extremely good question: how do we make sure that the NHS is equipped for the future and that everybody can benefit from the technological advances we are seeing take place? I point her in the direction of three issues. First, the National Institute for Health Research has more than £1 billion of funding and supports the translation of research into new technology every day. It is based in the NHS and uses NHS staff. I have also recently commissioned the department to look at the money spent on innovation, which we think is around £750 million in total, to make sure that it supports the uptake of effective medicines and treatments better than it does today, and to make sure that staff have time. Finally, in response to her last question, as we set out during the passage of the withdrawal Act, we will align ourselves to the clinical trials regulation as much as possible, whatever the outcome of Brexit.
Baroness Walmsley (LD)
My Lords, as a member of the Parliament choir I am a bit tempted to start singing, but I will resist. Given the remarkable success of the various vaccination programmes during the 70-year history of the NHS, will the Minister say when preventive measures for two modern-day diseases will be made equitably and nationally available? I refer to pre-exposure prophylaxis for HIV, which has already been shown by the trials to be remarkably effective, and vaccination against human papillomavirus, which should be made available for teenage boys as well as teenage girls to ensure full protection.
Lord O'Shaughnessy
I am sorry that the noble Baroness has not started singing; I am sure that we would have all joined in. As she rightly said, the NHS carried out the first major public vaccination programme in the world. We have always led the world in vaccination programmes. As she said, prophylaxis has been deemed to be successful; I will need to write to her on the specifics of the rollout. On the HPV vaccine and its availability for boys, we are still waiting for the final recommendations of the joint committee on vaccinations. We will act on those as soon as we get them.
Baroness Lane-Fox of Soho (CB)
My Lords, despite starting a chain of karaoke bars, I will also not sing. The noble Baroness, Lady Thornton, is right to talk about the advances but there are also some fundamentals to improving patient care. Two years ago, I made some recommendations to the Secretary of State about basic digital skills for NHS staff and free wi-fi in hospitals, which we decided would be the most important building blocks to dramatically improve things for those working in the NHS and people in the system. Can the Minister update us on the progress of those recommendations?
Lord O’Shaughnessy
The noble Baroness made some fantastic recommendations, which we have adopted. I mentioned the Topol review of skills, which will make sure that clinical skills are there to adopt technology. It is expected that all GP practices and secondary care trusts will offer free wi-fi by the end of this year.
Lord Forsyth of Drumlean (Con)
My Lords, the Question is on the availability of new drugs equitably across the NHS. Is my noble friend satisfied with the independence of NICE, given that ibrutinib is not available to patients in England after a round of chemotherapy of more than three years, but is available to patients throughout the rest of the United Kingdom?
Lord O’Shaughnessy
I am more than satisfied with the independence of NICE. I am grateful to my noble friend for raising this issue, which we have talked about both in and outside the Chamber. NHS England is currently considering further evidence on the prescribing of that drug for that group of patients, after I asked it to do so.
Lord Morris of Aberavon (Lab)
My Lords, what progress is being made by the National Health Service on even national delivery of modern technologies, such as flash monitoring systems, for diabetic patients? I declare an interest for a member of my family.
Lord O’Shaughnessy
The noble Lord picks a very good example of a technology that is transforming diabetic care, as he knows. A few months ago, I was pleased to be able to approve it for prescription in the NHS; it is now available across the country where clinicians think it is the appropriate course of treatment.
Lord Hamilton of Epsom (Con)
My Lords, is my noble friend concerned that the NHS, employing 1.3 million people, is too large to manage?
The Lord Bishop of Oxford
My Lords, the Question also asked about artificial intelligence. Can the Minister comment on the steps being taken to improve data transfer across different NHS trusts, and standardisation? Are steps being taken to ensure the ethical release of data for research purposes?
Lord O’Shaughnessy
I thank the right reverend Prelate for asking two very good questions. We recently announced the first local health and care records, covering around 40% of the population. Sometimes, you can pitch up in one part of the NHS and they cannot access all your patient and care data; this measure will make sure that that does not happen. Patients want this; it is essential for good direct care.
The right reverend Prelate is quite right about the ethical considerations. We will publish a code of conduct on the proper use of AI in the NHS later this year. We are working with the new Centre for Data Ethics to make sure that this happens.
Lord McColl of Dulwich (Con)
My Lords, there are 4 million type 2 diabetics in this country. Does the Minister agree that they could be cured quite easily if they ate fewer calories?
Lord O'Shaughnessy
Changes in eating habits certainly help, as do changes in exercise. Our obesity strategy tries to make sure that those good habits are ingrained from an early age.
Lord St John of Bletso (CB)
My Lords, will the Minister elaborate on how the forthcoming NHS digital innovation hubs, combined with the Data Saves Lives campaign, can deliver a fairer distribution of excellence in the regions with the greatest health and social care needs?
Lord O'Shaughnessy
One thing that has become apparent to me in 18 months of being a Minister is that the data in the NHS about patients and their needs, diseases and care is a unique asset. We have to ensure that patients trust the way that the NHS uses that data, which is why we have created things such as the national data opt-out, cybersecurity and so forth. If we can bring that public trust, that data can be used for research through these digital innovation hubs to develop new treatments and make sure that they are available for NHS patients first.
NHS and Social Care Services: Parity of Esteem
(6 years, 5 months ago)
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Baroness Wheeler
To ask Her Majesty’s Government what action they will take to ensure that their strategy for National Health Service and social care services recognises the importance of parity of esteem, including pay and professional standing, for staff across hospital, community and social care settings.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy)
My Lords, having the right number and quality of clinical and non-clinical staff is essential to realising our ambitions for the NHS, community and social care. Last week we agreed an Agenda for Change multi-year pay and contract deal, while the introduction of the national living wage has boosted pay for the social care workforce. Later this year, we will publish a 10-year integrated health and care workforce strategy informed by our recent consultations.
Baroness Wheeler (Lab)
I thank the Minister for his response. It is right today to pay tribute fully to the work and dedication of staff across the whole of health and social care. But for the future, both the NAO and our own Long-term Sustainability of the NHS Committee strongly criticised the absence of any long-term joint strategy to secure the well-trained and committed workforce that we need for a fully integrated service. The Minister told the House on 18 June that he is considering the implications of the very recent and welcome NHS staff three-year pay increase for the independent care sector. He recognised the need for the latter to be able to compete on a “level playing field”. Does he acknowledge that for the social care sector in particular that means aiming to level-up pay and professional standing between social care and the NHS, and accepting that parity of esteem is one of the key drivers to building integrated services for both patients and service users?
Lord O'Shaughnessy
I join the noble Baroness in paying tribute to staff, not just across the NHS of course but across all the caring professions. We published the draft strategy and will publish a joint strategy for the health and care workforce precisely for the reasons that she set out. We need to make sure that there is joined-up care across all sectors. That means that we need extra funding—a sustainable funding solution—for the social care sector. We have put in an extra £9 billion over the course of this spending review since 2015 to provide a short-term solution. The Green Paper is about providing a long-term solution. Some of the principles in the Green Paper emphasise the importance of this integration, delivering quality and integration, a valued workforce and sustainable funding. Those are the conditions necessary for what she wants to achieve.
Lord Laming (CB)
The Minister will know that in the social care field there are now numerous independent providers. What mechanism is there to ensure parity across the whole sector, including all aspects of social care?
Lord O'Shaughnessy
The noble Lord is right to point out that there are differences between the two workforces: clearly the NHS has a largely publicly employed workforce and social care has a largely privately employed one, so there will inevitably be some differences in form. We need to make sure that those workforces work together and are as attractive as one another, which is why finding a sustainable funding solution is so important so that those private contractors have the ability to pay what is necessary to attract the right staff.
Lord Clark of Windermere (Lab)
My Lords, the NHS proves that, with determined leadership, democracy can deliver long-lasting benefits to society. Will the Minister join me in paying tribute to those parliamentarians—in spite of them all being Labour—who, over 70 years ago, time and again traipsed through the Lobbies to bring about the National Health Service?
Lord O'Shaughnessy
Well, they say that success has many parents and we should pay tribute to the Liberal MP William Beveridge, the Conservative Health Minister Henry Willink, and the Labour Health Minister Nye Bevan in the founding of the NHS. It is important to point out that the Conservative Party has been in power for 43 of the NHS’s 70 years and it has thrived under our leadership.
Lord Hamilton of Epsom (Con)
Will my noble friend confirm that when Nye Bevan established the NHS he said that the demand was going to be strictly limited?
Lord O’Shaughnessy
Limiting demand is one of the challenges that we face to make sure that we are able to deliver a health service, but the NHS has proven to be highly effective not just in dealing with acute disease but now in supporting people with chronic disease, which is the greatest health challenge that we face.
Baroness Brinton (LD)
My Lords, what advice would the Minister give to the management of organisations throughout the NHS and social care services about maintaining morale, retaining staff, promoting professional development and rewarding good work when there is often little increase in funding from local authorities, which themselves face continuing cuts in their grant from central government?
Lord O’Shaughnessy
I recognise that staff work under a great deal of pressure and there are two ways we can help alleviate it. One is obviously to have social care and NHS staff work more closely together, and that is a stated ambition that we all want to achieve. The other is making sure that there are more resources, both to pay people better and to make sure that there are more people. That is what we are focused on delivering.
The Earl of Listowel (CB)
My Lords, is the Minister concerned to hear that, when speaking recently to a mental health nurse, I was told that she had received only four of her monthly supervision sessions in the last eight months? Does he agree that to ensure high-quality care across health and social care, all professionals and carers need their entitlement of regular supervision? Will he discuss with his colleagues in the education department whether there might be clinical supervision in some schools, to allow the mental health of children in schools to improve?
Lord O’Shaughnessy
I am concerned to hear the story that the noble Earl has raised: I am sure that he will write to me with specific details. We know that at the moment only 25% of people with a mental health problem are seen. That needs to rise. We want to get that up to 33%, but clearly that is not enough. To do that we need more staff at every level. We have committed to training another 21,000 mental health workers to provide exactly the kind of leadership and support that he describes.
Baroness Andrews (Lab)
Is the noble Lord aware that on 4 July 1948, on the eve of the creation of the National Health Service, Aneurin Bevan also said that the NHS was the highest expression of moral leadership? Does he agree that we now need an equally high expression of political moral leadership? The fundamental of that is to tell the truth about the funding challenges facing the NHS, whether they are in manpower or in innovation and drugs. Does he agree, therefore, with the Prime Minister that there will be a Brexit dividend? How much is it going to be and where is it likely to be accounted?
Lord O’Shaughnessy
I agree with the noble Baroness about the need for leadership and I think the Prime Minister has shown that leadership. Despite the many challenges that we face at the moment as a country and have done for many years, she has committed to a five-year funding settlement worth more than £20 billion extra in real terms by 2023-24. That is an admission that there are funding challenges, not just in the NHS and social care, and of course one of the ways that that will be funded will be through our not paying subscriptions to the European Union any more.
Health and Social Care Act 2012
(6 years, 5 months ago)
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Lord Hunt of Kings Heath
To ask Her Majesty’s Government, in the light of the Prime Minister’s criticism of the regulatory framework established under the Health and Social Care Act 2012, what plans they have, if any, to bring forward measures to amend or repeal that Act.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)
My Lords, the Government have announced a five-year funding settlement, and we have asked the NHS to develop a 10-year plan to transform health and care. As my right honourable friend the Prime Minister said, as it develops its plan we will listen to the NHS about whether there are any barriers created by legislation. We will consider, after that, what changes may be needed.
Lord Hunt of Kings Heath (Lab)
My Lords, in her speech on 18 June the Prime Minister referred to chief executives of NHS organisations having to make so many reports to different regulators that they have no time to improve their own organisation, and to a typical clinical commissioning group having to agree 200 contracts with other parts of the NHS. Is not the answer to the first question from the noble Lord, Lord Hamilton, that the NHS, employing 1.3 million, is not hard to manage, but the fact is that the Government have bequeathed to it an organisational structure that is dysfunctional and costs billions of pounds? If he really wants to help the NHS, will the Minister not come forward with a Bill to repeal the Health and Care Act 2012?
Lord O'Shaughnessy
My Lords, since the 2012 Act was passed, there have been some significant improvements in NHS performance, not least in cancer outcomes, for example. There are also around 42,000 more staff since 2010. So improvements have clearly been able to happen within the legal framework set by Parliament in 2012. Nevertheless, we recognise that as the service is required to become more integrated and people across different care functions are required to work together, we need to look at the structure. There is already joint working, for example, between NHS England and NHS Improvement at the regional level. But if the NHS identifies any barriers, we will look at those.
Lord Cormack (Con)
My Lords, when we are looking at the structure, which is clearly important, can we also look at priorities within the National Health Service? I heard this morning that certain treatments and unnecessary medicines are to be ruled out. Can we have a comprehensive list of those? It is not right that dandruff shampoo should be on prescription. It is not right that we should be looking at funding the treatment of gaming machine addiction. Can we have a real look at the priorities?
Lord O'Shaughnessy
My noble friend makes a very important point, which is that as we move ahead, even with the funding settlement, it is essential that the NHS becomes more productive. That means looking at whether there are medicines or treatments that are no longer producing the outcomes it was suggested that they would and taking those out of service. It is very important to state that this has to be a clinically led process. We have already begun that with certain low-value prescriptions. NHS England is now leading that process—as I say, it is clinically led—to look at whether there are other treatments that could be discontinued.
Lord Alton of Liverpool (CB)
My Lords, what does the Minister make of the poll that showed that 66% of British people would be prepared to pay more for the provision of the National Health Service? What is his view on a hypothecated tax to meet those needs?
Lord O'Shaughnessy
I am sure that the Chancellor will have taken that view on board and he will reveal his decisions in the Budget.
Baroness Blackstone (Ind Lab)
My Lords, have the Government made any estimates of the cost of the extensive and in some cases overintrusive regulatory system? The Minister has rightly said that the Government are looking for savings in the NHS. Surely this is an area where savings can be made, as well as that of questionable surgical procedures.
Lord O'Shaughnessy
That is one of the areas we need to look at to make sure that there is proper regulatory reform. It does not necessarily require legislation, primary or secondary. There are actually fewer managers in the NHS today than in 2010. We have tried to transfer responsibility to clinical staff. But if the NHS identifies any barriers, we are committed to looking at them.
Baroness Brinton (LD)
My Lords, the Minister has referred to the NHS five-year plan, but does he agree that that plan is worthless without a clear proposal for social care funding in the future, including on how the NHS and social care can fully integrate?
Lord O'Shaughnessy
I absolutely agree with the noble Baroness that they have to go hand in glove. That is why the Green Paper has been delayed, so that it can co-ordinate properly with the NHS plan. It is also important to point out that the Prime Minister was very clear in her announcement that, as a result of the settlement on social care, there would be no further pressures on the NHS.
Lord Elton (Con)
As we are looking for savings in the National Health Service, perhaps my noble friend can explain why the National Health Service does not reclaim crutches, Zimmer frames, moon boots, et cetera. Even wheelchairs are found in the attics of deceased former patients. There must be quite a reserve in your Lordships’ attics, which would be very helpful.
Lord O'Shaughnessy
I could not possibly comment on the latter point. My noble friend makes an important point. Of course it is right to be judicious with the use of these kinds of products. However, they are sometimes damaged in use and are not always reliable, which is one reason they cannot always be reclaimed and reused.
Lord Bradley (Lab)
My Lords, we should first congratulate and celebrate the establishment of the first NHS hospital at Park Hospital, now Trafford General Hospital, in Greater Manchester. But we should also have concern that the devolution deal for health and social care for Greater Manchester is being impeded because of the Health and Social Care Act. What changes would the Minister recommend to ensure that the ambitions of the devolution deal to integrate health and social care and physical and mental health are progressed as rapidly as possible?
Lord O'Shaughnessy
I join the noble Lord in congratulating Trafford General Hospital. I think that one of my colleagues is there today, unveiling a plaque. I am grateful to him also for raising the devo deal for Greater Manchester. It is a very important deal that goes further than any other in the area of health and social care. If it is the case that it is impeded by the Act—and I do not think that that is necessarily a given—I would say that the changes that need to be made ought to be promoted and proposed by Greater Manchester and by the clinicians themselves. That is exactly the sort of thing that the Prime Minister has asked for.
Baroness Meacher (CB)
My Lords, perhaps I may pursue the question asked by the noble Baroness, Lady Blackstone, to which the Minister responded, “Yes, we need to look at regulation”. The Minister knows that GPs are leaving the service at an unprecedented rate, and a large part of the reason for that is the regulatory burden. Will he make a commitment to undertake a full investigation of the regulatory burden on NHS staff, with the terms of reference being to reduce that burden?
Lord O'Shaughnessy
I agree with the noble Baroness about the importance of bolstering our GP workforce—that is one thing we are absolutely focused on. It is part of the five-year forward view and clearly of the long-term plan as well. I will identify one area where we are trying to make a big difference, which is indemnity insurance. We know that this has been a financial burden on GPs and we are looking at creating a state-funded scheme to provide reassurance. This is just one way in which GPs are looking for support from government.
NHS: Brexit-related Risks
(6 years, 5 months ago)
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Lord Bassam of Brighton
To ask Her Majesty’s Government what assessment they have made of (1) the risks to the National Health Service, and (2) the implications for access to medical supplies, of the United Kingdom leaving the European Union without a withdrawal agreement.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)
Nearly there.
My Lords, patient safety is our priority in the exit negotiations, and maintaining continuity of supply of medical products is a key part of ensuring that patients continue to receive safe, high-quality care from day one after we leave the European Union. Extensive work has been undertaken to understand the implications of our EU exit on the NHS, considering a range of negotiation outcomes, including exit without a withdrawal agreement. This has included a focus on continued access to medical supplies.
Lord Bassam of Brighton (Lab)
My Lords, I congratulate the noble Lord on his stamina this morning—more Fleetwood Mac than Iron Maiden. Given that the Government seem a long way off getting any sort of Brexit deal on goods and services, will the Minister tell the House whether there is a plan B to ensure that the NHS has continuity of medical supplies, and will he explain how he expects the interface of the medicines approval regime and the international regulation of medicines to work post Brexit? Will he also guarantee comparable levels of patient safety after we leave the EU?
Lord O'Shaughnessy
I am glad that the noble Lord’s train got him here in time for him to ask his Question. First, I do not share his pessimism about the outcome. We will publish the White Paper on our proposals next week and we expect it to get a warm welcome—and not just in this House. Nevertheless, it would be wrong if we were not working on contingency options. I think that the public would be surprised if we were not planning for every scenario. That is precisely what we are doing at the moment, and of course, as we do that, patient safety is our number one priority. We need to make sure that the supply of medicines and medical devices can come in to the country and be used by NHS patients, come what may.
Lord Purvis of Tweed (LD)
My Lords, I declare an interest as the son of an ambulance driver who drove ambulances for the NHS for nearly half of its existence. Some 45 million packs of patients’ medicines are exported from the UK every year, and 37 million are imported into the UK every month. Merck, GSK and AstraZeneca have all forecast that if we leave the customs union, it could take five to 10 years for any technological solutions to replace the system we have at the moment. They are now considering stockpiling, given the levels of extra documentation and checks that will be required. This will place an increased burden on the NHS. Would not the best thing for the NHS be if the Cabinet tomorrow agreed that we will continue as part of the European Medicines Agency and the customs union? Given that the Minister has been on his feet so much this morning, the simple answer “yes” will suffice.
Lord Morris of Handsworth (Lab)
Will the Minister take the opportunity to recognise the contribution that the Windrush generation has made to the development and continuity of the National Health Service?
Lord O'Shaughnessy
I am very pleased to do so. The Windrush generation has made a fantastic contribution to our NHS and caring services.
Baroness Hollins (CB)
My Lords, I am glad that contingency plans are being made. The British public voted to leave the EU because of the promise of £350 million a week to save our NHS. We now hear, however, that Brexit could have catastrophic consequences for the NHS in areas such as staff recruitment and essential supplies and for the adequate resourcing of the NHS to the standard of our EU partners—a standard that we do not yet reach. Will the Minister admit that these promises were wrong and tell the British people that we may need to think again?
Lord O'Shaughnessy
It would be a big mistake for anybody to tell the British people that they voted the wrong way. I point out to the noble Baroness, however, that, whatever was on any side of the bus, as a result of the funding plan announced by the Prime Minister there will be £394 million a week more in real terms for the NHS by 2024. I am also pleased to say that there are more EU staff working in the NHS today than two years ago.
Lord Reid of Cardowan (Lab)
My Lords, the problems and challenges of Brexit will only add to the massive challenges which, in our enthusiasm for the birthday of the NHS, we sometimes underestimate. These include demographic change, an ageing population, new inventions and therapies, new pharmaceutical products and so on. Although I very much welcome extra money, this problem will not be solved just by extra money; it will require massive organisation, radical restructuring, and innovation in technology on a massive scale. That will not be achieved by one party on its own. Why, therefore, do the Government constantly refuse the recommendations of some noble Lords and committees in this House to establish a cross-party consensus on this and take party politics out of it to the maximum extent? That is the only way—accompanied by money—that we can save the NHS for the next 70 years.
Lord O'Shaughnessy
The noble Lord knows better than most the challenges of transforming the National Health Service, and is right about the big challenges that we face—although I think it is better to look at them as opportunities. He is also right that reform has to go hand in hand with extra money. We promised the extra money; we now need to see the reform. Every part of the health service—the department, the NHS, and others—needs to drive that through. On his point about consensus, I do not think there is anything stopping that consensus: the Government want consensus. We do not necessarily think that it needs to be in the form of a royal commission or a parliamentary commission. We want to work with all corners of this House and the other place to make sure that there is support for a broad plan for the NHS for the next 10 years.
Clean Air (Human Rights) Bill [HL]
Thursday 5th July 2018
(6 years, 5 months ago)
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Supply and Appropriation (Main Estimates) (No.2) Bill
Thursday 5th July 2018
(6 years, 5 months ago)
Lords ChamberRead Full debate Supply and Appropriation (Main Estimates) Act 2018 View all Supply and Appropriation (Main Estimates) Act 2018 Debates Read Hansard Text
Ivory Bill
Thursday 5th July 2018
(6 years, 5 months ago)
Lords ChamberRead Full debate Ivory Act 2018 View all Ivory Act 2018 Debates Read Hansard Text Amendment Paper: Consideration of Bill Amendments as at 4 July 2018 - (4 Jul 2018)
Business of the House
(6 years, 5 months ago)
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Baroness Evans of Bowes Park
That the debate on the Motion in the name of Baroness Bakewell set down for today shall be limited to two hours and that in the name of Lord Darzi of Denham to three and a quarter hours.
Universal Credit
(6 years, 5 months ago)
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The Parliamentary Under-Secretary of State, Department for Work and Pensions (Baroness Buscombe) (Con)
My Lords, with the leave of the House, I shall repeat as a Statement an Answer given to an Urgent Question in another place by my right honourable friend the Secretary of State for Work and Pensions on the National Audit Office report.
“I had information on the Question being the letter I received yesterday, so that is obviously where we will be going on the letter that I received yesterday. Opening up on that letter was about a meeting that the Comptroller and Auditor-General had asked to have with me on 27 June, when he wrote, and our department got back at the end of the week. That meeting will be on Monday. There was possibly an inference from that that I had not accepted the meeting, or that there was not going to be one, but that had not been the case and it is diarised for Monday.
The next bit was about the information we received and accurate, up-to-date information being shared with the department, to which we agreed information had been shared up to 6 June. But what we talked about is when we signed off the factual information contained within it, raising the concern about the context and the conclusions drawn from that information and where we went from there. That goes on to the impact of those changes and if we look at the impact of those that were brought through—the waiting days being abolished on 14 February, the housing benefit being run on 11 April and the advance payment of 3 January—as I said in my apology yesterday, the impact of those changes is still being felt. Therefore the definition could not or cannot be that they have been fully taken into account by the NAO.
The Auditor-General also talked about slowing down the process, which we always agreed with, which is about the test-and-learn process. We will learn as we go along; that is what we agree with, too. But when he said,
‘I am also afraid that your statement in response to my report … has not been proven’—
the case for universal credit—that is where we differ in the conclusions. So while the NAO had the same factual information either way, depending on where you looked at it and how you then come to conclusions, we then came to very different conclusions because of the impact of those changes that we had brought in at the end of that period, which are still being felt.
That is where I would like to leave it. It said that you cannot measure the exact number of additional people in employment—we will agree with that. You cannot measure the exact number of additional people but we knew there was a plausible range which we had support on. There is a plausible range of people going into employment and we know that employment is increasing. Those are the key pertinent points from the letter and included with my apology yesterday for the phrasing of the words that I got wrong, which I fully accept, hence I came to the House. I will end that bit of the Statement there”.
Baroness Sherlock (Lab)
My Lords, I thank the Minister for repeating that deeply unsatisfactory Statement. This is quite extraordinary. The Comptroller and Auditor-General has been forced to issue an open letter to the Secretary of State for Work and Pensions to point out that she repeatedly misrepresented to Parliament the content of the highly critical NAO report on the rollout of universal credit. She has now apologised, up to a point, for one of the errors, in which she wrongly claimed that the NAO wanted UC rolled out more quickly.
However, Sir Amyas challenged two other misleading claims for which she has not apologised. The Secretary of State claimed that the NAO report had not taken account of the impact of recent changes to universal credit, even though her department had agreed the report just one week earlier, based on the latest information, and she repeated her unfounded claim that universal credit is working. Sir Amyas pointed out that the DWP has not even measured how many UC claimants are facing difficulties and hardship. I was particularly disappointed to see her repeat the claim that universal credit will help an extra 200,000 people into work, even though the NAO said:
“The Department will never be able to measure whether Universal Credit actually leads to 200,000 more people in work”,
because it is not able to separate other factors.
Anyone can misspeak—goodness knows, I have done it myself—but if the NAO says there is not and never can be evidence for a claim, you cannot simply say that it is a matter of interpretation. This is dangerous ground. The Secretary of State is entitled to her own opinion; she is not entitled to her own facts. The Government have told this House too many times that all is well with universal credit when manifestly that is not the case, so I have just two questions for the Minister. First, will the Government stop pretending that all is well and will they, in particular, stop using the misleading 200,000 figure and start telling the House how things really are? Secondly, will they implement all the recommendations in the NAO report? The DWP needs to put things right before anybody else is put through the misery of universal credit.
Baroness Buscombe
My Lords, first, I make it absolutely clear to your Lordships’ House that right from the start, when the report was published, there has been no issue with the factual information that the National Audit Office has used. In collating that information, there has been and continues to be a strong relationship between the National Audit Office, the Department for Work and Pensions and the officials. That is important. It is the interpretation of these facts and the conclusions drawn as a result that the department questions, as I said in the Statement. A lot of it is about context rather than saying that there is any issue with the facts.
We are absolutely clear that, as the report says, the National Audit Office completed its independent review of the universal credit programme after analysing evidence that we collected between August 2017 and April 2018. The issue we have is that we are still not able to judge, and nor is anyone, the full impact of significant policy changes that we have announced and implemented since the Budget last autumn. They include extending advances, which was implemented in January 2018, removing waiting days in February 2018 and the housing benefit run-on. The report makes it clear that it is referencing evidence up to April 2018. On the housing benefit run-on, it was impossible for us to measure the extra two weeks’ additional cash to cover people transferring from the old legacy benefit on to universal credit, which they would not have to repay. Each of these measures will take time to impact on the experience of claimants and stakeholders. Although some of these measures were mentioned in the report, their impact would not have been felt during the evidence-gathering period.
Lord Kirkwood of Kirkhope (LD)
My Lords, I am absolutely in agreement with the noble Baroness, Lady Sherlock. This is a quite extraordinary state of affairs. I have been following social security since 1986. I have never seen such an explicit letter of correction from such a distinguished public servant as the Comptroller and Auditor-General, Sir Amyas Morse. Two things follow from it. First, I hope the noble Baroness can give the House an assurance that the Secretary of State will take whatever steps are necessary to repair the relationship between the political leadership of the DWP and the Comptroller and Auditor-General’s office. That is essential for the good conduct of the universal credit programme in future, and that work needs to be done.
What I find extraordinary, because I know how much trouble goes into negotiating reports—and this one was signed off on 8 June—is that if the Secretary of State is founding her defence on the fact that she does not think that the NAO knows about the recent changes to waiting days, advance payments and HP run-ons, she is demeaning the value of the historical analysis that is so valuable to the prosecution of public policy. That must be put right too. This is serious territory that needs to be addressed urgently.
Baroness Buscombe
My Lords, it is important for me to make clear that my right honourable friend the Secretary of State for Work and Pensions has already apologised, and that apology has been accepted by the House of Commons and the Speaker of the House of Commons. Following Oral Questions on Monday, my right honourable friend was afraid that she had mistakenly used a term that was not an accurate term reflected in the report. My right honourable friend therefore went to see the Speaker. This was entirely independent of the letter produced on Wednesday, so there is no question that my right honourable friend has tried to avoid, evade or do anything untoward. My right honourable friend was very clear that she was mistaken, she was wrong and she was very keen to put that right at the earliest opportunity. Hence, the Speaker accepted that apology yesterday.
The meeting on Monday will of course be extremely important. We accept the facts in the report. We do not deny the facts; we support the facts. In a sense, we are saying, “Please, please, National Audit Office, we want to demonstrate that the impact of the changes undertaken, particularly those made last autumn, is yet to be proven”. She will want to make that absolutely clear.
There is no question but that we will look with care at what has been said in the report. I am sure that we will implement those recommendations that we feel able to from the report.
Lord Cormack (Con)
My Lords, I do not think the House can ever have heard a less clear Statement than the one repeated today. I appeal to my noble friend to ask the Secretary of State—although I am not impugning her good faith in any way—to realise that it is important that when she communicates with either House of Parliament, directly or through another Minister, she does so with clarity and in plain English. Perhaps it would be a good idea if Sir Ernest Gowers’s book on plain English was circulated to all Ministers and civil servants before we have that gobbledegook reported from the Dispatch Box ever again.
Baroness Buscombe
I say to my noble friend that, given his extensive years in another place, he will appreciate that the job my right honourable friend is doing is very tough. She is involved with the most important, fundamental and huge piece of welfare reform that has taken place for many years. It is close to her heart, as it is to all of us in the department. We absolutely accept that it is important that we reflect the need to be agile. Indeed, one of the incredibly positive aspects of the NAO’s report is on page 15, which is all about the development of the full-service system. It talks about the department using an agile approach for the full service and the need to constantly test and learn, test and learn. We are doing this continuously.
I am sorry if my noble friend feels that my right honourable friend has been less than clear, but the reality is that we are very keen to explain to all noble Lords and Members of another place that what we are doing is the right thing. We just want to stress that it is important to reflect the impact of changes that are still coming through the system.
Part-time and Continuing Education and the Open University
Baroness Bakewell
That this House takes note of part-time and continuing education, and in particular the future of the Open University.
Baroness Bakewell (Lab)
My Lords, I am pleased to rise to open this debate. Right now, in Westminster Abbey, a service is being held to mark the 70th anniversary of the NHS, an institution created under the outstanding post-war Labour Government of Clement Attlee. I am delighted to introduce a debate on another Labour achievement: the Open University, founded in the 1960s by the then Education Minister Jennie Lee— incidentally, the wife of Aneurin Bevan, creator of the NHS. The OU’s purpose was to promote greater equality of opportunity and widen access to the highest standards of education, endorsing those same values of civic life and mutual responsibility as the NHS. Like the NHS, cherished as it is, the OU also has current problems that threaten its survival. Next year it will be 50 years old.
In 2023, five years from now, another educational institution will celebrate its bicentenary. Birkbeck, of which I am proud to be president, was created in 1823 when philanthropist George Birkbeck pioneered a pattern of education by which working men—and it was working men in those days—could study while also earning a living. It was a system of part-time study that would lead to degree qualifications. To this day, it shares with the OU a commitment to part-time education, tutor-marked coursework and extended study that leads to full university degrees of international standing. There are of course other universities across the country that provide mature and lifelong learning as part of their student offer; several have over 30% of their students studying part-time. They too recognise the direction that future education provision should take and are keen to see it thrive. They too are confronted by problems. I would not trouble noble Lords with a history lesson that had no significance for today. I raise this debate because the needs are pressing, the system is in crisis and the Government have now the chance to address this in its policy review.
First then, are the needs. As a member of the Lords Select Committee on Artificial Intelligence, I was made keenly aware of how much change to the labour market lies ahead. Many existing jobs will go, many jobs will be enhanced by AI and many new, as yet unknown jobs will be created. The one constant is change—ongoing change to the labour market and to the lives of individuals. The Government will need to plan for the negative effects of AI, and to plan to maximise benefits from it. New skills will be needed; retraining will become the norm; and individuals will need to expect shifting patterns of employment, portfolio careers and mid-life career changes. Retraining, as the Select Committee emphasised in its report, will become a lifelong necessity. The Government agree: at the inaugural meeting of the National Retraining Scheme, earlier this year, the Education Secretary, Damian Hinds, declared that,
“we need everyone, regardless of their age, to be able to gain the skills they need to make the most of the opportunities that lie ahead”.
Such ideas are endorsed on every hand from every discipline. Sarah Harper, professor of gerontology at Oxford University, in evidence to the House of Lords Select Committee on Intergenerational Fairness and Provision, declared that, with longer life expectancy, there is a need for longer working lives that has to be supported by a move to lifetime education.
Thus, we have the state affairs and the need. Now the crisis, for crisis there surely is: a catastrophic fall in numbers of part-time and mature students. The OU has been hit especially hard, its numbers falling by 30% between 2010-11 and 2015-16. Numbers at Birkbeck have suffered too. The numbers for part-time study are falling everywhere. Social mobility has crashed. The decline in mature students has disproportionately hit certain important courses. Between 2009-10 and 2016-17 the number of part-time mature nursing students fell by 49%.
Institutions have been tracking the reasons and it is quite clear that this steep decline was triggered when the Government raised the cap on part-time fees to £6,750 a year. Their effort to address the crisis by improving financial support for some part-time students through the introduction of maintenance loans has not gone nearly far enough. Restrictions on maintenance loans to certain subjects—the STEM subjects—leaves the humanities beleaguered.
Government policy increasingly sees higher education as a marketplace where students shop for qualifications rather than as centres of learning, broadening student horizons across the whole range of human knowledge. Into this marketplace have come new for-profit universities, some only recently granted degree-giving powers. They offer students long-distance learning towards degrees in the most popular subjects. The insights of face-to-face learning are undervalued and under threat.
Other considerations also explain the collapse. There is no longer a pool of young people denied tertiary education: sixth-form take-up of university places is at an all-time high. Then there is austerity. Mature part-time students faced with the continuing levels of austerity have become debt averse. Many have mortgages to pay and young family commitments. With such responsibilities, taking on further loans is a push too far.
That the Government are aware of all that is evident in their establishment of a post-18 review, which we all welcome. It has now completed its consultations and is expected to report later this year. This is a major opportunity and one that must not be missed. The Higher Education and Research Act and the creation of the Office for Students have ushered in a new era. A Lords amendment to that legislation established that the Office for Students has a specific legal duty to consider different forms of learning, including part-time study and distance learning. It must now deliver on that commitment. I ask the Minister to ensure that the post-18 review addresses a major review of student finance and that it considers different policy responses for different types of students. It must reappraise the availability of maintenance grants and the restrictions on maintenance loans, and it must further relax restrictions on equivalent or lower qualifications, ELQs. I ask, above all, that it prioritises mature students and lifelong learning—
Lord Forsyth of Drumlean (Con)
I am listening very carefully to the noble Baroness’s speech and I agree with much of it, but she has been quite partisan in her comments. Will she acknowledge that the ELQ rule was brought in by a Labour Government and that it has been a major factor in the decline of part-time education?
Baroness Bakewell
I think that it is a contributory factor. I certainly do not deny it being brought in but I am constantly interested in revising the existing situation to make it better. That is why I raised it.
Above all, the Government should prioritise mature students and lifelong learning as the key to the country’s economic future and continuing prosperity. The needs are critical but the means are there. I am delighted to see so many speakers of experience and authority in this debate, and I am glad that they are here, even though the time for the debate has been cut short. I urge the Government to rescue a sector of education that has served, and continues to serve, students of all ages and backgrounds. I beg to move.
Lord Northbrook (Con)
My Lords, the whole House should be grateful to the noble Baroness, Lady Bakewell, for initiating this debate. I declare an interest in that my wife, who was born and educated in Canada and who never went to university, has recently started an Open University undergraduate course in history and history of art. I am already impressed with the variety of essay subjects she has had to cover, from Antony and Cleopatra to Stalin and Khrushchev, religious dissent in the 18th century, the art of Benin, and colonial attitudes to African societies. I am also impressed by the attention to detail in the marking of her essays.
I asked my wife to obtain her tutor’s views on the state of the OU and she replied as follows, giving me permission to quote her views. The most important point she made was that after the vice-chancellor, Peter Horrocks, resigned,
“the first thing the acting vice-chancellor did was scrap the ‘Students First’ brand which just about everyone working for the OU found to be toxic. It implied we had previously been putting something else first, and many, including me, found this to be an insult”.
Her final comment was:
“Most of my colleagues have felt so impotent having to stand by and watch whilst the OU has been forced into some kind of weird and inappropriate business model”.
I refer now to the petition organised by Change.org to give an indication of the concerns about the previous vice-chancellor. The petition states:
“The detrimental changes that have occurred include tutorial system changes, meaning that many students are allocated a tutor with whom they couldn’t possibly attend a tutorial”—
due to geographical location—
“and therefore have to attend a tutorial with another tutor; often leading to confusion on assessment criteria. Furthermore, the Open University has continued to alter the way they present their modules, moving away from print books towards online material. This is despite many students voicing their preference of print books to work with”.
A final issue were his comments,
“claiming that Open University academics ‘don’t teach’. The blatant disregard for the work and effort put in by OU academics leads to the final conclusion by many that Peter Horrocks needs to be replaced as Vice-Chancellor in order to save the Open University from irrelevance”.
In the time available, I want to make a very few points. The number of part-time entrants to higher education across the UK has fallen by 47.5% since 2008-09, with all types of course affected. The most striking fall was in those enrolling in foundation courses, certificates and diplomas. A 2014 report said that,
“falls in employment – particularly in the public sector”,
have been a major contributing factor.
Baroness Blackstone (Ind Lab)
My Lords, I begin by reinforcing what my noble friend Lady Bakewell said on the principle of lifelong learning. I have little doubt that all speakers in this debate will accept this principle. It is of course absurd to think that we have finished learning at the age of 21 or 22. We need to continue learning throughout our lives and to be helped to do so by access to education and training. Therefore, we need to invest in adults, not just young people, studying in universities and colleges. This is necessary first to enhance skills and knowledge and, secondly, to provide social justice and create social mobility.
At the higher education level, there are two institutions that focus on part-time undergraduate courses: Birkbeck and the Open University. I was privileged to be the head of Birkbeck for 10 years. What motivated me most was the commitment, determination and enthusiasm of its students studying in the evening, coping with families and jobs, and making sacrifices to achieve their educational goals. Those who have worked at the OU will have had similar experiences. Both institutions have been threatened by the collapse in part-time student numbers. Birkbeck has been forced, for the first time, to admit full-time undergraduates, and the OU has had to slash its courses and sack staff. Birkbeck will soon celebrate its 200th anniversary and the OU its 50th. We should do all we can to ensure that their special remit continues and that their celebrations are real.
Many other universities offer part-time undergraduate provision, especially post-1992 institutions. Sadly, many research universities have done too little for part-timers. FE colleges, however, have made a considerable impact in supporting them. Too often their contribution is forgotten, and the Government have not provided them with the resources that they need. Perhaps the Minister will say why.
The main cause of the collapse in part-time numbers is the foolish decision by the coalition Government to treble tuition fees. Of course, they probably needed to go up—but to treble them in one go! As my noble friend has already said, part-time mature students with mortgages and families are both debt adverse and price conscious. They have opted out because they will not take the risk of more debt. I applaud the noble Lord, Lord Willetts, the Minister who was responsible, for now expressing his regret, but I am puzzled that he did not see it at the time.
Will the Government make three specific changes? Will they provide a part-time premium to universities and colleges to promote the supply of part-time courses? Will they stop relying on their solution of maintenance loans for part-time students? Few of them will take them up, since the effect will be simply to increase their debt further. Thirdly, will they reduce the level of fees for part-time courses in line with any premium provided for universities, so that part-time students are not burdened by such harsh loans?
Lastly, will the Government remember that many part-time mature students are from disadvantaged backgrounds? If they are serious about promoting social mobility and genuine in this aim, they should urgently address this problem.
Baroness Garden of Frognal (LD)
My Lords, I join in thanking the noble Baroness, Lady Bakewell, for introducing this debate. She is a great champion of part-time and adult education, which is an enthusiasm I share—as, indeed, we share concerns over the Open University. I wafted from school to university and sort of worked for three years to get my degree. My sister did an OU degree while working full-time. Her commitment, dedication and hard work makes her degree a far greater achievement than mine ever was.
The OU was a visionary initiative when it was founded in 1969, and has been transformational for so very many people. It has opened horizons and opportunities to those enthusiastic to learn, many of whom missed out on education the first time round, and many, as we have heard, from disadvantaged backgrounds. Yet we have seen a catastrophic drop in numbers in recent years.
I was invited a while back to an OU degree ceremony at the Barbican, where Joan Armatrading was being awarded an honorary degree. In her speech, this internationally renowned singer and musician said that her greatest achievement was her OU degree. She was on world tours, before the days of internet or email, and in each country would have to find a post office and the last posting date for her assignments to get them back to the UK to be marked. What energy, what dedication, and how well deserved her results.
The ceremony had hundreds of people—some quite young and some very old. One woman must have been at least nine months pregnant, and there were members of the military in uniform—a total mix, all of them brimming with a well-earned sense of achievement. Celebrating such success was exhilarating. It is seriously bad news that the numbers have dropped.
Similar work is undertaken by Birkbeck. I declare an interest as a newly appointed fellow of the college, a great honour from an institution which I have long held in very high regard. Since 1823, it has championed the importance of educating the working people of London, with its evening teaching enabling people to work and study, as does the OU, and through study to aim high and to be ambitious in their life goals. This is good for social mobility and good for the economy. Yet Birkbeck, too, has seen a fall in its numbers.
How can the Government justify policies which result in such worthwhile institutions finding their numbers so reduced? We know that further education colleges are critical to continuing education, yet they, too, are suffering from loss of funding, a reduction in students able to self-fund and reduction in the number of employers willing to support employees through part-time study.
When will the Government release colleges from the tortuous and pointless demands of GCSE maths and English resits? This does nothing but entrench a sense of failure for young people who may have great practical talents where these GCSEs will be entirely irrelevant. Can the Minister reassure us that the Government are rethinking their damaging obsession with these academic subjects? If colleges could spend precious time and resources instead on adult and continuing education, it would make a significant and worthwhile contribution to society and the economy. I hope the Minister can reassure us that the Government are not only listening but acting to support part-time learners, whose skills are essential to the workforce.
I end by looking forward to the maiden speech of the next speaker.
Baroness Bryan of Partick (Lab) (Maiden Speech)
My Lords, it is with considerable surprise that I find myself here today making my maiden speech in your Lordships’ House—you will appreciate that I will have to be brief. I have received nothing but kindness and encouragement since I arrived. The staff in Black Rod’s office, and Black Rod herself, are so helpful, as are the doorkeepers and all the staff and Members who have helped me feel so much at ease. I owe particular thanks to my supporters, my noble friends Lady Hayter and Lady Chakrabarti, who both gave me moral support at my introduction but were also ready to catch me if I keeled over.
In my early political life, I was a member of the Independent Labour Party, so I cannot help but reflect on the ILP members who graced this place: Fenner Brockway, Neil Carmichael, Barbara Castle and, of course, Jennie Lee. Jennie Lee understood the value of education. She came from a mining village in Fife and, unusually for a working-class woman, gained a university degree. She was the first woman to be elected as a Labour MP in Scotland. She was only 24, but had 10 years of campaigning and public speaking experience. A maiden speech held no terrors for her—lucky woman. Many decades later, Harold Wilson gave her responsibility for establishing a University of the Air. She felt that adult education should be more than,
“dowdy and mouldy … old-fashioned night schools and … hard benches”.—[Official Report, Commons, 2/4/1965; col. 2062.]
She wanted a university to match the best available anywhere.
As an Open University graduate, I have a first-hand appreciation of the high standard of its courses. The downside when I was a student was that the courses ran right through the summer. Fellow students could easily spot one another at airports or on beaches because of the heavy course books that never left their side.
I know that in recent years lecturer contact with students has been reduced and that the OU has closed most of its regional offices, but worse could still be to come. Its lecturers say that the latest round of cuts will,
“destroy the OU as we know it”,
by reducing it simply to “a digital content provider”. Instead of being part of a learning community, students will be dependent on “virtual” support from staff and fellow students. There will be only limited opportunities for face-to-face contact and working in collaboration with fellow students.
For many students, the OU is the only realistic way to access higher education, but, as with other higher education institutions, the cost creates a barrier. The OU has a better record than most in reaching disadvantaged students, but the cost can still be prohibitive.
When I was an OU student in Scotland more than 25 years ago, I studied the same courses as students in the rest of the UK and, significantly, paid the same fees. Now, an OU student in Scotland pays only one-third of what a student from the rest of the UK has to pay.
Being able to offer people a second chance for learning or to take part in lifelong learning should be valued in every part of the UK. We should pool our resources to make sure that the Open University lives up to its aims, which were described by Jennie Lee as being,
“a great independent university which does not insult any man or any women whatever their background by offering them the second best, nothing but the best is good enough”.
Baroness Kennedy of The Shaws (Lab)
My Lords, it is a great pleasure to follow the noble Baroness, Lady Bryan of Partick, who also hails from my home city. It is wonderful to see her here joining us in this House. I welcome her, as do all our colleagues. It is clear from what she has said that her experience will be invaluable to this House. She has a well-documented commitment to social justice. I should let your Lordships know that she edited a book, What Would Keir Hardie Say? I have no doubt that, in the months and years to come, she will tell us what Keir Hardie would say about the state of our world at the moment.
I want also to congratulate my noble friend Lady Bakewell on bringing this debate before the House, but I am sorry that we have so little time to speak. I agree with her about celebrating the Open University and in expressing regret about what is currently happening. Education is a social good as well as a good for the individual. It hugely benefits society as a whole to have a well-educated and well-trained populace, and learning is central to our economic success and social cohesion. It is particularly important just now as we address national skills shortages and the challenges of a changed world of work, an environment in which there is huge technological change.
Those who are disadvantaged educationally are also disadvantaged economically and socially. We have to place learning at the heart of a national common purpose and draw into learning and training those who missed out the first time round and have come late to the party, but who want a change of direction. Turning education into a commodity has not served our nation well, but I am afraid that that is what is happening. Turning universities, colleges of further education and the Open University into businesses is not appropriate. While all of these institutions absolutely should be business-like in the way they work, they should not operate as business models, as they are currently being asked to do.
Large numbers of young people still leave school and begin adult life in need of compensatory education. School does not work for many people for reasons that are often related to their family circumstances, but sometimes it is because they have breathed in a sense of failure at an early stage in their lives and they do not go on to do what they could do. We see a great deal of thwarted potential in our society. However, a moment will come for someone in their late 20s, 30s or sometimes their 40s when they want a second chance. I have seen this because my name is borne by a small foundation that gives bursaries to people in this category. They know about real hardship. The financial model and the insistence on paying for everything is now putting them off and it is the reason we are seeing such a drop in the number of people taking up those second chances. I could tell noble Lords many stories of triumph over adversity, but we have not got the funding right.
I want to make two brief points. The Open University was a visionary initiative and what we need now is a new vision. I suggest that we draw on lottery funds that were put to one side for the millennium projects in order to create a “learning nation fund”. We should create a learning regeneration fund to go to the parts of the country where there are no opportunities but there has been great neglect. In that way, people would be given those second chances. We should also create more pathways from further education into higher education, thus giving people the know-how for their lives. Let us celebrate continuing education and the institutions that deliver it, in particular the Open University, Birkbeck and many others. I am about to become the chancellor of Sheffield Hallam University, which does this work very well. These institutions are part of the lifeblood of our nation. Let us seize the chance provided by the policy review to revitalise these educational opportunities.
Baroness Lane-Fox of Soho (CB)
My Lords, I declare not only an interest in but a deep love for the Open University as I am proud to serve as its chancellor. I also thank the noble Baroness, Lady Bakewell. I am sure that she will hate me for saying this, but it seems appropriate that on the day that we are celebrating the NHS and the Open University, we can also honour her as a great national asset.
As many other speakers have said, the Open University is an extraordinary and important institution which we must all continue to support. It is the only university in the world where access is open to anyone, whatever their background and previous educational record. Some 24,000 of the Open University’s 174,000 current students are disabled, more than many universities have in their sum total. The Open University has deep links with military personnel and veterans, providing programmes to help them back into education. Moreover, it has had extraordinary success with prisoners and is the only official academic institution working to help them get back into education. These are all fundamental tools for social mobility.
Unknown by many people, the average age of an Open University student is 28, and over 75% of our students are in work. As I say at our degree ceremonies, just after I have made the students do a Mexican wave—noble Lords should not worry; I am not going to attempt to do that now—the OU is not part-time learning, it is double-time learning. These are people who have put education above many priorities in what are often already stressed and complicated lives. You need only look at their faces as they walk across the stage to collect their degrees and you will see the emotion, the relief and the dedication in them. I am not a person who is drawn to tears easily, but I find myself fighting them back, often unsuccessfully, as I see the incredible dedication of the learners at our university.
As has been stated, this has not been an easy time for the university. The macroclimate, the funding situation and the decline in part-time learners have to a degree been compounded by some of the internal challenges. It is not my role as chancellor to behave like an executive. I simply stress to noble Lords and the wider communities beyond that the Open University is still an innovative place and still has a bold vision for the future. Next year is our 50th year, as the noble Baroness, Lady Bakewell, alluded to, and there will be some extraordinary and interesting things happening. But we do need to rebase the university for the modern age. No one believes that it should be a digital-only university; everyone believes in the power of the combined ways of learning. But we also have to be realistic that this is 2018, not 1968. Things need to be and to feel different. I am a firm believer that we need to build wider partnerships into different communities, with employers and with government, with the skills we need to build a modern and resilient society.
It is an irony—more than an irony, a tragedy—that at a time when, more than ever, we need continued learning as part of our culture, there has been such a dramatic fall in part-time learning. As the noble Baroness, Lady Bryan, who I welcome to the House, said in her brilliant maiden speech, Jennie Lee, who is such an inspiration—I wish I could have met her—said in 1973, “We cannot strive for anything other than the best for people, whatever their background”. I will do my absolute best to ensure that the Open University is fit for purpose for the future. I thank noble Lords for their support, but that is not enough. We need government support as well. I ask the Minister: what is the cohesive plan for part-time and continued learning? What signposts will learners have to understand the options open to them? What funding support do the Government plan on giving?
Lord Forsyth of Drumlean
My Lords, it is an absolute scandal that we have only three minutes to talk on this very important subject. I am very grateful to the noble Baroness, who introduced this debate so brilliantly, for taking only 10 minutes, which perhaps gives us a little leeway.
If the last coalition Government and the previous Labour Government had set out deliberately to destroy part-time education, they could not have been more successful than they have been. Of course, that is not the case: it is the unintended consequence of two reforms. One, which the noble Baroness, Lady Bakewell, mentioned in her speech and to which the noble Baroness, Lady Kennedy, also referred, was the decision to triple tuition fees and create a funnel that is driving people into doing traditional three-year degrees, as opposed to other forms of higher education.
In part-time education, the results have been absolutely catastrophic. I hope that we will have more time to debate this when we debate the report of the Economic Affairs Committee, which I have the privilege of chairing, which, in chapter 5, deals with many of these issues. I am very much in agreement with what the noble Baroness, Lady Bakewell, had to say. From 2010 to 2016, the Open University saw an 80% fall in sub-degree level qualifications. There has been a 60% fall in part-time education over that period. At Birkbeck, which the noble Baroness knows so much about, the figures are astonishing: a 64% fall in people doing part-time degrees and a 68% fall in sub-degrees.
Then there is the decision to bring in the ELQ rule, which says that students get no support, including tuition fees and maintenance loans, for qualifications that are equivalent or lower than they once held. How on earth are they meant to retrain or advance if that is the position? Indeed, before the rule was implemented by the previous Labour Government, 90% of those people were part-time students. Why are we surprised that the number of part-time students has fallen? For as long as I have been involved, the rhetoric of successive Governments has said that we need to increase our skills and people’s ability to retrain and to have lifelong learning, yet the financial policies and systemic structure are driving things in exactly the opposite direction.
Why has Birkbeck seen such a catastrophic reduction? Fifty per cent of its students were ELQ students; now it is 5%. Of course, they now have to find the fees and because the fees are higher, costs have gone up. Therefore, the burden on people who have to look after their families—and all the other pressures on people at present—is even greater. Even if they can get a loan because of the government changes in respect of STEM subjects, which benefit a few hundred people, they have to pay it back before they complete their course because part-time courses take longer than four or five years, as a rule.
It is not only the funding of students that is responsible for the decline. If institutions find that no students are coming, they do not run the courses. We have seen a catastrophic fall in the number not only of students but of opportunities, because the funding is not there. We need a radical change and we need to acknowledge that mistakes have been made. Funding is key to this. Why was it changed? George Osborne worked out that making the money follow the student—who would be largely dependent on tuition fees—would result in no increase in the public sector deficit. Instead, it will be met 30 years down the line when the bill will be £1.2 trillion. We have to be realistic about the true cost of higher education and we need urgent reform. I commend the noble Baroness, Lady Bakewell, for introducing the debate, albeit that there is little time to discuss it.
Lord Griffiths of Burry Port (Lab)
My Lords, it is always nice to follow the noble Lord, Lord Forsyth, especially on the rare occasions when we speak on the same side of the argument. It is a particular delight to follow my noble friend Lady Bakewell in bringing this important subject before the House.
Higher education is a devolved area. The Welsh Government have been active on this subject and may have some light to throw on the situation we are discussing today. They are introducing a new student support package, the only such system in the United Kingdom, to offer parity of support for full-time and part-time students alike. New part-time students starting their studies in September, in two months’ time, will be eligible for a non-means-tested grant of up to £750 towards their living costs, plus a further means-tested £3,750, dependent on household income and study intensity. Students who do not receive the full grant amount can apply for maintenance loans, ensuring that there is no barrier to study.
This approach, treating full-time and part-time students equally, may be a measure that addresses the “unforeseen consequences” described by the noble Lord, Lord Forsyth. It is a progressive measure that has the potential to make a significant difference to the number of part-time students in Wales. For instance, the new funding arrangements are already generating significantly increased interest in studying with the Open University in Wales. The university there is experiencing substantial increases in early registrations for study in the coming year, with figures currently running around 30% higher than at the same point last year. It is hoped that the UK Government can learn from the Welsh experience. Let Wales bring in the cavalry.
That underlines the importance of a flexible learning incentive. I am the father of a child who got her second degree from Birkbeck. My career started as a result of the Robbins report in 1963, with new universities and expansion of the sector. Many of my friends went to teach in the Open University at the end of that decade. It was a great moment for us to be alive—oh, that it were so for our children and our children’s children.
Lord Addington (LD)
My Lords, this is one of those debates when you could spend all your time saying that you agree with everybody who has gone before you. The noble Baroness, Lady Bakewell, has started something that we are in only the first act of. She is clearly pointing out something that has gone wrong because, whatever is said about the Open University, it has been a tremendous success and has the structure to reach people who are not being trained when everybody else is. This is one occasion when, very boringly, I agree with virtually every syllable said by the noble Lord, Lord Forsyth. We have to try to preserve the Open University and use it. The noble Lord, Lord Forsyth, pointed out two things: ELQs and fees. We have to find some way of removing these barriers because reskilling is not always upskilling and upskilling may require some reskilling to get people ready.
One thing that the Open University has a tremendous capacity for is credit transfer. It is a conduit between different skills being credited in another institution. We have probably not made the best of this institution yet. We have a structure and redistribution and we could get people ready for study courses somewhere else by using that. If we get radical and look at this as part of the university sector as opposed to something in a corner screaming and fighting for its bit of attention—all higher education institutions have a tendency to do that—and bring this together, we will get better results.
The Open University has a tremendous reputation. As the noble Baroness, Lady Lane-Fox, said, it is probably the best university for helping the disabled. We have to try to use this national system for reaching the public to enable us to get the best out of the higher education system as a whole. Unless the Government realise that and support it, we will be throwing the baby out with the bath water, and possibly its sibling as well.
Lord Haskel (Lab)
My Lords, the biggest provider of part-time learning services is learndirect. Although it has contracts with clients such as Sainsbury’s, the quality of training and supervision has drawn much criticism and dissatisfaction. We now learn that last week learndirect, on the verge of bankruptcy, was sold by a private equity company for a nominal sum. That was followed by an announcement that 22 senior managers are leaving the company. Does the Minister think that part-time learning is a suitable commodity for commercial and financial manipulation this kind? Obviously, our colleges will have to pick up the pieces. We are going to have to do a lot better than this, because delivering these skills and the productivity that will enable us to exploit new technologies and make our way in the world post Brexit is a central pillar of our industrial strategy. The industrial strategy recognises that without part-time education, even with a high level of employment, people will be stuck in low-paid jobs.
As the Taylor report indicated, the world of work is becoming more flexible, more connected yet more remote. In their response to the Taylor report, the Government promised an assessment of these jobs and what needs to be done so that people in the so-called gig economy and on zero-hours contracts will have the encouragement and the means to take on part-time education. By their very nature, these gig companies have very little motivation to encourage part-time learning. Surely all this is part of the need to improve and build on the current work of the Careers and Enterprise Company and the National Careers Service to advise young and old about part-time education. Is this work in progress? It is promised in the industrial strategy.
Some think that one way to improve these services is for contact with the training organisation or college not to finish when the course ends. Some colleges or organisations are trying to work out how they can continue the relationship and find out how well the skills and knowledge of past participants are keeping up with change. In this way, they hope to tell people when they need to return for an update or an upgrade. Will this be introduced as part of the national retraining scheme mentioned by my noble friend Lady Bakewell? Such a scheme was promised by the end of this Parliament. Can the Minister give us an update? Thanks to my noble friend, who introduced this report in such a brilliant manner, I think we are all convinced that enabling people to study part-time while earning, in order to improve their skills and knowledge, benefits not only the individual but the economy and society as a whole. The industrial strategy commits the Government to making it happen. Is this work being done?
Lord Rogan (UUP)
My Lords, I am an A-class student of the Open University. I hasten to add that this is not for academic ability but because I was a student joining in the first year, 1971. My wife enrolled in 1972 and by the end of 1976 we produced between us two BA degrees and two wonderful baby boys. In the time available I wish to comment positively about the Open University in Northern Ireland.
The number of part-time Open University students in Northern Ireland is increasing. At the moment we have 3,967 students. Interestingly, in the Republic of Ireland there are 1,077 OU students. Students in Northern Ireland may apply to the Student Finance Northern Ireland fund for a part-time fee grant or fee loan. Part-time student loans were introduced for the first time in the 2017-18 academic year. The Open University in Northern Ireland has introduced a significant paid work experience programme for its part-time students, initially working with companies in the STEM sector. There has been strong, positive feedback from employers about the work ethic, resilience and focus of OU students. Several have been given full-time jobs before completing their placements.
Furthermore, the Open University in Northern Ireland is now a major provider of graduate nurses to the Northern Ireland health sector. Its unique part-time programme works with healthcare assistants to develop their skills and knowledge: those staff remain in their substantive roles, so they bring their new skills directly to the work environment. This partnership programme is with the Department of Health, the Northern Ireland health trusts, the Royal College of Nursing and Unison. Perhaps this could be replicated throughout the Open University.
The UK Government have taken steps to promote part-time learning, such as relaxing the equivalent lower qualification restriction in STEM subjects, introducing maintenance loans for part-time students and consulting on accredited degrees. While these are welcome, they are piecemeal. It is clear that fundamental action is needed.
Viscount Hanworth (Lab)
My Lords, the crisis of the Open University, which has entailed a massive loss of income and a halving of student numbers, is rooted in the Conservative Higher Education Act 2012. The administration of the Open University has reacted to the financial crisis by declaring large-scale staff redundancies. It has also attempted to make savings by closing seven out of nine regional centres, which are where OU students gather for contact with each other and with their tutors. As well as declaring mass redundancies and closures of courses and regional centres, the proposals of the vice-chancellor, who has since resigned, included the elimination of the costly research activities of the university. Henceforth, the university was to become a provider of online courses, to be propagated via the world wide web from a platform called FutureLearn. The resulting MOOCs— massive open online courses—which are freely available to consumers, were extolled by David Willetts, the erstwhile Science Minister—now the noble Lord, Lord Willetts—as
“revolutionising conventional models of formal education”.
The current offerings of FutureLearn are threadbare and compare unfavourably with the traditional course materials of the Open University. They are more appropriate to recreational education than to serious academic study. The idea that university lecturers can be replaced en masse by static electronic material, which is attractive to administrators and paymasters seeking to reduce costs, is both fatuous and dangerous. If there were any validity in it, we would have seen the growth of academic libraries instead of the growth of universities.
I turn to the wider issue of the importance of adult education to the welfare of our society and our economy, and the seeming disregard of this by the Conservative Government. It is an oft-repeated truism that, if we are to profit from the scientific and technological advances that are occurring with increasing rapidity, we need a workforce that is constantly learning new skills and upgrading existing ones. This can be achieved only by a systematic programme of adult education and re-education. In many ways, we have regressed. Our provision of adult education is not what it once was. Large industrial enterprises are no longer as keen as they once were to sponsor the education of their workforce. Instead, we hear a chorus of complaints, mainly against our universities, about the skills shortages in the workforce.
In the meantime, opinions have changed regarding the purpose of education. The Russell report, which was presented to Margaret Thatcher when she was Secretary of State for Education and Science in the early 1970s, emphasised the necessity of providing,
“the fullest opportunities for personal development and for the realization of a true conception of citizenship”.
Nowadays the emphasis is on manpower planning. The Russell report was cold-shouldered by the Conservative Government, and their negative attitude has continued to affect the provision of adult education.
The attitude of the Labour Party has been very different. The Open University, established in 1965 by the Wilson Government, had its immediate antecedent in the Workers’ Educational Association, which was strongly supported by the Fabian socialist movement. The WEA embodied the spirit of the dissenting academies, which had a much earlier origin. Our party has been characterised by a studious and a pragmatic approach to all manner of social and economic issues, which has gone hand in hand with its approach to learning and education. It has tended to reject political and ideological dogmas in favour of careful policy-making. In this respect, it is very different from the party in power. The Conservatives express impatience with the advice of experts. They are liable to ignore issues of detail that can detract from the clarity of ideologically motivated policies. We are presently witnessing, in connection with the Brexit agenda, some of the most damaging effects of this Conservative mindset.
The Lord Bishop of Oxford
My Lords, like others, I warmly welcome this debate and thank the noble Baroness, Lady Bakewell, for introducing it so ably. Student numbers in part-time education are moving dramatically in the opposite direction to the one I am sure we all want to see, potentially with really dangerous consequences for our economy and society.
The Open University has its headquarters within the diocese of Oxford, in Milton Keynes. It is a remarkable institution, as others have said, which has pioneered access to higher education and the use of technology, supported by face-to-face learning. It remains at the forefront of all of that, and I echo the affirmation others have made of the need to preserve, develop and build up its contribution to our national life and its international reach.
Together with the noble Baroness, Lady Bakewell, I have recently been a member of your Lordships’ Select Committee on Artificial Intelligence. As we have heard, we examined the changing nature of work. AI can drive our economy forward, but it is a disruptive technology. We know that many jobs will go. Some new jobs will be created. It is not clear what the net effect will be. But we do know two things.
First, the effects of job reductions will not be even across the economy; they will disproportionately affect traditional post-industrial areas and sections of society. The Centre for Cities estimates that 27% of current jobs will be lost by 2030 in Doncaster and Wakefield—towns which already have a higher level of unemployment. That is really significant for those communities.
Secondly, what can be done to mitigate the effects of these massive societal changes? The key is what we are discussing today. It is the only key that has emerged from the work done so far: a really significant—bigger than we have yet imagined—proactive investment in part-time, continuing, lifelong education, accessible in every place and to every part of society. We need a more radical reimagining of our continuing education than the Government have yet embarked on: a part-time education revolution for the 21st century equivalent to the large education revolutions of the past that we heard described.
The technology that is so disruptive to jobs can actually help us achieve that—supported by face-to-face and community learning. This new deal needs to be means tested, as we have heard, at the point of delivery, to prevent the stagnation of much of our economy; it needs to focus on the building of character and the formation of wisdom, as the Open University and others have done in the past; it has to be about more than knowledge and skills; and it needs to be focused disproportionately on the areas of greatest need.
Lord Holmes of Richmond (Con)
My Lords, it is a pleasure to take part in this debate. I declare my interests as set out in the register. I congratulate the noble Baroness, Lady Bakewell, on securing this debate and on the way in which she introduced it. I, too, was lucky enough to serve alongside her on the Artificial Intelligence Select Committee, and what we all saw from the noble Baroness there was that it will be a long time before artificial intelligence gets close to the brain power stored in her skull. I also welcome the noble Baroness, Lady Bryan, and her excellent maiden speech.
In the time that I have, I will focus on two areas: the fourth industrial revolution and unpaid internships. It seems clear that we are in a time of tumultuous change, where everything is changing: the tools we use, how we work, where we work and when we work. If this is indeed the case, it seems clear that education—higher, further, primary, secondary—needs also to change, not just to be relevant but to address the ongoing needs of individuals. Everything that education should have been, it now absolutely needs to be. It seems that flexibility needs to be at the core of that.
I take every opportunity to crowbar unpaid internships into every debate, and I got my Private Member’s Bill through your Lordships’ House. How can someone, if they are forced to do an unpaid internship, hope to undertake part-time or further education? It is most likely that the people who most want to secure internships and part-time and continuing education—if we believe in social mobility, which I do and which the Government and Prime Minister have stated a commitment to—will not be undertaking unpaid internships or part-time, continuing education. They will be locked out of both routes to social mobility, locked out of both routes to being able to play their full part in our society, and we will not be able to address all the social, cultural and spiritual issues, and address the productivity crisis, that we have.
On those people whom the figures show are not able to continue part-time education and have dropped out, I ask the Minister what research the Government have done on who is in those groups. What are they now doing, and what is the Government’s view of that situation? Does the Minister agree that it is all about flexibility? Without that flexibility matched with relevant resource, people will continue to be unable to participate.
Do the Minister and the Government believe that the current student finance system is fit for purpose? Is the 6% rate in any sense realistic, satisfactory or designed to achieve the policy objectives and educational outcomes that we all want?
Ultimately, it seems pretty straightforward. We either have part-time education, continuing education, higher education and further education founded on flexibility, or we fail.
Lord Hunt of Chesterton (Lab)
My Lords, I welcome this debate, which was brilliantly introduced by my noble friend Lady Bakewell, at this critical time. The UK needs to increase the number of those taking part in part-time education, not the other way around. The OU and many other educational institutions have played, and will play, an important role.
The OU has been a great leader in the UK and abroad. I worked with the OU on a TV programme about air pollution dispersion—still important, as we discussed earlier this afternoon. It was broadcast in the middle of the night, whereas my son’s history programme was broadcast at about 8pm. That is the world we live in. My programme, however, which was made 30 or 40 years ago, is still used around the world. There are many other institutions providing part-time courses, in companies and governmental institutions such as the Met Office. In fact, incoming chief executives were given a very stiff day of introduction in the courses at the Met Office.
There could be much more collaboration between different types of part-time courses. During part-time lecturing to industrial engineers at what is now Coventry University, in the 1960s and 1970s, I learnt how such part-time courses can have the practical focus needed by industry—a focus that differs considerably from, while complementing, the fundamental courses taught at universities. This needs to be understood by educational policymakers concerned about the UK’s shortage of apprentice-level engineers and specialists. For example, there is a tremendous need for practical courses in innovative construction—areas such as green technology and remote offsite construction—which the House of Lords committee has just been looking at.
In the United States, however, universities have an alternative approach that has so far not been mentioned. There, part-time further education is integrated into full-time education: part-time students attend courses organised for full-time students. Seeing this in Arizona, I was very impressed that such part-time students can bring new and practical ideas—sometimes quite revolutionary—of value to the whole class.
Advanced postgraduate and doctoral part-time courses are also very important for specialised topics. In London there are many evening courses, in all sorts of places, on finance, but very few advanced, open evening courses of the kind that are easy to find in Chicago or Los Angeles. We tried it in London by setting up the Lighthill Institute, which I helped to run for a few years, offering evening courses in mathematics and advanced technology. I am afraid, however, that it no longer exists.
Finally, the OU is justly famous around the world for its teaching and research—for example space research—but is uniquely distinguished for its highly original and professional TV programmes. My point is that, while other universities also make online programmes, the OU needs to expand its excellent programmes and to continue its broad approach using the greatest talents from around the world.
Lord Shipley (LD)
My Lords, I too thank the noble Baroness, Lady Bakewell, for enabling this debate, which is particularly timely given the recent excellent report by the Economic Affairs Committee and the Government’s forthcoming review of post-18 education, which will inevitably wish to address the problems that part-time higher education has faced over the past few years—and to find urgent solutions. I declare my interest: I was privileged to be a member of staff of the Open University for some 34 years, from the heady days of the early 1970s to my retirement. Those early years saw the Open University establish itself in terms of both the extensive demand for distance-learning opportunities and the quality of its learning materials, underpinned by personal support for students. Applying rigorous standards, the Open University innovated in its teaching methods and was helped immensely by its association with the BBC. It became, and remains, a world leader.
The OU was very much the university of the second chance—except that for many students it was their first chance. It has thrived on open access and the desire for self-improvement. All of those principles remain vital for an inclusive and skilled society. As we have heard, however, numbers of part-time students have fallen heavily in recent years, right across the sector. The introduction 10 years ago of the rules that cut funding for students taking qualifications at the same level as, or a lower level than, the ones they already held was a serious financial disincentive for those seeking personal enrichment or professional updating. It was a mistake.
It is not, however, the whole story. As we have heard, it seems that students with families and higher living costs than 18 to 21 year-olds have found the cost of study a major disincentive. This is a huge disbenefit for the individuals concerned and is almost certainly not in the national interest. As we have heard, part-time nursing student numbers have fallen by half. I hope the Government will urgently look at whether it is justifiable for tuition fees for part-time students in England to be two and a half times higher than in the rest of the UK. It does not seem right to me that students in England should be so disadvantaged. Ways must be found to reduce the cost.
I hope the Government will look again at the benefits of lifelong learning for part-time and mature students for our productivity and skills base as we train people for a new generation of jobs. I hope too that the Government will examine the potential for individual lifetime learning accounts, which could prove extremely helpful. Finally, the Government could bear in mind one further fact: around 20 million adults in the UK do not have level 4 qualifications. That is a huge untapped resource.
Lord Parekh (Lab)
My Lords, I begin by congratulating the noble Baroness, Lady Bakewell, on securing this debate and introducing it so well. I am only sorry that it has taken so long to organise. We are also limited to about to about three minutes, which is hardly enough to cover an issue of this importance. That is, however, where we are and where I will begin.
We all agree that we live, as the noble Baroness pointed out, in a world of constant change—technological, social and cultural. Thanks to globalisation the world is increasingly becoming one, as different cultures and societies come together. In this situation it is vital that part-time and continuing education keeps pace with the world around us. If the world constantly changes, education must constantly change and expand. I do not really like the term “part-time education”, because it is lifelong education: the “full-time” and “part-time” distinction does not make much sense. Nevertheless, when one is employed in a full-time job and takes on a course, we call that part-time. That is fine. What it does, however, is increase social mobility and economic productivity, and provide skills that one may lack and—most important of all—job satisfaction. It makes for a contented workforce that can see the world as an expression of its own skill and powers, rather than as an alien entity trying to dominate it.
In that kind of world, part-time education becomes a form of self-expression and self-development. It is, therefore, natural to worry about the decline in the number of part-time students: a fall of 47% between 2008-9 and 2016-17. In England the fall is even greater: 59%. That is very disturbing. How have we come to this and what can we do about it? Three minutes, as I said earlier, is too short a time to explore those questions, so I will just make some quick points. First, it is a great mistake to regard so-called part-timers as being like full-timers. They are not, and that is a serious mistake. Part-time students form a distinct group with their own historical experiences. They are mainly older and mature, with family responsibilities, mortgages, and a reluctance to take out loans: they are notoriously debt-averse. In that situation, if they are offered a grant in the same way it is offered to undergraduates—by saying that payment will be deferred—they are not going to take it. The result is that when these grants are offered, they are certainly not taken up. That is not how mature students respond.
Finally, a word in half a minute about the Open University. Again, it puzzles me why it is called the Open University, which by definition implies that other universities are closed. Happily, we are not. I am a university professor and my university is not closed, as in the Soviet Union or anywhere else; it is open. However, the Open University is open in a special way. It is independent of qualifications that have been obtained at A-level; it is also independent of space, so that it can teach wherever students are. The Open University is one of the great achievements, like the NHS. It has had a great impact on India and other countries. I would even be inclined to say that it is a jewel in the crown. Nothing should therefore be done to damage it. That depends not only on the Government but on the Open University itself. It is important that the Open University should remain innovative and make savings, but at the same time the Government should be more hospitable to the presence and contribution of the Open University.
Lord Haskins (CB)
My Lords, the noble Baroness, Lady Bakewell, has vividly and starkly analysed and shown the scale of the problem we are talking about today. I was chair of the council of the Open University for 10 years, between 2004 and 2014, when these changes began to emerge. The reality has come home to roost only in the last couple of years.
The first change was the introduction of student loans. As the noble Lord, Lord Forsyth, clearly said, that was a piece of financial engineering and chicanery by the Treasury, introduced by Gordon Brown and accelerated by George Osborne. It was a completely unnecessary and cynical piece of financial engineering. Secondly, we had the elimination of ELQs, which were not a huge issue in money terms but were huge symbolically. They were part of the values that the Open University stood for; never mind the financial side, they were a cornerstone of it. The third trend which I found strange was, on the one hand, the championing of the devolving of power—I championed it very much—away from Milton Keynes to the Celtic nations while at the same time, rather against my best interests, there was the increasing centralisation of power in England towards Milton Keynes. We have an English problem here because the trend in student numbers, awful as it is in the Celtic nations, is twice as bad in England. There is a lesson there to be learned.
There are two issues for the OU to consider. First, is the model of 50 years ago, modified as it has been as things have gone along, still up to date with today’s student requirements? Secondly, has centralisation in England gone too far? I suggest two possible initiatives for the OU to consider in getting out of this difficulty. One is collaboration with universities across the United Kingdom, locally and regionally, to develop a new form of distance learning. Those local universities have their feet on the ground and collaboration seems an interesting proposition, which would not cost much money. We have to remember that part-time education has virtually disappeared from the curriculum of most universities anyway, so it would revive that. The other is that I chair one of the local enterprise partnerships in the north of England, where the biggest problem we face is the lack of skills and training in non-academic jobs and circumstances. Could not the Open University model be adjusted to address that need in society, which is not academic, using the technology and the distance-learning skills the university has in an innovative way to deal with a local problem?
What should the Government do about all this? First, we welcome the post-18 review and we obviously consider that it must primarily review the impact of student loans on part-time education, because a loan to a 28 year-old is very different from a loan to an 18 year-old. Secondly, they should restore the priority of lifelong learning, which for 20 or 30 years had become a stronger and stronger issue in government. They should change that and put it back as a policy priority. Thirdly, they should consider incentives for employers to use the Open University more than they do. There has been a significant fall in the number of employers sponsoring students going to that university, which is a disgrace and a bad reflection on those businesses, which cannot see beyond the end of their noses. Lastly, the Government should pay far more than lip service to devolution in England and recognise that it makes huge economic and social sense in the way that we deliver economic development, health and education.
Lord Puttnam (Lab)
My Lords, if the Minister entered the Chamber this morning with any doubts as to the significance of the Open University, those doubts should by now have been well and truly extinguished. I declare my interest as a former chancellor of the Open University, a role in which I served from 2007 to 2014. If I regret any one thing during my term as chancellor, it is my failure to persuade any Minister to attend an OU graduation ceremony. Had it been any other university, this would just have been a pity but, for the reasons touched on by the noble Baronesses, Lady Lane-Fox and Lady Garden, in the case of the OU it is tragic. It is tragic because unless you have experienced one of those celebrations—and celebrations they are—you can never truly understand the impact of the OU on the lives of its graduates.
One of the assets that this House brings to the national debate is informed experience, so allow me to quickly set out the actual experience of being a part-time learner. I had failed badly at school and belatedly realised that I needed some sort of education if I was to make anything of my life. In that pre-OU era, I enrolled at the City & Guilds. I studied nine subjects at what was then called night school. I was up before 7 am to get a bus and a train to where I worked as a messenger in an advertising agency. Three evenings a week, I would cross London to study from 6 pm until 9 pm. I then got the Tube and a bus home, reaching there just before 10 pm. I did that for four years, during which time I got married and our first child was born. I am in no way regretful but that allows me to know that unless you have lived with the challenge of doubling up on childcare and doing your homework on a train while juggling with every other facet of adult life, you are very unlikely to have the imagination to understand—let alone appropriately legislate—for non-traditional forms of education. Those forms of education are imposed by circumstance rather than privilege, be that privilege intellectual or financial.
I sincerely hope that the Minister, when he replies, will prove me wrong but I get no sense that the Government have demonstrated a full understanding of the role that the OU could play in a post-Brexit, productivity-challenged Britain. Surely, one of the few issues on which remainers and Brexiteers ought to agree is the overwhelming importance of developing a workforce in which every person, no matter what their age or background, can develop an active and constructive role. In my opinion, this is a task that the Open University is better equipped than any other institution in the country to fulfil.
Baroness Taylor of Bolton (Lab)
My Lords, I too congratulate my noble friend Lady Bakewell on achieving this debate and regret that we have only three minutes. I should draw attention to my university declaration in the register but the reason that I wanted to speak in this debate is that many years ago, I taught with the Open University. One of the common themes that we have seen in this debate, whether we are talking about people who have been students, the families of those who have been students, people who have been tutors or those who have served in governance at the Open University, is the enormously high respect that every single person who comes into contact with the university has for it. I was going to make the point that my noble friend Lord Puttnam has just made: if anybody has not been to an Open University graduation ceremony, they really should go. But they should also take a box of handkerchiefs because it is an incredibly moving experience.
In my days in the Open University, many years ago, I was always impressed by the quality of the course material. It was interesting to see how much of it was then used by other conventional universities. More than that, I was particularly impressed by the students and their motivation. My noble friend Lord Puttnam has just outlined what he went through. It proves that the motivation of students who come to the Open University or to Birkbeck must be very high. Many of us were the first in our families to go to university but, for the most part, those who are the first to go to university have full-time jobs, families and mortgages. If anybody thinks that the funding arrangements do not matter, they should look at what has happened with bursaries for nurses. Nursing places are still being filled by very good candidates, but they are not being filled by mature students, as they were a few years ago, because those people do not want to inflict an extra burden on their family, especially when they are taking time away from them.
The OU briefing that we have all been sent sets out several points it would like to be pursued. I shall concentrate on and explore one factor that has not been mentioned too much today. It is the need for this sector of education to be very flexible and to provide progressive pathways. It is desperately important that people can move from one sector of education and one type of qualification approach, and we need credit accumulation and credit transfer to become an integral part of all we offer to part-time and mature students. I do not think we are talking about the US model of a credit for basketball, although what my noble friend Lord Hunt said was interesting, but the Open University’s foundation courses—the building blocks and segment approach—is vital if we are to be able to provide people with the multiple skills that they will need in the future. The report on AI has been mentioned, as has the fact that people no longer have jobs for life. We have enough experience to design this for the future. I am glad that we have this debate today. We are celebrating the National Health Service, but the Open University is the other great achievement, of Harold Wilson and the Labour Government.
Lord Kerr of Kinlochard (CB)
My Lords, I agree with the noble Baroness. The noble Lord, Lord Forsyth of Drumlean, referred to the report of the Economic Affairs Committee. He chaired the work, he is an extremely skilful and wholly impartial chairman and we never discuss Brexit. I am a member of his committee and I want to draw attention to one terrifying statistic that we came across in writing the report. The number of part-time students aged over 30 fell by 41% in the four years to last year. The trend had been going on for 10 years, but it accelerated. That is a terrifying number when we think of the needs of the economy, as the noble Lord, Lord Shipley, did. It is a story not just of personal opportunities forgone but of national self-harm. I think we have a crisis on our hands.
Lord Storey (LD)
My Lords, I thank the noble Baroness, Lady Bakewell, for this debate, I congratulate the noble Baroness, Lady Bryan, on her maiden speech and I wish the Open University happy birthday. I congratulate all the other colleges, whether higher or FE, that do a tremendous job in continuing education. I taught all my life in deprived communities on Merseyside. One of the things I vividly now remember is the number of parents who ventured into school to help out. They were often single mums whose children were no longer in the home so they could come into school to help out. They suddenly got a taste for learning and thought to themselves, “I can do that”. Sometimes it was retired dads as well. Guess what? They went on to do courses and degrees because they had the confidence from being in school and seeing they could do that and had the provision available.
The traditional pattern for the most able, often well-off, students is well-known: primary education, secondary education and then on to further education or university. Indeed, I assume that many, if not all, of my noble colleagues followed that path, en route to a distinguished career in their chosen field and then into this Chamber. However, although this is a path trodden by many more students than was the case 49 years ago—I will explain the significance of this later—the majority of young people do not follow this route, and it should not be the only route to acquiring knowledge and skills.
Further and continuing education offers a door into personal development and skills that is never closed, whatever your age or circumstances—although the Government seem determined not to shut the door, but to make it more difficult to squeeze through. In addition to offering a chance to those who did not, at 18, move on to higher education, the further and continuing route is now even more necessary. The changing pattern of employment and the new skills demanded by the speed of developments in industry mean that updating skills and learning new ones is vital to our economy.
I had the pleasure of meeting Harold Wilson when he was president of the North of England Education Conference. I had to collect him and take him to his room at the Adelphi Hotel—remember “Just cook, will yer?” He met Sir Keith Joseph, who was then the Secretary of State for Education. I was 26 or 27 and the chair of education. I was amazed how well those two individuals got on. I was a bit overpowered by them, but Harold Wilson started to talk to Sir Keith about his greatest achievements in government. This is true: he said to Sir Keith Joseph that one of his greatest achievements in government was establishing—yes, you guessed it—the Open University. I always remember that, and it was important to me.
The most important word in the title of the Open University is not, in my view “university”, but “open”. When the Open University admitted its first students in 1971, only a tiny fraction of 18 year-olds went on to study for a first degree. The barrier then was not the thought of a debt of tens of thousands of pounds. In the 1970s, tuition was completely free and the means-tested maintenance grant of £10 a week during term-time meant that the poorest student could pay for accommodation, food and clothes and still have enough for an occasional pint or Babycham. The barrier then was aspiration. For many young people whose parents had left school at 14, even those who had passed the 11-plus, university was not an option and even staying on until 16 to take GCEs was not automatic. I remember one student who on his 15th birthday, the school leaving age then, had among his birthday cards a letter giving the time and date of the dockyard apprentice exam. A friend of mine was allowed to stay on to take A-levels against his parents’ wishes—they wanted him to get to work—only after his English teacher went to plead with them and tell them how important doing an A-level at school was. His parents wanted him to bring home a wage.
Noble Lords may wonder what any of this has to do with the Open University. Well, when it was established it offered, for the first time, a university education to those who would never have dreamt of the traditional university route. Since 1971, more than 2 million students have studied its courses, many of whom have used their higher education to contribute to an economy which is always in need of a well-educated and highly skilled workforce, but never more so than in the 21st century.
We have heard many statistics about the Open University, the most alarming of which is the 63% drop in undergraduate entrants between 2010 and 2015, which was even worse than the 51% nationally. It is the number of disadvantaged students that has fallen the greatest, which is another blow against the Government’s fine words about social mobility. The Centre for Cities says that rather than replacing low-skilled jobs with more of the same or welfare, we need greater investment in lifelong learning and technical education to help adults adapt to changing labour markets and better retraining for people who lose their job because of those changes. It is worth noting that there are 20 million adults who do not even have a level 3 qualification. Imagine if they had the opportunity to do that. Imagine how it would change their lives and how it would help our economy as well.
Time, tide and the changing labour market wait for no man. It is not a matter of the Minister being carried to the beach and commanding the waves to stop. Whether or not we are in Europe we are just a small island 40 kilometres off the coast of mainland Europe. We cannot afford to lose our place as a high-tech, well-skilled and competitive economy. I was taken with the important contribution by the noble Lord, Lord Forsyth. Like other colleagues, I agree with every word he said. We have created a vicious circle. The decline in numbers leads to a decline in courses and a decline in courses leads to a further decline in students, so we need to look at radical solutions.
One solution, which my noble friend Lord Shipley mentioned, may be to support all young people with an endowment or individual learning account, which they can use at any stage—early or later in life—to help to finance further or higher education. I was taken by my noble friend Lady Garden’s description of how she did her degree at the Open University. She used the phrase, “I wafted in”. I cannot imagine my noble friend wafting into anything.
We as a party are not simply waving a shroud on this matter. Vince Cable has made continuing education a priority of his leadership, and has launched an independent commission on lifelong learning to develop new proposals to give everybody the chance of self-improvement and employment at every stage of their life.
I have a few simple questions for the Minister which have been alluded to. When can we expect the review of post-18 education to report back? When will the Government respond to the recommendations? What does the Minister have to say to those students who will not be able to start a continuing education course or a degree next September?
As we have heard, 2019 will be famous for two fifties: one is to do with Article 50; the other is the 50th birthday of the Open University. I hope that the Government will give us and the Open University something to celebrate.
Lord Watson of Invergowrie (Lab)
My Lords, my noble friend Lady Bakewell is due our gratitude for securing this timely debate on a subject of real importance to the economic future of this country. That fact is not reflected in the mere three minutes allocated to Back-Bench speakers, although I think we all understand the need to accommodate more time for the debate marking the 70th anniversary of the National Health Service. I am wearing the sticker commemorating that today, and have a personal interest as someone born in the first year of the National Health Service.
None the less, it has been an excellent debate. I start by congratulating my noble friend Lady Bryan of Partick on a fine maiden speech. We first met many years ago, and I welcome my noble friend and her brand of socialism to your Lordships’ House. I can tell your Lordships: “You ain’t heard nothing yet”.
My noble friend Lady Bakewell opened the debate most effectively and highlighted the fact that, as the National Health Service celebrates its 70th anniversary, the Open University is preparing to celebrate its 50th. I had not made the link between these two events but, as my noble friend reminded us, that link is, of course, Aneurin Bevan and Jennie Lee. Surely in terms of the foresight of their socialism and the legacy it has produced, they must qualify as the all-time power couple.
Last year, the OECD highlighted the fact that the United Kingdom is full of highly educated workers with skills that often do not match the jobs available. Its report said that employers often do not train enough of their employees for new skills and that they should work more closely with the education system to ensure that school pupils and college and university students achieve the skills that the economy requires.
Research suggests that there are key process stages which influence school leavers’ decision-making: the UCAS cycle, open days and published information—whether comparison sites or league tables. These are all places where part-time or distance learning options tend not to feature. Prospective part-time students are generally much less well informed. A study commissioned by the Open University earlier this year showed that nearly three-quarters of prospective part-time students in England, all of whom were interested in studying part-time at higher education level in the next five years, were unaware that tuition fee loans were available for part-time study.
We need a single national portal which shows career opportunities with available jobs, apprenticeship options and links to training requirements and where and how study can be pursued. This would need to be strongly supported by face-to-face mentoring and guidance to give people the best knowledge of their options, and should come under the Government’s careers strategy.
That strategy needs to go further and address retraining and upskilling at all levels. The National Careers Service needs to be more ambitious and have a more innovative design, including better search facility and more advice, with direct links to taster courses to help build confidence and inform the decisions of those wanting to learn. Part-time higher education will be a determining factor in confronting skills gap issues, as well as the other major economic challenge that the UK faces: low productivity. However, part-time higher education in England is in crisis, with the continuing fall in the number of part-time and mature students, to which many noble Lords have referred, largely the result of the huge increase in tuition fees since 2012. With Labour’s pledge to end fees, that barrier will no longer face those who want to combine work with adding to their skills.
It must be acknowledged that those challenges cannot be met by relying on young people alone. The skills gaps are too many and too pressing. All adults of working age, whatever their background or level of qualification, need regular opportunities to upskill or reskill throughout what we all know will now be lengthening working lives. That fact was firmly grasped by the Economic Affairs Committee of your Lordships’ House, ably chaired by the noble Lord, Lord Forsyth. I chuckled rather when the noble Lord, Lord Kerr, said that the noble Lord, Lord Forsyth, had been impartial. I guess he would be in that committee, but the noble Lord and I go back some way, and one adjective that he is not usually associated with is impartial. I certainly welcome the fact that the committee produced a report containing much wisdom. I was particularly struck by the chapter on flexible learning, where it recommended the introduction of a credit-based system allowing people to learn in a modular way at a pace that suits them and their circumstances.
The Government have recognised this by launching their review of post-18 education and funding. That is to be welcomed, as is the fact that they will consider how to encourage more flexible learning, including part-time and distance learning. The review represents an opportunity for a fundamental rethink of the system of further and higher education that has developed in England over the past 20 years. For the first time, it is considering adult education and training at the same time as university-level education.
I hope that the Minister can explain how he sees the opportunity to strengthen the pathways between further education, apprenticeships and higher education to ensure there is joined-up thinking to enable young people to see their training as not just for a job but for a career. Flexibility must be placed at the heart of the post-18 education review. The Government have taken steps to provide part-time learning by introducing maintenance loans for part-time students, but they do not apply to those studying via distance learning. When will that gap will be addressed, because it currently acts as a disincentive to mature students returning to education?
As I said, the main priority for the UK must be lifelong learning, with individuals having both the incentive and the opportunity to develop and update flexible skills that are not attached to a particular employer. That philosophy will be central to the national education service which Labour will deliver in government, and will encompass further education colleges. They will continue to have an important role in earning and learning. They are drivers of social mobility, as various noble Lords said, including my noble friends Lady Bakewell and Lady Blackstone. I believe that the role of further education colleges is underplayed. It certainly seems undervalued by the Government in the funding that they get, but they will have a continuing role to play in economic growth. Part-time higher education students at colleges are typically aged over 25, although, worryingly, the Association of Colleges points out that their numbers have declined by more than 10,000 over the past four years.
However, the Open University will remain at the forefront of access for second-chance and, indeed, third-chance learners. A third of its students have only one A-level or a lower qualification when they join. As the noble Baroness, Lady Lane-Fox, said, 75% of them are in work. The Open University is responsible for one of the least-known facts, I believe, about first-year undergraduate students in English universities: almost one in five of them study part-time. With increasing degree apprenticeships, FutureLearn and OpenLearn, the OU will, as it approaches its half century, continue to push the boundaries of education technology into its second half.
Yesterday, I attended a reception in Parliament hosted by the Royal Academy of Engineering and EngineeringUK. That industry will be central to the ability of this country to build a strong economy when the shockwaves caused by leaving the EU are felt. Some 125,000 engineers and technicians with core engineering skills are required every year and the OU is already playing its part, with more than 40,000 STEM students preparing themselves for those demands.
This has been a debate high on quality in terms of the contributions by noble Lords, many with vast experience of the Open University itself or of part-time learning in other institutions or sectors. Much more could have been said were greater time available but, as the noble Lord, Lord Forsyth, said, we shall have the opportunity to revisit some of the issues around lifelong learning when your Lordships’ House debates the excellent report of his committee. I echo the question put by the noble Lord, Lord Storey, about the post-18 review and report. My noble friend Lady Bakewell said that she anticipated it appearing by the end of this year; my information was that it will be into next year, so it would be helpful to have clarification from the Minister. I trust that he has absorbed the many important routes signposted by noble Lords on how to promote and expand on part-time and continuing education and I look forward to hearing his response.
Viscount Younger of Leckie (Con)
My Lords, it is a great pleasure to respond to this debate on part-time and continuing education, and I note the specific reference to the future of the Open University. I thank the noble Baroness, Lady Bakewell, very much for raising this subject again. Studying part-time and supporting the education of individuals throughout their lives can bring considerable benefits for individuals, employers and the wider economy.
Let me start by setting the scene. Noble Lords have spoken at length today about the importance of the Open University, and they are right to do so. It has been particularly interesting to hear remarks from those who have been its previous leaders and from its current leaders and alumni, and particularly from those who have taught at it—including, if I picked it up correctly, the noble Baroness, Lady Taylor, and the noble Lord, Lord Shipley. Since 1969, the Open University has brought the opportunity to engage in higher education to people across the country who would not otherwise have had the chance to do so. There has been a theme of social mobility in what has been said today.
I also say at the outset how much I appreciated the maiden speech of the noble Baroness, Lady Bryan of Partick. She gave a particularly warm and thoughtful speech and I am certain that her experience as a graduate of the OU has added greatly to the debate today—and that she will continue to do so in the future. We also look forward to no doubt hearing the views of Keir Hardie transmitted from above via the noble Baroness in the future. Given that football is in vogue, in addition to the importance of study, I hope that she is a keen supporter of Partick Thistle.
The Minister for Universities, Science, Research and Innovation last month described the Open University as,
“essential to our future higher education landscape”.
I agree with Sam Gyimah on this point. I can also report that the Minister took part in an online meeting with Open University students on Monday, making use of the same videoconferencing technology that they use for their studies, to join in a conversation with students from all parts of the country. I am myself looking forward to joining the noble Baroness, Lady Lane-Fox, chancellor of the Open University, and others at a round-table meeting to discuss the work of the OU on 16 July. I note its important work for education in prisons, which we are reminded of today.
It stands to reason that part-time education offers opportunities to many people who are not catered for by the traditional undergraduate model of university. We know that the part-time student population in higher education is different from that for full-time—the noble Lord, Lord Parekh, cited some demographics. Over half of part-time students are older than 30, while this is the case for only 7% of full-time students. As an observation, part-time students also happen to be nearly 10 percentage points more likely to be female than their full-time equivalents. There are numerous testimonials provided by Open University graduates over the years that speak to this. These include people whose caring responsibilities or disabilities made part-time study the appropriate choice for them. Part-time education, however, also carries benefit that will follow an individual throughout their career. Many of those who choose to study through such routes do so because it can complement their existing job roles. Research has found that there are significant employment advantages for those who complete part-time courses, when they start with only a level 3 qualification or below.
Education is of course considered to be a pleasure and a challenge in itself, stimulating and maintaining what Monsieur Poirot referred to as those “little grey cells”. I hope that this will be the experience of the lady wife of my noble friend Lord Northbrook when she graduates. Part-time and continuing education allows this pleasure to be extended to a broader span of the population. Put simply, it is good for people’s well-being and mental health, where appropriate. Contrary to what the noble Viscount, Lord Hanworth, said, we do understand this and I hope that he realises that.
The Open University stands out as by far and away the largest provider of part-time higher education in England. In 2016-17, over a quarter of all entrants to part-time undergraduate study started at the OU. I will though also pay tribute to other universities and institutions, such as Birkbeck—where the noble Baroness, Lady Bakewell, is president, and where the noble Baroness, Lady Blackstone, was previously and the noble Baroness, Lady Garden, is now a fellow. I also mention Teesside University. All make important contributions to part-time study in this country. I also point out that—as the noble Baroness, Lady Bakewell, will know—over 93% of part-time undergraduate qualifiers at Birkbeck were in further study or employment six months after graduating. As noble Lords know, outcomes are a very important part of our government policy.
The noble Baroness’s Motion refers to continuing education as well as part-time education. Continuing education of course extends beyond what we may commonly refer to as higher education and I will return to this theme later on.
Let me now address directly the challenge posed by the changes observed in participation in part-time higher education in recent years. There are now record numbers of 18 year-olds going to university to study full-time, including those from disadvantaged backgrounds. However, we know that there has been a marked decline in the number of people studying part-time in higher education in England. This downward trend goes back to 2008. The noble Baroness, Lady Bakewell, eloquently highlighted the statistics, and a number of reasons for this have been given during the debate, which I will not rehearse again. The Government have taken a number of steps to address the decline in part-time study in higher education. First, noble Lords will recall that, during the passage of the Higher Education and Research Act, the Government brought forward an amendment that gave prominence to part-time study, distance learning and accelerated degrees. This amendment set out that such types of study are included in the need to promote choice for students, which the Office for Students must have regard for in pursuit of its wider functions. The Government also offer part-time tuition fee loans. I am pleased to note that in 2016-17, 47,000 OU students were able to benefit from a tuition fee loan for undergraduate courses. OU students made up around 64% of all the part-time students supported by English tuition fee loans in that year.
I pause for a moment to note that, just this week, the Government have announced that the maximum tuition fees that a university will be able to charge in the 2019-20 academic year will be frozen for the second year running. My noble friend Lord Forsyth spoke passionately on this particular matter. The Government have removed, as he has said, the “equivalent or lower qualification” restrictions—the so-called ELQ restrictions —for all science, technology, engineering and mathematics part-time degree courses. This means that students who already held a degree on these courses were then able to access support through student loans.
Lord Forsyth of Drumlean
My Lords, I am most grateful to my noble friend for giving way, and for the initiative that has been taken in respect of that particular group of students. However, if the Government have conceded the principle, why not extend it more broadly? Am I right in saying that the number of students who have benefited from that are a few hundred? After all, in the whole of England this year, the number of students who did A-level engineering was 10.
Viscount Younger of Leckie
My noble friend will know that I do not have those statistics to hand but I take note of what he has said. It ties into the report that he has produced, and I hope that at a later point we will have time to debate the details of that report.
I turn to HEFCE—now replaced by the Office for Students—which targeted an element of the teaching grant in recognition of the additional costs of part-time study. Twenty-nine and a half million pounds of the £72 million made available through this allocation was granted to the Open University. Importantly, in addition, this Government have in recent months tabled regulations that will allow part-time students on higher education courses to access maintenance loans similar to those received by their equivalents on full-time courses. These loans will be available to students starting honours and ordinary degrees, and equivalent qualifications, on or after 1 August this year.
Baroness Blackstone
I mentioned the likelihood of the take-up of these loans being very low because they will simply add to the debt of these debt-averse students. Perhaps the Minister would like to comment on that. What number does he believe will take it up? I suspect that it will be very small.
Viscount Younger of Leckie
We hope to be more positive on that. However, on a specific question like that, I think that it would be wise for me to write to the noble Baroness with details of how we see this going forward.
In their response to the part-time maintenance loan consultation in March 2017, the Government committed to seek to introduce maintenance loans for part-time distance learning courses. This is subject to the development of a robust control regime to manage the particular risks and challenges associated with this mode of study.
The noble Lord, Lord Addington, asked a question about credit transfer. He may know that Section 38 of the Higher Education and Research Act provides the OfS with the duty to monitor and report on the availability and take-up of student transfer arrangements, together with the power to encourage or promote awareness of such arrangements.
I turn now to the post-18 review. Your Lordships will know that the Government are undertaking a major review of post-18 education and funding to ensure that we have a joined-up education system that is accessible to all and encourages the development of the skills that we need as a country. It is looking at how to ensure that funding arrangements across post-18 education and training are transparent and do not act as a barrier to choice or provision. The noble Baronesses, Lady Bakewell and Lady Blackstone, asked a number of questions about this review. It will look at how we can ensure that the system is supported by a proper funding system that provides value for money and works for students and taxpayers alike. It will also ensure that the system gives everyone a genuine choice between high-quality technical, vocational and academic routes.
The review is being informed by independent advice from an expert panel chaired by Philip Augar. Indeed, the noble Baroness, Lady Wolf, is a member of the independent panel, sitting alongside representatives from further education, higher education and industry. My understanding is that the panel will publish its report at an interim stage at some point this year, before the Government conclude the overall review in early 2019. That is as far as I can go in answering the question raised by, in particular, the noble Lords, Lord Storey and Lord Watson.
Of particular relevance to this debate, the review’s terms of reference state that it will address:
“How we can encourage learning that is more flexible (for example, part-time, distance learning and commuter study options) and complements ongoing Government work to support people to study at different times in their lives”.
To reassure my noble friend Lord Holmes, the word “flexible” is very much in there.
My noble friend Lord Forsyth and the noble Lord, Lord Kerr, shared with us a glimpse of the findings of the important work that the Economic Affairs Committee has done. We agree with the committee that for too long young people have not had a genuine choice post-16 about where they study and what they study. For exactly that reason, we have overhauled apprenticeships to focus on quality and are fundamentally transforming technical education. As I said earlier, there will no doubt be an occasion when we can more fully debate the committee’s findings in this area.
The noble Baroness, Lady Kennedy, raised her concern about turning universities into businesses. Students and taxpayers all contribute to our higher education system and rightly expect value for money. Our reforms are continuing to open up access to higher education, enabling students to make more informed choices. However, I say to the noble Baroness that there is a balance to be struck, because part of that value is having the student experience at university—that is equally important—and I think that she has probably heard me say that before.
The noble Lords, Lord Rogan and Lord Griffiths, asked about funding arrangements in Wales and Northern Ireland. The review is looking widely at the evidence and ideas available, including those from other countries such as the devolved Administrations. The Government noticed with interest the recent changes in Wales.
I said earlier that continuing education, of course, extends beyond what we might commonly refer to as higher education. In order to respond to changes in the labour market, including from the impact of automation, which includes artificial intelligence, it is becoming increasingly important that people both upskill and reskill throughout their career. The right reverend Prelate the Bishop of Oxford and others rightly pointed out the changes that we must acknowledge and address to help the next generation and those beyond. The right reverend Prelate and the noble Baroness, Lady Bakewell, spoke about changes that have come about with the digital revolution. Through innovative industrial, skills and digital strategies, government departments are working together to ensure that the population is prepared to seize the opportunities that the fourth industrial revolution might bring.
Following a manifesto commitment, the Government announced at the Autumn Budget 2017 that the national retraining scheme would be set up by the end of the Parliament. This is an ambitious, far-reaching programme to drive adult learning and retraining. The noble Baroness, Lady Lane-Fox, and the noble Lords, Lord Haskel and Lord Watson, asked whether there is a cohesive plan or strategy. They also asked for an update on career learning. In response, I can say that the strategic direction of the national retraining scheme is being set by the National Retraining Partnership, which is a coming together of employers, workers and government. The national retraining scheme will include a series of phased interventions and pilots, starting this year. As part of these, the flexible learning fund pilot, launched in October last year, is designed to address barriers relating to the “delivery side” of learning. It aims to do this by supporting providers to develop and test ways of delivering accessible learning for adults with low or intermediate-level technical skills or those who simply lack basic skills.
The Open University, in partnership with the Bedford College Group, Middlesbrough College and West Herts College, was successful in its £1million bid to develop its “bringing learning to life” proposal. Targeted at adults in paid work, or those looking to return to the labour market following an absence, it proposes to expand its existing online platform, OpenLearn, to include functional skills English and maths provision.
I was going to go on to talk about apprenticeships but that subject did not crop up in the debate as much as I thought it might, so I will move on swiftly to some concluding comments. I should like to focus on an important subject raised by the noble Lord, Lord Puttnam—productivity. The positive effects of part-time and continuing education should not be considered through the prism of individual benefit alone. We should also bear in mind the impact that they have on our nation’s productivity and broader economy.
Education and training make people more productive and they contribute more to our economy as a result, which I think was the gist of the noble Lord’s argument. Some estimates value universities’ contribution to human capital in one year alone to be as high as £63 billion. This Government therefore, rightly, value the world-class higher education system that exists in England, and they are taking steps to transform the other post-18 education options that are available. At this point, perhaps I will sympathise with the noble Lord, Lord Addington, who said that we are “in the first act”. I do not know how many acts he has in mind as part of his play but, to reassure him and the House today, I can say that there is an awful lot of work to do.
As the largest provider of part-time higher education in this country, the OU plays an important role in this system as it approaches its 50th year. I have two or three more questions to answer but I fear that we are running out of time. I will therefore write to the noble Lord, Lord Haskel, and the noble Baronesses, Lady Blackstone and Lady Garden, on a number of questions that they raised. However, I hope that today noble Lords have been left in no doubt that we hold the OU in high esteem and will continue to support and applaud its successes.
Baroness Bakewell
My Lords, I thank the Minister for his response to this debate, which has been extremely vigorous and well informed. First, I have to honour my colleague, my noble friend Lady Bryan, who demonstrated in her maiden speech that her values and her heart are in the right place. I look forward to her expressing those values in future.
A lot of people in this room know a lot of things about further education. We are a room full of experts and we should not be ashamed of that: we know what we are about. We have high hopes that the Government, in their post-18 review, will tackle what many of us perceive as a major contributor to this country’s economy. I feel that there is passion and information, and plenty of suggestions to be read in Hansard and noted. I commend the report and look forward to its application.
Social Care: Funding
Baroness Brinton
To ask Her Majesty’s Government what steps they are taking to ensure that social care in England is adequately funded.
Baroness Brinton (LD)
My Lords, today, the country marks the 70th anniversary of the NHS, but another equally important anniversary next month is not getting the publicity it deserves. The Seebohm report, which laid the foundations for adult social care, was published 50 years ago in August. It was an important next step that set out the way for society to provide the right support for those in our communities who needed care, whether at home, in sheltered accommodation or in a residential or nursing home. I can remember, as a schoolgirl in the late 1960s, visiting a lady in my home town’s elderly care home. It was the old workhouse, with long wards and little communal space. It was a grim and desolate place to live. Most of the residents had no visitors. How different many of today’s services are, where the focus is on keeping our elderly active and independent for as long as possible, with rooms of their own for privacy. We know that good adult social care is an absolutely vital service that transforms people’s quality of life and that it is inextricably linked with the NHS. The sustainability of the NHS cannot work without a sustainable social care system.
Much has happened in the intervening 50 years since the Seebohm report but, shockingly, over the last few years much has also gone backwards. Many of us were encouraged when the 2011 independent Dilnot Commission on Funding of Care and Support proposed a carefully structured new integrated system with a cap on social care costs, which could enable people to plan for their old age. However, since 2015, the Conservative-majority Government—and now Conservative-minority Government—have dithered and delayed, repeatedly promising that they would sort out the social care funding problem. We still await the Green Paper promised in the Conservative manifesto last year, and have seen the side skirmish of the dementia tax, a form of inverse Dilnot which so outraged voters it was dropped by the Prime Minister mid-general election.
The aspirations for a sustainable social care system, fully integrated with the NHS, are, I think, all agreed in principle. However, the current funding mechanisms make it impossible to deliver. Local authorities have faced massive cuts to all services, making £6 billion of savings in adult social care since 2010. They are still being asked to make more each year at the same time as coping with increased numbers of elderly living in their communities and an increasing number of disabled adults and children. Worse, public health, one of Seebohm’s key pillars, has taken a double hit, with £200 million cut in 2015 and a further reduction of over £300 million proposed.
These numbers are shocking enough, but the reality of reductions in funding is a reduction in services for vulnerable adults, increased charges to clients and distressing waits for people to be discharged from hospital to receive care in their communities. It is also affecting our NHS, minute by minute, hour by hour, day by day. The A&E crisis, with ambulances queuing for hours, typifies how failing to tackle social care funding impacts on the NHS. I applaud the recent announcement by the Government to rename the Department of Health as the Department of Health and Social Care, but the renaming will do nothing without the funding. The King’s Fund has identified a local government funding gap of over £2.5 billion by 2020, which is close to the Local Government Association’s own estimates. The NAO said, as it published its recent report on the health and social care interface:
“The report finds that the financial pressure that the NHS and local government are under makes closer working between them difficult and can divert them from focusing on efforts to transform services. Short-term funding arrangements and uncertainty about future funding make it more difficult for health and social care organisations to plan effectively. Although the report acknowledges the recent announcement of extra funding for the NHS, additional funding has, at times, been used to address financial pressures, rather than to make essential changes to services or adopt new technologies”.
It is those efforts to transform services that are most affected.
That is why it is good to hear that a number of think tanks and other organisations are researching this. For example, Independent Age has commissioned a series of ground-breaking data to identify the costs of social care. The project will look at the social care funding gap going up to 2031 and hopes to offer financial options that can help provide the resources needed for free personal care, as well as reporting on how these funding options will affect different social groups across the regions. The data from these reports will highlight how much the social care gap will increase without intervention, but will also offer solutions on how the Government can fill the void by modelling various revenue-raising streams, such as changes to income tax, national insurance, an age-related levy, council tax, business rates and corporation tax. It hopes also to calculate the income distribution across local authorities for each funding option.
I have one main question for the Minister. The long-promised government Green Paper must have exactly this sort of data and research sitting alongside it, along with a promise of how services will be funded. This must happen as soon as possible—there can be no more delays. Can the Minister guarantee that there will be no further delays in bringing forward a proposal to provide a real, fully funded way forward? This is necessary because behaviour in both the NHS and the social care system is being driven by financial constraints, not by the needs of individuals.
One of the more shameful periods of our history has been the warehousing of children and adults with learning and physical disabilities, who were removed from their families and even their communities. That was the norm 50 years ago, and 30 years ago there was a recognition that this was—to use a parliamentary word—inappropriate. It was more than that: it was just wrong. Over the last quarter of a century, we have moved to a better—but not perfect—system of providing where possible tailor-made support to individuals. Surely that is what a society should do for its most vulnerable members. But cuts are now driving a different behaviour.
The disability champion Lucy Watts, who was awarded an MBE for her services to young people with disabilities, lives at home with her family, who help to provide her social care support, alongside a complex care package to meet her needs. In March, when her mother was taken into hospital with a brain tumour, Lucy was told by Castle Point and Rochford Clinical Commissioning Group that she would have to move into an elderly nursing home or a learning disability home instead of staying in her own home. She is neither elderly, nor does she have a learning disability. Worse, she was told that she would not be allowed to go out, not even to visit her mum in hospital, because as a resident she would have no right to be independent. There is a happy ending to Lucy’s story: the CCG backed down. I have to say that taking on one of the country’s best young advocates for disability did not work well for it, but there are increasing reports of new care packages not offering supported living at home but a cheaper, institution-based package that removes independence but may save the funders money.
Other behaviour is worrying too. Your Lordships may know that I work closely with the Disabled Children’s Partnership, and especially with parents of the most severely disabled children in Hertfordshire, who have been fighting to keep their short-break centre open. Nascot Lawn, funded by the CCG, is special because it offers proper medical support, which these children need. The Disabled Children’s Partnership report that short-break support and social care support, whether provided by the NHS or by local authorities, is being limited and cut across the country. In the case of one family, this has meant they cannot manage their child 24 hours a day, seven days a week, 52 weeks a year, and their child has now been moved to a long-term hospital. Instead of costing the state a few thousand pounds per annum, the cost is now closer to £250,000. Some CCGs now have funding people sitting on assessment panels. That is wrong. The law is clear: an education and healthcare plan for someone aged under 18 must address the needs of the child.
The better care fund, created by the coalition as a pilot for the sharing of good practice and for helping more funds to go into local authorities to ensure that people are moved out of the NHS and back into their communities with social care support, is important and remains an excellent interim plan. Since 2015, the Government have increased the funding going into it, but they have repeatedly delayed the new funding mechanism for social care. Specifically, the delays to the Green Paper, at the same time as announcements about the long-term funding of the NHS, demonstrate that there is a failure to grapple with the social care system in England and its systemic fault lines with the NHS.
Integration is essential, with new partnerships across England—real partnerships, with joint funding and shared KPIs. A long-term funding settlement, owned by government, Parliament, all political parties and the people, is essential if we are to have a social care system of which we can be proud.
Baroness Eaton (Con)
My Lords, I declare my interest as a vice-president and former chairman of the Local Government Association. I start by thanking the noble Baroness, Lady Brinton, for initiating this important debate.
Adult social care is a vital council service that helps to transform people’s quality of life. It supports adults of all ages with a range of different needs and it supports their carers. Despite the fact that it is so vital to the fabric of our society, there is a crisis in social care. We are grappling with the challenges of rising demand, people living longer and needing extra support in older age, care providers closing and contracts being handed back to councils. In my view, we need to invest new money into social care and we need to do it urgently. Despite this point being recognised across the Floor of this House, successive Governments have to date struggled to get political consensus on the long-term solutions to our national care crisis.
In my time as chairman of the Local Government Association, I was involved with many initiatives and we put forward solutions that in the end did not lead to positive change. From my many years’ experience in politics, I have to say that unfortunately sometimes our electoral cycle hampers our ability to deliver long-term solutions. But it does not need to be like that. Pension reform is a recent example of consensus and, of course, the post-war experience showed what was possible as our modern welfare state emerged.
This is not just about past precedent. Only last week, a cross-party group of Members from the Health and Social Care Committee and the Housing, Communities and Local Government Committee published their report on this issue. They called for new funding for adult social care and made it clear that bold decisions are needed if we are to solve the crisis facing the sector.
Last week’s commendable report is not the only one that has contributed to establishing cross-party support for a new way forward. The noble Lord, Lord Warner, led an excellent inquiry last year and his committee’s report, The Long-term Sustainability of the NHS and Adult Social Care, made a significant contribution to moving this conversation forward.
We also know that Members of this House and the other place recognise the need for additional funding for social care. A recent ComRes poll commissioned by the Local Government Association found that the vast majority of parliamentarians agree that additional funding should go to councils’ social care budgets to tackle the funding crisis. There is agreement among many national and local politicians that we need new money for social care. We need to work with the Government to deliver this.
As I said, there is now a clear political consensus that new money must go into social care via councils to help them to protect care services. Many council services, including housing, leisure and libraries, also help to save the NHS money. Without essential council services, we will almost certainly see further rises in demand and the accident and emergency crisis spiral to an unresolvable, year-round problem. Investing in social care will help to prevent crises in the NHS by reducing the number of people who are admitted to hospital in the first place.
Local government is absolutely essential to resolving the problem and helping people to live independent lives. Councils are the most efficient, transparent and trusted part of the public sector. They are effectively managing ever tighter budgets to maintain their track record of delivering quality services. The latest figures show that councils have reduced delayed transfers of care from hospital due to social care by 33% since July 2017. This has been at a faster rate than the NHS. This should surely help to persuade the Government to fully fund our social care system.
To conclude, I am sure that all sides of the House will welcome the new money for the NHS; the 70th birthday bonus funding is great news and much needed. We now need a similar funding boost for social care and prevention services. We need more money spent on preventing ill health. This is good for our communities and an efficient use of taxpayers’ money. I look forward to the publication of the Government’s Green Paper on social care in the autumn and with it, I hope, new money for social care services and new innovations to create a system fit for the people of the 21st century.
Lord Parekh (Lab)
My Lords, I congratulate the noble Baroness, Lady Brinton, on securing this debate, although it is slightly overshadowed by the following debate, which seems to be concerned with the same issue. As a result, attendance in this debate is slightly thinner than it should be. Nevertheless, the noble Baroness has addressed an important question and I am happy to participate in the debate.
For purely historical reasons, healthcare and social care have been separated in Britain. Both were established in 1948 but under different Acts and based on different operational and funding models. The NHS was largely free at the point of delivery, whereas social care was needs or means tested. That created inequality. For example, a cancer patient could get full state funding, whereas somebody suffering from dementia could not. The question is how, in the eyes of neutral people, to justify this moral or medical asymmetry.
There is a further question. NHS funding came from central government taxation, whereas social care funding came from non-ring-fenced local authority budgets or private individuals. That was contingent, as local budgets change a great deal and do not have the same degree of certainty as central government funding does. For all those reasons, we have two separate streams with different consequences. The lack of integration between the two has cost quite a bit of money. In October 2017, there were 145,000 delayed days, as they are called, when hospital beds are taken by people for whom no home help can be found for them to be discharged to. There is a need to look at this binary distinction and see how the two can be brought together.
Need will be greater, because the population is ageing and younger people with a disability are living longer. The number of adults aged 85 or over has increased by 31%, whereas the population as a whole has increased by only 8%. So the question of social care is important. How should we handle this? What are the means to deal with it? Should we look to central taxation, which would be my suggestion? The question is whether such care should be entirely free at the point of delivery, in the same way as healthcare. I am not entirely sure that it can be, for at least two important reasons. The first is the issue of intergenerational fairness. Older people are wealthy, own houses, have assets and savings, and receive pensions, while many young people are paying off student loans, have family commitments and face higher housing costs, so they are not as well off as some elderly people. The second reason is that the personal care component of social care is different from the other components, and while that care can be guaranteed by the state, factors such as the accommodation cost component of social care perhaps need not be. We have to discuss these matters because they involve issues of moral principle. The two parties are bound to disagree, but it is important to build a cross-party consensus in this area.
There is a further question: when social care payments are made, what are the best ways of handling that? You could give cash to the individual being cared for, and in turn she or he might give that cash to the friends and relations who work for them. There are ways and means of handling social care and of getting the funds required, but again, some kind of cross-party consensus needs to be established. For me, that is a priority.
The Lord Bishop of Rochester
My Lords, I too join in with the general rejoicing on this the 70th anniversary of the NHS, but as others have observed, I am glad that this debate has been brought forward by the noble Baroness because it is a necessary counterpoint to that. I join the noble Lord in expressing slight surprise at how few people have wanted to contribute to this debate, but that does give those of us who are speaking a little longer to do so.
As the recent National Audit Office report, referred to by the noble Baroness, into the interface between health and social care indicates, the two areas are inextricably linked. Indeed, the dividing line can be quite hard to define, and that is one of the difficulties. For example, an exchange earlier today in your Lordships’ House touched on the different regimes in the two different worlds in terms of pay and conditions and the issues that that raises. That is but a single, tiny dimension of the challenge of joining up these two worlds. In a speech in March the Secretary of State talked about,
“whole-person integrated care with the NHS and social care systems operating as one”.
That is of course a laudable aspiration which many of us have already affirmed. He also spoke of the desire to find a sustainable funding model, and therein lies the challenge given the tendency over many years for social care always to find itself the poorer of these two siblings. Along with others, we await the Green Paper and what it might say.
Perhaps I may approach this subject in a slightly different way from other speakers by focusing on two specific areas in which I have some experience. As Bishop to Her Majesty’s Prisons, a few months ago I visited HMP Stafford, which is a prison with a growing elderly population. Carers commissioned by the local authority go into the prison to provide personal care for elderly prisoners, and when I met the governor and his senior team they were thinking positively and practically about adapting buildings and regimes to provide, in effect, a care home within the prison. As the Prisons and Probation Ombudsman observed in a report last year,
“prisons designed for fit, young men must adjust to the largely unexpected and unplanned roles of care home and even hospice”.
The challenge in HMP Stafford was clear, and while I commend those on the ground there for seeking a response, it did feel rather as if they were working on their own to find solutions; perhaps something more substantive, structured and deliberate is needed.
Some 17% of the prison population is now aged over 50. While, dare I say it, that in terms of your Lordships’ House that may not seem very old, it is the case that people in the prison population by and large age 10 years in advance of the general population, so it is a serious issue. A possible way forward was suggested when, later in that series of visits, I went to HMP Oakwood where I met fit, young prisoners who were offering informal care and support to older, infirm prisoners. While not wanting to let the public purse off the hook, I did wonder whether prison training programmes might be extended to include training and qualifications in care, thus enabling properly trained prisoners formally to support those prisoners who are their neighbours and in need of some care. Not only would the training do that, but it would give those prisoners a qualification which would enable them to find employment on release from prison. Perhaps the Minister might care to discuss that in due course with colleagues in the Ministry of Justice.
I also wonder whether there is a mechanism whereby local authority funding formulae might be adjusted where there is a prison within the local authority area which houses a disproportionate number of elderly prisoners, given the demands that that places on the local authority concerned.
My second area of comment concerns partnerships between the voluntary, community and faith organisations with statutory and other agencies. Voluntary action and activity does not mean that it is unprofessional, nor does it mean that it should come on the cheap. Many voluntary and community sector organisations employ seriously professional people at proper wages. There is also, however—I hesitate a little in talking about this because again I do not want to let the public purse off the hook—a role for that which is voluntary, in terms of time and remuneration, where people offer their expertise and their skills.
In my own diocese of Rochester, we are working with a national charitable initiative called “The Gift of Years”, with funding from the Henry Smith Charity, to establish a network of Anna chaplains and Anna friends—Anna being an elderly woman mentioned in the gospel of St Luke. Our particular focus is the pastoral care of those living with dementia and that of their carers. After a relatively short period, we now have more than 30 trained and commissioned volunteers. We have one paid professional specialist, funded by the Henry Smith Charity, and our first remunerated dementia chaplain who is funded locally by churches in Bromley. On the partnership side of this initiative, we are finding that—surprise, surprise—the local authority is increasingly beating a path to our door. There are opportunities to work closely with other organisations such as the Abbeyfield housing society and the Heart of Kent Hospice, where our pastoral carers go in to offer support to residents and patients, and of course to their families.
I hope that as government policy develops in this area and as the Green Paper is brought forward, some attention might also be given not just to, as it were, the voluntary and community sector in its big institutional forms but also to the role of local initiatives and how the relatively modest funding that is needed for them might be provided in various ways, possibly by means of grant funds for which people could apply.
I believe that there may be patterns in both of the examples I have given for other places and in other dimensions of care. In relation to the Anna chaplaincy model, it is worth noting that many of those who offer their time and skills as chaplains and friends are themselves relatively elderly people. They find huge fulfilment in serving the needs of those in their own communities.
Baroness Jolly (LD)
My Lords, I declare my interests as set out in the register as chair of a charity providing services for adults with learning disabilities, and I thank my noble friend Lady Brinton for securing this important and timely debate.
The social care sector provides invaluable support to some of the most vulnerable adults in society: those who are old, frail and unable to look after themselves; those with a learning or physical disability or suffering from mental health issues or alcohol and substance abuse; and people with severe dementia. Their care is delivered thanks to the recommendation made in the Beveridge report and the subsequent legislation, but more of that in the next debate.
Learning disabilities account for one-third of the adult social care provision in England, and it is also the fastest growing sector. In 2005, only six of the 151 local authorities in England spent more on care for working-age adults than they did on care for the elderly. By 2017, 57 authorities did so. Adults with learning disabilities are living longer, although, sadly, they will still die 28 years younger than non-disabled adults. I would say to the right reverend Prelate that there are also many people with learning disabilities in prison.
In general, people with learning disabilities are leading better lives. They are moving out of institutionalised, health-based settings into supported living settings in the community. Although supported living undoubtedly delivers better life and health outcomes, it is also a more expensive option for providers. This increase in costs is increasingly not being factored into the rates paid by local authorities.
The funding gap in adult social care has been widely reported and debated in your Lordships’ House on several occasions. Several organisations have now agreed that there will be a funding gap of around £2.8 billion by 2019-20 unless we have decisive action from government. As financial pressures—such as costlier methods of support, unfunded increases in the national living wage and the apprenticeship levy and the uncertainty surrounding historical liabilities for sleep-in pay—all continue to plague the sector, a sustainable funding solution becomes increasingly vital.
The learning disability sector would like to see an annual uplift in funding of 5% each year to remain financially viable. According to the IFS, the total amount spent on adult social care in 2015-16 was £16.8 billion. To remain stable, the sector would have needed an additional £840 million for 2016-17. Instead, the IFS reported a cut of £300 million, with total expenditure falling to £16.5 billion in 2016-17. The CQC has already reported that the social care sector is at “a financial tipping point”. Earlier this year, the Government were warned that the proportion of providers in the learning disability sector now reported to be running at a deficit has more than trebled, rising from 11% in 2016-17 to 34% in 2017-18.
The sector was denied a place in the social care Green Paper, being instead part of a so-called parallel body of work that is to encompass all working-age adult social care, while the Green Paper focuses almost exclusively on older people. With the recent announcement that the Green Paper is to be postponed until the autumn and with little public detail on the parallel body of work, local authorities and social care providers alike are becoming more concerned about the financial viability of essential support services for vulnerable adults. In their recent joint report on the future of adult social care, the House of Commons Health and Social Care, and Housing, Communities and Local Government Select Committees called on the Government to widen the scope of the Green Paper to incorporate all of adult social care. When can the sector expect to hear more concrete proposals about the parallel body of work? What are the work streams? Who is on the panel? Who has given evidence and when might it report?
All of this uncertainty is overlaid on the anticipated costs as a result of sleep-in. For the sector as a whole, this should be around £400 million. I appreciate that the Government are now engaged with this situation and the results of a judicial review are awaited, so any way forward is unclear, but I would be grateful if the Minister could give me details of what consultation was done on these regulations, or even an impact assessment. If she does not have the details, I would be grateful if she would write to me and place a copy in the Library.
The funding situation is now so critical and our care and support system is in crisis. This message comes from right across the sector, the CQC and the LGA. Of course, any failure in the social care system impacts directly on the ability of the NHS to function effectively. We also need interim funding to stabilise the system as a whole. Then, new money will be needed until well into the next spending review period in order to be sustainable and to maintain quality. Without funding, we risk implementing Green Paper reforms to a system that is too destabilised by financial pressures.
Do the Government have plans to deal with failing providers, and do they understand that the tipping point is nearer than ever before? How many organisations will need to fail before the Government come out of their corner to defend the most vulnerable people in our society?
Lord Beecham (Lab)
My Lords, I refer to my local government interests and I congratulate the noble Baroness, Lady Brinton, on securing this debate. When I chaired Newcastle’s social services committee in the 1970s, we trebled the meals on wheels service and doubled home care provision. We created a welfare rights service—one of the first in the country—that is now helping citizens in Newcastle to receive £8 million of benefits, and we improved residential care. Forty years on, we see a service struggling to cope with the growing needs of an ageing population, while the council’s budget, like those of councils up and down the country, has suffered savage cuts. Never before in a long political life have I witnessed Conservative councils, and the national local government bodies they lead, being as critical as they now are about the policies of a Conservative Government and their impact on local authorities and communities.
The funding cuts have been dramatic. Critically, they include £890 million in preventive services, including measures to avoid the need to admit people to hospitals, thereby adding to the problems of a radically overstretched NHS. Yet the Government expect councils somehow to reduce the number of what are described as “social care attributable delayed transfers of care”. As the LGA points out, such delays are a symptom of the problems of pressure on the NHS, not its cause. Even if the funding gap were closed, this would still leave the service significantly less well funded than in 2010, before taking into account the increasing demand of an ageing population and greater recognition of the need to tackle issues such as mental health in adults and children, which have manifested themselves increasingly over time.
Meanwhile, the Association of Directors of Adult Social Services points out that, in addition to an extra £2 billion by 2020,
“just to stabilize the market and to enable key statutory duties to be fulfilled”,
an additional 29%—£3 billion—would be required to bring social workers’ pay into line with their NHS counterparts. The 1.5 million people working in social care, as the association states, deserve such parity of esteem and should have a common structured training programme and a defined career pathway.
There are also issues, as the LGA points out, with the public health budget, which has also been hit hard, with cuts of £200 million a year and plans for a further reduction of £331 million. Such cuts, in what is essentially a preventive service, are likely to generate more demand for the NHS and social care, in addition to impacting on the lives of those the service should be protecting and enhancing. Furthermore, the early intervention grant has been slashed by £500 million since 2014, with an anticipated further fall of £183 million by 2020.
The prevention of hospital admissions per se demands a higher focus. The LGA cites evidence from a Public Health England report on falls prevention, demonstrating that for every £1 spent on assessing the home and modifications for elderly people—I declare my interest in that respect—£2.17 is saved on primary and secondary care while reducing hospital admissions by 23%. Of course, this group is growing. As Age UK reports, 1.2 million—12.5% of the age group—are living with unmet care needs.
Alarmingly, less than a third of directors of adult social care are confident that their authorities will meet their statutory duties this financial year. Councils and other providers, including charities, have hanging over them potentially large claims for payment of the national minimum wage for care workers on sleep-in shift, with HMRC pursuing providers for up to six years’ back pay. Charities estimate that HMRC could be seeking as much as £400 million to meet this bill. Given that the Government instructed local authorities to make such payments only as recently as last July, will they meet this cost? If not, what is their estimation of the impact on councils and providers?
The sector, as ADASS has pointed out, is fragile, with the percentage of the budget of county and unitary authorities spent on social care rising from 34% in 2010 to 38% now. There is concern that the growth in the number of older and younger adults with complex needs is likely to cost an additional £448 million this year. In addition to that, the so-called national living wage will cost around £585 million—essential if quality staff are to be retained and recruited. On top of all this, the expectation is that by 2025 another 350,000 people will need high levels of social care from councils.
Moreover, although the return of public health some five years ago from the NHS to local government and Public Health England is welcome, there are profound concerns about funding. Councils suffered a £200 million cut five years ago and now face a further cut of £331 million, while the early intervention grant faces a further cut of £183 million by 2020, in addition to the £500 million cut since 2013. At the time, the Conservative-led Local Government Association protested that this risked underresourcing councils in delivering early support to the children, young people and families who needed it most. It warned that councils would be,
“less able to provide support for children and families affected by disabilities or existing/potential development delays”.
All of this will surely generate greater needs and greater costs.
In Newcastle, where we are losing £280 million a year, the number of people receiving home care has fallen from 3,000 to 2,000, while adults with learning difficulties are getting four hours less of support per week. We have 71 fewer social workers than in 2014—a 12% reduction—while there has been an 86% increase in the number of safeguarding alerts. The Government have belatedly announced an increase in funding for the NHS, albeit less than is needed. When will they realise the need to increase funding for social care substantially, which would contribute to reducing the burden on the NHS? I join Sir David Behan, chief executive of the Care Quality Commission, in,
“calling for a bold and courageous settlement for future social care because we must address the quality and experience of care that older people receive”.
I would add all other people in need of such care to that.
Baroness Manzoor (Con)
My Lords, I thank the noble Baroness, Lady Brinton, for bringing this important debate on social care funding to the House. I thank all noble Lords for their valuable contributions. I want to take this opportunity also to personally wish the NHS and our social care system a happy 70th birthday. I thank all the people who work in it for their commitment and dedication in often difficult and challenging circumstances.
Everyone is entitled to good-quality care and support; as the noble Baroness, Lady Brinton, and the noble Lord, Lord Beecham, said, they are vital. We recognise that, as the noble Lord and others said, there are challenges, and we are doing something about them. Although 81% of adult social care providers are rated “good” or “outstanding” by the CQC, as of March 2018, it is completely unacceptable that standards in some settings fall below those rightly expected by care users and their families. That is why the Government have introduced tougher inspections, led by the Care Quality Commission, to make sure that services meet quality and safety standards.
The noble Lords, Lord Parekh and Lord Beecham, the noble Baroness, Lady Jolly, and my noble friend Lady Eaton stated that social care spending has stopped or has gaps in funding, but over the years, more money has been spent on social care. However, the growing population and the fact that people—including people with disabilities—are living longer are contributing factors, as acknowledged by my noble friend Lady Eaton. The noble Baroness, Lady Brinton, acknowledged that in the short term, the Government have given councils access to up to £9.4 billion more in dedicated funding for social care over the three years up to 2019-20. This means that overall funding for social care is increasing by 8% in real terms over this spending review period.
The additional resources are helping councils to commission care services that are sustainable and diverse, offering sufficient high-quality care and support for people in their areas. As I have already said, I recognise that there is much more to do, as stated by the noble Lord, Lord Beecham, the noble Baroness, Lady Brinton, and my noble friend Lady Eaton. Performance is not just about money. Funding will be supplemented with targeted measures to ensure that the areas facing the greatest challenges improve services at the interface between social care and the NHS.
My noble friend—he is a noble friend—Lord Beecham mentioned Newcastle. Thanks to a range of government actions, Newcastle-upon-Tyne received an additional £20.4 million for adult social care in 2018-19. We have already seen a real difference to services across the country. Social care-related delayed transfers of care had been rising year on year between 2014 and February 2017, but since taking action last year, we have achieved a reduction of 40%. Some councils, such as Darlington, Slough and Telford, had no delayed discharges, which I know my noble friend Lady Eaton will be pleased to hear.
Looking ahead, it is right that social care funding be agreed alongside along the rest of the local government settlement at the forthcoming spending review. Decisions on future reforms must be aligned, which is why we will publish the Green Paper in the autumn, around the same time as the NHS plan. As identified by the noble Baroness, Lady Brinton, yesterday’s NAO report also made it clear that,
“the changing needs of the population require changes to the way health and social care services are organised and delivered”.
I cannot give the guarantee that the noble Baroness requested regarding the timing of the Green Paper, but I will return to some of the issues that she raised. The NAO also stated that carers and those who need care must be put at the centre of any reform. The Green Paper will take its report into account.
The noble Baroness, Lady Jolly, and the noble Lord, Lord Beecham, raised the issue of the Competition and Markets Authority report, which also presented important findings on the care market, the need to strengthen consumer protections and the importance of supporting people to make choices about their care. Having accepted all of the CMA’s recommendations earlier this year, we are now working closely with industry, wider stakeholders and the CMA through the implementation phase. Those issues will be further addressed in the Green Paper.
As stated by a number of noble Lords, through the better care fund, local areas voluntarily pooled more than the minimum required in both 2015-16 and 2016-17, taking the total to £5.3 billion and £5.9 billion respectively. In 2015-16, 90% of local area leaders said the better care fund had already had a positive impact on local integration. I agree with the noble Baronesses, Lady Jolly and Lady Brinton, that people with disabilities and people of working age with care needs face a number of challenges. As indicated by the noble Baroness, Lady Jolly, we are taking forward a piece of work—led by the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government—that will consider any issues specific to working-age adults and therefore not covered in the Green Paper. We will set out the results of this work in due course. I will write to the noble Baroness, Lady Jolly, to answer her specific questions on impact assessments and the consultations that have taken place, and place a copy in the Library.
As mentioned by a number of noble Lords, the recent Select Committee report, Long-term Funding of Adult Social Care, suggests that a tax on the over-40s or a social care premium similar to the German-Japanese model is the right way forward. The Government are committed to ensuring that everyone has access to the care and support they need, but we are clear that people should continue to expect to contribute to their care costs as part of preparing for later life. I can confirm for the noble Baroness, Lady Brinton, that the Green Paper will set out proposals for a sustainable system. Reforms must be affordable and fair across generations, including to working-age taxpayers. As noted by the right reverend Prelate the Bishop of Rochester, the Green Paper will bring forward proposals to build on the seven principles set out by the Secretary of State: quality and safety in service provision; whole-person, integrated care with the NHS and social care systems operating as one; better practical support for families and carers; and a sustainable funding model for social care supported by a diverse, vibrant and stable market. However, we are looking at the exact proposals in the Select Committee’s report and the Government will of course respond in due course.
Noble Lords did not mention the parliamentary commission, but I want to say that we welcome parliamentarians across the House and people in the NHS and social care coming together to look at how we can improve and make a more sustainable system.
The right reverend Prelate commented on informal carers and voluntary work. The Government are committed to continuing to support carers to provide care as they would wish, and to do so in a way that supports their own health and well-being, employment and other life chances. On 5 June, the Government published the Carers Action Plan which sets out a cross-government programme of targeted work to support carers over the next two years. As noble Lords have stated, a sustainable future for social care will simply not be possible without focusing on how our society supports carers. They are vital partners in the health and care system. I would be delighted to look at the Ministry of Justice system and learn from that experience. Indeed, as the Minister is here, I will ensure that that system is also drawn to his attention.
The noble Baronesses, Lady Brinton and Lady Jolly, and the noble Lord, Lord Beecham, also identified NHS mental health services. Of course, mental health services are important and are available for people with poor mental health, including carers. The improving access to psychological therapies programme provides treatment for adult anxiety disorders and depression in England.
My time is nearly up. I think I have answered most questions and as I said, I will write to the noble Baroness, Lady Jolly, about the two questions she asked. If there are any other questions outstanding, I will write to noble Lords and put a copy of my response in the Library. I conclude by thanking all noble Lords for their contributions and I look forward to us working together to find a long-term, sustainable solution—a sustainable way forward—to meet the care needs of some of the most vulnerable people in our society. I end by saying to the noble Baroness, Lady Brinton, that I was very sorry to hear Lucy and her family’s story. Those sorts of issues should not be in the system. I acknowledge that they are and we will try to sort them out. Thank you.
The NHS
(6 years, 5 months ago)
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Lord Darzi of Denham
That this House takes note of the creation of the National Health Service in 1948, and the case for integration of health, mental health, social and community care to equip the National Health Service for the next 70 years.
Lord Darzi of Denham (Lab)
My Lords, in opening this debate, I declare my interest. I am a practising surgeon in the NHS at St Mary’s Hospital, Paddington, and the Royal Marsden and am the chair of surgery at Imperial College. I proudly sit as a non-executive director of NHS Improvement. Over the past 10 months, I have led an independent review of the health and care system with the Institute for Public Policy Research.
As a surgeon and a former Health Minister, it is a great honour to speak in this place to mark the 70th anniversary of the National Health Service. The NHS is this country’s most treasured institution. It touches our lives at times of the most basic human need when care and compassion matter most. This is a time for reflection to celebrate the institution and give thanks to NHS staff for their service to our nation, and to look to the future.
The NHS is the expression of the moral principle that no one should be denied healthcare because of their means—the idea that the provision of healthcare should be based on need and not the ability to pay. Most people alive today cannot recall the time before the health service was created. With each passing year, the number of people who can recall the pre-NHS era recedes, but if we are to secure its future we must never forget what preceded it.
A friend recently told me the story of his family. His parent worked in the textile mills in Lancashire that have long since disappeared. In the simple kitchen there were two sugar bowls. One was for the sugar and the other for the doctor. It was where they would save a penny or two whenever they could so that, if any member of the family got sick, they could pay for a visit to a doctor. Fear of falling sick was a normal part of daily life in Britain. Illness was the surest path to poverty and destitution, not just for the individuals but for whole families. The founding of the NHS took that fear away for millions and it is a fear that those of us born since have never known and can only imagine.
The NHS was the greatest achievement of the post-war Labour Government. We owe an eternal debt of gratitude to Nye Bevan for his vision, passion and determination to establish the health service. He memorably described the NHS as taking the place of fear. It remains one of the most extraordinary achievements of any society anywhere in the world. It is on occasions such as the 70th anniversary that we must make and remake the case for comprehensive, universal healthcare, free at the point of need for all.
Never let anyone tell you that we cannot afford the NHS. The moral principle of universal access to healthcare is shared by all people everywhere. Those countries that have made it a reality have done so in different ways, but by far the most efficient, dignified and lowest cost is to create a universal service free at the point of need funded by taxation. Private insurance and social insurance systems are much more costly. Those who argue that we cannot afford the NHS are seriously wrong. It is a fundamental error of logic to say that something is unaffordable so we should make the move to something more expensive.
The NHS is funded by us all. It serves each of us and it reflects the best of us. The health service employs 1.5 million people across the four nations of the United Kingdom—that is 5% of all working people in our country. The NHS is its people, not only the doctors and nurses but clinicians of all kinds and the porters, cooks, cleaners and, yes, the vital managers and administrators too. Spending a day working as a porter in the NHS was one of the most illuminating moments of my career. Every member of Team NHS matters. Every one has a contribution to make and each is valuable. I pay tribute to the NHS employees of today who are my colleagues, and to the NHS staff of previous generations. On this day of thanksgiving, we owe them a lasting debt of gratitude.
I have worked in the NHS for longer than I have been a citizen of this country. In a time of great anxiety, I pay a special tribute to the citizens of other countries who have helped to build our NHS throughout its existence and remain the backbone of it today. From the Windrush generation to the European citizens and nationals of every race and creed, from every corner of the world today, they have made an immeasurable contribution. Let that never be forgotten.
NHS staff work at the frontiers of innovation because healthcare exists at the limits of science. This country is a scientific superpower with an extraordinary record of discovery and invention, yet in recent years we have fallen behind on investments in R&D. R&D is the engine of innovation yet R&D spending as a share of GDP has been falling while our competitors have invested more. We need a new commitment to be at the top quartile of advanced countries for R&D investment. The future prosperity of our country depends on it.
Many of the most important medical discoveries took place in this country, often through partnership between the NHS and the universities. No matter the challenges, we are constantly finding new ways to treat disease and soothe pain and suffering. That means that high-quality care is constantly a moving target: to stand still is to fall back. What energises NHS staff is relentlessly improving the quality of care they deliver to their patients. In my review of the NHS with the IPPR we found that, on a wide range of measures, the NHS has maintained and improved the quality of care it provides. Fewer people are harmed and more people are cured than ever before. There is a huge amount to celebrate and to be proud of, yet we should frankly acknowledge the difficulties the health service has faced. The past decade has been the most austere since the health service was founded. Waiting times have risen considerably and the system has been subject to needless destructive reforms. The NHS is not failing, but it is fragile.
A properly funded NHS is the foundation on which a fair, cohesive and inclusive society is built, so the new funding settlement announced by the Prime Minister, the Chancellor and the Secretary of State for Health is very welcome. My friend the noble Lord, Lord Prior, and I, together with the IPPR, recommended a 3.5% annual funding increase: the Government came close, with 3.4%. However, the settlement did not include public health, capital investment or education and training. Each of these is vital and the Government must now deliver on them too.
Securing the NHS is an eternal task. It is no more perfect than life itself. That is why new investment must be joined with reform. Together with the noble Lord, Lord Prior, and the IPPR, I set out a 10-point plan for a 21st-century NHS. At its heart is a new vision, what we call “neighbourhood NHS”, where services are organised around groups of patients with broadly similar needs, rather than groups of professionals with broadly similar skills. We argue that there should be a new option for single integrated care trusts, able to take responsibility for all the health and care needs of a population.
Warm words on mental health must be followed by bold actions. Parity of esteem should mean parity of service. Bringing care closer to people is a crucial principle for a modern NHS, yet for too long the NHS has said it would invest more in care closer to people yet continues to do the inverse of its stated strategy. Each year we say that resources will shift and each year they flow upwards towards hospitals rather than outwards towards communities. That is why we must lock in more spending on primary, community and mental health services each year in the decade ahead.
As we celebrate the past on this anniversary day, we must also look to the future. It is our duty to seize all the technological opportunities that this new era offers. There must be a tilt towards tech to create a digital-first health and care system. That will demand investment in digital infrastructure, improved data sharing and embracing full automation. Many people fear that automation will destroy jobs, but it is much more likely to reshape them by taking away mundane tasks that fill most of our time working in the NHS. This will release more time to care and give more space for clinical reasoning, for research and for innovation.
I have spent decades developing robotic surgery. The robots have yet to replace me, but they have helped me deliver higher-quality care to my patients. For all these improvements to happen, we need a radical simplification of the system. It has become impossibly complicated and is in desperate need of change. I therefore welcome the Prime Minister’s commitment to bring forward legislative change. Tinkering at the edges will not be enough: we need fundamental reform. Above all else, we need to confront the great social challenge of today, which is social care, as we heard earlier.
When the NHS was founded, life expectancy for men was 66 and for women it was just 71. Today, it is 79 and 83 respectively. Today, one-quarter of NHS beds are occupied by patients who are medically fit to go home, if there were good enough support for them. More than £3 billion a year of NHS money is wasted by delayed transfers or transitions of care. If Bevan were designing the health service today, it is unimaginable that he would have excluded social care. We must now extend that simple, noble, brilliant principle of care based on need rather than the ability to pay from the NHS and apply it to social care.
Social care reform has become the third rail of British politics: any politician touching it swiftly expires. Between now and 2030 the number of people over the age of 65 will increase by about one-third and the number of those over 85 will nearly double. At the same time, the working-age population will increase by just about 3%. If we do not act now, a heavy burden will fall on families to take care of their relatives. Since 2010, social care has been slashed. Despite rising demand, state social care has plummeted by 27%. That does not mean that less care has been provided. There has been a dramatic rise in informal care. Critics will argue that the older generation should contribute more of their wealth to pay for social care, particularly the wealth locked up in housing, but tying social care reform to the thorny issue of wealth inequality and taxation is wrong. If we make that hurdle for social care reform, there will be no progress at all. Surely, the level of personal wealth is a better basis for wealth taxation than the need for social care.
Better social care means that families spend less time on functional tasks and more time on relationships. If we want a less lonely and more dignified future for our ageing society, now is the time to act. There could be no better birthday present for the health service. It has been a privilege for me to open this debate, but it has been the greatest honour of my life serving the National Health Service for nearly 30 years. In 30 years from today I hope to see the NHS’s centenary. It is a great comfort to know, for me just as for all of us, that the NHS will be there to provide care and compassion when it matters most.
Baroness Manzoor (Con)
My Lords, to assist the House, I say that Back-Bench speeches are limited to four minutes so, when the clock strikes four, time is up.
Lord Ribeiro (Con)
My Lords, I thank the noble Lord, Lord Darzi, for introducing this important debate. It is a privilege to follow him, as a fellow surgeon. The debate marks the 70th birthday of the NHS and the social care system, and the role that Aneurin Bevan played in it. Making our health service free at the point of need and use while social care remains means-tested has created an unfair system. Equal opportunities and the emancipation of the workforce has meant that an army of carers which used to exist to look after one’s own is no longer there, and increasingly we turn to care homes for our elderly.
The noble Lords, Lord Darzi and Lord Prior, in their excellent report Better Health and Care for All, published in June, focused on social care, public health and life sciences. This debate makes the case for integrated health, mental health, social care and community care. The creation of a Department of Health and Social Care this year is a welcome first step in recognising the importance of integration. This report makes the case for releasing time for health professionals to care and makes a plea to trust the judgment of professionals. These words are welcome in a health service where professionals feel that top-down management calls the shots, rather than those at the coalface—that is not meant to be a reference to Tredegar.
The challenge for government is to extend the principle of need and not the ability to pay to social care and to fully fund the service as part of a new social contract between citizen and state. We await the Government’s Green Paper on social care, alongside the NHS plan, in the autumn with keen interest, mindful that in the past 20 years, with 12 Green Papers and White Papers and five independent commissions, successive Governments have kicked the can down the road when social care reform is considered. The Government accepted the proposals in the Dilnot report of 2011, albeit with a different cap, yet in 2018 we do not have any action on them. I am sure that my friend, the noble Lord, Lord Warner, will say something about that in his speech. Can we expect a definitive statement on this, along with the Green Paper, in the autumn?
There also needs to be a paradigm shift in the model of urgent and emergency care, the workforce to deliver it and the contribution of patients to manage their own health. The days of “doctor knows best”—let alone politicians or managers—are over. As chairman of the Independent Reconfiguration Panel, which advises the Secretary of State for Health on contested service change, I know that a sound clinical case for change is necessary but not sufficient to achieve change. For that to happen in the future, the views of patients and the public must lead the decisions about their health and healthcare. The challenge, as always, is how to achieve that in a meaningful and effective way.
Lord Winston (Lab)
My Lords, it is a great pleasure to congratulate my noble friend—and respected colleague at Imperial College—Lord Darzi on the outstanding way he introduced the debate. I was just talking to the noble Lord, Lord Reid, in the Bar and he said that sometimes you tear up the speech that you have written. This is one of those occasions.
At 8.40 am today, my grandson was born at Queen Charlotte’s and Chelsea Hospital under the National Health Service. My daughter had a horrendous pregnancy four years ago. I went through every single red light in London, I think, on my way to Queen Charlotte’s, when she had the most serious obstetric emergency and could have died. In fact, both she and the baby, Ellie, survived and are well, and she had this last pregnancy by elective caesarean section. It is striking that the National Health Service has been an example of the most amazing care. When I took her into Queen Charlotte’s the first time, she was delivered within 13 minutes of arrival on site and they did not even recognise me, even though I had helped design the building in which she was being delivered. That is a great credit to the health service.
Today there was a slightly different welcome when I drove up to the car park. It was completely blocked by television cameras, with various news media filming Queen Charlotte’s in all its panoply of glory, accompanied by wonderful, syrupy comments about the National Health Service. While I was hoping to hear a baby cry in the operating theatre next door, I was watching the coverage on television as an example of exactly what we do not need. My noble friend Lord Darzi was completely right, in the humble way he introduced the debate, to point out how magnificent the health service has been, but it is also important for us to be realistic. There is a major problem that we have to face and it is often easy to be really quite untruthful about the impact.
We are not having a proper debate about the health service in this country. I mean no disrespect to the Prime Minister or anybody else but we cannot continue on handouts. Both parties have been equally responsible. We always claim on this side that we invented the health service. I remember that when the dreadful internal market was brought in by Margaret Thatcher, Frank Dobson, the shadow Health Minister, promised he would abolish it. He did not when we came into power. We still have that iniquitous system, which is costing the National Health Service millions in bureaucracy and all sorts of other things, and of course resulting in health inequality, with the postcode lottery and many other examples.
We have to recognise that we need to have an honest debate and the only way we can do this is to depoliticise the system and the argument. We have to recognise that on all sides of this House we agree about the value of the National Health Service. We all realise that it is a remarkable and unique but fragile organisation. We need to do something about recognising that first we have to agree on a proportion of gross domestic product to understand how we are going to fund it before we consider taxation or any other form of spending. We have to understand how much it actually costs and at the moment, with that internal market, sadly, we do not know that. That is a major problem for us and something that I hope we will look at.
My noble friend Lord Darzi reiterated a very important point that I made in a debate about a month ago when I pointed out the importance of academic healthcare and the academic science centres. This is something which really is unique in the health service and unless we continue with that aspect of science, there will be a problem. So we have to weigh that in the balance of how we fund the health service in the future.
Baroness Tyler of Enfield (LD)
My Lords, I congratulate the noble Lord, Lord Darzi, on securing this extremely timely debate, and pay tribute to the wonderful work and care of all staff in both the health and social care sectors. I will start with my favourite Bevan quote before someone else gets it in. Back in 1948 he said:
“Illness is neither an indulgence for which people have to pay nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community”.
How do we reinterpret this incredibly important founding sentiment of the NHS in the modern age and over the next 70 years?
Recent polling by the King’s Fund shows that the British people have a great deal and pride in and good will towards the NHS. Despite this, securing proper long-term investment to achieve a fully integrated health and care service has sometimes felt like pulling teeth. Yes, the Prime Minister announced that the NHS would get a 3.4% yearly rise for its birthday and of course that is to be welcomed, but we cannot ignore the fact that the often-cited 4% necessary to even maintain existing standards, let alone improve and transform services, is still some way off. Sadly, as others have said, this new long-term funding settlement has so far ignored social care and public health and there is no clarity on what proportion of this money will go into mental health care—something I hope the Minister will be able to help us with this afternoon.
To meet increasing demand, the NHS will need more than just money: it will need a wholesale shift to promoting health as well as healthcare, to ensuring wellness rather than just treating illness, and to integrating health services so that they can be centred around the individual and the holistic needs of each patient. It came as no surprise to read in the Guardian last week that keeping the same doctor improves a patient’s life expectancy. This is great news so why is it so often not the case?
Turning briefly to social care, as we have just heard, continuous cuts, coupled with chronic long-term underinvestment, have left social care in a dire state. In their recent report, What’s the Problem with Social Care, and Why Do We Need to Do Better?, four leading health and social care bodies reported that to qualify for publicly funded social care, someone now needs to be 12% poorer than eight years ago. Meanwhile, informal carers continue to carry the bulk of the burden. The IPPR estimates that insufficient social care costs the NHS £3 billion a year, and with an ageing population these costs are bound to increase. If we are serious about safeguarding the NHS and its future, social care needs its birthday cake, too, and it needs to be a big one.
Turning to public health, in their recent report, The NHS at 70: Are We Expecting Too Much from the NHS?, those same four health bodies again emphasised that the most important factors in people’s health and life expectancy relate to the economic, physical and social environment in which they live. Therefore, public health must be made a priority if we are to have a healthier population.
Mental health is starting to get the public attention that it deserves. A recent Ipsos MORI poll found that the public rate it as their second-to-top health priority, which is great—but it is critical that those money increases are accompanied by mental health services that are much better integrated with physical health, community care and social care. So when the Minister winds up, perhaps he will tell us whether he feels that it is acceptable that currently only some one in four people with a mental health problem is able to access treatment, and what plans the Government have to increase this—and, specifically, what percentage of the new money announced for the NHS will go to mental health.
I conclude by saying that a good way of addressing all the issues that I and others have raised today will be to reframe the way we talk about the NHS as a national wellness service rather than one that just treats illness. I like to think that Aneurin Bevan and Beveridge would approve of that sentiment.
Lord Mawson (CB)
My Lords, I thank the noble Lord, Lord Darzi, for introducing this important debate. My colleagues and I have been at the cutting edge of the integration agenda for 35 years now. We are today generating a national and international movement and infecting the NHS culture. This year we have welcomed leaders from 23 countries across the world to see our work. Today I am taking our experience to 10 cities and towns in the north of England, through the Well North programme, which I have been asked to lead by the CEO of Public Health England. I declare my interests.
If we are to have an NHS in 70 years’ time, we suggest the following steps, based on hard-won practical experience. First, we must return to the fundamental question raised by the Peckham experiment in 1948, “What is health?”. The NHS closed this project in 1952, saying that its services would now be delivered by the NHS. It was wrong. Some 50% of our patients today do not have a biomedical problem: they have a housing, education or employment problem, or they are lonely. I am finding similar numbers in communities in the north of England. The Bromley by Bow Centre is Peckham mark II, but this time with a business plan.
Secondly, we should stop building health centres. Today we offer a vast array of services to our local community and our 40,000 patients. They stretch from conventional healthcare for local residents to opportunities to set up your own business, from support with tackling credit card debts to help with learning to read and write and help up the career ladder. We should stop building health centres, but that is not to denigrate clinical health. On the contrary, we need to position clinical health within a broad range of services to drive well-being in communities.
The list in this debate question is far too limited. We need to create a locally blended offer, where doctors sit alongside others, including patients and local residents, to provide what people need. It is healthier for doctors. Our health centres are more like a John Lewis store, where the customer is welcomed in and a host of choices are laid before them. The people who run successful department stores know that a diverse product range makes complete sense for the customer and financial sense for the business. You can capture the customer and have an opportunity to offer myriad products and services. It is the same principle in integrated holistic centres, where health is about life and living, not just disease and illness. It is about sweating our community assets. This approach would create benefits and savings across a range of Whitehall departments, not just the Department of Health.
We are working with our partners to build two new town centres in Rotherham and Stocksbridge, just outside Sheffield. The retail sector is challenged at the moment by the internet, but there is a real opportunity to rethink what a town centre is and to put the heart back into it. We will require flexibility and imagination from the NHS and other government departments.
Thirdly, over the years we have developed many innovations that have quietly gone national. The latest is the social prescribing movement which we founded in Bromley. It is now in 20% of GP practices nationally and 80% in Tower Hamlets; there is a network of 2,000 social prescribers across the country. Social prescribing should be the norm in every practice, because it focuses on what matters to patients rather than what is the matter with them. It also ensures maximum engagement with patients in managing their own health. Let us unleash healthy communities.
Finally, there is too much focus on beds and hospitals rather than on early intervention. People believe that the NHS will solve their health problems; often it will not. We are breeding a massive dependency culture through an institution that I would suggest is far from well. Let us be honest. It is not lack of resources that is the problem, but what we have chosen to focus on. I fear more of the same. What happened to the five-year plan? It is time to be more radical. Let us drop the sentimentality about the NHS and return to the fundamental question: what is health in the modern world for our children, in a society that is increasingly atomising? I agree with the noble Lord, Lord Darzi. It is time for fundamental reform, based not on sentiment, theories or ideology but on practical innovation and experience on the ground—and it cannot be led simply by the vested interests of the medical profession.
Baroness Manzoor
My Lords, we must keep to time, otherwise noble Lords at the end of the debate will not get their full four minutes.
Baroness Morris of Bolton (Con)
My Lords, I am delighted that the noble Lord, Lord Darzi, has not been replaced by a robot, and I thank him for the wonderful way in which he introduced an important debate on an important day. Like many people in our country, I owe a huge debt of gratitude to the NHS. It nursed me back to health when I broke my back in a riding accident at the age of 17, and today the brilliant rheumatology and orthopaedic departments at Guy’s and St Thomas’, along with my exceptional GP Stephen Liversedge, literally hold me together and keep me physically and economically active. I congratulate the noble Lord, Lord Winston, on the birth of his new grandchild. Three weeks ago my daughter gave birth to my grandson at St Thomas’. I cannot praise the community midwives and the staff of St Thomas’ who looked after her highly enough.
It is hard work not being well, especially as you get older or suffer economic hardship alongside being poorly. In the mid-1990s, when I was deputy chairman of the then Salford Royal Hospital NHS Trust, I would regularly pop into the hospital at weekends to speak to visitors, patients and staff when they had a bit more time to talk and were less stressed. Invariably, at the top of their health concerns would be worries about not being able to park, difficulty getting transport to hospital, childcare while they were in hospital or visiting, weariness at constantly having to explain their symptoms and their circumstances, fear of losing their independence and their job and fear of not being able to cope with the financial burden of recuperation or to care for themselves or their relatives when they returned home. Much of this is beyond the control of the NHS, but all of it is an important ingredient in the recovery and well-being of patients and their families. That is why it is crucial that we bring together as many services and patients as possible, taking a holistic view that puts people at the centre of decision-making.
In 2015 the 37 NHS organisations and local authorities in Greater Manchester came together to form the Greater Manchester Health and Social Care Partnership and signed a ground-breaking agreement with the Government to transfer the management of these services to Greater Manchester. The Government’s enabling legislation, the Cities and Local Government Devolution Act 2016, made this a reality. In one of its documents, the partnership said:
“Our health and social care reform is built on the need to reimagine services across our whole care system”.
I am delighted to say that, in my home town of Bolton, which is one of the 10 metropolitan and city councils that make up Greater Manchester, reimagining began on Tuesday with a decision by the council and the NHS to work together to take steps to join up health and care. I wish them well.
This builds on an already established and visionary partnership between the council, the NHS and the University of Bolton, which in 2012 saw the opening of Bolton One, a £31 million health, leisure and research centre. Our universities, with their research facilities and training in new ways of working, are vital in this mix of integrated care—and it is not just universities with medical schools but all universities across the country that are delivering excellent work in health and social care. I hope noble Lords will indulge me if I single out the University of Bolton, where I served as the first chancellor, for being ranked number one in England for teaching quality across its nursing courses in the Times and Sunday Times Good University Guide 2018.
I cannot begin to imagine what the future of the NHS will look like, with new technologies and redesigned services. But the one constant will be the dedication and experience of the people on the ground, doing the job and working so hard to look after us and keep us well. I pay tribute to them and wish the NHS a very happy 70th birthday.
Lord Pendry (Lab)
My Lords, I, too, congratulate my noble friend on initiating this important debate. It is true that the National Health Service has grown under successive Governments, but currently the growth is slower than at any time in its history. Even the latest cash injection, recently announced, will, in the view of many health service organisations and influential experts, including the Association of Directors of Adult Social Services, the MS Society and the local government society are saying that it is clearly disappointing, that funding is at a standstill and that it is a sticking plaster at best.
The statement from the Prime Minister that social care must wait until 2020 for extra funds—which will not be additional to the £20 billion injection—beggars belief. Where, however, does that leave the Secretary of State? During the debate of 25 January I congratulated him on standing up to the Prime Minister with his implied resignation threat. However, when he was appeased with another string to his bow—the addition of social care to his title—he backtracked. I, and no doubt he, along with others, believed that that would bring extra cash on top of what came with his previous title. Since then, the Prime Minister has made it absolutely clear—Green Paper or not—that no extra money will be forthcoming. Surely Mr Hunt expected more money—for mental health issues, obesity, carers and the vulnerable in our society—when he threatened resignation.
The honourable thing to do, surely, is to adhere to his earlier threat and resign. Ruling out any increase in social care until 2020 makes a nonsense of giving the Secretary of State the additional handle of social care. By definition, that means extra responsibilities and funding now. That is what I thought when we debated the National Health Service and social care in January and I said that the Secretary of State had a golden opportunity—when the Green Paper comes to light—to prove his critics wrong and produce a meaningful improvement in social care provision. Unhappily, however, the Prime Minister has done it again: another promise not kept.
As the noble Lord who introduced this debate said, in a debate of this kind it is important to remind the nation—especially on the 70th birthday of the NHS—that it was Clement Attlee’s Government, and no other, that brought to life the National Health Service, and hopefully to end for all time the lie espoused by Jeremy Hunt at the last Tory party conference, when he claimed that the Tories, and not the Labour Government, invented the National Health Service. History books, and Hansard, clearly show that it was Aneurin Bevan who introduced the first comprehensive national scheme in 1948, when Tory luminaries Winston Churchill, Anthony Eden and Harold Macmillan—all former Tory Prime Ministers—were among other Tories who voted against the implementation of this bold policy. The result of that vote was an enormous victory for the Labour Party and for the nation. I hope that this gigantic lie by the Secretary of State will be laid to rest for ever.
The Lord Bishop of Carlisle
My Lords, I too am most grateful to the noble Lord, Lord Darzi, for securing this timely debate. On the one hand, I am grateful because it is an opportunity to recall and be thankful for the establishment of the NHS in 1948 as one part of a comprehensive vision of social welfare—which, incidentally, owed much to the insight and energy of Archbishop William Temple and other Christian thinkers and activists. Temple and Beveridge were close friends, and much of the post-World War II vision that led to the creation of the welfare state by Bevan and others emerged from church-led consultations.
On the other hand, I am grateful for the clear emphasis in this debate on integration. Our word “health” comes from an Old English word meaning “wholeness”, and the Old Norse version of that word meant “holy” or “sacred”. From the start, when churches and monasteries founded our first hospitals, healthcare has been understood holistically. There is a real sense in which our National Health Service should include caring for all aspects of well-being in all our people. Certainly, in the Select Committee report on the long-term sustainability of the NHS the word “integration” appeared several times.
In the brief time available, I will suggest two aspects of healthcare that fall into the community care category, and which, like mental health and social care, urgently need integrating with other parts of the NHS. The first and most obvious is public health. Here I declare an interest as an associate of the Faculty of Public Health. Other noble Lords have raised this and I am sure others will. I will not, therefore, dwell on it, but from a purely financial point of view money spent on prevention bears obvious dividends: it is never wasted. From a well-being angle, furthermore, prevention has always been better than cure and always will be, especially in relation to our consumption of food and alcohol and our commitment to taking exercise.
The second aspect is spiritual well-being. The World Health Organization understands spirituality as,
“an integrating component, holding together the physical, psychological and social components of a person’s life”.
It is often perceived as concerned with meaning and purpose. For those nearing the end of life, this is commonly associated with a need for forgiveness, reconciliation and affirmation of worth.
Delivery of spiritual care is the responsibility of all professionals in the multidisciplinary healthcare team. This debate, however, provides the opportunity to affirm the vital role of healthcare chaplains, who minister to the spiritual needs of those from all religions and none.
Underlying all this is a significant question of responsibility. Who is responsible for making all this integration happen? We ourselves have an obvious responsibility, as every citizen does, when it comes to prevention but with regard to the integration of physical and mental health with social and community care, do we look primarily to NHS England, regional STPs, local trusts or Parliament to take a lead? I would be most grateful for the Minister’s view on this. There is also the question of consultation. The foundation of the NHS followed a comprehensive and inclusive debate in UK society. Are there any plans for a similar process of inclusive debate, in which all voices are heard and all concerns addressed, as we look forward to the next 70 years of our invaluable National Health Service?
Lord Lexden (Con)
It is an immense pleasure to follow my favourite Bishop. Fortunately, none of the others are here to learn that I care for them less.
I would like to offer a few reflections on the historical background to this important debate, introduced so memorably by the noble Lord, Lord Darzi. I am a historian and a few words about what happened in the 1940s would perhaps not come amiss. I should say at the outset that I take a view very different from that of the noble Lord, Lord Pendry.
In this very month 74 years ago, the then Minister of Health broadcast a message of historic importance to the nation about the Government’s plans for a national health service. He said:
“Whatever your income, if you want to use the service … there’ll be no charge for treatment. The National Health Service will include family doctors whom you choose for yourselves, and who will attend you in your … homes when this is necessary. It’ll cover any medicines you may need, specialist advice, and of course hospital treatment whatever the illness”.
It was with these words in July 1944 that Henry Willink, the Conservative Minister of Health in Churchill’s wartime coalition, heralded a new era in which comprehensive health services would be available to all, free at the point of use. It would be the fulfilment of the vision that Neville Chamberlain, a formidable Health Minister in the 1920s and the greatest of all Tory social reformers, had hoped would one day be accomplished.
Willink set to work. The British Medical Association swiftly assumed the role that was to become so familiar to British politicians over the years, putting the self-interest of its members before all other considerations. Willink was an able but emollient man. He made many concessions to the BMA, though without weakening the Tory commitment to the principles of universality and free delivery of services underlined in the 1945 Conservative election manifesto.
Today, no one remembers Henry Willink, who gave up politics in 1948 to become the master of a Cambridge college, while enduring fame is attached to his successor. Nye Bevan fought the BMA with vigour and panache, which Willink would never have done. He too made significant concessions but his ferocious public rows with the BMA dominated the headlines, while his concessions attracted much less notice. This worked hugely to Bevan’s advantage. As his perceptive biographer, the leading historian Dr John Campbell, has observed,
“it was politically useful to Bevan that the BMA made such a fuss. It seems clear that Bevan privately welcomed, if he did not positively encourage, the BMA’s help in making the NHS appear a more socialist measure than it really was”.
There was not a great deal in Bevan’s plans that the Tories found wholly objectionable; after all, they shared the same objectives. But Bevan, consummate party politician that he was, exploited the Tories’ decision to oppose the complete nationalisation of hospitals. He relished blackening their name as the enemies of a great national reform. It was on the evening before the NHS came into operation that he made his notorious speech denouncing them as “lower than vermin”.
One of the great tragedies, perhaps, of the fierce partisan wrangling that took place over the structure of the NHS is that no one thought about its cost, even in Whitehall. Finance was not discussed as the legislation went through Parliament. As a result of this omission, politicians of both parties would be plunged into recurrent funding crises over the next 70 years. Bevan’s achievement was prodigious. Nevertheless, as John Campbell has pointed out,
“it must be said that too much can be claimed for him, and in Labour mythology often is”.
There was wide cross-party support for the NHS at its inception, just as there is today on its 70th birthday. It is perhaps a time for remembering Sir Henry Willink, as well as the great Nye Bevan.
Baroness Donaghy (Lab)
I thank my noble friend Lord Darzi for initiating this debate and I thank Nye Bevan for his towering achievement in setting up the NHS against concerted opposition—a miracle for those who had no money.
We still expect the NHS to cure all our social ills while tackling permanent supply and demand challenges. Government-imposed changes in legislation, reorganisation and financial stop/start policies make it difficult to plan for the long term and apply consistent recruitment and training policies.
If there is a chronic shortage of doctors, we import them. The Royal College of Physicians says that we are currently training only half the number of doctors required by 2030 and the cap on medical school places means that we reject half of all eligible applicants— 770 of them with at least three straight grade A’s at A-level. While I am not trying to correlate the possession of three A-levels with suitability, we should be training more in the UK. Instead, 700 rejected medical student applicants a year are studying to be doctors in the eight English-language medical institutions set up in former eastern bloc countries. This is crazy, and it is the responsibility of the Government. The recent announcement of more places is too little, too late.
The NHS cannot solve all our social ills. We do not have a proper social care system, and that has an immediate impact on hospital beds. Our GP system has been weakened to the extent that many patients do not have a hope of seeing their local doctor when they need to. There were 1 million hospital visits last year because of drug or alcohol usage. The human cost of obesity is appalling, but so is the cost to the health service, which has to pay for larger stretchers, beds and mortuary places.
It is vital that we improve transparency and accountability in our NHS. The Government abolished the independent review panels in 2004 and the recently established Healthcare Safety Investigation Branch plans to cover only 30 cases a year. Will the Minister say how the Government intend to invest in independent reviews, deal with complaints and protect whistleblowers?
The advances in medicine in the past 70 years are almost beyond belief. Some of the potential breakthroughs are exciting. One drug is being made from the strain of cannabis grown legally under Home Office licence. It has a high concentration of anti-convulsant and very low content of THC, the psychoactive compound. If approved, it could help up to 5,000 people with epilepsy. Research has shown that metformin, an anti-diabetes pill, also cuts the number of heart attacks, strokes and heart failures. Researchers call that repurposing.
Finally, I thank the BBC and ITV for their coverage of the 70th birthday of the NHS and for all the programmes that have been enjoyable, historical and absorbing. They have been inspiring and have made me realise that any future attacks on the health service will be met by an army of fierce defenders, all of whom have a story to tell.
Baroness Masham of Ilton (CB)
My Lords, I was in this Chamber when the noble Lord, Lord Darzi, then Minister of Health, saved the life of a noble Lord who collapsed in the debate. I congratulate him on all his wonderful and inspiring work. I declare an interest, as the National Health Service saved my life when I broke my back in 1958.
I celebrate the 70 years of the NHS, but I feel that safety in medicine should be the top priority. Without good communication and leadership, the patient can be left in limbo. Last week, I spent two-and-a-half days in St Thomas’ Hospital with an infection. It brought home to me the hugeness of the NHS and the pressure that it is under. The nurses I met were all agency nurses, and I understood their reasons for that, but I never saw a sister, so answers were not forthcoming. I left wondering what Florence Nightingale would have thought. There were some charming young doctors. One of them told me she had had problems since Brexit and was thinking of leaving. This is tragic when they are so badly needed. The Government need to work very hard on providing a competent NHS workforce across the UK, with good communication between hospitals and the community.
When injuries were expected from Normandy, a specialised spinal unit for the military was set up at Stoke Mandeville Hospital. In 1948 when the National Health Service was born, civilians with spinal injuries were admitted, and having specialised treatment and rehabilitation free at the point of need made all the difference for them. Stoke Mandeville is also celebrating the 70th anniversary of the paraplegic games this year. They were founded by Sir Ludwig Guttmann, who said that sport helped to rehabilitate patients. The games became the Paralympics of today. I cannot stress enough the importance of specialised treatment centres for many rare conditions. Their specialised teams of staff and drugs can save and extend life.
Our NHS must find watertight systems to safeguard patients and protect whistleblowers who may suspect and expose dangerous procedures. Safety is of the utmost importance. The duty of candour should become part of our health and social care culture.
Baroness Finn (Con)
My Lords, I thank the noble Lord, Lord Darzi, for introducing so beautifully this important debate. In an age where some view suggestions of NHS reform as heretical, I welcome the opportunity to put down ideological swords and approach the NHS and the issue of social care with the clarity of debate that our healthcare system so desperately needs.
Lots of people, including my family and close friends, rightly testify to the wonderful care that they have received from the NHS. I do not yet have grandchildren and congratulate the noble Lord, Lord Winston, and my noble friend Lady Morris on their recent arrivals, but St Mary’s in Paddington looked after me very well when I had both my children on the NHS, so I understand the emotional attachment that we have to the noble ideal of the NHS and the numerous examples of superlative care experienced.
However, although we are often told that the NHS is the envy of the world, it is not the envy of the developed world. The UK healthcare system consistently receives mediocre rankings in international reports. Even the Commonwealth Fund report ranked us last but one for healthcare outcomes. We need outcome-driven improvements to our National Health Service, as those matter most to patients.
There have been and will be many important contributions today from those with direct experience of the NHS. I shall therefore limit myself to three short observations. We must invest in early diagnosis. The UK has lower cancer survival rates than comparable health systems. The cost of late diagnosis can be up to four times that of early diagnosis, which in turn dramatically improves the chance of cure and survival.
Secondly, we need to help to transform a culture in the NHS that can be resistant to innovation. Without this, reform will prove ineffective. Healthcare professionals must absolutely be able to speak up for the benefit of patients without the risk of victimisation. The national guardian, Dr Henrietta Hughes, is leading a positive culture change by publishing case reviews to support the proper treatment of whistleblowers. Our remarkable NHS staff are our greatest asset and a rich source of knowledge. They must be empowered to identify concerns and provide solutions.
Finally, we must have a proper debate about the funding of the NHS. It is simply wrong to perpetuate the myth that any alternative to the current system is a malicious attempt at privatisation. It is not a binary choice. We all agree that healthcare in this country should be universally accessible. This was the original and great gift when the NHS was created. Although every developed economy now provides its citizens with universal access to healthcare, none has copied the UK model. Other healthcare systems—in Germany, the Netherlands and Switzerland—offer feasible alternatives that deliver not only better value for money but better outcomes for patients. We know that the NHS needs more money, but we should not presume to know how to get it.
I welcome the proposal of a cross-party commission, but if we seek a sustainable future, we must keep an open mind, fairly evaluate alternative regimes and resist the narrow dogma that hampers rather than protects the NHS.
Baroness Emerton (CB)
My Lords, I, too, congratulate the noble Lord, Lord Darzi, on opening the debate and thank him for being such a breath of fresh air, as he always is when he speaks in this House. I also thank the right reverend Prelate the Bishop of Carlisle for his words. It reminds me to confess my qualifications in the register as a retired nurse and midwife who started 65 years ago. I started in 1946 as a volunteer in the order of St John as a cadet, and learned the basics of life-saving and care. I have always been grateful for that background and the privilege that I had as a registered nurse.
In one of my jobs, as the youngest member of a consensus management team, I was asked to close two large hospitals and move mentally handicapped patients into the community. The first hospital had 1,500 patients and the second had 1,200 patients. It was my job to find a team that would work with me, with the money coming from the health service. I learned a tremendous amount about social services, working with two county councils and five London districts. It taught me one very large lesson: we have tremendous barriers that have to be broken down when we are concerned with delivering care. It is not a question of care in hospital and care in the community being different; we are looking at the whole person and their whole life. One thing I hoped, as I travelled through this task of 10 years, was that we were on the verge of reaching where we are today: considering bringing together health and social care.
I have always valued that experience, because I learned three things. One was that we needed the money, but that it needed to be spent cost-effectively and that we had to look at the way in which people were trained for this new model of care. The second was the high quality of care, which was different from that in an institution. The last was the culture in which people were cared for. I hope that, as a result of today’s debate and all that we have heard from the Government, we will be able to move forward, get rid of the barriers between health and social care and become one caring service.
Lord Colwyn (Con)
My Lords, I welcome the debate of the noble Lord, Lord Darzi. I must also declare my 40 years in the NHS and that I am a fellow of the British Dental Association.
In 1948, the nation’s dental health was in a worse state than that of defeated and occupied Germany; decay and gum disease were rife and more than three-quarters of the adult population had complete dentures. The creation of the NHS meant that, for the very first time, dental care was free at the point of use and the demand was overwhelming. By late 1948, more than 80% of practising dentists had signed up to work in the NHS and, in the first nine months of its existence, NHS dentists provided over 33 million artificial teeth, performed 4.5 million extractions and put in 4.2 million fillings. By 1951, the NHS started running out of money and so charges for dentures were introduced—the first charges of any kind for NHS treatment. This controversial move caused much debate and led to the resignation of Aneurin Bevan. Charges for other types of dental treatment soon followed and, to this day, dentistry remains the only part of the NHS that is not free at the point of use.
NHS dentistry today looks very different from the way it did 70 years ago. Modern technology means that dentistry today is relatively pain free compared with the dentistry of the past. Our nation’s oral health continues to improve and most of us keep at least some of our own teeth past the age of 85. Satisfaction with NHS dentistry is at a record high. Despite an estimated 10 million adults in the UK reporting dental anxiety and 6 million experiencing dental phobia, 85% of patients rate their NHS dental experience as positive.
We cannot, however, afford to be complacent. Although oral health on average is steadily improving for the general population, there are still unacceptable variations in outcomes, depending on where you live. Almost half of five-year-old children living in places such as Pendle, Rochdale or Burnley have tooth decay, but a mere 5% are affected in Waverley or Guildford. Tooth decay remains the leading reason for hospital admissions among young children, despite being almost entirely preventable—a scandal in 21st-century Britain. Increasingly, there are also problems with access to NHS dentistry in many areas. A recent BBC investigation revealed that only 52% of dental practices were able to accept new NHS patients. Almost half of all adults in England—a total of 21 million people—have not seen an NHS dentist for over two years.
The reasons for that can be traced back to two main problems: the lack of funding and a failed dental contract. NHS dentistry has been chronically underfunded in recent years. Nominal spending on dental services per capita fell from £41 in 2013 to £36 in 2017. This drop is even greater if we take into consideration inflation and the rising cost of dental materials. At the same time, patient charges in England have increased at an unprecedented pace—a 5% rise each year for the past three years. Data shows clearly that this fee makes many people delay going to the dentist until the problem has escalated, ultimately requiring more expensive treatment.
The second reason for problems with dental access and rising inequalities in England is the way that dentistry is commissioned. The failed NHS dental contract effectively sets quotas on the number of patients a dentist is able to see on the NHS.
Baroness Manzoor
I am so sorry. We are running late and have to go to the next speaker.
Lord Colwyn
I have only one more sentence. It has led to such low morale in the workforce that 58% of dentists are looking to leave the NHS in the next five years.
Lord Parekh (Lab)
My Lords, I am prepared to loan the noble Lord a second of my time.
I thank and congratulate my noble friend Lord Darzi on introducing this debate so beautifully. Having only three and a half minutes to talk about the NHS, I shall simply say that the NHS is a product of its time. That is very important to bear in mind, because the fact that it was born in 1947-48 penetrates its inspirational principles as well as its structure.
On the division between healthcare and social care, healthcare is free at the point of delivery, whereas social care is means tested, and that binary division is itself a product of its time and was introduced into the structure. There is also a distinction between physical and mental health. When the National Health Service was created, it should have meant the national physical and mental health service, but it tended to mean physical health. Mental health was added later and has enjoyed a Cinderella status; it has not enjoyed parity of esteem in the National Health Service.
My first point is that these various strands that the NHS has inherited have to be integrated, but the question is about how you do that when they are moving in different directions. We need to integrate but in a manner that respects the differences between the strands.
The second way in which the NHS has historicity is in the role of the GP. The GP began as a family doctor—an old tradition in this country—but he is now a gatekeeper. There is a division between the GP and the hospital, and that division also affects the relationship between the GP and his patients.
The third important feature of the NHS that is worth noting is that it began as a highly centralised institution. Those were the days of centralisation, with everything done from the centre. Now, there is an increasing realisation that that is not the way to deal with many of the problems, because problems are localised and so are the solutions. How do we move from a centralised to a decentralised structure? It is not just a question of decentralising an already centralised structure; it is a question of designing it from below and asking fundamental questions.
Here, I want to emphasise the important distinction between the way in which the NHS was conceived, based on excellent principles, and the way in which it has developed certain flaws. Some flaws are adventitious; others are structural, and the structural flaws need to be addressed very carefully—the fact that many of our doctors leave the NHS and leave the country rather than stay here; the fact that there is low morale; and the fact that hospitals are structured in such a way that the management takes over and the doctors count for very little. Those are some of the flaws. Therefore, while we celebrate the achievements of the NHS, we will celebrate them more sincerely and honourably if we are also alert to the weaknesses that it has developed.
When we talk about what we should do for the next 70 years, I simply urge a note of caution. Given the way we have tried to change it over the years, if we can get it right for the next 20 years, I shall be more than happy. Due to the way in which mental and physical health problems are distinguished and new insights into medicine and human health appear, there will be new questions, new divisions and new ways of organising our hospitals. In the light of that, let us think of the next 20 years, rather than the next 70.
Lord Dykes (CB)
My Lords, it is fitting and symbolic that the debate was opened by three of the foremost medical experts in this House. We thank the noble Lord, Lord Darzi, for initiating the debate. He was followed by the noble Lord, Lord Ribeiro, and the noble Lord, Lord Winston, who, although not a surgeon himself, is a great expert on his own subject in the medical field. We thank them for their remarks. I must give a strong word of thanks to the noble Lord, Lord Darzi, for his inspiring introduction. He covered a lot of ground and dealt with a lot of things. I agree with his implication—possibly it was even stronger than that and was a full expression—that we can all be proud and sentimental about the amazing National Health Service and what it has achieved but, at the same time, call for modernisation, efficiency and so on. I hope and pray, however, that we will avoid yet another upheaval of the administrative structures, which would drive people mad. That all comes together, and there is no sense of shame in saying that this taxpayer-funded service should receive more funds in the future. The period of austerity from this Government has been very painful for the National Health Service and we need to get over that now.
The noble Lord, Lord Darzi, mentioned his connection with the Royal Marsden. In 2003, for very sad family reasons, I had occasion to experience the Royal Marsden Hospital and its superb and wonderful treatment of people facing cancer. To a lay man like me, an example such as that remains in your memory for ever. I have always tried to avoid private healthcare, although I suppose that on occasion there is an emergency or one needs something quickly and therefore has to agree to a date being fixed if the NHS asks you to wait a bit longer. However, the service provided by the NHS is superlative. Even private medical companies often use its facilities and equipment because they do not have the same range of skills, equipment and expertise.
I commend the very good briefing note by the Library. It reminded us that the cost of the NHS as a percentage of GDP is similar to the EU average and very similar therefore to other leading countries. The cost of private healthcare is much more expensive for self-evident reasons, and I do not think it can ever match the efficiency of the NHS, despite it being funded in the way that it is. It is an amazing achievement.
I conclude not by trying to be clever for its own facile reason but by genuinely linking the dangers of Brexit with the National Health Service. Although there is no obvious connection at all between them, I was very grateful to the noble Lord, Lord Kinnock, for his letter to the Guardian today referring to these problems. He talked about the degradation of the physical economy and GDP as a result of the falling size of the economy already because of Brexit—it has already started and it is going to get worse if Brexit is to occur—and the departure of nurses and doctors from this country back to where they came from or elsewhere because they fear there will not be a positive future for them if we are not members of the EU. He quite rightly concludes by saying:
“Of the 52% who voted leave, few, if any, voted to sabotage the NHS”.
I am sure that is right. Therefore, that must be yet another collection of reasons why we have to think about the future of the NHS but also the future of the country.
Baroness Verma (Con)
My Lords, I am delighted to speak in this debate celebrating the 70th anniversary of the National Health Service. I join all noble Lords in congratulating the noble Lord, Lord Darzi, on opening the debate. The NHS is proudly the envy of the world but, with the increase in population and the discovery of new illnesses and diseases over time, we need a fresh way of looking at how it will function in the next 70 years. In saying this, I would like to speak about a part of the health service that is often seen as a separate arm but really should be an integrated and well-bedded key component of the delivery of care that the NHS must provide.
I declare an interest as a provider of adult social care, through a business I started 18 years ago. Since that time, we have seen huge changes both to the National Health Service and to social care. In my opinion, we should see them as two parts of the same ecosystem. Instead, they have had to fight for budgets and space within the political debate.
There seems to be a huge deficit in the understanding of how social care is delivered and how well funded the social care system should be to support the NHS. Every day, we hear politicians saying how much they love the NHS. It does not matter from which part of the political spectrum they come, but this mantra never includes the words that they also love social care. Until we have a radical change in our thinking about social care, understanding that it is part and parcel of the delivery of support in the health systems, the burdens on the health service will continue to increase and the funding of social care will continue to decrease.
An easy example to illustrate this is that, if you suffer from cancer, you would expect the health service to provide medical care and support to you free. Why then should someone who has dementia not have the same support at the point of need, just because they are being cared for in a residential setting? It is unjust to pit one type of illness against another, and it needs to be addressed, if we are to be a community that values justice and respect for everyone. With age come new challenges of illness specific to growing older. Does that mean that because we want people to live in their own homes we ignore their needs?
Social care is not just for the elderly; it also supports those with disabilities across the whole age spectrum, so it is high time to rethink how our health service and social care work are made to work as one. Social care has always been the poor relative of our healthcare systems yet, as we become more and more dependent on treating people at home, there is a large recognition that we are fast running short of adequately trained care workers to support people in their communities. The fact that funding for social care is delivered through local authorities and is never ring-fenced means that often any extra funding from government may be used for other immediate pressures faced by local authorities. That cannot be right.
If adequate resources were put into providing people with access to well-trained and better paid care workers, it would have an immediate and huge positive financial impact on the NHS, in terms of improved exercise, dietary plans and mental well-being. How does the input of social care providers get integrated into Ministers’ wider thinking about policy? I urge the Minister not to call just on the work of clinical commissioning groups. We know that there are huge gaps in social care provision; trying to find people to work in the social care sector is getting ever harder. How does the Minister feel we are going to fill the gaps of doctors, nurses, therapists, cleaners and carers once we leave the EU? The NHS cannot change for the sake of change; the Government must understand that you cannot fix a problem unless you fully understand what all the solutions are.
Lord Brooke of Alverthorpe (Lab)
My Lords, I am grateful to my noble friend Lord Darzi for a towering speech, made with spirit and committed to the fundamentals of the health service. We are extremely grateful to him. I express my gratitude to all who work in the NHS for all the outstanding work that they continue to do, often in difficult circumstances. I wear no badge today, but I have a kind of badge on my head, as I am wearing an NHS bandage from treatment I had this week. I shall be going to my doctor’s surgery tomorrow morning.
It is all part of my life. I was born before the health service was created, but I have had two near misses with my life. When I was 55, I had bowel cancer and was saved by the Royal Marsden. I was quite close to death, and here I am, 20 years on and still enjoying a fruitful life, for which I am eternally grateful to the health service and the people who work in it.
I shall take a different approach from anyone else. I have a different concern about the extent to which the public and I are responsible for the care of the NHS and how we deal with it. People can take it for granted in many instances and, as a consequence, the health service suffers. We do not get efficiency and effectiveness from it because of that—people not turning up for appointments and so on. It is important to continue to look at what we as individuals can do to make the health service even healthier.
I have suggested, and raised previously with the Minister, that one way in which we might bring about a change in attitude is to know what the cost of our health services is; after all, there is not much that we get in life whose cost we do not know, but that is not so with the health service.
The Government do not like this idea because they say that it might discourage people from taking up services. That is questionable. I have suggested in turn that those who would like to know the cost should be told, so that, if they feel gratitude to the NHS, they could make a charitable contribution towards a fund. It would be a fund that not just went towards the hospital where they had been treated or given the service but would be redirected to those areas in the country where we see the most ill health and the greatest deprivation in terms of health services.
The Minister has not responded very positively to these suggestions on previous occasions, so my appeal today is not to the Government but to my fellow Peers and to MPs: we should come together and, instead of words, words, words with nothing happening, we set up an all-party parliamentary group to look at how we might establish a charity that commemorated the 70 years of service that we have had from the NHS but in turn found ways of taking in contributions from those who were able to make them and wanted to express their gratitude for the services or operations that they had had from the NHS. I would certainly be prepared to do that. We would have a group of qualified people—maybe Peers or surgeons—who redirected the funds or gave advice on where they should go in the NHS. We should do it ourselves. If the Government will not do it, this is a source of considerable money among the public at large to which the NHS fails to respond. There is great feeling for the service. I believe that people would make bequests or offerings after they had had operations. It is time that we took advantage of what is there for us. I hope the Minister will respond that when he replies.
Baroness Watkins of Tavistock (CB)
I thank the noble Lord, Lord Darzi of Denham, for introducing this debate and for his excellent speech. I also thank the noble Baroness, Lady Verma, whose eloquence on social care and the need for investment in it I wholeheartedly support. I declare my interests as in the register, most specifically as a mental health nurse of some 40 years’ standing.
There is a clear case for further integration of physical and mental health and community and social care provision if we are to meet the needs of our citizens and promote healthy living and, where necessary, treatment intervention. I am involved with the social movement Nursing Now, working with policymakers and senior nurses from several continents.
In Africa, a phrase is used: “Health is made in the home and communities and hospitals are for repairs”. We need to adopt this approach in our communities to serve our citizens as cost-effectively as is feasible. We are celebrating our investment in 70 years of the NHS, which has resulted in people living longer and healthier lives. However, this has brought the challenges associated with many older people having several complex health and social needs, a situation that was not fully anticipated in 1948. The challenges facing our young people in terms of mental problems and the increasing prevalence of non-communicable diseases associated with lifestyle are resulting in higher demand for healthcare intervention.
The demands on the NHS will continue to rise unless we focus on public health policies that encourage citizens to become more responsible for their own health. With the access we all now have to digital data, why should we not be more responsible for our own health records and monitor our responses to exercise, diet and medication? If our citizens are to be more accountable for their own health and well-being, they will still need health education, support and guidance to do so. Families need help in the early years of their children’s lives through effective health visitor interventions combined, where necessary, with structured support from social services and mental health interventions for families with experience of anxiety, depression or severe and enduring mental health conditions. Yet we know that these services are under considerable strain and that, even when sufficient resources are available, families and individual citizens complain that different workers often fail to work collegiately to provide coherent packages of care. If community-based health and social services were better integrated, it would be easier for individual providers of care to deliver appropriate services, as indicated in some of the vanguard sites. This also includes successfully reducing delayed transfers of care.
I have two further suggestions that I would like the Minister to consider. First, there should be a move towards more clinical treatments for people in their own homes, care homes and nursing homes. In Spain, it is not uncommon for a person with pneumonia to be treated with intravenous fluids and antibiotics in a nursing home, and even occasionally in their own home, without the need for hospital admission. Serious consideration of more simple treatments being given outside acute hospitals needs to be undertaken. This would reduce the need for more hospital beds and allow a redistribution of resources towards community-based interventions.
Secondly, all healthcare workers should be expected to be proficient in coronary pulmonary resuscitation and physical first aid. The APPG recently heard, when reviewing progress against the five-year mental health strategy, that there is a real need to increase training in acute in-patient first aid across society. I very much hope that we will do this.
Baroness Harding of Winscombe (Con)
My Lords, I begin by declaring my interest as the chair of NHS Improvement and thanking the noble Lord, Lord Darzi—my esteemed colleague on the NHS Improvement board—for his masterful introduction to the debate. After listening to various noble Lords who have contributed their whole working lives to the NHS, and thinking about the more than 5,000 NHS staff members who are still working there after more than 40 years’ service, I have to say that I feel like a bit of an impostor in this debate, having all of seven months’ experience of working in the NHS, in NHS Improvement. I have tried to hold three things in my head as an employee of the NHS who is still learning. The first is that the NHS is undoubtedly the best health service in the world. In the round, taking everything into account, it is the fairest service and is definitely the most efficient one. As my noble friend Lady Finn said, clearly there is room for improvement, but I would contend that it is one of the most cherished institutions in the land. While we look at how to improve it, it is really important to remember, in everything that we say and do, how brilliant it is.
Secondly, it could be so much better. The variation in outcomes for patients across the country is just not acceptable. You only have to be a patient or the carer of a patient for 10 minutes to see how money is being wasted. We could be more efficient and at the same time deliver better outcomes. Thirdly, we are all living longer. Technology is enabling us to live well for longer, which is a good thing. It is a problem of success, not failure, but it is none the less a problem that must be faced, and in reality it is one that will require more money for the health and social care system.
What should we do? Many noble Lords have talked about the important need to integrate care in the health and social care system: the governance, the structures and the money flows. I would like to focus on the people: the 1.7 million people across the United Kingdom who are working for the NHS. They are our greatest asset and it is really important that we help and support them by preparing them for the future. If we are to deliver integrated services, we will need to drive considerable change in the NHS. That will include organisational change, process change and technology change. Change is hard for everyone, however clever and experienced they are. It means that the NHS needs to improve significantly the way in which we manage and lead.
Just as there is variation in clinical practice and operational processes, there is enormous variation in management and leadership capability in the NHS. I have met some of the very best managers I have ever seen in any walk of life in the last seven months, but unfortunately our NHS staff tell us very clearly in their staff survey that that is not uniformly the case. I have been shocked by the results of the NHS staff survey, first by how small a percentage of staff actually fill it in—50% to 60% filling it in is deemed as a huge success in the NHS. Best practice in industry would tell you that 80% to 90% just filling the survey in is a measure of real engagement. The percentage of people who say that they have been witness to or have experienced bullying is terrifying. On average it is 24% of staff and at the worst trust it is 41%. All this points to a management and leadership culture that needs to change to prepare us for the future.
We need to instil a consistently just and learning culture. We need to root out bullying and replace it with honest and open management, and to encourage much more flexible working and the greater diversity in leadership styles that reflect the way our society is changing. These are not “nice to dos”; these are the essential building blocks if we are to transform the NHS to meet the challenges that various of your Lordships have set out. I know that it is tempting at this national political level to focus on money, organisational structures, regulatory levers and command and control, but it is the people of the NHS who have made it the national treasure that it is today. Focusing a bit more on supporting and developing the people in the NHS, their culture and ways of working will be the essential ingredient for success in the next 70 years.
Lord Faulkner of Worcester (Lab)
My Lords, like every other speaker I am delighted to congratulate my noble friend Lord Darzi on the brilliant way that he introduced the debate. I thank him for the hundreds—probably thousands—of lives he has saved during his very distinguished career as a surgeon. My contribution will focus on why treating tobacco dependency must be embedded throughout the plan that NHS England has committed to delivering in return for the additional £20 billion it has been allocated. The evidence for this is set out in a major new report published just last week by the Royal College of Physicians. I declare an interest as a long-standing officer of the All-Party Group on Smoking and Health.
Helping smokers quit is not just about prevention. It improves treatment outcomes and helps poorer people in particular to live longer. Take lung cancer. Currently, at diagnosis one-third of lung cancer patients still smoke and their average life expectancy is nearly doubled if they quit, yet fewer than a quarter get advice to quit from their GP and only 13% are prescribed stop smoking medications. Helping to quit smoking costs hundreds of pounds and has a similar impact on life expectancy as the latest lung cancer drugs, which cost tens of thousands of pounds per course of treatment. So why are lung cancer patients not being given the help to quit that they need?
Tobacco dependency treatment is cheap and saves the NHS money. The RCP has calculated that if all smokers were provided with help to quit the NHS could save £60 million annually in hospital admission costs and A&E attendances alone from year one onwards. This includes the cost of the treatment, which is only £182 per quitter. By freeing up beds and saving money, it would ensure the additional £20 billion can be used more cost effectively.
We need only look to Greater Manchester, where the CURE programme will start to deliver treatment for all smokers from September, to see the potential gains. Manchester has almost 53,000 hospital admissions of active smokers every year. Smokers are admitted with cancer, heart disease, mental health conditions, HIV/AIDS—the list goes on. It has been calculated that providing patients with tobacco dependency treatment will save the equivalent of 250 additional beds per day. This will help to tackle the winter bed crisis in Manchester. Smokers are five times more likely to have micro-biologically confirmed influenza. When combined with other smoking-related respiratory diseases, such as chronic obstructive pulmonary disease, this can lead to their admission to hospital at the worst time of the year.
Supporting smokers to quit will also deliver improved maternity outcomes. Every year, maternal smoking in the UK causes 5,000 miscarriages, 300 perinatal deaths and 2,200 premature births. Younger mothers in disadvantaged circumstances who have never worked are more likely to smoke throughout their pregnancy. These are the immediate savings; the benefits in the longer term are even greater, as current smoking costs hospitals almost £1 billion a year, most of which is avoidable.
It is not that smokers do not want to quit—over 60% say that they do—but our hospitals are not providing the help that the most addicted need if they are to succeed. Will the Minister ensure that NHS England takes into account the evidence and recommendations set out in the recent RCP report on treating tobacco dependency as it develops the new plan for the NHS?
Lord Hennessy of Nympsfield (CB)
I add my congratulations to the noble Lord, Lord Darzi, on an inspiring opening speech.
In the life of a nation, there occur a few ripe, golden days—the kind of day that you want to “bite to the core”, to borrow a line from the poet Edward Thomas. Undoubtedly, 5 July 1948 was such a day. The British state came as close as it ever has to institutionalising altruism when the Attlee Government created the National Health Service. As we have heard already, it was shaped by that man of genius and brilliant word power, Aneurin Bevan, who the noble Lord, Lord Morgan, once aptly described as “an artist in the use of power”. Its core principle was the pooling of human risk and financial resource—that the National Health Service should be taxpayer funded and free at the point of delivery—which has been sustained by every Government since.
The National Health Service was, and is, one of those national banners around which my generation rallied, as it has served us since we were in our cradles. No doubt we will still laud it as it eases us towards our graves. Talking about the welfare state in 1948, Nye Bevan said to his Parliamentary Private Secretary, Barbara Castle, who recorded it for me in a television interview 20 years ago:
“Barbara, if you want to know what all this is about, look in the perambulators”.
Given our average age, that encompasses many of us in the Chamber—we very fortunate children of the early post-war period.
Let us go back to vesting day 70 years ago. More anxiety was lifted off more shoulders on 5 July 1948 than possibly any other single day in British history. It was an extraordinary day. The creation of the NHS was a declaration of great national purpose. Achieving it over seven decades has been freighted from the beginning by the core problem that we have heard much about this afternoon: demand has always outrun the funds available to meet it. We now have a golden chance to tackle that. Let us rally once again around the banner of the NHS, the flag that we have rallied around all our lives.
In this vexing era, when we torture ourselves daily with our differences over Brexit, perhaps here at last is a consensus that is there for the taking. I dearly hope that it will be taken, shaped by that rigorous, realistic national debate of which the noble Lord, Lord Winston, spoke so forcefully. We owe it to the founders of 1948 and the generations who have devoted their professional lives to this extraordinary institution over the past 70 years. This is an hour for seizing.
Baroness Gardner of Parkes (Con)
My Lords, I emphasise that I have worked in the health service for well over 60 years, but there is still such a lot to learn about it. Something important to have come out of today’s debate is that we should look at a lot of things again.
I know that the noble Lord, Lord Mawson, spoke about doing away with health centres. I do not agree at all with that. As a dentist, I found that health centres were a very effective way of giving treatment to children. Parents, especially now that you have to pay for dental examinations, no longer take their children to their own dentist twice a year, which is what used to be the practice. Now, children are lucky if they are seen before they are in pain, which is a most awful reason for anyone to go for treatment: you are automatically very worried and unhappy from the start.
I congratulate the noble Lord, Lord Darzi, on securing this debate. It is very far-reaching and should be considered in detail. Certainly we should use more of those health centres, as we did in the past, and more respite care, or cottage hospital-type recovery after hospital. We are using a very expensive facility to keep people in hospital during their recovery when they would probably much rather be in slightly more homely surroundings. Of course, they would have to be adequate for the treatment that they were recovering from, but all these things are possible if enough thought is applied to them: that is what I believe should happen.
In these couple of minutes which is all we have, I pay tribute to the very many dentists and doctors—huge numbers of them—who came from the Commonwealth in the early days of the National Health Service. In Australia, where I graduated, anyone who had been in the forces was allowed to go to university if they had enough qualifications. As a result, 150 dentists a year qualified in Sydney and there was no work for them; they were just out digging the roads or working on the Snowy River scheme; anything to be earning a crust. Then someone discovered that, yes, there were jobs over here. The first ones came and they passed the word on to all the others. In the early years, in this country, the big thing was that people looked to full clearance of teeth at the age of 21 as the desirable situation in dentistry, which was unbelievable. When we arrived, children’s teeth were in a terrible condition.
Commonwealth dentists, in particular from Australia, New Zealand and South Africa, all of whom had a higher degree, which was acceptable here, did a huge amount. We almost got the situation completely under control, but now it is as bad as it ever was. In Manchester, we find that children cannot have ordinary operations under general anaesthetic because every slot is taken with clearance of baby teeth: that is just hard to believe. I have almost run out of time so I will not go on further, but I think we have a lot to think about and a lot to aim at. I want to pay tribute also to Lord Pitt, David Pitt, who did a marvellous amount here, coming from quite a different part of the Commonwealth. He was a hospital patient in the hospital I was chairman of and was so undemanding it was just hard to believe. There is still a great deal for us to do.
Baroness Gale (Lab)
My Lords, I thank my noble friend Lord Darzi for bringing this important debate before us today and for the wonderful story he told, making us realise how much we must cherish this precious asset we have. The improvement in women’s health since 1948 has been absolutely amazing. I have the time to mention just three measures: the oral contraceptive pill, the Abortion Act 1967, and the improvements in the treatment of breast cancer.
The pill was introduced in the UK and became available on the NHS in 1961, but it was for married women only at that time. That all changed in 1974, when family planning clinics could prescribe single women the pill: it was a very a controversial decision. Now it is taken by 3.5 million women in Britain between the ages of 16 and 49. It gave women, for the first time, the freedom to control their own fertility and it was a great liberation for them. It avoided unwanted pregnancies and a woman could decide when to have children. It proved to be a great advantage in so many ways. Women could now plan their lives, in terms of their education and their job development, and could choose when and if they wished to get married. It changed our society and allowed women the freedom that women of earlier generations could not have dreamt of; that was all because of the National Health Service.
The Abortion Act 1967 allowed women to have safe, legal abortions under the NHS and did away with the illegal back-street abortions that many desperate women turned to because there was no alternative. In 1990 the time limits were lowered from 28 weeks to 24 weeks for most cases because medical technology had advanced sufficiently to justify the change. The Act does not apply to Northern Ireland, but at the last general election the Labour Party manifesto said:
“Labour will continue to ensure a woman’s right to choose a safe, legal abortion—and we will work with the Assembly to extend that right to women in Northern Ireland”.
We are committed to ensuring that women in Northern Ireland will have the same rights as women in the rest of the UK. I trust the Government are equally committed.
Screening was introduced for breast cancer in 1988 in the United Kingdom and now women aged 50 to 70 are offered tests every three years; older women can ask for one. More than 55,000 women are diagnosed with breast cancer each year in the United Kingdom, but the good news is that more women than ever are surviving breast cancer thanks to better awareness, better screening and better treatments. Around five out of six women diagnosed in the United Kingdom today will be alive in five years’ time, compared with three out of six 40 years ago. The charity Breast Cancer Now has an ambition that by 2050 everyone who develops breast cancer will live. It believes that its research will allow it to achieve its ambition to stop breast cancer taking lives. Combined with the work that the National Health Service is carrying out in research and medical advancements, I think this is possible.
Everyone in this country can give thanks to the National Health Service, especially for the advancements in women’s health. I give thanks to the National Health Service for bringing about such a great improvement in women’s health.
Lord Bird (CB)
I am really pleased to be talking in this debate about the National Health Service. I started life in St Mary’s Hospital. My mother, a lovely Irish lady, said that I was the most difficult birth because instead of it taking 10 Woodbines to birth me, it took 20. I should not really be here: I should be dead, because I come from poverty. I am in the House of Lords because of poverty, to try to dismantle poverty and to prevent poverty happening.
I do not want to sound like Mark Antony at Caesar’s funeral, but talking about the National Health Service raises a number of questions for me. One is: are we talking about the National Health Service or the “I will get you back to health” service? My problem is that when I look around, I look at the big, ugly sun that sets and rises over all of us, which is poverty. According to a friend of mine who worked at St Thomas’ Hospital, 60% to 70% of the people the NHS has to deal with come from poverty. Because they come from poverty, they present their poverty in many ways and one of the big ways is in their health.
I will quote two human beings. One, John Newton, is the director of Public Health England, who makes the point that 40% of all illnesses that present in hospitals and the National Health Service are preventable and 23% of deaths need never have happened.
I have a quotation from 1944, from the MP for Rochdale, Dr Hyacinth Morgan, who said:
“The whole question of social medicine, with the questions of good milk supply, prevention of disease, good food and nutrition, good housing, good recreational facilities, prevention of mental disability in its early stages—all this has been left out of the White Paper”.—[Official Report, Commons, 16/3/1944; col. 494.]
Looking at the National Health Service over the past 70 years, I would say that it is an absolutely wonderful invention that has saved many members of my family. I have yet to use it, but, when it does come along, I am sure you will give me a brilliant send-off.
The point is that, unless we find a way, instead of spending 5% of the national health budget on prevention, to move it mainstream, we will always be worshipping at the altar of the accomplished fact. We will always be dealing with health rather than the terrible reality that exists behind it, which is the fact that we live in a poverty culture; we have poverty capitalism, where the poorest among us have to resort to the kind of food that can lead only to bad health. Until we get rid of poverty capitalism, we are not really going anywhere, and we will be talking about more and more needs for the National Health Service. The National Health Service will become even bigger unless we tackle the elephant in the room, which is poverty.
Lord Bhattacharyya (Lab)
My Lords, I thank my noble friend, Lord Darzi, for securing this debate, which has demonstrated how important our National Health Service is to the lives of so many in this House. I was very proud of the IPPR report—I was a long-standing trustee of the IPPR. I am an engineer; I am not a doctor. I design cars. However, I am married to a midwife, as well as the proud father of both a dietician and a recently qualified junior doctor; I have taken a great interest in this area. On that note, I should draw attention to my interests in the register.
This debate asks how the National Health Service can serve our nation in future. I want to raise two examples of how digital technology can improve our national health. Today the National Health Service is far from being a digital organisation. In fact, it is the world’s largest purchaser of fax machines. However, current digital resources can be used to improve future NHS services. In radiology, the NHS has held images and reports for a decade: millions of X-rays, scans and diagnoses. At the same time, radiologists face ever greater time pressure. Only seconds can be given to reviewing each new X-ray. This leads to outsourcing to expensive tele-radiology firms, which then make a lot of mistakes that cause a lot of errors.
We have an opportunity to build artificial intelligence systems that use the NHS’s historical data to identify which new X-rays radiologists should examine first. It is a form of digital triage. At my place we are developing such a system for chest X-rays. In future, the same principles could be applied to CT scans and MRIs.
Data anonymisation is essential, but, as my very good friend Dame Julie Moore of Queen Elizabeth Hospital in Birmingham, with which we are co-operating, said, no patients have refused consent to her trust collecting outpatient data.
Another way we can improve the use of current data by the NHS is with patients who have multiple chronic conditions. These cases are so complex that the causes of worsening symptoms may not be apparent even to experienced healthcare professionals. Furthermore, when multiple treatments are prescribed the patient can be overwhelmed. These patients do not need to present to a GP or an A&E as often as they do. A digital care planning programme could intelligently understand how treatments interact, prompt patients to medicate correctly and allow healthcare professionals to monitor patients remotely. Such technology and devices are available now. This would reduce the pressure on front-line NHS providers and provide better care to patients at home or in social care.
We desperately need to support innovation if the NHS is to succeed for the next 70 years. Sadly, as the Science and Technology Committee report on life sciences has said, the structure of the NHS stifles innovation. Innovation is a topic I am familiar with. We have been innovating in British manufacturing industry for a long time. We need to transform the way the NHS applies new technologies. To achieve this we need strong leadership on innovation in the National Health Service. Innovation is simply essential and is very easy to use. However it is important that we have the skills base to use it.
Baroness Finlay of Llandaff (CB)
My Lords, the noble Lord, Lord Darzi, in his superb opening speech, reminded us that we must not forget what the alternatives to the NHS look like, when whole tranches of the population cannot pay for care. As Bevan said:
“The field in which the claims of individual commercialism come into most immediate conflict with reputable notions of social values is that of health”.
It is said that you cannot know where you are going unless you know where you have come from. Our roots go back far. Lady Beatrice Webb led the 1909 minority report of the Royal Commission on the Poor Law, which called for a unified medical service. Beveridge, himself a researcher for the minority report, recognised the influence of that on himself. Then Bevan, in an inspired political appointment, took on the medical resisters, and we all celebrate the benefit from their defeat.
My interests go back more than four and a half decades, working fully in the NHS. I am grateful to all the patients I have looked after, who have taught me so much and enriched my life. It is a two-way process, and it is has been an honour and privilege to work with them.
In Bevan’s book In Place of Fear, he wrote:
“Preventable pain is a blot on any society. Much sickness and often permanent disability arise from a failure to take early action”.
By embracing artificial intelligence, we now have amazing opportunities for early action: we can decrease error, diagnose sepsis, acute kidney injury and melanomas, use CT and MRI to diagnose cancers, and so much more. The horizons are expanding before us. In my own cancer centre we are using virtual reality to help patients understand what is happening to them. Yesterday, at the Bevan Commission international conference—I declare my interest as a commissioner—artificial intelligence was seen as key to reducing error but was not expected to replace clinical roles in the next 10 years.
The latest paper from the Bevan Commission stresses the need for social support and social change. This week, Vaughan Gething, the Minister in the Welsh Assembly, has announced plans for Wales to be the first “compassionate country”. Across society, we must all take responsibility. Loneliness is a killer.
We must recognise the unique value in each individual and harvest it, recognising that adverse childhood experiences result in poor physical and mental health in adulthood, and take responsibility. For these children, the most important factor in their future is a stable adult in their lives.
Social care prevents some problems and delays others. It does not substitute for, or replace, life-saving technology or highly complex interventions when we need them.
We need a huge shift in controlling data. Patients should be able to access all their data. The OpenNotes trial found that 99% of patients and 75% of doctors want to continue with open access.
Bevan said that we would be in a state of constant change, and we are. We must look forward. We must not carry on squeezing until the pips squeak, but we must value care, science and vocation in our staff, so that in 70 years’ time we can meet the greatest need without the threat of somehow having to find money to pay—perhaps even millions of pounds if it is life-saving.
Lord Naseby (Con)
My Lords, it is an honour for all of us in this place to speak in this debate on the 70th year of the NHS. We owe a great thanks to the noble Lord, Lord Darzi, for showing the initiative. We also owe him a thank you for when he was the Minister on the Benches for the Government, over a number of years, because he certainly got a grip of things when he was there. I also pay tribute to my noble friend sitting on the Front Bench, as it is a long time since we have had a Conservative Member sitting there who has tried really hard to get a grip of the issue.
I am a marketing man by profession and I am looking at the things on which we need action on a practical basis. I start with the GPs; I am married to a retired one. It is not working at GP level today, on the whole. I exempt the GP practice where I am a patient at Greensands in Potton, which is pretty good, but it is not working because there are not enough GPs. There are also not enough district nurses. Those are the two key areas. Just look at the figures for district nurses. The graph has gone down for the last X number of years, certainly the last 10 years. We have to double the number of district nurses, because they are the people who visit patients at home and keep them out of hospital and the GPs’ surgeries. That is point number one.
Secondly, my wife was a full-time GP and she looked after me and three children in our constituency, and all the rest. Initially, she had a small practice and she built up to a very large practice in Bedfordshire. There were night calls and weekend calls. One of the doctors did minor surgery and it worked well. None of that happens today. Why do we not have minor surgery from our GPs? That would relieve our hospitals a little. Why do we not have more GP hub units like the one in Biggleswade today, which works at weekends? It is looked after not by doctors who are running their normal practices, but other doctors do the work and that unit works well.
Thirdly, we need to look at the number of doctors. We have about 50% of what we need. I hope nobody thinks that I am biased, but there is something wrong with the gender balance. Nearly 60% of the medical school intake is female now. The net result, as ladies across the medical profession will know, is that 5% never work, 80% work half-time and about 15% work full-time. Against that background we need two women for every man, so that is a challenge. Moreover, my son works as an Army doctor and he had it in his contract to work for five years. In Singapore, if you take a medical degree you have to work full-time for five years. Not surprisingly, if you leave early you have to pay back the money that has been spent on you.
As a further point, in Bedfordshire there is the Luton and Dunstable Hospital. It has a unit where, when you arrive, they assess you and you go either to its GP unit or to A&E. Seventy per cent go to the GP unit. That is the situation.
Finally, on payments, I am fed up with looking in my surgery at the number of people who do not turn up. Somehow, we have to find an answer to that. Personally, I think we should trial a £10 fee for those who fail to turn up.
Lord Dubs (Lab)
My Lords, I congratulate my noble friend Lord Darzi on initiating the debate and on his speech.
Exactly 70 years ago today, I was a patient in Stockport Infirmary. I was quite ill. In those days, when the consultant did his rounds it was like God visiting, with a team of doctors, matron and so and, if I remember rightly, one was supposed either to stand to attention if one was well enough or lie to attention if one was not. I was lying to attention. The consultant came by and I said, “Just a minute. I have a question to ask you”. One did not ask consultants questions like that, so he turned around and said, “What is it?”, and I said, “Are we having a party today?”. He said, “What for?”, and I said, “The hospital’s ours. Isn’t it terrific?”. He walked on. I was the only child in the ward and the other patients asked me what was going on. I explained and I think I got a few Labour supporters out of that.
I should declare that, more recently, I was a member of an area health authority and, even more recently, I was a member of a mental health trust, and I found it a privilege to serve on both those bodies.
I welcome the Government’s recent announcement of a bit of an increase, although it is only a standstill increase and does not increase the resources going into the health service. For all the criticism of the health service, I think we get fantastically good value for money out of it. If we look at the percentage of GDP spent on health, we compare extremely well with many other countries. Most of the major European countries spend more of their GDP on health than we do, and the Americans are way ahead. The trouble is that we get all this on the cheap. It is to the detriment of the health service that it is too easy for the Government to turn off the financial tap for reasons of austerity, and there are no safeguards to protect the health service against a Government’s short-term need to save money. My noble friend Lord Winston made that point earlier. I believe the value for money is incredibly good.
I hope that the Government will tackle the problem of social care. It is all too clear that so much bed-blocking takes place and that the health service would benefit if people could be moved out of hospital when they are well enough into their home with support or into other forms of residential support. It is to the detriment of the health service that we allow this to continue. We have to tackle it.
At a local level, Charing Cross Hospital in West London, which is much loved and much appreciated, is still under threat. There has been a big campaign to save it. The local health authorities wanted to close it down. At the moment, it is still there, at least until 2021. In the meantime, the Government have added £7 million to the A&E services, which are very important, but there is no point in putting money into A&E in the short term unless we have some assurance that the hospital will continue. The trouble is that we have to get out of the position in which the Government can too easily cut off the money so we do not have any long-term assurance about the health service.
Finally, I believe this most sincerely: the British people would accept an increase in taxation in order to fund the health service more securely. They would accept that, provided it was hypothecated for the health service. I know the Treasury does not like that, but I believe that if the people of Britain were told that more money from taxation would be used directly for health and social care, they would accept that.
Lord Warner (CB)
My Lords, I, too, add my congratulations to the noble Lord, Lord Darzi, on his excellent speech and his constructive IPPR report. He and I have both had a go at reforming the NHS, and I think we can at least congratulate ourselves on not creating a mess on the scale of the Health and Social Care Act 2012, from which the NHS still suffers.
The NHS has been a key part of our welfare state and a great piece of communal risk pooling and social cohesion. It has survived some difficult years with its funding veering around from famine to feast and back again. It has become like David Attenborough and Judi Dench: a national treasure. However, the trouble with national treasures is that they can end up like Danny Boyle at the 2012 Olympics, engaging in a fantasy view of something that badly needs to change but gets frozen in the national psyche.
The NHS and its staff are tired in part because its business model and operations badly need a major overhaul. The NHS still operates the organisational silos created 70 years ago. It has not integrated its own services very well, let alone integrated with social care. It is still largely a sickness service rather than a health service. Public health, mental health and adult social care remain Cinderella services financially, while the acute hospitals remain the financial preoccupation of most elected politicians. The patient base of the NHS now lives much longer than in 1948, with a set of comorbidities that come largely from lifestyle choices, but the service delivery system has changed little, despite countless reorganisations. It certainly does not deliver consistent quality across the country.
The way services are delivered needs to change radically and swiftly. Simply giving giving the NHS shedloads of new money without a credible and enforceable long-term reform plan would be a waste of taxpayers’ money. The NHS England long-term plan promised for this autumn needs to provide for a radical shake-up of the way in which services are delivered outside hospital, the way in which staff are trained, treated and deployed, and the way in which technology and regulatory change are to be implemented. There needs to be a sweeping away of the 2012 governance and accountability arrangements. This plan must lock funding into reformed services outside hospitals and will need regular parliamentary scrutiny on its delivery. It must also be supported by a new, credible and sustainable funding system for adult social care, which remains in a parlous state both financially and through the growing collapse of the publicly funded social care provider market. Unless the Government show a greater sense of urgency about a new funding system for social care, they are setting up the NHS to fail.
Let us be clear. There is no Brexit dividend for the NHS. The OBR forecasts show the UK economy flattening out, flatlining at about 1.5% growth a year after Brexit. This will make it very difficult to sustain a 3.4% real-terms annual increase for the NHS over a long period. So the NHS had better get on and reform itself quickly while the financial sun shines briefly for a moment.
Lord Astor of Hever (Con)
My Lords, I, too, congratulate the noble Lord, Lord Darzi. I was in the Chamber when he leapt across that Bench to save the life of a noble Lord who had had a heart attack, and a very impressive sight it was. I, too, have suffered a cardiac arrest and I received life-saving care from two wonderful paramedics from the South East Coast Ambulance Service.
My personal experience, not in a way that I would have chosen, was of the NHS at its very best. Everything at every stage, from the moment the cool-headed handler took the 999 call, the paramedics who got my heart going, the surgery, to the kindnesses and the professional aftercare that I received in East Surrey Hospital, could not be faulted. I was honoured when the hospital asked me to open its wonderful new cardio wing and meet the staff. It was an emotional event for me to stand in front of the very people who had saved my life, giving me an opportunity to join this debate today.
I declare an interest, in that my sister was a state registered nurse, my brother-in-law is a retired senior surgeon with the NHS and my niece is a junior doctor training in infectious diseases. She is extremely proud to be part of the NHS and very optimistic for the future.
While we bask in the reflected glory of all that the NHS has achieved in the past 70 years, I agree with the noble Lord, Lord Winston, that we must be realistic. We need to remember the winter pressures and looming targets that put the NHS under immeasurable pressure and result in less than optimal patient care.
At this late stage of the debate, I will touch on just one challenge facing the NHS, which has been mentioned by many noble Lords: creating a sustainable workforce moving forward, particularly as we rely so heavily on European and overseas staff. Since we voted to leave the EU, there has been a dramatic reduction in the number of staff coming from Europe. Although immigration restrictions have been lifted, it is going to take time to recruit staff. The NHS must be able to offer a long-term future, or why would they come? The focus should be on making medicine and nursing attractive again and developing a long-term plan that meets workforce challenges. There is much bridge-building to do after last year’s junior doctors’ strikes if the NHS is to keep them once they have completed their training. Junior doctors welcome Jeremy Hunt’s pledge for more medical school places, but there are ongoing concerns about low morale and rota gaps in the workforce causing significant issues with retention of staff. Worryingly, junior doctors are leaving not only the NHS but the profession altogether.
With regard to nurses, this is the last year that those in training are entitled to receive a bursary and will not have to pay university fees. They will then have to pay £29,000, plus living costs, for a three-year period. This means that most nursing graduates will leave university with debts of around £54,000. I would be interested to hear whether the Minister is concerned that this issue will have a negative impact on nurses’ recruitment.
Lord Murphy of Torfaen (Lab)
My Lords, I was born in 1948, five months after the maternity unit in which I was born was taken over by the National Health Service—that was 70 years ago today and we are debating that anniversary.
Yesterday, in the House of Commons, my successor as Member of Parliament for Torfaen, Nick Thomas-Symonds, gave a lecture on Nye Bevan—on whom he has written a wonderful biography—and the National Health Service. In it, he referred to the Tredegar Medical Aid Society, which was an embryonic version of the National Health Service, based as it was on the spirit of community and solidarity of the people in south Wales. It was Nye’s intention then, as he put it, to “Tredegarise” the rest of the United Kingdom, which he successfully did. We have heard—particularly of course in my noble friend’s brilliant opening speech—of the three principles of that service: it is free at the point of use; it is financed from central government; and everybody is eligible to use it. In Nye’s words, he believed that it would,
“lift the shadow from millions of homes”.
Since Nye’s day, the NHS has of course been devolved. He was not too keen on devolution but I think that he might have changed his mind as the years have gone by. In Wales today, a country of 3 million people, we have 20 million patient contacts a year, 1 million seen in A&E, £7 billion spent on health and social services—in Wales, the two are put together—and 100,000 staff. It has been the fashion over the past few years for Prime Ministers, when they face criticism of the English health service, to say that the Welsh health service is not up to much. Far from it. In fact, it is an unfair comparison. The people of Wales worked mainly in coal, steel and heavy industry and, in consequence, there was a much greater need for health services than in parts of England. Nor was the comparison necessarily like for like because, as I said, health and social services in Wales are combined, which is not the case in England.
Over 90% of Welsh people are well satisfied with the National Health Service. More is spent per person on health in Wales than in England. Wales was the first of the home nations to ban smoking in public places, to ensure that parking in hospitals is free and to introduce free prescriptions. I certainly want to celebrate our National Health Service today by thanking all those 100,000 people who work in the health service in Wales and, of course, all those hundreds of thousands of others who work in the United Kingdom.
Finally, to quote Nye:
“Society becomes more wholesome, more serene, and spiritually healthier, if it knows that its citizens have at the back of their consciousness the knowledge that not only themselves, but all their fellows, have access, when ill, to the best that medical skill can deliver”.
Lord Selsdon (Con)
My Lords, I apologise for my delay in speaking but my mobility is not as great as I would have hoped. I made the mistake of being a wicket keeper for many years and was suddenly told that I needed a new knee, having found that I could not walk.
One thing about the NHS is that, when you do not know it, you do not know what to expect. The NHS gave me a new knee. Attractive girls came to drip-feed me every evening, and then I found that I could walk and almost run. Against that background, I find it quite intriguing that we now have the technology to deal with all forms of sports activities. I found that the first thing the NHS needed to get was a new knee, which had to be ordered from the United States. I wondered why we did not do new knees. The surgeon was American and the operation was done by the NHS in London, then I was told, “You can go home shortly”, but they were not sure that they could trust me. When I got home, I found that every day at six o’clock two ladies turned up to give me injections in my arms and so on in case anything went wrong. Then—lo and behold!—I found, with joy, that I could walk properly, and I have been able to do so almost ever since.
With that thought in mind, I turn to the difficulty of dealing with the authorities. You make a telephone call and, before you know it, you get into the bureaucracy of receiving pieces of paper requiring you to attend another hospital appointment. I have had nearly 10 hospital visits with people wanting to check me out—they found that I had lost weight. It was the care that I received from the NHS that impressed me, as well as the fact that I can walk again. I am extremely grateful to it for what it has done for me.
Baroness Jolly (LD)
My Lords, I join other noble Lords in thanking the noble Lord, Lord Darzi, for tabling this timely debate and for his excellent speech in kicking it off. It is one of those speeches that we will want to reread, and we will need to pick up a copy of Hansard on Monday.
These Benches are proud that on this day 70 years ago the Leader in your Lordships’ House was Lord Beveridge, author of the report implemented by the Attlee Government, thus creating the NHS and social care entitlement. So perhaps this is true co-production.
I start by noting the contribution to today’s NHS of all the staff who over the last 70 years have worked tirelessly, whether as clinicians, carers, cleaners or managers, and I pay tribute to the current employees too. But what would somebody from 1948 make of the NHS now? My father-in-law graduated from Leeds medical school in that year and was one of the first cohort of NHS doctors—and very proud he was too. He recalled that there was a handful of drugs that they could prescribe, and after their six years’ training they knew pretty well all the medicines that there were to know. Later, he ran a GP practice from his home. One room became the waiting room and another the surgery. The family recall syringes being sterilised on the kitchen stove. He and a partner set up a practice which grew and grew, and it still exists. Today, I think he would be delighted to see his practice offer patients the ability to book appointments online and order repeat prescriptions, but he might be rather bemused by the need for a practice Facebook page.
Today, the life expectancy for men is 77 and for women 81. Then, it was 66 and 71. I think several of us have been looking at different briefings with different numbers, but the numbers are in the right sort of order. No one quite appreciated the impact of the impending baby boom rippling through the population. Most of the residents in today’s care homes were born before the NHS came into existence, and unless we mend our lifestyles a large proportion of us will not live as long as our parents.
In the new NHS, public health and prevention was important. I remember queuing in the village hall for cod liver oil, orange juice and polio jabs, and once at school we had nit inspections, eye and hearing tests, and TB jabs. Public health looks very different today—gone are the nit inspections—but local authorities have public health responsibility all over again. They look at health as a determinant in housing, social care and wider community services.
Prior to the NHS, the first port of call often was the high-street chemist for a chat with the pharmacist, who would be able to recommend the right remedy. This conversation was free, and a visit to the GP was out of reach for many. Now, too many of us visit our GPs expecting a prescription when we have a cough, cold or sore throat. We are unaware that we can get better with the help and advice of the pharmacist. If this was to be adopted as the first port of call by us all, our GPs would have time to deal with the people who are really poorly.
There cannot be a sustainable NHS without sustainable adult social care. Adequately funding social care would deliver benefits for local communities and savings for the public purse. For example, funding an expansion in social care capacity would alleviate NHS pressures and therefore enable more people to be discharged quickly and safely from hospital. We all have friends and relatives who, whether due to age, ill health or dementia, have found themselves in need of social care. The continued underfunding of social care affects us all. It is making it increasingly challenging for local authorities to fulfil their legal duties under the Care Act, leaving the ambitions of some aspects of the legislation at risk. Equally concerning is that, by 2025, another 350,000 people will need high levels of social care from councils. As the ADASS budget survey highlights, moving towards prevention and early intervention is one of the most important savings areas identified by councils. However, as budgets reduce, it becomes harder for councils to manage the tension between prioritising statutory duties towards those with the greatest needs and investing in services that will prevent and reduce future needs.
The current move towards integrated care organisations is welcome, but success will depend on strong leadership and a willingness of both health and care to co-operate, to share a budget and to involve patients, those in care and carers, and the voluntary sector in system design. As mentioned by the noble Baroness, Lady Morris of Bolton, the initiative currently under way in Greater Manchester, where 10 councils came together to deliver health and care services locally, has much potential. We await evidence of success and impact on the health community. In Cornwall, my part of the world, for the last year or so the local council has been working closely with the CCG to achieve the same end but on a much smaller scale and in a rural setting. However, where any services are devolved, we are also clear that national standards need to remain and that accountability will be key. As a quick note to the noble Baroness, Lady Gardner of Parkes, Cornwall still has all its community hospitals and they are used as step-up and step-down units. The challenge posed by the increased localisation of services is the risk of a postcode lottery in both availability and standards. Those local councils where there was the greatest need have low-rated housing, and any dividend from raising council tax is not enough to plug a gap.
Almost two years ago now, my right honourable friend Norman Lamb commissioned a group of experts from within the sector to look at the vexed issue of funding the NHS and social care. Among the recommendations were an annual rise in real-terms funding for the NHS in England in line with long-term growth. For the next five years, we believe that a 2% rise per year is a realistic figure. This should be matched by equivalent increases in funding for the devolved nations under the Barnett formula. A further recommendation was to set up an independent OBR for health to make recommendations to government about the funding required for a three-year cycle.
Recently, the noble Lord, Lord Patel, who sadly is not in his place, chaired a Select Committee of the House on the long-term sustainability of the NHS and adult social care. This was a look at the current system by a group of Peers with long experience of working in the NHS, government and social care. Their report was full of positive recommendations—it read like a critical friend’s review of an organisation in need of change. It took the Government some time to bring it to the House for debate; let us hope it takes less time to implement some of the recommendations.
Artificial intelligence, biosimilars, genomic medicine and robotic surgery would have been unimaginable to those doctors in 1948, but who knows what the next 70 years will bring. In many areas, we are on the cusp of system failure yet, in others, of huge system innovation. Organisations needing support should be encouraged, not punished. The Government need to be bold in their decisions and announcements in November. The Green Paper on social Care and its funding should be person-centred, encourage creative solutions and provide the necessary funding to deliver appropriate support for the NHS and for its stable future.
Lord Hunt of Kings Heath (Lab)
My Lords, it is an honour for me to wind up for the Opposition in this debate. Because I am going to refer to NHS management, I remind the House of my presidency of the Institute of Healthcare Management, the Health Care Supply Association and the Hospital Caterers Association.
I start by expressing my thanks to my noble friend Lord Darzi for his magisterial opening speech. The vision that he set out was profound and inspiring in urging us to revitalise quality as the organising principle of health and care, investing in health and not just healthcare and investing in the talent of our staff as well as tilting, as he said, towards technology to create a digital-first health and care system. My noble friend Lord Bhattacharyya really very much reinforced that. He also said something very important—that he saw the NHS as the expression of a moral principle that no one should be denied healthcare because of their means. I could not help thinking that Nye Bevan would have approved. In his essay “In Place of Fear”, he uncannily anticipated the wretched outcome of the Government’s attempt to marketise the NHS when he said:
“Preventive medicine, which is merely another way of saying health by collective action, builds up a system of social habits that constitute an indispensable part of what we mean by civilization. In this sphere values which are in essence Socialist challenge and win victory after victory against the assertions and practice of the competitive society”.
Amen to that, my Lords.
The intervention from the noble Lord, Lord Lexden, in response to the noble Lord, Lord Pendry, about the history of the Conservative Party and the NHS was very interesting. However, at the end of the day, the party voted 21 times in that Bill on the formation of the NHS. I say to the noble Lord, Lord Lexden, that I think Bevan was entirely right to believe that Henry Willink’s plan to leave the voluntary and local authority hospitals in their existing ownership would have led to a much patchier and second-rate service.
The remarkable speech of the noble Lord, Lord Hennessy, recalled the profoundly positive impact of the lifting of the financial fear of the consequence of illness. It is right to celebrate that—but I am with noble Lords who want a sober analysis of the NHS and the challenges that it faces. The BBC should be commended on commissioning a report on the relative strengths and weaknesses of the NHS from the Health Foundation, the IFS, the King’s Fund and the Nuffield Trust. You could not look to better institutes than that for it—and it was sober. It said that, although the NHS leads the world in terms of equity of access and ensuring that people do not suffer financial hardship and performs well in managing long-term conditions, such as diabetes and kidney disease, and is relatively efficient compared to other systems, outcomes are its Achilles heel.
Although the NHS is closing the gap in a number of areas, we still lag behind in saving lives when treating many of the leading causes of death, including several types of cancer, heart attacks and stroke. It is comparatively poorly resourced. I do not think that having average GDP spend for the whole of Europe is actually anything to be proud of, given that we are the fifth or sixth-wealthiest country in the world. We are poorly resourced. We have markedly fewer doctors and nurses than comparable health systems. We have the lowest number of hospital beds, CT scanners and MRI scanners. We are one of the slowest nations to take up new medicines and new developments. We have a long way to go. Although international comparisons are always subject to the caveat of being a partial picture, it is clear that we enter the eighth decade in uncertain health.
Funding is a clear issue. Of course we welcome the injection of £20 billion for the NHS over the next five years, but it is not the long-term solution that my noble friend Lord Winston and other noble Lords have called for. It is nowhere the near the 4% per year that most organisations reckon should be the base funding. Of course, that money does not cover public health, training, capital spending and social care.
All my noble friends have talked about the need for a fundamental change in social care. The Green Paper is awaited in the autumn. All I have to say to the Government is that they had better deliver on this. Frankly, there is no chance of integrated care in the way they talk about unless we deal fundamentally with the problem of the current means test and find a way to cap the cost for individuals having to pay for their own care. Nothing else will deliver the kind of integrated care that we need.
Noble Lords have talked to an extent about other forms of funding. The noble Baroness, Lady Finn, implied that we need to look at those. I repeat what my noble friend Lord Darzi said: by far the most efficient, dignified and lowest-cost way is to create a universal service free at the point of need. As he said, it is a fundamental error of logic to say that because something is unaffordable we should move to something more expensive and, indeed, more inefficient.
Noble Lords have raised many issues. On mental health and public health, I echo their points, but I want to end on the workforce. The NHS faces some pretty fundamental issues in relation to its workforce. One in nine nursing posts is unfilled and the number of unfilled vacancies among GPs is soaring, as is that of young doctors qualifying, leaving the NHS and going abroad. Morale is probably the most serious issue that we face. My noble friend Lord Parekh suggested, I think, that front-line workers were inhibited by managers. In my role as president of the Institute of Healthcare Management, I want to defend the role of managers in the health service, but I accept, as my noble friend Lord Darzi said in his report, that poor leadership and demotivated staff are a precursor of system failure. That echoes one of the most incisive reports on NHS leadership and management, by the noble Lord, Lord Rose, when asked to look at this in 2014. The Secretary of State did not like the response, so nothing happened because of it, but it talked about the,
“level and pace of change”,
being “unsustainably high”, with,
“the administrative, bureaucratic and regulatory burden fast becoming insupportable … The NHS has committed to a vast range of changes”,
but,
“there is insufficient management and leadership capability to deal effectively with the scale of challenges”—
that echoed what the noble Baroness, Lady Harding, said. However, I have to say to her that it is no good just blaming managers. There is a combination of overbearing regulators, an absence of leadership from Ministers, the complexity of the 2012 Act, the tightness of funding, the risk aversion and the widely prevalent bullying culture—which starts with the Secretary of State, with his insistence on sacking chief executives willy-nilly. It is no good the Secretary of State talking about bullying in the health service until he looks at his own behaviour and how he and the regulators relate to people in the service, because no one locally will believe in this unless the people they are answerable to change their own behaviour.
We come now to the issue of the disastrous Health and Social Care Act 2012. It was the most ill-conceived piece of legislation that the health service has ever seen. As was said earlier in the debate, in an extraordinary speech made on 18 June, the Prime Minister basically said that the Act was a disaster. She referred to clinical commissioning groups having to negotiate 200 different legal contracts with other parts of the NHS. That is ludicrous, costly and totally ineffective. I say to the Minister that the Government should consider bringing forward a Bill to get rid of the current bureaucracy and the enforced marketisation contained in the 2012 Act.
No one can pretend that the future is going to be easy for the NHS and social care. The challenges are formidable and the solutions are tough. Moreover, the demands will not go away. However, the NHS is resilient. It has brilliant people and it enjoys huge support. My noble friend Lord Darzi said that in 30 years’ time, he hopes to see the centenary of the NHS. I am pretty confident that he will and that the people of this country will demand nothing less.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)
My Lords, I join other noble Lords in congratulating the noble Lord, Lord Darzi, on an inspiring and typically incisive speech, and thank him for his leadership both in this House and in the NHS. We are truly grateful to him. I also want to thank all noble Lords for their contributions to the debate. Most of all, I want to thank the millions of people who work in the NHS and social care services because they look after us so expertly every day. Noble Lords have shared their personal experiences and we all have our own reasons to be thankful for the service. For me, it was the care that we received before, during and after the very complicated birth of our third child. It was simply world class. I am pleased to say to the noble Lord, Lord Winston—as I think I have before—that the birth was at the Queen Charlotte’s and Chelsea Hospital. All my children were born there and I am delighted to hear that his grandchild has been delivered successfully there too.
I want to take up the spirit channelled by the noble Lords, Lord Winston and Lord Hennessy, about consensus. As I said at Question Time this morning, it is important to recognise that politicians from all the main parties had founding roles in the NHS. The noble Baroness, Lady Jolly, talked about the role of William Beveridge. My noble friend Lord Lexden reminded us of the White Paper published in 1944 proposed by the Conservative Health Minister Henry Willink, and of course many noble Lords reminded us about the founding of the NHS by that very special and particular politician, Nye Bevan, on the principles—as the noble Lord, Lord Murphy, pointed out—of the Tredegar Medical Aid Society. It is also important to acknowledge the point made by the right reverend Prelate the Bishop of Carlisle that it was also an expression of Christian purpose, something that Nye Bevan himself acknowledged. As the noble Lord, Lord Hennessy, said, it was the nationalisation of altruism. It is also, as the noble Lord, Lord Bird, reminded us, part of our national effort to end poverty; that is what is at stake. My view, which I shared with noble Lords during a debate initiated by the late and much-missed Baroness Jowell at the beginning of this year, is that the NHS’s enduring popularity is not just because of the service it delivers but because of the many noble ideas it represents: reassurance, compassion, service to others and hope.
In delivering world-class care over the past 70 years, the NHS has changed enormously. The budget has gone up by 10 times. As my noble friend Lady Harding pointed out, the NHS is rated as the best health system in the world. The reasons for that were set out compellingly by the noble Lord, Lord Darzi, in his speech. Over those seven decades, the NHS has led the world in a great many aspects of healthcare. In 1958, the NHS introduced the first public vaccination programme; in 1968, the first heart transplant in Britain and the 10th in the world; in 1978, Louise Brown was born, the first baby ever successfully conceived by IVF; in 1986, we had the world’s first major government-sponsored national AIDS health campaign; and, as the noble Baroness, Lady Gale, reminded us, in 1988 the national breast cancer screening programme was set up. In 1994, the NHS established the first national organ donation register, while in 2002, doctors at Great Ormond Street carried out the world’s first successful gene therapy. Moreover, just last year, the NHS introduced the world’s first trial of 3D-printed bionic hands for children. That is an extraordinary and ongoing record of success.
But while the NHS has an enviable record, as noble Lords pointed out, of delivering world-class care, we know that it can get better. I read with great interest the excellent review of the NHS from the noble Lord, Lord Darzi, which he wrote with my noble friend Lord Prior of Brampton. I also note the improvements in care quality and safety that he says have been achieved since his original review in 2008. But we are all agreed—as my noble friend Lady Finn, the noble Lord, Lord Hunt, and others have pointed out—that there are great challenges ahead. Our cancer survival rates are not good enough, not least because of late diagnosis. Mental health services, which I will return to, still lag behind. Poverty is still a factor in outcomes. Too many babies and their mothers are lost at birth, and our growing and ageing population presents us with entirely new pressures.
There is an urgent need to address these challenges, as we all agree, and to provide an NHS fit for the future. It is for precisely that reason that the Government have announced that there is to be a five-year funding settlement for the NHS of, on average, 3.4% a year. The noble Baroness, Lady Tyler, the noble Lord, Lord Hunt, and others have talked about whether that is enough and mentioned 4%. It is important to point out, as Simon Stevens has done, that the NHS has got more productive than the UK economy overall. When you add in those productivity gains that is a big increase in the effective budget. Over the timeframe of that five-year funding settlement that will take us up to the level of France in terms of the percentage of GDP spent.
Noble Lords have talked about leadership. It is an act of leadership by the Prime Minister and my right honourable friends the Secretary of State and the Chancellor. It provides us with a unique opportunity for the NHS to develop a long-term plan to transform the service and, as the noble Baroness, Lady Donaghy, and the noble Lords, Lord Dubs and Lord Warner, pointed out, to avoid the feast-and-famine approach that has bedevilled us.
Several noble Lords have pointed out that only the NHS is included in this plan. That is quite right at this point in time. Nevertheless, it is important to point out that public health and social care were specifically mentioned in the settlement insomuch as, whatever the funding settlement for those in the spending review, it will not put extra pressure on NHS services. We will of course deal with those in the spending review next year.
The NHS plan will be led and developed by clinicians and patients. I promise the right reverend Prelate the Bishop of Carlisle that it will be inclusive. It is based on six key principles: focusing on the prevention of ill health; significantly improving access to good mental health; driving forward the integration of health and social care; spreading best practice and eliminating variations; embracing the opportunities of technology; and building the workforce we need for the future. Contrary to the suspicions of the noble Lord, Lord Dubs, Simon Stevens, the head of the NHS, has said himself that, together with his plan, the money will enable us to do more than just stand still. We have before us the opportunity—as the noble Lord, Lord Hennessy, said, the golden opportunity—to transform health and social care in the years ahead.
The right reverend Prelate the Bishop of Carlisle pointed out quite rightly that, first and foremost, we must continue to focus on prevention, not least because, as the noble Baroness, Lady Jolly, pointed out, unhealthy behaviours are associated with a significant number of early deaths in the UK. Each year there are around 80,000 deaths related to smoking, a point alluded to by the noble Lord, Lord Faulkner; 30,000 deaths related to obesity; and 7,000 deaths related to excessive alcohol consumption. This must change.
The noble Lord, Lord Faulkner, spoke powerfully about the pernicious impact of smoking. Our tobacco plan lays out an ambition to reduce smoking among adults in England to 12% or less. I confirm to the noble Lord that that aligns with the Royal College of Physicians’s proposals. We are making all NHS estates smoke-free by next year.
As noble Lords will know, to fight childhood obesity—a hot topic in this House—there are new taxes on sugary drinks, and we are helping children to exercise more and cutting sugar and calories. As we have shown in our most recent chapter, chapter 2, of the obesity plan, we are prepared to take radical steps to beat this epidemic. I am also grateful to my noble friends Lord Colwyn and Lady Gardner for pointing out the essential role that NHS dentistry has in delivering a truly preventive care service. However, we all agree that there is a need to go further. We want to help people to develop the right habits for healthy living. The noble Lords, Lord Hunt and Lord Brooke, my noble friend Lord Naseby and the noble Baronesses, Lady Finlay and Lady Watkins, all quite rightly said that we need to take more personal responsibility for our health, not just relying on it being delivered by others.
As we know, mental health problems affect people of all ages and all backgrounds. There is an unacceptable difference between the way that people with physical health and those with mental health problems are treated. We know that we have legislated for parity of esteem, but we have not yet delivered it. As a first step, this Government are investing more than ever in mental health services. We invested nearly £12 billion last year and aim to create 21,000 new posts by 2021 as part of the mental health workforce plan, with the first waiting time standards and an expansion of support for schools. In response to the question of the noble Baroness, Lady Tyler, on percentages, as long as less than 100% of those with mental illness do not receive the care that they need, we will not have succeeded. The challenge for the NHS as it develops its plan is how close we can get to that magic figure in the next 10 years.
Probably more than any topic that has been discussed today, integration is key to delivering the outcomes that we want. We have to break down barriers. As my right honourable friend the Prime Minister said, we have to deliver “integrated patient-focused care”. I am incredibly grateful to the noble Baroness, Lady Emerton, for sharing her experiences, although it is slightly depressing that we still face the same arguments about how to deliver truly integrated care.
My noble friend Lady Morris and the noble Baroness, Lady Watkins, talked about the fact that current health and social care services can be difficult to navigate, particularly for those who are frail, elderly or have multiple comorbidities. Increasingly, that is the typical NHS patient. We have made some progress, with the better care fund encouraging local health and care system leaders together. The noble Baroness, Lady Watkins, mentioned the vanguard areas, where we are making significant progress in reducing pressure on A&E. We are now giving the best-integrated local areas the chance to become integrated care systems, giving them more freedoms and the ability to join up systems in their area. Several noble Lords talked about Greater Manchester, which is indeed a shining example in this area. On the challenge from the noble Lord, Lord Parekh, we need to demonstrate that more areas are capable of leading that kind of work.
The noble Lords, Lord Warner and Lord Hunt, have deep concerns about the legislative framework and whether it hinders care today and will do so tomorrow. It is right to focus on the signal given by the Prime Minister to the NHS about wanting to heal the barriers to the provision of integrated care, legislative and otherwise, that are out there. That was a genuine and open offer. There is a desire to build consensus on this if consensus emerges on the need for change.
My noble friend Lord Naseby joined the noble Lord, Lord Darzi, the noble Baroness, Lady Watkins, and my noble friend Lady Gardner in saying that more care needs to be delivered closer to home. I absolutely agree with that idea of neighbourhood care. Having met the noble Lord, Lord Mawson, to talk about his work, I applaud him for leading that very local integration of care. I would absolutely recommend that noble Lords who are not aware of it investigate his work and find out more about it.
Quite rightly, many noble Lords talked about the future of social care. We know that there are funding needs. Over three years, about £9 billion of extra funding has gone into social care in the short term. Clearly, there is a need for a fundamental settlement. A Green Paper is coming, and it is a golden opportunity. We know that successive Governments have failed in this area. I hope that we can solve this, not just as one party but with all parties working together. The noble Lord, Lord Hunt, asked about the means test, the cap and floor. I can confirm that that will be in there. As my noble friend Lady Verma pointed out, this is not just about funding; the paper also has to address the many iniquities and inequalities that exist not only in the social care system but between the social care and NHS systems. Those words are very well taken.
As the noble Lord, Lord Hunt, pointed out, variation in care has been the NHS’s Achilles heel. The Care Quality Commission’s latest state of care report found substantial variation in care quality in and between services, in the same sector, between different sectors and geographically—and historically, between genders, as pointed out by the noble Baroness, Lady Gale. That is clearly unacceptable. As we would expect, the noble Lord, Lord Darzi, made a very profound recommendation in his IPPR report that we should,
“revitalise quality as the organising principle of health and care”.
We quite agree, as does my right honourable friend the Secretary of State, who has made quality—particularly patient safety—the leitmotif of his work in the health service.
That is one reason why we are funding the “getting it right first time” programme—I do not know how many noble Lords are aware of it, but I encourage those who are not to look at it—where data from front-line medics helps eliminate unwarranted variation and spread best practice. Since it began in 2016, GIRFT’s recommendations have helped trusts reduce the length of stay for hip and knee operations for the sportsmen of today that the noble Lord, Lord Selsdon, talked about, freeing up 50,000 beds a year and finding £50 million in savings over two years. That is just in one specialism, orthopaedics, although GIRFT is now looking at 35 different clinical specialities nationally. However, I take the point of the noble Baroness, Lady Masham, that with greater specialisation in services there is a need for greater transparency to prevent closed cultures. There are a number of programmes, however, as is often the case, aimed at reducing variation—GIRFT, RightCare, the Model Hospital, regional medicines optimisation committees—and one of the goals of the long-term plan must be to bring these efforts together into a single, co-ordinated approach to eliminate unwarranted variation.
The noble Lord, Lord Darzi, and others talked about tilting towards tech: I could not agree more. Despite being, as my former boss said of the then Chancellor, a slightly analogue politician in a digital age, noble Lords may know that I have become a passionate advocate for the unique opportunities of technology in the NHS. I quite agree with the noble Lord, Lord Bhattacharyya, and the noble Baroness, Lady Finlay, about the importance of patient data—giving them more control over their data to drive that technological change. It has to be recognised that the NHS, and the universities and life science companies that work with it, are wonderfully innovative. Being creative in coming up with new ideas is our great strength. Spreading those ideas throughout the NHS is often where we fall down, as my noble friend Lady Finn, and the noble Lords, Lord Bhattacharyya and Lord Hunt, pointed out. It is one of the reasons that I was so delighted last month to be able to appoint the noble Lord, Lord Darzi, as the new chair of Accelerated Access Collaborative—he may need to add that to his lengthy list of declarations—which brings together leaders from the NHS, industry and government to fast-track access to transformative medical innovations. We are expecting great things.
The noble Lord, Lord Winston, asked about academic health and science centres. They are very much in our thoughts as we work towards our improvement of the innovation landscape in the NHS. We have also commissioned Dr Eric Topol to lead an independent review of how advances in genomics, digital medicine, artificial intelligence and robotics can improve clinical staff skills, to make the most of those technologies. The noble Baroness, Lady Finlay, talked about the use of virtual reality in care and the noble Lord, Lord Bhattacharyya, talked about the use of AI in pathology and radiology. Those are just some of the areas in which we are making great advances: we could talk about genome sequencing or the new NHS app. There is an opportunity for the NHS to lead the global healthcare revolution in technology in the years ahead.
Finally, we all agree that the NHS is nothing without its wonderful people. We are absolutely committed to ensuring it has the staff it needs to meet increasing patient demand, both now and in the future. I agree with the noble Baroness, Lady Donaghy, when she pointed out that more of these should be recruited locally. I also agree with my noble friend Lord Naseby about the need for more GPs and district nurses. It is one of the reasons we announced a 25% increase in training places for doctors, nurses and midwives. I congratulate my noble friend Lady Morris, and more specifically the University of Bolton, for achieving that number one rating in nurse training. My noble friend Lord Astor spoke about the fact that not only are we increasing the number of doctors, but we are opening new medical schools in Sunderland, Lancashire, Canterbury, Lincoln and Chelmsford.
It is important to reflect on the point made by many noble Lords about the role that staff from outside the UK have played, not just in the founding of the National Health Service but in the National Health Service today, whether it is the Windrush generation, people from the Commonwealth or people from the European Union. We salute the work that they have done. We know there has been some anxiety around because of Brexit and it is important that we now have the settled status opportunity: the route is out there, it has been publicised and we have written out to the NHS and social care to make sure that our social care and healthcare workers can take advantage of that opportunity.
Later, alongside the long-term plan that we are publishing, there will be an integrated health and social care workforce strategy, making sure that we have the right number of staff, with the right skills and the right level of morale, to deliver the care of the future. My noble friend Lady Harding and the noble Lord, Lord Parekh, were on the money in pointing out the importance of leadership in actually changing some of the negative cultural problems that unfortunately persist.
To conclude, as we celebrate the NHS’s 70th birthday, we can look ahead to what the next 70 years might look like: powered by technological innovation, fuelled by intelligent uses of data and increasingly personalised. This future would be barely recognisable to the founders of the NHS in its speed of innovation, power to fight disease and ability to deliver care to people at the right place and time. But it is still a future where, I and the Government believe, the founding idea of the NHS—free at the point of need for everyone—remains its shining principle. This Government are committed to that future, as our five-year funding settlement has shown. After 70 successful years, the NHS’s own 10-year plan will set out the next part of its life-changing journey. I look forward, as all noble Lords do, to seeing what it brings.
Lord Darzi of Denham
My Lords, I have a few minutes to finish off. I thank everyone here for their amazing contributions on this very special day—the 70th anniversary of the NHS. The thoughts and ideas, although diverse, were all united in one thing: not just celebrating the past but designing the future. I particularly thank the noble Baroness, Lady Jolly, my noble friend Lord Hunt and the Minister. The noble Lord, Lord O’Shaughnessy, is a man of tremendous integrity and resolve. He addressed every speech. I know of his ability but also the talent he is surrounded with. We all wish him the best with his six-point plan.
I will end with one piece of advice: as we move into the future, we need to work with the patients and the public who are funding this, while remembering that the NHS staff whom we congratulated are people we would want to work with rather than do things to. We have learned that by experience and we look forward to the autumn and the plans that the Minister will bring back to this Chamber. I very much hope that all parties in this Chamber will support it. We have one chance to do this. I congratulate the Minister on making sure that we got the money—3.4%—which none of us was expecting. We need to spend that money wisely because there is a confidence issue out there with the taxpayer and the public. Again, I thank noble Lords for a wonderful debate.
Amesbury Incident
(6 years, 5 months ago)
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The Minister of State, Home Office (Baroness Williams of Trafford) (Con)
My Lords, with the leave of the House, I will now repeat a Statement made in another place by my right honourable friend the Home Secretary. The Statement is as follows:
“With permission, Mr Speaker, I would like to make a Statement regarding the events that have been unfolding in Amesbury and Salisbury. This morning, I chaired a meeting of the Government’s emergency committee, COBR, covering the ongoing investigation in Amesbury. Separately, I have been briefed by the security services and the counterterrorism police.
As many of you will now know, a 45 year-old man and a 44 year-old woman were found to be unwell at a property at Muggleton Road in Amesbury on Saturday. Both are British citizens. Paramedics attended the scene and admitted the pair to the A&E department at Salisbury District Hospital. Here they were treated for exposure to an unknown substance. Further testing by expert scientists in chemical warfare at the Porton Down laboratory confirmed this to be the nerve agent of the type known as Novichok. This has been identified as the same nerve agent that contaminated both Yulia and Sergei Skripal. The pair are currently in a critical condition and I am sure the House will want to join me in wishing them a swift and full recovery. I would also like to express my sincere thanks to the emergency services and staff at Salisbury District Hospital for their tireless professionalism and the dedicated care they are providing.
I understand that there will be some concerns about what this means for public safety. In particular, I recognise that some local Wiltshire residents are feeling very anxious. Let me reassure you that public safety is of paramount importance. Public Health England’s latest assessment is that, based on the number of casualties affected, there is no significant risk to the wider public. Its advice is informed by scientists and the police as the facts evolve. Dame Sally Davies, the Chief Medical Officer, has confirmed that the risk to the public remains low and has asked that the public follow the advice of Public Health England and the police.
She has also advised that people who have visited the areas that have been recently cordoned off should wash their clothes and wipe down any items they were carrying at the time. She has also urged people not to pick up any unknown or already dangerous objects such as needles and syringes. This is not new advice and it follows what was said in March. We have a well-established response to these types of incidents and clear processes to follow.
I also want to add that all the sites that have been decontaminated following the attempted murders of Sergei and Yulia Skripal are safe. All sites which have been reopened have undergone thorough testing and any items that may have harboured residual amounts of the agent were safely removed for disposal. We have taken a very robust approach to decontamination and there is no evidence that either the man or the woman in hospital visited any of the places that were visited by the Skripals. Our strong working assumption is that the couple came into contact with the nerve agent in a different location from the sites which have been part of the original clean-up operation.
The police have also set up two dedicated phone numbers for anyone with concerns relating to this incident. Salisbury District Hospital remains open as usual and is advising people to attend routine appointments unless they are contacted to state otherwise.
We are taking this incident incredibly seriously and are working around the clock to discover precisely what has happened, where and why. Be assured that we have world-leading scientists, intelligence officers and police on the case. Local residents can expect to see an increased police presence in and around Amesbury and Salisbury. All six sites that were visited by the pair before they collapsed have been cordoned off and are being securely guarded as a precaution. An investigation has started to work out how these two individuals came into contact with the nerve agent.
Around 100 detectives from the National Counter Terrorism Policing Network are working to support this investigation, alongside colleagues from Wiltshire Police. Samples from the victims have been tested by experts at the Defence Science and Technology Laboratory at Porton Down, who are world-renowned experts in the field.
Obviously this incident will evoke memories of the reckless attempted murder of Sergei and Yulia Skripal earlier this year, given the similarities. I know that many of you will question whether this incident is linked to that one. This is the leading line of inquiry. However, we must not jump to conclusions and we must give the police the space and time to carry out their investigations. The police’s work will take time. But we are ready to respond as and when new evidence comes to light and the situation becomes clearer.
Following the events in Salisbury earlier this year, we rapidly worked with international partners at the Organisation for the Prohibition of Chemical Weapons, OPCW, to confirm our identification of the nerve agent used. Through a process of extensive, impartial testing and analysis, our findings were confirmed correct beyond doubt.
The use of chemical weapons anywhere is barbaric and inhumane. The decision taken by the Russian Government to deploy these in Salisbury on 4 March was reckless and callous. There is no plausible alternative explanation of the events in March other than that the Russian state was responsible—and we acted accordingly.
The British Government and the international community immediately and robustly condemned this inhuman action. In light of this attack, the UK expelled 23 Russian diplomats from our shores, and we were joined by 28 of our closest international allies in this action, from the United States to Ukraine, who expelled over 150 of the Russian state’s diplomats in similar condemnation of this action.
We have already seen multiple explanations from state-sponsored Russian media regarding this latest incident. We can anticipate further disinformation from the Kremlin, as we saw following the attack in Salisbury. As we did before, we will be consulting with our international partners and allies following these latest developments. The eyes of the world are currently on Russia, not least because of the World Cup. It is now time that the Russian state comes forward and explains exactly what has gone on so that the most appropriate course of action can be taken.
Let me be clear, we do not have a quarrel with the Russian people. Rather, it is the actions of the Russian Government that continue to undermine our security and that of the international community. We will stand up to actions that threaten our security and the security of our partners. It is completely unacceptable for our people to be either deliberate or accidental targets, or for our streets, our parks or our towns to be dumping grounds for poison. We will continue our investigations as a matter of urgency, and I will keep the House and the public updated on any significant developments.
I commend this Statement to the House”.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, I thank the noble Baroness for repeating the Statement given by her right honourable friend the Home Secretary in the other place earlier today.
The first duty of government is to keep citizens safe. The Government have our full support for the important work they are doing in that respect. The two individuals who have been poisoned have been named as Charlie Rowley and Dawn Sturgess. They will be getting the best possible care at Salisbury District Hospital. I join the noble Baroness in wishing them a speedy and complete recovery. I also join her in recording my thanks to all the emergency services workers who attended the scene, the staff at the hospital, the security services and the staff of Porton Down laboratory.
The nerve agent, which has been confirmed as Novichok, is the same as that used to contaminate Yulia and Sergei Skripal four months ago. Local residents will be concerned that this is the second poisoning in four months and that Amesbury is approximately eight miles from Salisbury.
I note from the Statement that the working assumption is that the couple have come into contact with the nerve agent in a different location from the sites that were part of the clean-up operation a few months ago. I am not going to speculate about what could or could not have happened: that helps no one, particularly those trying to get to the bottom of all this and the local residents. The public will, however, want reassurance, and timely information—based on the facts as they emerge—will be welcome and reassuring.
Can the Minister therefore confirm that every assistance is being given to the emergency services working on the ground and that funding will never be an issue? Will she also say something about support for Salisbury and Amesbury? The attack hit the business and retail sector very hard and it is important that it is helped. It is probably a matter for another department, but support for the retail sector, which needs people to visit the centre of Salisbury and now Amesbury, is nevertheless an important part of the response, in collaboration with the local authority led by her noble friend Lady Scott of Bybrook.
I agree with the Minister that we have no quarrel with the Russian people. The welcome that England supporters have received in Russia has been most heartening to watch on television. We do, however, need an explanation from the authorities for what has happened here. It is regrettable that we have not had it to date, as is the disinformation referred to by the noble Baroness in her Statement.
I again thank the Minister for repeating the Statement and assure her of the full support of the Opposition Benches, which we also offer to all the emergency services workers and the staff at the hospital, along with our security services and the staff at Porton Down. I look forward to further updates from the noble Baroness in due course.
Lord Paddick (LD)
My Lords, I too thank the Minister for repeating the Statement made earlier in the other place. This is clearly a shocking and unexpected development, and our best wishes go to the couple and those who responded—and continue to respond—to this incident.
I understand that the incident is ongoing and we should not make assumptions, but does the Minister agree that there appears to be a lack of motivation, which might suggest that this is not a deliberate poisoning? In the last 10 minutes or so, the police have said that the couple have been contaminated by handling a contaminated item. Somebody from the Chief Medical Officer’s staff told the “Today” programme this morning that in high concentrations the nerve agent can be absorbed through the skin but in lower concentrations it has to be ingested. Is there any indication that the victims may have injected the substance? It would clearly be reassuring to members of the public if that was the case.
On the one hand, a chemical weapons expert is quoted by the BBC as believing that the latest victims could have come across the Novichok that poisoned the Skripals after it had been haphazardly disposed of. On the other hand, a Russian scientist who first exposed the Novichok programme cast doubts on that theory, saying that Novichok would have decomposed in the four months since the attack on the Skripals. The Minister talked about the expulsion of Russian diplomats across the globe as a consequence of what happened before, but what if the Russian scientist is right that this is a fresh batch of the nerve agent? What would the international implications of that be? The Russian scientist told the BBC that this must have been a separate incident because Novichok was unstable, especially in damp conditions. Can the Minister add to this?
I know that it is difficult, as I am about to tell the House in the debate that follows this Statement, to provide clear information in the early days following such an incident. That is difficult to do but the public need to be told whether this is a new attack, which could throw doubt on the whole matter, or whether it is an accidental poisoning caused by leftovers from the Skripal attack. Residents are very concerned. What can the Minister say to reassure them? When we had the previous nerve agent attack, we learned more from the media than we learned from the Minister’s Statement in the House. Can she provide the House with some additional information that will help your Lordships to understand what has happened and reassure the residents in the area affected?
Baroness Williams of Trafford
I thank the noble Lords, Lord Kennedy and Lord Paddick, for their very constructive comments and questions, as is usual following this type of incident and the making of such a Statement to your Lordships’ House.
The noble Lord, Lord Kennedy, talked first about the names of the victims. I know that they have been in the press but we have not confirmed their names. He and the noble Lord, Lord Paddick, talked about local residents being very concerned. Of course they will be concerned; they have had two almost identical incidents in their vicinity in the last few months. I hope that the words of Dame Sally Davies and the police have provided some comfort to them that the risk is low, while saying that people should remain vigilant and not touch things such as syringes, which might be dangerous, and that if they see anything they are concerned about or feel unwell, they should immediately contact the helpline.
The noble Lord, Lord Kennedy, mentioned the different location and he is absolutely right. Not only did the events of the weekend take place in a different location but the couple in question do not appear to have visited any of the original sites. He also asked whether there would be constant reassurance of the public and constant updates to them as time goes on. We have seen over the past couple of days that the police and Dame Sally Davies have been very forthcoming in the information that they have given to the public. Any funding or assistance required will of course be forthcoming. Some 100 counterterrorism police detectives have been deployed and mutual aid from other police forces has been sent to Amesbury to assist.
The noble Lord, Lord Kennedy, mentioned a crucial point: the local economy. I know it suffered the first time round and people will be very concerned. Another department, MHCLG, provided a lot of assistance in the aftermath of the previous event and I expect it will deploy similar assistance to the local area following this one.
The noble Lord, Lord Paddick, asked several questions, some of which I will not be able to answer. One was about whether it was a deliberate poisoning. The police have said that the poisoning was due to handling a contaminated item. He spoke about injecting the poison and made a point about the Russian scientist who said that in his opinion it was a fresh batch. I cannot substantiate any of those points. As the investigation proceeds the facts will become much clearer and it is not for me to comment on them at this stage.
Baroness Finlay of Llandaff (CB)
My Lords, after the Salisbury attack general practitioners in the area and the emergency department were advised to phone 111 for information. That resulted in delays in clinicians understanding what to do. It is completely understandable that complete secrecy is needed while an investigation goes on for that investigation to be secure and for national security. However, there is also a need to link with somewhere such as the National Poisons Information Service so that clinicians at the front line can receive appropriate targeted clinical information. Has such a system now been put in place following the concerns expressed by GPs last time? Unfortunately, we all feel that there may be further incidents in the future involving acts of terrorism.
Baroness Williams of Trafford
It is a sad thing to say, but because there has been a previous attack I think the whole system has operated far more smoothly this time. The noble Baroness is right to point out that any delays could be life-threatening to the people involved. There is a number to ring. I understand that the hospital is the one the Skripals were in, so there is experience of dealing with this. I assume that what the noble Baroness requests is happening and that the whole process will run a lot more smoothly this time.
Lord Robathan (Con)
My Lords, after the Salisbury attack the response of our allies, NATO and the international community was very heartening. Notwithstanding the successful football tournament going on in Russia at the moment, can my noble friend reassure the House that the initial response of our allies, whatever the circumstances of this incident, remains steadfast and determined and shows solidarity with the British people on this?
Baroness Williams of Trafford
I can confirm, as my right honourable friend the Home Secretary confirmed this morning, that a number of international engagement opportunities are coming up. Let us not forget that we are at the beginning of an investigation, but of course there will be opportunities for international engagement as time goes forward. I fully expect that our international partners will stand with us this time, as they did last time.
Lord Harris of Haringey (Lab)
We are all grateful to the Minister for the Statement even though there is only a limited amount that she can tell us. What arrangements have been put in place for the health and welfare of the first responders from the emergency services who will have attended the scene?
Baroness Williams of Trafford
The noble Lord raises a very important point, because he will remember that, last time, they were clad from head to toe in special suits to stop contamination. Their welfare is of the utmost importance. They risk life and limb to attend these things, and I assure him that their health and welfare is of the utmost concern to us, and we have of course put measures in place to ensure their safety.
Earl Attlee (Con)
My noble friend will be aware that the UK Armed Forces have trained for a very long time to be able to counter chemical weapons attacks. The training is not very pleasant. My noble friend Lord Robathan and I will both have stood in a CS gas chamber and been told to eat a dry biscuit. It is not fun training.
We have a range of technologies available to detect and counter chemical agents. A persistent nerve agent can normally be detected by hand-held equipment, which is held at unit level. Am I right in believing that Novichok cannot be detected in that way? Does that partially account for why the clean-up operation has been so time-consuming and difficult, and why the authorities were unable to find any discarded equipment? They could go to obvious places where it might have been discarded, but it was very difficult to detect.
Baroness Williams of Trafford
My noble friend is absolutely right to point out that Novichok is a military-grade nerve agent. Therefore, the usual methods of detection are impossible. It is a lengthier process and far more difficult to pinpoint—hence, possibly, why we have had the events of the past few days.
Lord Arbuthnot of Edrom (Con)
My noble friend is quite right to refuse to speculate about the causes of this, but will she ask the media not to speculate about possible causes as to why this couple were found in a distressed situation? Some disgraceful things have been said in the media which should not have been aired there; that was most unhelpful.
Baroness Williams of Trafford
I thank my noble friend for making that point. Perhaps the media should have guarded against naming the couple in the first place before their families had been informed, which is the reason that the Government have not named the couple. I have read all sorts of things in the media over the past 24 hours. Thank goodness I do not get my briefings from the media, else we might have heard all sorts of nonsense across the Dispatch Box this afternoon. I totally support a free press, but my noble friend is right: this reporting has been irresponsible.
Baroness Neville-Rolfe (Con)
I thank my noble friend and noble Lords on all sides of the House for expressing their support for the emergency services, who do such an amazing job in the circumstances. I especially endorse Salisbury hospital and its A&E. As a resident near Salisbury I have used it often and thought it was brilliant with the Skripals—to have the expertise in these awful weapons of mass destruction, which I think meant that they saved the lives of that wretched couple. I very much wish that the latest unfortunate incident will have a similarly good outcome.
I want to ask a different question about Salisbury itself. My noble friend mentioned that some things have been done to try to alleviate the hit on the shops and market of Salisbury from the incident, but I go there every Saturday. There are lots of closed shops. There was some help with parking. Can she either give us a little more detail or ask the MHCLG to write to us with details of what has been done for the people of Salisbury and may be done in future, because this is a double whammy?
Baroness Williams of Trafford
I join my noble friend in paying tribute to the emergency services. It must be very frightening to go in to assist, knowing that this substance is so deadly, but trying to save lives at the same time. I agree with her that Salisbury hospital has done an incredible job saving the lives of the Skripals, and I hope it will save the lives of the couple involved in this incident.
I will ask the MHCLG to write to my noble friend about how it has helped the local economy following the previous incident and how it intends to bring confidence back to a place which must have been really badly shaken by this latest incident. She is absolutely right: help is badly needed for the town to get back on its feet.
Lord Marlesford (Con)
Does my noble friend agree that it sounds unlikely that this was an attack aimed at individuals? In its social, economic and psychological impact, is not an incident such as this much closer to something such as a cyberattack and does it not underline the vulnerability of modern societies to these new, mysterious and amorphous risks?
Baroness Williams of Trafford
On the first question, clearly I cannot comment, because the investigation has not reached its conclusion but that certainly seems to be what is promoted in the press. In terms of likening it to a cyberattack, agents such as Novichok have in fact been around for some time—it kind of reminded me of the Cold War, where such methods were used; I know that, after the first attack, people seemed to compare it with the Cold War era. The number of different ways, including cyberattacks, that can debilitate a town, region or even a country are growing and we are right to be concerned.
Terrorism: Emergency Communications
(6 years, 5 months ago)
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Lord Harris of Haringey
To ask Her Majesty’s Government what steps they are taking to improve communications for use in the event of a terrorist incident or other major emergency.
Lord Harris of Haringey (Lab)
My Lords, I should start by referring to my various interests in the register, in particular my role as UK co-ordinator for the Electric Infrastructure Security Council. I am grateful to the distinguished list of noble Lords who have put their names down to speak.
Less than two weeks ago, Michael Dowden, the London Fire Brigade watch manager for North Kensington gave evidence to the Grenfell Tower inquiry and said:
“For me … to facilitate and change a stay-put policy to a full evacuation was impossible. I didn’t have the resource at that time. We’re looking at 20 floors above the fire … I just don’t know how that could have been done with the resources we had in attendance at that moment in time”.
Tragically, the technology to deliver that message to those waiting in their flats exists and, had it been adopted in this country, could have been used on that terrible night.
I have spoken to Michael Hallowes, who is sitting below the Gallery watching this debate, who tested Australia’s “emergency alert” for just such an emergency at the 37-storey Department of Justice building in the heart of Melbourne back in 2012. He drew a warning polygon on the system’s mapping tool over that building, which detected the presence of 5,736 mobile devices. The location-based SMS alert that followed reached over 90% of those devices within 12 seconds, delivering the alert successfully to people on every floor. The system’s configuration also meant that the alert was kept to just that building. This technology could undoubtedly have saved lives in Grenfell Tower. It could also have been used to reduce the panic and stampedes in Oxford Street last November as people responded to erroneous reports that gunshots had been fired.
We know that social media play a huge role in the event of a terrorist incident or indeed any other emergency. Sometimes, of course, the result is that misinformation is spread, as members of the public caught up in an event and the media try to make sense of what may be a very confusing situation. It is essential that civic agencies are able to provide a swift and authoritative voice during such events.
Three months ago I raised this matter in your Lordships’ House and the noble Lord, Lord Young of Cookham, said that,
“the Cabinet Office has been requested to provide Ministers with … An initial analysis of what a scheme might look like and what delivering a scheme might entail … for May 2018”.—[Official Report, 16/4/18; col. 981.]
In a later answer, the noble Lord admitted that this timetable had been set by him that morning in preparation for my Question in the afternoon—I am grateful to him for doing that. But my questions now are: has that analysis been completed—we are now in July, not May—and when will action be taken?
The legal duty exists in Part 1, Section 2(1)(g), of the Civil Contingencies Act 2004, which requires category 1 responders to,
“maintain arrangements to warn the public, and to provide information and advice to the public, if an emergency is likely to occur or has occurred”.
This technology was tested by the Cabinet Office five years ago. As I have said, it is already in use in Australia, but also since 2012 in the United States, the Netherlands and elsewhere.
Therefore, my questions to the noble Lord are as follows. Which Minister and which government department will be leading on this going forward? Have the police and the other emergency services identified their operational requirements and, if they have not, will Ministers be asking them to do so as a matter of urgency?
I would like to move on to the replacement of the current system for communications within the emergency services. The police, fire and ambulance services must have reliable communications between control rooms and personnel in the field. This is currently delivered by a radio system known as Airwave—a system which the National Audit Office pointed out has served the emergency services effectively in dealing with life-or-death situations—but now it needs upgrading and improving, in particular to enable it to handle data better in addition to voice communications.
In 2011, the Government took a decision to replace this system with what is to be known as the “Emergency Services Network”. Unlike Airwave, it will not have its own exclusive part of the spectrum; instead, it will share it with a commercial 4G network—in this case, EE. This puts all our communications eggs in one basket: it creates a single point of failure. If, for whatever reason, the 4G network goes down, so do the communications for the emergency services.
At this point, we were supposed to be half way through the rollout of the new system, but the NAO pointed out less than two years ago a number of rather significant facts: the ESN is inherently high risk and such an approach has not been used nationwide anywhere in the world; the ESN is “technically cutting edge”; no suitable hand-held and vehicle-mounted devices that will work with ESN existed at the time of the NAO’s report; the ESN requires the percentage of Great Britain’s land-mass covered by EE’s network to rise from 70% to 97%; and, as the NAO said,
“the programme has adopted a timeline for delivering ESN that is very ambitious”.
What could possibly go wrong? Not surprisingly, the programme is running behind schedule. Can the Minister tell us the current timeline for the rollout? What are the extra costs for each month of delay, and, perhaps more significantly, why do so few senior officers in the police, fire and ambulance services seem to feel confident that it will all work as promised?
The present arrangements are based on a series of contracts that expire next year. As I understand it, there are 105 contracts with the emergency services around the country and 307 with other public sector organisations. These will be replaced by one single contract managed by the Home Office. I repeat: one single contract managed by the Home Office—that instantly inspires confidence.
The individual providers will have a call-off arrangement with EE, but this is much more limited than the contract that they currently have with Airwave and gives those services very little direct recourse for poor service. Is the Minister satisfied that a local police force or a local ambulance service will have the leverage they need to get the quality of service required to keep the public safe in their area without recourse to separate expensive investment in back-up facilities?
We all know what it is like using the mobile phone network, particularly at times of high demand. The question that has to be answered is: will emergency services personnel have priority over other commercial users of the network? I am told that software and protocols are being developed to enable this to happen. Perhaps the Minister can tell us how this will work and, very specifically, whether the prioritisation will mean that existing users will be bumped off the service if it is needed by the emergency services.
My understanding is that the prioritisation being offered is that, if it is a choice between the emergency services provider coming on to the system and someone who wants to initiate a call—perhaps to a loved one to say they are all right or are on the train—the emergency service provider will get priority. But what about those people who are already using the system, either making an extended phone call or, more significantly, using a lot of data to stream music videos? Will they be bounced off the system in an emergency? My understanding is that they will not, and I think that is a significant weakness.
All of this assumes that the 4G network is operational and is not disrupted by the emergency itself. At the beginning of my speech, I mentioned the work I do on infrastructure security. I will not go into this at length, but there are a number of “black sky” events that could, for example, produce a widespread power failure. Under those circumstances, the 4G network would be viable for at best two to four hours before the batteries in the cell-site masts run down.
This brings me back to the concerns I expressed earlier about the single point of failure and to the last point I want to touch on: the High Integrity Telecommunications System. HITS is intended to be—again I quote the Minister,
“a resilient communications solution providing a voice and data link to 47 fixed sites across the UK. It is intended to provide failsafe communications in times of national crisis, connecting local responders and the Devolved Administrations with COBR”.
The Civil Contingencies Secretariat says in its information pack that this is a “resilient and independent” network that,
“will still function when the main networks (such as landlines and mobile phones) are unavailable or degraded”.
The collapse of the 4G network is acknowledged as a real risk. The existing contract for this system ends in March. When I asked the Minister about this a few weeks ago, I was told a review was “currently under way”. Is this urgent enough if the contract expires in less than nine months?
Connecting with 47 fixed sites was always a very limited aspiration—I understand it is one for each police force. Originally, this was supplemented by transportable terminals that could be deployed to specific locations in addition to the fixed sites. These were withdrawn at the end of 2013, are no longer available and have not been replaced. I have spoken to those involved in emergency planning around the country and their view is that the existing HIT system is approaching obsolescence and is inadequate for maintaining central co-ordination in the event of the sort of crisis for which it was designed. Can the Minister tell us what the plans are for the future of HITS and when decisions will be taken?
I apologise if some of this speech has appeared to be rather technical, but let me be clear: effective emergency communications in a time of crisis are vital. It is genuinely a matter of life and death, and it is essential that as a nation we get this right.
Lord Arbuthnot of Edrom (Con)
My Lords, I begin by congratulating the noble Lord, Lord Harris, on three things: first, on securing this debate, which is not an easy thing to do; secondly, on his excellent work on London’s preparedness to respond to a major terrorist incident; and, thirdly, on his speech, in which he has said many of the things that I would like to say but has done so with more eloquence, and so I shall not.
I declare my interest as an unpaid member of the advisory board of the Electric Infrastructure Security Council. In recent decades, the West has become increasingly—and is now totally—dependent on one commodity: electricity, as the noble Lord, Lord Harris, mentioned in his speech. Everything relies upon it. Water is pumped by electricity; cash machines operate by electricity; money is maintained and moved by electricity. Without electricity, we would have difficulty cooling the radioactive cores of our nuclear power stations and, without electricity, we would have no WhatsApp or Instagram, and all our children would have nervous breakdowns.
If our electricity were somehow switched off by a cyberattack, by an electromagnetic pulse, even by a solar flare or by other means that may not yet have been invented, we would be in real trouble, but the first thing that we would want to restore would not be hospitals or money but our communications. The Cabinet Office, among others, recognises that our communication is the key to restoring order, reassuring the public and allowing the subsequent restoration of health services, government and finances.
We saw in New Orleans during Hurricane Katrina that the collapse of law and order can happen in a matter of hours, and looting did happen. So the restoration of communications, bringing explanation, information and understanding, is key to what is needed in an emergency such as we are talking about today—by the way, I am a very gloomy person to listen to about most of this because I am more pessimistic even than the noble Lord, Lord Harris.
However, there is one thing working in our favour; that is, smartphones and mobile computing. That is one of the most widely distributed networks—a national set of independent, battery-powered operations. It includes local computing devices and even torches. It is an amazing network which people have bought for themselves, so the Government do not even have to go out and buy it for them. If we can use that system, as the noble Lord, Lord Harris, was talking about, in relation to emergencies, first, to restore communications and, secondly perhaps, to support the delivery of crisis information, so much the better. If that system could also provide some form of digital emergency toolkit, possibly for personalised disaster communication, localised evacuation suggestions or localised suggestion of where to find resources, that would also be so much the better.
What steps are the Government taking on this? The noble Lord, Lord Harris, has talked about the new emergency services network which the Government say is based on the latest technology delivering secure and resilient voice technology and broadband data services. That is very good, even if it is delayed—I shall not quibble about the fact that it is delayed. But will it work if the electricity has gone off?
I recently asked some questions and received some reassuring answers. The first was that a significant proportion of airwave sites were fitted with additional power resilience to ensure that they could run for a minimum of five days on autonomous power. I have also been told that resilience against extended power outages is achieved using a range of technical solutions that include tow-to-site and fixed generators and batteries. That is good as far as it goes, but, first, what happens if the power outage lasts for more than five days? That is, I am afraid to say in my depressed frame of mind, perfectly feasible. If the power outage struck more than just a small area of the country, the demand for back-up generators and new transformers for things all taking place in circumstances of cascading failure of different parts of our infrastructure, would be very difficult to manage.
The noble Lord, Lord Harris, mentioned that we were putting all our eggs in one basket. Has thought been given to identifying and then possibly tasking some form of back-up radio ham network across the country that might be able to operate on vehicles and chip in, if the 4G network were not available? On 4G, we are just about to introduce into the country the new 5G network. As I understand it, the existing 40,000 aerials are going to have be expanded to something like 400,000 aerials. I may be wrong about that—but is not that an opportunity for the Government to design an additional degree of resilience into those new aerials, which would be of great benefit to the country?
Finally, I have read the Government’s Civil Contingencies Act Enhancement Programme. When viewed in the light of the possible loss of electricity, I am sorry to say that it leaves a little to be desired. The public are wholly unaware of most of the contents of that document and of most of the things that they should be doing. I suspect that Ministers, too, are pretty unprepared, and I am sure that they are unpractised in dealing with catastrophic events such as the ones that we are talking about. I would hope not only that Ministers would begin to form plans of what to do in the face of major catastrophes—because forming such a plan once the catastrophe has taken place is not wise—but that they should practice that plan from the top to the bottom of government and the top to the bottom of civil society, because a plan that is not practised is no plan at all.
Viscount Brookeborough (CB)
My Lords, I too thank the noble Lord, Lord Harris, for introducing this very important subject and echo what we have just heard about the compliments about his service.
I accept that my experience is, or was, in Northern Ireland and that that time has passed. However, we may not have had all the technology, but a lot of the same principles exist today. There were occasions when I was on duty in an ops room when there were more than two bomb incidents going on at the same time, so I fully appreciate what happens with communications when a lot of people want to be on them about one subject. It makes a lot of systems very vulnerable—therefore, we have to have the best.
The first and most important principle is that there must be efficient command and control as soon as possible after an incident, and this can be achieved only with the use of communications technology and the complete inclusion within it all of the responding agencies. That is called interoperability, which is defined by the joint emergency services as the extent to which organisations can work coherently as a matter of course. That is very difficult to practise because, as a matter of course, they are dealing with everyday minor events, and we are talking about exceptional events. The foundation stone of all that has to be communications. Luckily, because so much has been said by the noble Lord, I can leave out stretches of my speech—so it will not be quite as joined-up as it might have been.
After Hillsborough, it is very significant that Lord Taylor said that,
“so many previous reports and guidelines must indicate that the lessons of past disasters and the recommendations following them had not been taken sufficiently to heart”.
There is no point in holding inquiries or publishing guidance unless the recommendations are followed diligently. That must be the first lesson. Many of us would feel that that is still going on today. Reviews come out with sensible answers and suggestions, and what happens? They disappear into desks in Whitehall, or elsewhere, and we definitely do not see the results on the ground.
I was going to talk about other communications, but that has been done. One thing was that, of course, they are not always capable. In Manchester, the casualty bureau was seriously hampered by a complete failure of the National Mutual Aid Telephony system provided by Vodafone. What is the future of this means of communication for that service? Again, with the overload of mobiles in mind, we have exactly the questions that were asked previously.
One of the other strategic issues, apart from communications directly, is doctrine. Doctrine involves communications because anything that goes on involves them. Can the Minister tell the House whether there is a common doctrine throughout the UK for reacting to major emergencies? Does he not agree that this is of the utmost importance regardless of the individuality of emergency agencies in different areas? We all feel that there is a bit of empire building and that this is difficult. For instance, some ambulance services have HART—hazardous area response teams, which are allowed to operate in hot areas or warm areas. However, not everywhere has such teams. We have had sad occurrences in Manchester and London, but they are centres of population and thus centres for emergency services. If we get something in more rural areas, the local services will have to be supported by others. I am not sure that I am confident that having reached the area, they will be able to integrate properly. This is about the human side rather the technology aspect. We really should do something about having a national doctrine to cover many of the things that happen.
The police, with their gold, silver and bronze commanders, are not always co-located with their equivalents in other agencies. In Manchester, the fire and rescue service was outside the loop by not being present at the strategic gold command location. That was an example of poor communication and procedures. We simply have to eliminate what are quite clearly errors in human planning, otherwise we cannot rely on our technology. It cannot work if the people are not there. Communication involves people and face-to-face contact as well as what we have been talking about.
The fact that a plan had been practised in Manchester really showed, and Manchester did not go badly; there were just ways of improving it. Another strategic issue is training, which is always difficult because it costs a lot of money. Police forces do not have a lot of money to do realistic training. Coming from Northern Ireland and all the problems and issues we faced over 40 years, I am amazed by and greatly admire the initial responders to terrorist events that we have had in London. They are fabulous and we should give them credit for that. They took out the threat, albeit sadly with civilian casualties, without—touch wood—collateral damage. Having lived in Northern Ireland for so long, I would not have believed that the length of training and preparedness the police officers have had for those events could produce such an effect. Not only are they to be congratulated, but again, it is utterly amazing.
My second issue concerns communications, about which I feel very strongly indeed. Are we briefing the media too much and are they debriefing the terrorists? I have three straightforward examples of this. Around 10 years ago, explosives or terrorist equipment was found in a garage located either in London or the Midlands; I cannot remember the details. The next day, a diagram of where the surveillance cameras and sensors were, along with an account of how the garage was found. In Northern Ireland, down to the lowest rank of policeman and serviceman, there was absolute confidentiality. Instead, they would have said something like: “Three or four children were playing football and one of them hit the ball at the door. It came up, and do you know what was inside?” What the media did in publishing that information and what the emergency services did was to let everything down because it begs the question: how did we know? That gives terrorists an opportunity. Why do we allow that?
The next incident was the tube bombings. One of the terrorists did not blow himself up and went to Italy, where he was captured. Two days later he was captured with mobile phone technology. It was remarkable: an off-duty policeman went on holiday in Italy and, lo and behold, he saw a face that he knew. We cannot afford to be like this—that is the honest truth.
More recently, for the bomb on the tube that did not go off properly, we knew within 24 hours why it had not gone off. That is ridiculous, because a bomb has to be put together with many things. I got into trouble in the ops room in Belfast because an ATO came in one day and he told us why a bomb had not worked. I put it on the nightly report in code; it was secure. It was something to do with silicon over bared wires. I leave the rest to noble Lords’ imagination. I was seriously reprimanded for doing that, even though it was secure.
We must be confident. There must be a good cordon and it must be secure. This chatter must stop. They are getting full details of the incident when we say that the bomb partially exploded. We are informing them of what went wrong. We are saying where the emergency service response came from and how. It is potential identification of intelligence. We have to get away from that—it is seriously not good at all.
Why do we not adopt the Northern Ireland policy to provide a watered-down version of events? Conceal methodology and make up a device. Do not release in detail why it failed to go off. Most importantly, we should develop a code of conduct with the media. We have to do this. We have to get out of our boxes and do it, because we cannot put up with things as they are. This would save lives. If you have a bomb, you set it and you do not know why it has not gone off—it takes an awful lot of rebuilding and trying to find out why it did not. If all you have to do is go to the TPU—time power units—you will have the answer and someone will die the next time round. We need that absolute confidentiality. This is about communication. I realise that that is not quite what the noble Lord, Lord Harris, was talking about, but it is very important, if not vital.
Lord Rees of Ludlow (CB)
My Lords, I contribute to this debate with diffidence. Others speak with far greater authority and have had direct experience of and responsibility for dealing with terrorist incidents, or, more generally, with infrastructure failures that could cause disruption and social breakdown. I pay tribute to the commitment of the noble Lord, Lord Harris, to these issues. He has emphasised particularly that enhancing the resilience of the electricity grid is surely a priority.
I will focus rather less on the communication medium than on the messages that need to be communicated in a context where we can expect far larger-scale and more catastrophic breakdowns and terrorist attacks that we have had up to now. Cities would be paralysed without electricity. The lights would go out, but that would be far from the most serious consequence. Within a few days, our cities would be uninhabitable and anarchic. We know what even an intrepid maverick with cyber skills can do, and there have been warnings from senior officials in this country and the US of how devastating and long-lasting a highly organised cyberattack could be.
Our high-tech and interconnected world is vulnerable in other ways. We depend increasingly on elaborate networks: air traffic control, international finance, globally dispersed manufacturing, biothreats and so forth. Unless these networks are highly resilient, their benefits could be outweighed by catastrophic, albeit rare, breakdowns. Social media can spread panic and rumour, and economic contagion, literally at the speed of light.
Not enough effort goes into minimising these risks, nor, for the focus of this debate, into preparing for how to cope with the aftermath of catastrophic events. There are two reasons for this underpreparation. First, we are in denial. We respond rationally and proportionately to fire risks, for instance, because, even though the chance of our home burning down is small, we have frequent reminders of fires and the damage they can do. We can estimate their probability and therefore the risk.
However, catastrophic events are rare—perhaps unprecedented or newly emergent—so we do not have this experience. We are lulled into believing that they will never happen so we are underprepared. It is an analogue of what is happening in the financial world. Gains and losses are asymmetric; many years of gradual gains can be wiped out by a sudden loss. Likewise, in cyberdisasters and those that might be caused by bio-error or bioterror, the risk is dominated by the rare but extreme events. The magnitude of the worst potential catastrophe is growing unprecedentedly large. Too many people are in denial about this; it needs to be higher up in public policy and attention.
The second reason for underpreparation is political reluctance to spend money in ways that may prove nugatory, as is likely to be the case for any low-probability but high-consequence scenario. For instance, in some years when a flu epidemic has been predicted, the Government have prudently stocked up on the appropriate virus but then been unfairly criticised for waste if some was not needed. We must overcome that mindset if we want to prepare for these extreme events. It is reassuring that the Government have given priority and resources to cyberdefence, where there is an arms race between the attackers and the defence and it is unclear whether the defence will always win.
It is surely not scaremongering to raise concerns about human-induced risks from bio-error or bioterror. We know all too well that technical expertise does not guarantee balanced rationality. The global village will have its village idiots, and they will have global range. The spread of an artificially released pathogen cannot be predicted or controlled. The rising empowerment of tech-savvy groups, even individuals, by biotechnology will pose a growing intractable challenge to governments and aggravate the tension among freedom, privacy, and security. Most likely, there will be a societal acceptance of a shift towards more intrusion and less privacy.
Before closing, I want to focus on nuclear threats. Even a stalwart establishment figure such as William Perry, the former US Defense Secretary, has expressed concern about scenarios involving terrorist nuclear weapons. Be that as it may, there have already been nuclear incidents that involved not explosions but serious radiation release. Such nuclear accidents hold lessons about the appropriate response—evacuation versus staying put, for instance—and messages that should be sent. In 2011, the Japanese tsunami claimed 30,000 lives, mainly through drowning. It also destroyed the Fukushima nuclear power stations, which were inadequately protected against a 15 metre-high wall of water and sub-optimally designed. For instance, the emergency generators were located low down, and were inactivated by flooding.
Consequently, radioactive materials leaked and spread. The surrounding villages were evacuated, but this was done through unco-ordinated messages and in an unco-ordinated way. Initially, just those within three kilometres of the power stations were evacuated, then those within 20 kilometres and then those within 30, with inadequate regard for the asymmetric way in which the wind was spreading the contamination. Some evacuees had to move three times and some villages remain uninhabited, with devastating consequences for the lives of long-term residents. Indeed, the mental trauma and other health problems, such as diabetes, have proved more debilitating than the radiation risk. Many evacuees, especially elderly ones, would be prepared to accept a substantially higher cancer risk in return for the freedom to live out their days in familiar surroundings. They should have that option. Likewise, incidentally, the mass evacuations after the Chernobyl disaster were not necessarily in the best interests of those displaced.
In Japan, it was the tsunami itself, not the nuclear accident, that caused the major death toll. The public fear of radiation is enhanced by a special dread factor and a feeling of helplessness. As a consequence, all nuclear projects are impeded by disproportionate concern about even very low radiation levels and the cost is raised by overstringent clean-up requirements. To offer a specific recommendation, were a city centre to be attacked by a dirty bomb—a conventional chemical explosion laced with radioactive material—some evacuation might be needed, but, just as in Fukushima, there is a risk that present guidelines would mandate a response that was unduly drastic, both in the extent and the duration of the evacuation.
The immediate aftermath of a dirty bomb incident is not the right time for a balanced debate. That is why this topic needs a new assessment and wide dissemination of clear and appropriate guidelines of the risks to different categories of people. We need discussion of a proportionate response and how to communicate it.
Finally, it is clear that such threats are growing in their variety and severity. We need to devote more resources to reducing our vulnerabilities, planning the optimum response and communicating it. The past is a poor guide to the future when fast-changing technologies are involved. There is a salutary mantra: “The unfamiliar is not the same as the improbable”.
Earl Attlee (Con)
My Lords, I am grateful to the noble Lord, Lord Harris of Haringey, for asking his Question. With the leave of the House I would like to speak in the gap. I apologise: I omitted to put my name down to speak, but it is just as well because I misinterpreted the Question on the Order Paper.
Many noble Lords touched on the need for electricity in modern society. My understanding until recently was that to restore power in the case of a total blackout across a large portion of the country would take several days—we have already talked about that today. That would be whatever the cause, whether it was a cyberattack, or a couple of power stations and a large substation being taken out simultaneously. I always thought that each thermal power station would have the ability to black start from cold and with no external assistance from the grid, and, most importantly, that it would have the ability to synchronise its frequency with the rest of the grid. The noble Lord, Lord Harris of Haringey, is shaking his head: I suspect he thinks that that is not the case—that it would not have the ability. I think it should. So can my noble friend the Minister write to me and tell me what is our capability of black starting thermal power stations? I think they all ought to be able to black start and synchronise their frequencies relatively easily. My understanding is that it is very difficult to do and that is why it would take several days to restore the power, with the attendant, very serious consequences.
Lord Paddick (LD)
My Lords, I too thank the noble Lord, Lord Harris of Haringey, for giving us an opportunity to discuss these very important issues. Perhaps I should declare an interest: when I was a senior police officer I was trained as a gold commander to deal with the kinds of incidents we are talking about. The noble Lord, Lord Harris, talked about Grenfell and the difficulty of changing the established policy of “stay put” to one of evacuation, and not being able to communicate it. He is right: this technology does exist. It has been discussed, yet no progress seems to be made. Clearly, there are circumstances in which it could be extremely useful. Of course, false reports have resulted in, for example, the Oxford Street stampede—false reports of a shooting took place, as the noble Lord said. Such misinformation being spread can actually come from official sources. I shall come back to that by way of example shortly.
Clearly, there are very serious concerns about the replacement for Airwave, the emergency services network, relying on a commercial 4G network rather than a dedicated emergency service and other public service system. Any reassurance the Minister is able to give on that would be welcome.
The noble Lord, Lord Arbuthnot of Edrom, talked about the importance of practising for such emergencies. The noble Lord, Lord Rees of Ludlow, talked about underpreparation for catastrophic events. Certainly, in my time as a gold commander, I spent many a happy weekend with other emergency services, local authorities and even representatives of the media, regularly exercising for these sorts of emergencies. I would be surprised if that does not continue to this day.
On 7 July 2005 I was in my office at Scotland Yard, having a meeting with the health service. My staff officer came in and said there had been a serious incident on the Underground. I thanked her but she insisted on me abandoning the meeting. I went to the first floor of Scotland Yard where a commander was in charge of a public order event at that time. The first information that we were given by London Underground was that there had been a power surge on the Underground. That was misinformation but it was the information that we were given. As I was talking to the commander, the explosion happened on the bus and I said, “Power surges do not happen on buses”, and we realised that we were under terrorist attack.
I agreed with the gold commander that I would do the press conferences for the Metropolitan Police. I went to the press bureau on the 13th floor and agreed with the head of public affairs that that would be the right course of action. We went to see the commissioner in his office. Although the commissioner insisted that he should do the media, I can remember his staff officer coming in and saying, “COBRA says the commissioner is not to do the media”, and the commissioner saying, “Tell COBRA I’m doing it”. Why did COBRA insist on this? Because in the immediate aftermath of such an incident—on 7 July, a series of catastrophic incidents—there is confusion and it is very easy to say, with the authority of the country’s most senior police officer, something that turns out not to be true. The “swift and authoritative voices” that the noble Lord, Lord Harris of Haringey, talked about are not always possible to deliver in the immediate aftermath of such incidents.
On that occasion, the information given by the commissioner was that there had been five incidents on the Underground. In fact, there had been three; two had happened midway between two Underground stations and people were evacuating from both ends of the train, making it look as though there had been more incidents than had actually taken place. I say to the noble Viscount, Lord Brookeborough, that actually it was the attempted bombings two weeks later on 21 July when none of the bombs exploded and all the perpetrators managed to flee, rather on 7 July, when all the suicide bombers died.
It is essential that the emergency services are seen to be in control and to speak authoritatively about what has happened. In the initial stages, as a more junior officer, I prefaced everything I said in every press conference I did in the immediate aftermath with “from what we know at this time”. Such an approach means that when the smoke clears, the most senior police officer in the country can be seen as completely trustworthy and the reassurances he or she gives can equally be trusted.
Even a day or so later, what we believed to be the timings of the bombings on the Underground were proved to be wrong. They had actually exploded simultaneously, at a prearranged time agreed by the bombers. One of the bombers did not follow the plan and got off the Underground but when he realised that his fellow bombers had carried out their murders, he detonated his bomb on the bus, with devastating consequences.
I tell this story to emphasise that, while it is important that there is communication with the public to provide advice, guidance, instruction and reassurance, initially and for some time afterwards, it is not always obvious what has happened and therefore the advice, guidance, instruction and reassurance we can give are limited.
In addition to having mechanisms to get messages to the public quickly, it is important that we ensure that the information is accurate. Thankfully, the scenario that we are very wary of—that the initial explosion is perhaps designed to push people into areas where other devices are about to explode—did not happen in the Manchester Arena attack. If there was confusion, as the noble Viscount said, between the fire and rescue service and the other emergency services during the Manchester incident, it showed how important it is that such initial confusion is not communicated erroneously to the public, thereby undermining public confidence in the ability of the emergency services to deal effectively with such outrages and hampering a return to normality, which is the best response we can have to attempts by terrorists to disrupt our way of life.
Baroness Hayter of Kentish Town (Lab)
On Saturday it will be exactly 13 years since the noble Lord, Lord Paddick, was doing press conferences and I was awarded my PhD. It turned out to be quite a day for both of us, although not in the same way. I was on the Tube, due to travel via Aldgate to Mile End for the PhD ceremony. For reasons we now know, the Tube was suddenly evacuated. I was one of the lucky ones not only to get off the Tube unaffected but to be able to use my phone to reassure my other half, who was also travelling that way, that both of us were alive and safe.
In different ways, it was a surreal day. What slowly dawns on one is the absolute horror of what has happened, the number of deaths and injuries—and there is also an awareness, even at that level, of the amazing response of all concerned: Transport for London; the emergency services; the taxi driver who took pity on me; Queen Mary University of London, which turned out food, beds, help and advice to parents and graduates; and a host of others whom we know of now and who were centrally or peripherally involved.
As I said, I managed to use my phone just before it went down. What I then watched, of course, was the students arriving, ready to be gowned up, and the parents ready with their cameras to beam down with pride on their children. In the absence of mobile phones there were terrible gaps: some parents arriving but not the graduates, some graduates arriving but not the parents. As we finally sat down, there were gaps on many seats. Given our proximity to Aldgate, our alarm is easy to understand. Fortunately, we learned—although not until the next day—that nobody, despite where we were, had been affected by that.
Of course, at the time, little did I know about all the issues of the attack, which we now know far more about—nor about the wise words and the content of the report of my noble friend Lord Harris. By the way, I knew him when he was getting ready for his first degree—supposedly, anyway, but I think he spent rather more of his time then as chairman of the Cambridge Fabian Society than studying, as he should have been. However, he has grown a lot since then.
Baroness Hayter of Kentish Town
I did not mean—well, when you are in a hole, stop digging.
Both my noble friend’s report and his speech today gave us much food for thought—or indeed gloom, if I may use the word of the noble Lord, Lord Arbuthnot. I will highlight two issues. The first is the robustness of the infrastructure and governance of the systems now emerging. The other is the public. This issue has been touched on already, in all the various scenarios.
On infrastructure, my noble friend’s questions leave one slightly less reassured than is good for one’s blood pressure. I do not know whether he was trying to discomfit us, but the more he spoke, the more I realised the size of the unanswered questions. As he spelled out some of those, it made one realise the seriousness of what we are doing.
As my noble friend Lord Harris says, unlike Airwave the proposed new emergency services network will not have its own exclusive part of the spectrum but will share it with the 4G network—putting our communications, as he said, in one basket, with a single point of failure. He hopes that the 4G never goes down. I also hope—like the noble Lord, Lord Arbuthnot, and the noble Earl, Lord Attlee—that we never have a widespread power failure.
It is not, however, just the noble Lord, Lord Harris, or indeed the noble Lord, Lord Paddick, who have concerns about this. The NAO pointed out the high risk, given that the ESN approach has not yet been used nationwide anywhere in the world and there are currently no suitable handheld and vehicle-mounted devices that will work with it. Some reassurance, therefore, is needed today, provided that it is genuine and not just warm words. That would be appreciated.
How people’s own mobiles work in an emergency is also crucial, as is the question of whether they will give way to emergency personnel with higher priority than a mere member of the public—as I was in those days. As we have heard, emergency personnel may have priority over new calls from the public while still allowing heavy-usage calls already in progress to continue unabated. That was the question posed by my noble friend, to which we look forward to an answer.
The second issue is the public’s access to a network, or to information, during an emergency. That draws on the examples of Grenfell and Oxford Street and of other countries’ experiences—in Nice, Belgium and elsewhere—as well as 7/7. We must recognise people’s need to contact friends and relatives, and for reliable information at such times. I was particularly struck, in the Cabinet Office’s Civil Contingencies Act enhancement programme’s comments on communicating with the public, not simply about the guidance on warnings and providing advice in a timely manner—though that was a strong recommendation—but about the need to provide such information not just at the beginning but throughout the emergency, and at its conclusion. The latter point—something I had not realised or thought about—is crucial: it can be very easy to wind down at that stage and forget that other people do not know that the emergency is over.
The Cabinet Office research also demonstrates the importance of understanding people’s drive to maintain family contact: it is an important issue. We also need to prepare and understand the public’s mindset when faced by such events, as was mentioned by the noble Lord, Lord Rees. Research and understanding of that area is crucial to a successful emergency system. That understanding should be built into all the systems planning and rank high with the relevant leadership at each event. I am not referring to the kind of highly confidential information described by the noble Viscount, Lord Brookeborough, but to the information that people need at that time to know what to do.
Clearly it is easy to say that, but difficult questions arise over priorities—not only in access to communication systems but in the ranking of who gets told what and when. Those are issues for government, so I would also like to know who leads on it. I also ask the Minister for some assurance that even if the public as a whole cannot be involved in the planning and design of such systems, then civil society, consumer groups or communications experts are part and parcel at every step, so that the public’s needs are not an add-on, too late to influence the decision-making infrastructure and management system. I also ask that professional expertise on how to communicate—as was mentioned by the noble Lord, Lord Rees—is central to the planning, and not left to people who do not understand such ways of communicating. It is vital that it is built in throughout the planning system: the pre-warning and the training, whether we are talking about outward alerts from the police to mobile phones—really, the equivalent of what I remember as sirens when I was little—or the other issues. I hope that this will be built into our development of new systems and their governance.
These are serious issues and we already have a lot to be thankful for in what is being done in this way. I hope that today’s debate might serve to nudge the Cabinet Office to move a little faster on this vital issue and that my noble friend Lord Harris might be further involved, given that he seems to know rather more about this than I ever wanted to have to know about it.
Lord Young of Cookham (Con)
My Lords, I thank the noble Lord, Lord Harris, for the Question that he has asked about improved communications in the event of a terrorist incident or major emergency and for focusing, as he did at the beginning of his remarks, on the progress on public-alerting technology. I also commend his wide-ranging review of London’s preparedness for a major terrorist incident to the House, which a number of noble Lords referred to and which I read with great interest when he asked an Oral Question a few weeks ago. I am grateful to all noble Lords who have taken part. This has been an astonishingly well-informed debate, with expertise from a wide variety of interests focused on it.
I understand the real anxiety that we should get decisions right. Major decisions are confronting us and it is crucial that we take on board some of the questions and concerns raised in this wide-ranging debate. I want to focus on communications—I am conscious that I will not be able to answer all the questions—and particularly on the subject of mobile alerting, championed by the noble Lord. When he asked me about this on 16 April, some noble Lords were concerned about the speed of progress being made. I am now able to report that we are making headway on the very topic of using mobile phones for alerting citizens to a major incident.
Doing nothing regarding an alerting system is not an option. It is absolutely right that the Government should take every step possible to reduce harm to citizens when faced with emergencies, such as the terrorist incidents that recently afflicted major cities in the UK. But the evidence linking use of an alerting scheme for emergencies to the actual saving of lives needs further work, especially given the nature of risks in the UK. To move matters forward, the Cabinet Office recently commissioned work to provide an insight as to what is happening elsewhere in the world, as mentioned by the noble Baroness, Lady Hayter, and to gain a wider appreciation of the technical issues behind a scheme. It is right to do this exploratory work to help understand how we get the best value out of the system. The matter is currently under active consideration by Ministers.
These days, a very large proportion of society—some three-quarters—owns a mobile phone and it seems appropriate to use phones as a vehicle for sending alerts to citizens. However, their wide appeal hides complexity in using them in an alerting scheme. It seems prudent to explore the situations where a scheme would stand the best chance of successfully reducing harm, which is where the police have a major role to play, especially in fast-moving terrorist incidents. There are already a number of schemes in the UK and internationally with very different objectives, delivered in different ways at different costs.
The sort of scheme that the Government have in mind should build upon arrangements already in place, such as the very successful flood warning scheme run by the Environment Agency. To have additional value and reach the maximum number of potentially affected people, our desirable characteristic for a scheme is one which addresses emergencies in general and is of national stature since emergencies do not respect administrative boundaries, as demonstrated in recent years. Importantly, we believe such a scheme should not involve citizens having to take any action to receive a message, such as having to install an app on to their smartphone. As such, we envisage it to be rather like a reverse 999 scheme. By using such a scheme only for real emergencies, thereby keeping the threshold for use high, a scheme will hopefully attract the same level of importance within society as calling 999 or 112. We also see any scheme as being as inclusive as possible by delivering messages to as many citizens as we can reach and to mobile devices that are not necessarily of the latest technology.
A number of noble Lords, including my noble friend Lord Arbuthnot and the noble Lord, Lord Rees, focused on how crucial it is to get the message right. That point was also made by the noble Lord, Lord Paddick. The noble Lord, Lord Rees, helpfully suggested some guidelines for the sorts of messages that go through. Traditionally, alerting schemes address slow-burn incidents such as flooding. In these, the hazard is understood, the location is increasingly known and the evolution of the situation is by and large readily comprehensible. In comparison, fast-moving terrorist incidents probably require a different response. The response could be both temporal and geographic, with a timely low-content alert in the immediate vicinity of the incident and different content sent more widely to advise people entering the affected area on foot or in vehicles both public and private. As a consequence, in-depth work needs to be undertaken at both a policy level in the Home Office—to answer some of the questions about where responsibility initially lies—and operationally with the police to see how an alerting scheme fits with existing response arrangements for major incidents, as described by the noble Lord, Lord Paddick.
Most of the schemes around the world tend to broadcast messages to phones that are in the vicinity of a mobile phone mast—a scheme aptly called cell broadcast. There is an alternative that looked very attractive in the trials that the Cabinet Office reported on in 2014 where text messages are sent to phones in a specified area, much like cell broadcast, but since the phones are uniquely identified they can receive subsequent messages even if they leave the area of danger. That arrangement could have been useful in Salisbury, for example, where a nerve agent was used in an attempt to murder the Skripals and people in the area at the time needed to be contacted later.
A number of noble Lords mentioned the tragedy at Grenfell, where a facility of this kind could have meant that people in the tower could get information on their mobile phones that could not otherwise be communicated. That is a compelling case for making faster progress. These schemes all involve having a message involuntarily pushed to a mobile phone in a specified area. By keeping the threshold for use of a scheme high—for real emergencies where lives are at risk—we hope that recipients would not see it as intrusive and that the benefits would outweigh concerns over privacy.
A real challenge for all alerting schemes in terrorist incidents is that the protagonists will also receive the messages. Getting the content of the message right is absolutely crucial so it does not play into the hands of those who seek to cause harm. As a consequence, there is work to be done to shape the content of the message—that has been a theme coming out of this debate—so that it stands the best chance of getting the behavioural response sought, while not risking the recipient’s safety. That is a difficult call to make since bland messages would be rather like a news service, and we have plenty of those on social media.
The introduction of a scheme is not without considerable cost, but there may be an opportunity to contain the cost to the public purse. The Department for Digital, Culture, Media and Sport is transposing Article 102a of the European Electronic Communications Code into law before we leave the European Union. The code makes provision for reverse 112, which is an alerting scheme by a different name. As part of the transposition, consideration can be given to whether the costs should lie with those who own and operate our mobile phone systems in much the same way as occurs for 999.
On mobile alerting, I can tell noble Lords that the Government take it seriously and are adopting a considered approach to explore how a scheme may be introduced that reduces harm to citizens alongside wider work to keep people safe in emergencies.
I shall try to answer some of the questions raised during the debate. I am conscious that I may not be able to do justice to all of them. One of the themes introduced by my noble friend Lord Arbuthnot and developed by other noble Lords was about the resilience of the electricity system. The national grid is extremely resilient to mass failure and has not completely failed since it was wired up from the regional companies in the 1930s. Plans are in place to restore the grid in the event of a catastrophic failure—the so-called black start arrangements. I accept my noble friend’s invitation to write to him in more detail about that. We are currently reviewing the preparedness for a major power outage, and I understand that the noble Lord, Lord Harris, is actively involved in those discussions.
There was concern about the replacement of Airwave with ESN. It is designed to be as resilient as Airwave on coverage and hazards such as power outages. Priority will be provided for the emergency services. They will have pre-emption and, if circumstances demand, they can kick off members of the public, but it is being designed to have adequate capacity in the event of emergencies, and 4G has been substantially rolled out in recent years.
On putting all our eggs in one basket, I understand the point being made, but Airwave is no different from ESN in that both are stand-alone networks. ESN is leading technology, although I understand that South Korea is ahead of us. Airwave was a pioneer. It was the first system of its type and will remain in place until ESN is proven. ESN handsets are currently available and have been demonstrated since the spring. Capacity on 4G is very much greater than it was on the 2G system in use during the 7/7 incident, and it is very different from 2G from a technical perspective.
I was struck by the point made by the noble Viscount, Lord Brookeborough, about the media. It was a subject that I had not thought about before: the way an incident is reported can give assistance to terrorists. I take very much to heart the point he made that the media should be responsible in how they report the discovery of certain incidents. There is a lot to be gained from the experience in Northern Ireland when, as he said, a police officer in plain clothes would miraculously come across a cache of weapons, thereby not revealing the real source of that information.
We must continue to learn lessons from the emergency services about the recent Manchester Arena attack. The noble Viscount made the point that we should learn lessons, and we are looking at lessons across all the incidents that took place in 2017 and this year. The Kerslake review was broadly positive about the emergency services’ response and preparations, although there are lessons to be learned, and some noble Lords touched on some of them. We have improved interoperability during major incidents through the joint emergency services interoperability principles— JESIP—and we will continue to improve it. More than 12,000 emergency service commanders and control room managers have already been trained, alongside their peers.
I see that the clock is ticking and I am conscious that I have not done justice to the very important speech of the noble Lord, Lord Rees. On Vodafone and the issue of enhancement of helpline services, the Home Office immediately acted on the problems with this service during the Manchester Arena attack, and has firm assurances and confirmation that robust arrangements are in place to prevent it happening again. It is an important service to ensure that the concerned public can contact the police.
As I said, I will write to noble Lords and thank them again for a very interesting and well-informed debate, which I know the Government will take seriously as they take the decisions referred to during this discussion.