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Lord Bates
That an humble Address be presented to Her Majesty as follows: “Most Gracious Sovereign—We, Your Majesty’s most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament”.
The Parliamentary Under-Secretary of State, Department for Education and Department for International Trade (Baroness Berridge) (Con)
My Lords, on behalf of your Lordships’ House, I thank Her Majesty for her gracious Speech and am grateful for the privilege of opening today’s debate on the Motion for a humble Address. Today I shall outline the Government’s plans to support the economy, business, education and health to build back better from the Covid-19 pandemic. However, it is important to stop and recognise those 127,629 people who have died with Covid, those who are bereaved and those who have long Covid, and the tireless work of our NHS, businesses, charities and key workers, who still had to work even during the lockdowns. It is due only to their efforts that we find ourselves in the position to build back better, for which I am sure your Lordships are also truly grateful.
Vaccines are the way out of the pandemic, and the rollout has been a huge national effort. As someone who had their vaccine in Westminster Abbey, I can testify that we are working with faith leaders and grass-roots organisations across our diverse communities, as well as charities, and have listened to their ideas to get vaccines to as many people as possible. Over 35.5 million people have now received their first dose of a vaccine, and over 18 million have received their second dose. All those 50 and over, clinically vulnerable, or who are health and social care workers have been offered a vaccine, so we can confidently say we are ensuring that the most vulnerable have protection from the virus.
We will bring forward a landmark health and care Bill this Session. This will promote collaboration, ensuring that every part of England is covered by an integrated care system, and it will reduce bureaucracy by simplifying the provider selection regime and ensure that NHS England remains accountable, while maintaining its clinical and day-to-day operational independence. We will also enhance patient safety, delivering a new independent body to investigate healthcare incidents, which I know is legislation that your Lordships have seen before.
Throughout the pandemic, the NHS has worked incredibly hard to keep services going, going truly above and beyond. Today marks International Nurses Day. This year more than ever we must thank nurses for their incredible work in fighting a global pandemic—and sadly, of course, some have paid the ultimate price.
We now face the challenge of NHS catch-up and recovery, with over 4.7 million people currently waiting for care. The Government will support the NHS, as throughout the pandemic, and will ensure it has what it needs. We have confirmed an additional £3 billion for the NHS for this financial year, on top of the long-term settlement, to support recovery, including around £1 billion to begin tackling the elective backlog and around £1.5 billion to help ease existing pressures in the NHS caused by Covid-19.
The pandemic has also taken its toll on people’s mental health. We have published our mental health recovery action plan, and will provide around £500 million for mental health services and investment in the NHS workforce, to ensure that we have the right support in place over the coming year. We are also working towards reform of the Mental Health Act to give people more say over their own care.
Experiences during this time could have an impact on the health, well-being and opportunity of our youngest children throughout their life, even though they may not have been conscious of living through a pandemic. As demonstrated by the Leadsom review, the care given during the first 1,001 critical days from conception to age two has a significant impact on a child’s future. Attending early years education lays the foundation for lifelong learning and positive outcomes, which is why we prioritised keeping early years settings open as much as possible, in line with health and safety requirements, during the pandemic. Throughout the pandemic, even when early years settings had to close, we continued to fund entitlements, which are currently around £3.6 billion a year.
The Government are committed to ensuring that no child is left behind because of learning lost over the past year. We will put in place a long-term recovery plan to allow us to build a better and fairer education system. We have already provided £1.7 billion in the past year to enable education settings to support children. The package includes significant funding aimed at addressing the needs of disadvantaged pupils. The recovery premium will be allocated to schools based on disadvantage funding eligibility and the expansion of our tutoring programmes will provide targeted support to children and young people hardest hit by disruption to their education.
The Government’s vision is for every school to benefit from being part of a strong family of schools, because multi-academy trusts are the best structure to enable schools and teachers to deliver consistently good outcomes. Seventy-five per cent of sponsored primary and secondary academies that have been inspected are good or outstanding, up from their previous grade of inadequate, compared to around one in 10 of their predecessor schools. We plan to release up to £24 million through the next phase of the trust capacity fund to help trusts grow, and we have recently launched a “try before you buy” trust partnerships model for schools to experience the benefits of being part of a strong trust. Following its autumn visits, Ofsted reported that many schools in trusts had found the support they received invaluable. What it found further cements our belief in the unique strength of the academy trust model. We are also clear on the need to improve schools where there is long-term underperformance by bringing them in to strong academy trusts—a key manifesto commitment. These include schools which have been judged “requires improvement” or worse by Ofsted in their last three consecutive full inspections. This will ensure that these schools also have access to the support of a multi-academy trust.
I turn now to HE and FE. Our universities have a long and proud history of being institutions where views may be freely expressed and debated. However, there are growing concerns that fear of repercussions is preventing open and robust intellectual debate. Over the course of this Parliament, with legislation introduced today, in the other place, we will strengthen freedom of speech and academic freedom in higher education in England. Duties on higher education providers and students’ unions will be strengthened, with clear consequences introduced for any breach. We will ensure that higher education providers in England are places where freedom of speech can thrive and that academic staff, students and visiting speakers feel safe to put forward new ideas and controversial or unpopular opinions. In addition, UK students will be able to study and do work placements across the world through the Turing scheme, a new international educational exchange scheme. The scheme is backed by £110 million and provides funding for around 35,000 UK students in schools, colleges, and universities to go on placements and exchanges overseas, from September.
Skills are one of the Prime Minister’s key priorities and, in this Session, we will bring forward legislation to reform the post-16 education and skills sector. I am grateful for the exceptional effort of the further education sector, which adapted so quickly to remote education during the pandemic. The skills and post-16 education Bill will form the foundation for the reforms set out in the Skills for Jobs White Paper laid before the House earlier this year. I thank noble Lords for their thoughtful welcome for the White Paper. As part of the Bill, we will introduce a lifelong loan entitlement, giving people the opportunity to study flexibly at colleges and universities across their lifetime. We will improve the training available by making sure that providers are better run, qualifications better regulated, and providers’ performance effectively assessed. As this Government are focused on improving communities, rather than just providing a ladder out of them, we will put employers at the heart of the skills system to ensure that local provision meets local needs so that people can thrive where they live. Together, these reforms will ensure that people can get the skills they need to succeed.
Supporting our highly skilled, regulated professions to deliver vital services is key. Our regulators must have the autonomy to set the standard required to practise in the UK. The Professional Qualifications Bill, introduced into this House just now, will establish an effective regulatory system for professional qualifications. It will facilitate the recognition of professional qualifications that meet the needs of all parts of the United Kingdom and support our professionals to deliver their services in overseas markets.
The Government are also committed to our role as a global science superpower. To complement UKRI as the steward of our R&D system, the Advanced Research and Invention Agency Bill will create a new agency focused specifically on funding high-risk, high-reward research. With £800 million invested in ARIA by 2024-25, it will diversify the R&D funding system. The agency’s leaders will be able to experiment with innovative funding mechanisms and push the boundaries of science at speed. To also ensure that we have the skilled workforce to deliver net zero and our 10-point plan for a green industrial revolution, we launched the green jobs task force, in partnership with skills providers, unions and business. We are also providing over £1 billion for public sector buildings, including schools, to install heat decarbonisation and energy efficiency measures. This will upgrade school buildings and reduce carbon emissions.
The UK is taking advantage of its new-found freedoms as an independent trading nation. The subsidy control Bill will create a new domestic subsidy control system, to provide certainty and confidence to businesses investing in the UK. It will protect against subsidies that risk causing distortive or harmful economic impacts and ensure a consistent approach throughout the UK. It will ensure that the UK meets its international commitments on subsidy control and provide a legal framework that reflects our strategic interests and national circumstances. The Bill will enable public authorities and devolved Governments to design subsidies that deliver strong benefits for the UK taxpayer.
This Session we will also introduce legislation to support workers. The national insurance contributions Bill will introduce NI relief for employers in freeports, employers of veterans and the self-employed receiving self-isolation support payments. This Bill supports the delivery of the 2019 manifesto commitment to create 10 freeports across the UK to promote job creation, by providing a relief from NI contributions for eligible new employees for three years, up to earnings of £25,000 a year. The Government are also supporting veterans to secure stable and fulfilling employment as they transition to civilian life by encouraging employers to hire veterans. There will be NI relief of up to £5,500 per year for each hired veteran. We also want to ensure that self-isolation payments will not attract NI contributions. The Bill will also clamp down on the tax avoidance market, enabling action to be taken against promoters of tax avoidance schemes.
Public service pension reforms were introduced in 2015, and the Government agreed to allow those closest to retirement to stay in their legacy schemes. This was later judicially challenged, where it was found, inter alia, to be unfair to younger members. We will now be giving all eligible members a choice between legacy and reform scheme benefits for the period from the date the reforms were made to April 2022. We will continue to reward public servants with pensions that are among the very best available, in a way that ensures they are fair, affordable and sustainable. We will also bring forward reforms to help recruitment and retention in the judiciary, continuing to attract and retain high-calibre judges.
As we now exit the pandemic, I hope noble Lords will be assured that we will support the NHS, plan the education recovery carefully, upskill adults and drive innovation. My noble friend Lord Callanan and I look forward to hearing the valuable insights of many noble Lords today, especially the maiden speeches from the noble Baroness, Lady Blake of Leeds, and the noble Lord, Lord Lebedev, and—sadly—the valedictory speech from the right reverend Prelate the Bishop of Portsmouth.
Lord Watson of Invergowrie (Lab)
My Lords, I thank the noble Baroness the Minister for setting out the Government’s plans, and I should like to echo her good wishes to the right reverend Prelate the Bishop of Portsmouth on the occasion of his valedictory address to your Lordships’ House. I have often enjoyed his enlightened contributions, not least on the economy. He will be missed.
After all the hype over the weekend, what we heard yesterday was, to put it mildly, an anti-climax. Indeed, it is a legislative programme more notable for what is not included than what is. There is nothing on adult social care reform. The Prime Minister said in 2019 that he had a ready-made plan. So where is it? The Government absolutely must deliver plans for social care reform in this Parliament. There is also nothing on protecting the rights of 16 and 17 year-old children in care, a matter on which the Government are facing legal action.
Ministers speak of a so-called “levelling up” agenda. Implicit in that is a trashing of their own record, because the undulating landscape that is life in England today has been carved out largely by 11 years of Tory and coalition misrule. “Levelling up” is a suitably vague term but, if it is necessary, then who is to blame? It is Tory Governments, responsible for politically driven austerity policies—policies which hit the disadvantaged hardest, blamed the poor for their poverty and punished people for their disabilities. Now, apparently oblivious to the inherent hypocrisy, the Government want to level up. Really? I have to say that I doubt it. This programme involves the Tories cleaning up their own mess—I pray in aid the health and care Bill, on which my noble friend Lady Thornton will have much to say later. Noble Lords may have noticed that the noble Lord, Lord Lansley, has ducked today’s debate and will speak in Monday’s. I wonder why that might be?
We welcome the skills and post-16 education Bill and its lifetime skills guarantee because investment in lifelong learning is needed more than ever, given the impact and aftermath of the Covid pandemic. I also welcome the fact that the Bill will begin its journey in your Lordships’ House. But, since 2010, further education and skills have borne the brunt of government funding cuts; access to learning has been restricted and maintenance support for younger learners abolished, resulting in fewer studying in further education and fewer workers able to retrain and upskill. The number of apprentices has also plummeted, with new starts down by over a third compared to five years ago.
Yet, nearly a million “priority” jobs will be excluded from the lifetime skills guarantee, exposing the Government’s empty rhetoric on creating opportunities, as the Loyal Address fails to deliver for young people hardest hit by the pandemic. The country is facing a skills shortage in jobs such as vets, architects and computer programmers, with the Government designating those jobs as a priority for work visas. I hope that the Minister will explain why these sectors are excluded from the lifetime skills guarantee offer to help adults gain a new level 3 qualification. Will the Government’s good intentions be backed by the resources necessary to make them effective? Developing the skills that the economy needs will work only if people can afford to live while studying through a mixture of loans, grants and social security support. Without that, the legislation simply will not be meaningful or far-reaching enough.
There is another education Bill, of course, but it is not one that addresses priorities in the education portfolio. There is a yawning gap where a Bill to rescue the early years sector should be. According to the Government’s own data, more than 2,000 early years providers have been lost since the start of this year alone; yet they offer no plans to address that. It is widely accepted that children’s first years are crucial in shaping so many aspects of their lives. But, to the Government, early years settings seem to be little more than a means of allowing parents to return to work, rather than essential building blocks in the development of a child’s learning and basic life skills. Of course enabling parents to return to the job market is important, but nurseries are first and foremost places of education, not simply childcare facilities.
The Loyal Address is shamefully silent on measures to tackle child poverty. No change, then, from a Government who had to be dragged kicking and screaming to provide free school meals during the holidays, while too many children were left without the resources to learn at home. At least the Conservatives have been consistent—they have treated children as an afterthought throughout this pandemic.
Health inequalities feed into education inequalities, and that includes universities. Uncertainty leads to anxiety, which leads to issues that impact on mental health. One aspect of that is the Secretary of State for Education’s dithering on school exams. He must avoid a repeat and should remove some of the stress now from this year’s year 10 cohort by announcing that they will have centre-assessed grades next year.
We will not be able to “build back better” if the generation who will be the foundation for the future are weakened by poverty and a mental health crisis. This generation have had their childhoods and life chances disrupted and damaged by the pandemic. So, it is a failure on the part of this Government to see so little on greater support for children in their plans. Perhaps that should be placed in the context of a Government led by a Prime Minister whose concern for children does not seem to stretch even to being certain how many he himself has. That underlines the necessity of the Minister for Children being returned to Cabinet status.
The learning gap between children on free school meals and their peers had not narrowed in the five years before the pandemic, and all the evidence suggests that the impact of lockdown is delaying young children’s language and social development. Yet Ministers have announced just a single-year catch-up plan, amounting to a paltry 43 pence a day per child over the next school year, with no specific support for well-being or social development. Despite warnings from experts that the pandemic is leading to an increase in mental health conditions, the Loyal Address went no further than to say that:
“Measures will be brought forward to … improve mental health”.
There was no mention of support for children’s mental health or well-being. In responding to this debate, can the Minister set out what advice he would give to children, students and adults suffering with mental health issues now and who need support now, not at some indeterminate point in the future?
Rather than addressing those urgent matters, the other education Bill announced today deals with a subject that grips the whole country: freedom of speech in universities. To prioritise such legislation is a blatant attempt to continue the culture war that the Government are determined to wage. Their focus on manufacturing an argument over free speech on campus is an attempt to distract from their failure to support students and universities through this pandemic. Students are seriously worried about getting the skills and experience that they need for the workplace. Despite Labour’s calls, Ministers did little to support the graduates of 2020 who entered a shattered jobs market; they simply must do more to secure the futures of the class of 2021.
A glaring omission from the Loyal Address is an employment Bill, first promised in 2019 to
“protect and enhance workers’ rights”.
That commitment has been repeated by Ministers on no fewer than 50 occasions, yet workers’ rights are mentioned only once in the background briefing to the Loyal Address. Worse, there has been a significant change in language from 2019, when the Government said they would “enhance workers’ rights”; now, there is merely a whimsical aim of “upholding workers’ rights”. What rights, I wonder? The Loyal Address of 2019 said that an employment Bill would provide
“better support for working families”
and
“enhance workers’ rights, supporting flexible working, extending unpaid carers’ entitlement to leave”.
Yet there are no such landmark reforms to zero- hour contracts or the gig economy. So much for levelling up; what we are seeing is a levelling down on employment rights. The Prime Minister recently described the iniquitous practice of hire and re-hire as unacceptable —but not, it seems, sufficiently unacceptable for his Government to do anything to prevent it. When he replies, will the Minister explain why the Government have now abandoned working families during a pandemic?
Covid has closed much of our economy, but the Conservatives, in effect, crashed it. Their ineptitude and capriciousness has left Britain with a record: the worst economic crisis of any major economy. Yet they plan a return to the same old policies that left us exposed to the virus, and organisations from the IMF to the OECD have warned the Government about the dangers of slamming the brakes on too soon; I hope that they will be heard. People are desperate for the security that a resilient economy brings: a good job, a reliable wage, a roof over their head and the confidence that comes with all those things. As we recover, Labour would take responsible action to secure jobs, support our high streets and strengthen our communities to deliver that stronger, fairer, regionally balanced economy that Britain so desperately needs.
Over the past decade the Government have wilfully underfunded local authorities, forcing them into a choice between charging people more or slashing services. Now they are allowing family incomes to be hit by rises in council tax which are not the fault of cash-strapped councils. Why have the Government learned nothing from the austerity years dating back to the coalition?
The legislative programme set out in the Loyal Address is not the bold and expansive agenda that might have been expected from a Government with such a majority. Even today’s Times—normally a cheerleader for them—describes it as lacking ambition. That is what has characterised this Government and, in the months ahead, we on these Benches we will use the opportunities presented by the Bills listed in the Loyal Address to set out how we believe they can be improved. There are opportunities that we will exploit in a legislative programme that could and should have been much better equipped to prepare the country for the serious challenges that lie ahead.
Baroness Brinton (LD) [V]
My Lords, I declare my interest as a vice-president of the Local Government Association. From these Benches, we also thank the Queen for her gracious Speech yesterday, and I too offer my best wishes to the right reverend Prelate the Bishop of Portsmouth. We look forward to the maiden speeches of the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev.
The Government had an opportunity to bring together the key issues that sit at the heart of the way our country operates. But much of the programme ignores the key strategic priorities that the country needs to focus on to recover from the pandemic and adjust to life outside the European Union. There is no strategy here, just a series of one-off initiatives designed to grab headlines.
The Prime Minister constantly talks about levelling up and building back better and says that these are all about caring for those who feel excluded. But look as hard as we can at the Government’s proposals, we cannot find concrete proposals to reduce inequality. Where is the care? We see an unnecessary voter ID Bill and a puppy farming Bill, but we do not see a desperately needed social care Bill. Where is the care?
From these Liberal Democrat Benches, we believe we must rebuild a fairer, greener and more caring country in the aftermath of Covid. Yet the Government’s proposals for this next Parliament are still failing small businesses and the self-employed. Where is the care? They are still not rising properly to the climate emergency. Where is the care? They are still ignoring millions of unpaid people caring for loved ones at home. Where is the care?
The stark ONS data publication today shows that our economy shrunk a further 1.5% in January. Government is the guardian of public services, whether core services that everyone needs such as the NHS and education, or our vital safety net for those who cannot, for whatever reason, support themselves, which includes social care and benefits. For there to be an effective public sector, we need an economy that can support our needs. How will that be delivered when, earlier this year, the BEIS Secretary Kwasi Kwarteng abandoned the industrial strategy that he inherited from successive Governments? He replaced it with a compendium of repackaged press releases and lots of colour photos. Meanwhile, the financial services industry—such an important taxpayer—awaits some movement, any movement, on its post-Brexit access to the EU market.
There are further problems caused by the absence of a long-term economic plan. The Government were right to create the furlough scheme. But if unemployment rises sharply as lockdown is lifted, those already struggling with debt are likely to need help from many of the services in the public sector. Worse, the furlough scheme ignored the millions of self-employed. This country prides itself on the vision, imagination and determination of our self-employed. They have been ignored by this Government for over a year and now face a much harsher return to business. Where is the care?
Instead of publishing a much-needed and anticipated employment Bill, the Government are silent—silent on the consequences of the explosion of the use of zero-hours contracts and of companies such as Uber attempting to get around their responsibilities as employers. Where is the care? Instead, the Government focus on picking and choosing the places for economic growth. Their latest flagship proposals for freeports have not understood that a UK business exporting will now face tariffs to 23 countries, costing them extra money. Where is the care?
The Bill to reform apprenticeships and lifelong learning must address the failings of the current government apprenticeship scheme. Frankly, it is a total mess. The number of apprentices is less than when the Government started it. Where is the care? Can the Minister tell us how this new scheme will work? These Benches will judge it on its effectiveness, inclusiveness, flexibility and the speed at which it is delivered. It is vital that it is also designed to help small and micro businesses, which already struggle with their capacity to support training and skills in their business. Where is the evidence that this Government understand their needs?
Liberal Democrats believe that small businesses are essential to building their local communities’ recovery, whether on the high street or a local industrial estate. We need a new workforce strategy that looks at new modes of working, including the flexibility of working from home.
Equally important is the need for a real public procurement strategy and clarity of the rules. This last year has exposed cronyism at its worst. The details of the proposals in the Queen’s Speech’s on procurement at page 74 say that one of
“the main benefits of the Bill would be: … Embedding transparency throughout the commercial lifecycle from planning to procurement, contract award, and performance evaluation. Procurement data will be published in a standard, open format, so that it is more accessible to anyone.”
The irony of that statement is staggering. Was it this Government who were taken to court by openDemocracy because they were not publishing contracts on time or in appropriate detail? Were existing, approved suppliers of PPE elbowed aside for chums of Ministers or Tory donors with no experience of PPE, who then won multimillion-pound contracts? Not surprisingly, a good chunk of these did not meet the appropriate standards, putting our health and social care staff at risk. Where is the care?
When Mr Johnson became Prime Minister in July 2019, he said:
“My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care and so I am announcing now—on the steps of Downing Street—that we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve … I will take personal responsibility for the change I want to see. Never mind the backstop—the buck stops here.”
There are 91 vital words that gave hope. For just under two years, we have been waiting for the urgent and detailed plans from this Government to reform social care. But there were only nine little words in the Speech yesterday:
“Proposals on social care reform will be brought forward”—
just one-10th of the words the PM uttered two years ago.
Millions of people—those who need care, many unpaid carers and the entire social care sector—are desperate for some change, not least to the financial structure. In coalition, the Liberal Democrats and the Tories agreed to implement the Dilnot review. In 2015, the Conservative Government ditched the plans, and, as a broken social care system waits, this Government fail them again. Not just “where is the care” but where is the social care?
The details of the Bill on integrated health services have some interesting omissions. There is no mention of a long-term, 10-year workforce planning strategy, for either health, social care or mental health. Nothing on pay and professionalism though the development of social care staff is mentioned. There is still no concrete timeline for mental health reform legislation, let alone the parity of esteem for mental health and physical health which the coalition Government committed to six years ago. There is no mention of how the NHS will manage long Covid, among both its health staff and its patients. There is nothing on health education, apart from in the context of the professional qualifications Bill and recruitment. Vitally, there is no evidence on how these NHS reforms will reduce inequalities. By contrast, the section on NHS reforms makes multiple references to improving efficiency, which was not a major theme in the White Paper. That had better not be code for cuts to the health budget. Where is the care?
I echo the words of the right honourable Edward Davey, who has welcomed the fact that the Prime Minister has confirmed that he will begin a Covid inquiry in this parliamentary Session. It is crucial that he sees this promise through; it must be a full and independent inquiry. This Government must be answerable for the mistakes so that lessons can be learned. The bereaved families of the 150,000 dead deserve justice, and Ministers must be held to account. I fear, though, that this Government favour opportunism over long-term strategic planning. Their actions over the past 15 months, particularly on contracts, make them look dodgy and like they are favouring their friends, at best. At worst, cronyism and questions about corruption are beginning to emerge.
This country needs a plan to help the country recover. This country is waiting. Where is the care?
Lord Stirrup (CB)
My Lords, the events of the past 14 months have reminded us, if we needed reminding, how much we as a society benefit from our National Health Service. It is worth remembering, though, that even before the pandemic, the NHS faced serious challenges, and these have not disappeared. Some were temporarily obscured by the Covid crisis and some were thrown into even sharper relief by it, but the fundamental problems remain.
Perhaps the most urgent pre-pandemic issue was poor morale among large sections of the clinical staff, who were experiencing unsustainably heavy workloads with no immediate prospect of relief. They nevertheless responded magnificently to the crisis, with an all-out effort that took little or no account of the personal costs involved. Their performance was superb, and they earned our heartfelt gratitude, but we owe them much more than that. As the pandemic recedes, they are left not just exhausted from the struggle, not just contemplating a return to the already debilitating status quo ante, but facing the daunting additional challenge of the clinical backlog that has built up over the past 15 months. Something must be done to address this.
Part of the solution is to embed more efficient processes and better ways of working, such as the continued use of telephone consultations for certain cases; the faster and more efficient flow of clinical information, where the NHS continues to suffer from severe shortcomings; and addressing the total lack of digital connectivity between clinical and social services. These and similar issues require urgent attention. I therefore welcome, in principle, many of the proposals set out by the Government in their White Paper on integration and innovation in health and social care, and the subsequent legislation referred to in the gracious Speech, but I want to make three points about the overall approach.
First, the initiative will fail if it focuses too much on reorganisation. I accept that some changes may be necessary, but I speak from bitter experience when I say that constant shuffling of the deckchairs diverts effort and energy from those things that really matter—in this case, improving health outcomes and the work/life balance of NHS staff. It also seldom gets to the heart of things. No large endeavour such as the NHS can be managed effectively as a monolithic structure. It has to be divided up somehow, and the divisions will introduce boundary and interface issues which can hamper efficiency. Reorganisation does not solve such issues; it simply moves them elsewhere. What is needed is the development of a culture that ensures efficient management across such boundaries, and this requires not just legislation but many years of strong leadership and sustained effort.
Secondly, I return to a point that I have made in this Chamber before: healthcare is an inherently ungoverned system of ever-increasing demand and ever-increasing technological opportunities. The growth in pressure has already outstripped the new resources that have been promised in recent years. Left to itself, demand will always exceed supply, wherever we set the level of funding. We have to exercise control over the outputs as well as the inputs, but I see little sign of this in the Government’s current proposals.
Thirdly, the issue of morale cannot wait. NHS staff clearly need some immediate relief from the pressures under which they have laboured for so long, and which they continue to face. Pre-Covid, the Interim NHS People Plan made some proposals in this regard, but a number of them were neither specific nor quantifiable, so when will we see a comprehensive and detailed plan of action for the urgent relief of the pressures on NHS clinical staff, to include milestones and accountable persons? How will progress on these measures, and their impact on NHS morale, be assessed and reported?
We urgently need a way forward on the future provision of health and social care in the round. The foundation of the NHS was perhaps only made possible by the upheaval and dislocation of a world war. The global Covid crisis now gives us the necessary impetus to ensure that Beveridge’s legacy is made fit for the 21st century; we must seize the moment.
Lord Bridges of Headley (Con)
My Lords, we all know the challenges and opportunities that lie before us: the green and digital revolutions; competing in a post-Brexit world; paying for our ageing population; and, of course, repairing the economic damage caused by Covid. The last time a Conservative Government enjoyed a majority of this size, they too faced enormous challenges, and they seized that opportunity to remodel the economy. Everyone knew that Government’s direction of travel and even their opponents grudgingly respected the Government’s willingness to take tough decisions to achieve their aims. So, with that in mind, I ask whether this Government are using their political power and this golden opportunity to meet the challenges this nation faces. How does the gracious Speech rise to the moment and set us on a new course?
There are good things within the gracious Speech. Free ports could breathe life into depressed communities. I applaud measures to reform the planning system and to improve skills and lifelong learning. Previous Governments have expressed similar bold ambitions, so I hope this one will succeed where others have failed—they will certainly have my support. However, apart from those Bills, I ask: is this all the Government have to offer, given the scale of the challenges, the plentiful opportunities and the political wind in their sails?
For example, as we undergo the digital revolution, why are we not updating our analogue employment laws? What plans have we to revamp our complex analogue tax system? How, specifically, are we going to help people and businesses go green? What new powers are we going to give to city mayors to help them level up communities? And how will we pay for our ageing population? Sadly, we will not be debating Bills on these topics, although the Government have found time to legislate to stop puppy smuggling. I remain to be convinced that we are really confronting the major challenges we face.
I also detect something deeper. Far from a wish to unleash enterprise and support risk-takers, I sense a worrying drift towards big government. Of course, we needed to support businesses during Covid—that goes without saying—but my concern, and I very much hope to be proven wrong, is that the Government’s tendency is to think, once again, that the man in Whitehall knows best. By that I do not wish to imply that government has no role at all to play, but what I am saying is that I believe that the private sector, not Whitehall, will drive growth; that competition, not state intervention, will boost innovation; that low tax provides incentives for investment and hard work; and that a strong economy is founded on stable finances, not debt.
Look at the direction we are heading in. By 2025, we will have 3 million more higher rate taxpayers than in 2010. Corporation tax is heading towards its highest level since 1989. The tax burden is rising to its highest level since the 1960s. Our stock of debt is at its highest level since 1958. Borrowing is at its highest level since 1947, when records began. Although the nation is deep in the red, this Speech implies still more spending and my understanding is that, other than the NHS, schools and defence, all other areas face real-term cuts in 2022-23. Maybe, when my noble friend sums up, he can tell us how the plans in this Speech are going to be paid for and where the money will come from.
Governments are best when they are bold, and this Government have a once-in-a-generation opportunity to reset the course of our nation, so we are able to meet the challenges and make the most of the opportunities that lie ahead. Sadly, at the end of the gracious Speech, I was left wondering: is that it?
The Lord Bishop of Durham
My Lords, it is a privilege to be the first to speak from these Benches on Her Majesty’s gracious Speech. I look forward to the valedictory speech of my colleague, the right reverend Prelate the Bishop of Portsmouth, who has served the House so well during his years as a Lord spiritual. I also look forward to the maiden speeches of the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev.
I make my comments within a very specific framework: are the measures contained in the gracious Speech good for the children and young people of our land? At the outset of her tenure as Children’s Commissioner, Dame Rachel de Souza commented:
“I want to see childhood right at the top of the Government agenda. That means every speech from the Prime Minister and Chancellor mentioning children, and every Government department constantly pushing to improve the lives of children”—
so it was good to hear a range of references to children. Having the best start in life by prioritising early years is essential. There is no debate any longer that the months in the womb and the first 1,001 days of a child’s life are absolutely critical to lifetime development. Much deeper investment in all aspects of early years well-being—mental, physical, social and spiritual—is essential. It was good to note reflection on building back better through all aspects of education. It is essential that this begins with children’s spiritual, social and mental well-being rather than academic achievement. The latter will follow the former. It must be truly a long-term plan, not one limited to the lifetime of this Parliament.
We welcome the plans for flexible funding within the skills and post-16 education Bill. The flourishing of the further education sector is crucial to our future. We as a Church stand for human flourishing at all levels. Therefore, this is at the core of our core educational vision:
“Deeply Christian, Serving the Common Good”.
We as a Church recognise that we must become younger and more diverse. Engaging in further education needs to be at the core of what we do. This is as much a matter of social justice as it is about skills for jobs, social mobility or greater productivity. Therefore, we are seeking to form new partnerships and to reach out on areas of common concern such as well-being, mental health, bringing communities together and the place of spirituality in further education.
We offer key themes to inform these discussions: vocation, transformation and hope. We also challenge ourselves to reimagine chaplaincy for all those in further education. Currently, we are exploring how best to fulfil this vision in partnership with colleges that share our vision and commitment to serve the needs of people of all faiths and none. We are grateful for engagement with, and are committed to, an ongoing working partnership with the Secretary of State and the Government to explore these issues together for the common good.
In further developing integrated health and social care, the needs of children, especially around mental health, disability and special educational needs, must be central. Children need properly joined-up working between all sectors. The commitment to online safety for children must be turned into reality. I hope the Government will work closely with 5Rights and others to achieve this.
The ongoing international commitment to girls’ education is very welcome. It is such a pity that it comes against the backdrop of the savage cuts in other areas of international development, which will reduce those same girls’ access to clean water, better hygiene and healthcare. The international aid budget needs to be returned to 0.7% immediately. Sadly, this was not indicated in the gracious Speech; might the Minister comment on this lack?
The charitable voluntary sector is a vital part of children’s well-being. I hope that the charities Bill will address concerns that make life for smaller charities particularly difficult.
Children must be at the heart of how we build back from the pandemic. Since the Prime Minister has committed to appointing a Cabinet-level Minister to co-ordinate the start for life initiative, might it be better if this was for children of all ages, not simply nought to five year-olds?
I finally want to touch on the New Plan for Immigration Bill. The Home Office has said it is committed to a culture that is respectful, compassionate, collaborative and courageous. No one is more deserving of this approach than children forced to seek sanctuary through no fault of their own. The Government’s New Plan for Immigration references children and young people rarely, other than in the discussion on age assessment. I trust this omission will be rectified in the Bill, given that the Home Secretary spoke of prioritising the protection of vulnerable women and children in refugee camps. There are other things we welcome in those proposals, but no child deserves a hostile start in a new home where they will be trapped in a precarious life, vulnerable to exploitation and poverty—and there are real concerns that that will happen under the current proposals.
Children need to be at the heart of every aspect of building back better. There are signs of hope; there are also signs of deep concern, including no commitment to keep the uplift in universal credit or address the two-child limit. A bigger, bolder vision for children is still needed.
Lord Eatwell (Lab)
My Lords, a debate on the economy must begin with the news this morning that the economy is 8.7% smaller than it was pre pandemic. Do not be fooled by claims of spectacular growth rates in the next few months; it is how soon we get to pre-pandemic levels that really matters.
Our economy has been permanently scarred by the pandemic and Brexit, permanently reducing output below previously attainable levels and therefore reducing the resources available to fund recovery. Consider the task before us: the NHS has a backlog of 4.7 million cases; the £1.7 billion pledged by the Chancellor to restore our schools has been labelled “nowhere near enough” by the Education Recovery Commissioner; the Crown Courts have a backlog of 56,000 cases, with some trials not scheduled to begin until 2023; and, all the while, economic relations with our major trading partner are mired in jingoistic rancour and red tape.
The Prime Minister is right to say that recovery is the biggest challenge since the Second World War. To face that challenge, we need a practical vision, clear goals and a framework to guide economic policy. Sadly, taking the Budget and the measures announced in the gracious Speech together, there is only incoherence. The gracious Speech is littered with promises of spending commitments. The Budget speech told us that public spending is to be cut by £4 billion per year, with major cuts targeted at local authorities—hitting hardest those areas promised the beneficence of levelling up. The much-lauded lifetime skills guarantee comes with a sting in the tail—the guarantee is to provide not training but loans to pay for training. So new skills will come with new debt.
The commitment to fund research and development is welcome. It would have more impact if the science base were not at the same time losing even greater funding from European research programmes.
In 1945, Clement Attlee, in far worse circumstances than we find ourselves today, presented a vision for post-war recovery based on three pillars: education, health and culture. The economic framework was simple yet profound; it was economics for the common good. Economics for the common good seeks to manage the risks of daily life by providing appropriate collective provision where individuals’ lives would be blighted. The NHS is a magnificent collective scheme with 60 million members. Similar collective commitment is necessary to mitigate the risks in social care, as Sir Andrew Dilnot has proposed.
Economics for the common good recognises the need for collective provision of the foundations of production that individual companies cannot or will not provide—hence the need for investment in infra- structure, where infrastructure, properly understood, is not just railways and internet connections but protection for the environment, education and cultural industries and affordable childcare. All require collective investment to attain national productive efficiency.
The two elements of risk and infrastructure come together in the collective funding of innovative research. It was no accident that the vaccine to tackle Covid was developed at Oxford University, nor that the science behind the BioNTech vaccine was developed at the universities of Mainz and Tübingen. Cutting-edge research is inherently very risky, which is why it must be funded by the public sector. I therefore welcome the commitment in the gracious Speech to more funding for research and development but I am doubtful about the need for yet another advanced research agency. We have a lot of those already—they are called universities.
The economics of the common good could transform the muddled economics in the gracious Speech. In particular, it would place in context the ominous commitment to
“ensure that the public finances are returned to a sustainable path”.
No one would suggest that the public finances should be on an unsustainable path, but we all know that in the hands of this Government, “sustainable path” is code for “cuts in public expenditure”. The economics of the common good suggest that we should fund the recovery from the pandemic and the reconstruction of our economy as it reels from the blows of Brexit by the same method as we funded the war and the post-war recovery: by eschewing the nonsense of Treasury fiscal orthodoxy and instead pursuing a balanced management of the public debt that funds recovery, maintains demand and secures full employment.
Lord Storey (LD)
My Lords, we have a school system in England which is geared towards a knowledge-based curriculum and academic success. The hallmarks of that success are passing enough GCSEs at suitable grades to move into the sixth form and then achieving the required number of A-levels to move on to university. At every successful step on this journey, the pupils are praised. But, of course, not every pupil is able to cope with an academic-based education. We know that 40% or so of our pupils would be much better suited to a vocational education, which would give them the skills and opportunities for success in the jobs market and provide the much-needed skills that our nation needs.
Over the years we have seen our further education sector underfunded and downgraded and FE teachers paid less than teachers in the school sector. We have sat back and marvelled at the success of other countries such as Germany, Switzerland and Finland, which have created an education system that is tailor-made for the individual needs of every pupil and which provides the necessary skills for the economy. I therefore welcome the Government bringing forward a Bill on lifetime skills. As the Secretary of State said in his lifetime skills guarantee and post-16 education Statement in October 2020:
“I have been determined to raise the status of further, technical and vocational education … this sector has been overlooked and underserved, playing second fiddle to higher education. All too often, it has not given the young people and adults of this country the skills that businesses are crying out for, or enabled them to pursue the careers they dreamed of.”—[Official Report, Commons, 1/10/20; col. 541.]
So, yes, we will work constructively on this Bill, and see a lifetime skills guarantee and flexible lifelong learning entitlement as crucial to its success.
The Covid pandemic has played havoc with our children’s education. We have seen an increase in undesirable behaviour in pupils, some minor but persistent and some more extreme. Anxiety has become a growing issue—about catching Covid-19 and infecting family members, missing school and not being ready for examinations. Poorer physical health has also been noticeable for some children. School staff’s well-being has been affected, with constant moving around classrooms and no staffroom support from each other. Primary schools have seen a negative curriculum impact on key stage 1 pupils’ social communication and listening, speech, phonic knowledge and gross motor skills. Regression in fine motor skills is a particular concern; some pupils are now not able to hold a pencil. Some subjects were not taught in the depth they usually are because of the focus on maths and English. The effectiveness of remote education is varied. Many children with special educational needs and/or disabilities were not attending school and were struggling with remote learning, and were at risk of abuse and/or neglect. Even more schools report even more children being home schooled. By the way, this is not me saying this. This is not me reporting from some charity or teachers’ union handout or briefing; this is from the Government’s own Ofsted.
The Government’s response has been mixed. Laptops have been made available but head teachers have told me there have not been enough laptops for every child who needed them and the scheme was slow to get off the ground. The catch-up programme has given an extra £80 per pupil. Is this catch-up money really sufficient for schools in deprived areas or with large numbers of children with special needs? The national tutoring programme provides one-to-one catch-up, with schools having to pay 25% of the cost—and, by the way, if the tutor is off sick, they still have to pay that cost. Many pupils have found it difficult to relate to virtual strangers. Schools have also had to cope with pupils’ well-being and mental health problems.
I hope that we are now getting back to normal in our schools but government should give schools the time and the resources. Let us take the pressures and burdens of SATS off the shoulders of our primary schools, at least for a few years. Again, let us use Ofsted as a supportive mentor, giving schools detailed help and advice on the road to recovery. When we need to return to full inspections, let us make them initially light touch. We are now seeing thousands of children being home schooled. We have to make sure that those home-schooled children are safeguarded and taught in a proper and appropriate way. At the very least, let us agree that if you choose to home teach your child, that has to be registered with the local authority and the local authority has to make a visit at least once a year. I also worry about pre-school and nursery but I do not have time to deal with that.
Children have not only lost their schooling; perhaps more importantly, they have lost part of their childhood.
Baroness Chisholm of Owlpen (Con)
My Lords, as the vaccine programme continues and the country reopens, the Government, quite rightly, are taking stock of the condition of the NHS and public health.
As is well known, lockdown and shielding have worsened numerous physical and mental health problems, particularly among vulnerable segments in the population. After the heroic efforts of NHS workers, there is now a need for a period of resetting and recovering in all healthcare settings—a chance to take stock, not only for the improvement of those who use the NHS but for those who work in it. We need the right investment and the right use of digital technology, and I was pleased to hear in the gracious Speech the Government’s commitment to support innovative technology in the field of healthcare. I trust that the Department of Health will take note of a recent report by the Covid-19 Committee, on which I sit, called Beyond Digital: Planning for a Hybrid World. There is much in that which I think could help the Government.
I will give osteoporosis as an example of how, with forward and joined-up thinking, people suffering from debilitating diseases such as osteoporosis can have their lives improved. Osteoporosis is dubbed the silent disease because of underdiagnosis, undertreatment and chronically low levels of public awareness, yet as many people die of fracture-related causes as those who die of lung cancer, diabetes and chronic lower respiratory diseases. We now have a chance to build back better and level up, not only for those using the NHS but for those who work within it.
As with many others suffering from health problems, those suffering from osteoporosis have found that a postcode lottery stands in the way of diagnosis and treatment. Missed opportunities for early intervention in both primary and secondary care lead to problems routinely being left to escalate. For example, in the case of osteoporosis, two-thirds of people with vertebral fractures—2.2 million people—are undiagnosed. One-fifth of women who have broken a bone break three more before receiving a diagnosis. The most powerful intervention for osteoporosis sufferers is a British-born success story: the fracture liaison service model. Figures show that the FLS saves the NHS £3.28 for every £1 invested. Its record in saving lives and reducing healthcare costs is why the model was exported at pace across the developed world. Yet here we find an example of a postcode lottery. People in Scotland and Northern Ireland enjoy 100% coverage, while only half of people in England have access to FLS. This postcode lottery means that two patients who live either side of the same city have markedly different risks of refracturing, with all the consequences for quality of life and the extra burden on the NHS.
We know that people living in deprived areas, families for whom English is a second language and people with learning difficulties are significantly more likely to suffer from health problems. For these people, levelling up across the country could not be more vital.
I am highlighting the disease osteoporosis because it is an area I have knowledge about, but the problems faced by osteoporosis sufferers are mirrored by those faced by many who suffer from other diseases. Everyone across the UK should have access to quality treatment. Clearly, this will not only improve people’s lives but save the taxpayer money. For instance, if everyone across the UK had access to fracture liaison services, it would prevent 5,686 fractures every year, saving the NHS £65.7 million in annual costs.
I would be interested to hear from my noble friend how the Government plan to encourage people to come forward in areas where late diagnosis worsens outcomes. I welcome the health and care Bill setting out ways for different parts of the healthcare system, including doctors, nurses, carers, local government officials and the voluntary sector, to work together to provide joined-up services. The Government have the opportunity to make sure investment is going to where it is most required and will make the most difference. For goodness’ sake, let us make sure best practice is shared around the country.
Older people have already borne a heavy burden throughout this pandemic. The Government must concentrate on ensuring that preventable problems in healthcare are dealt with early and at source, so that people’s lives can be decisively levelled up to ensure a high quality of life and ageing well.
Baroness Greengross (CB) [V]
My Lords, I want to address three issues arising from the gracious Speech: dementia research, the lifetime skills guarantee and the manifesto commitment to help people to live five extra healthy, independent years of life by 2035.
The Queen’s Speech reiterated the Government’s commitment to increasing funding for research and development. Here, I declare my interest as co-chair of the All-Party Group for Dementia. Will this include honouring the Government’s 2019 manifesto commitment to double funding for research into dementia to £160 million each year? This funding is needed more than ever, with many dementia research programmes being halted or paused due to the pandemic. It is very worrying, particularly given the ONS’s announcement just last month that dementia is now the leading cause of death in England. We never realised that. We also know that one-quarter of Covid-19 deaths in this country involved people with some form of dementia, so research into this is incredibly important. Many people do not know that 40% of dementia cases are linked to preventable risk factors, and this figure could well increase as we learn more about the condition.
I commend the Government’s commitment to the lifetime skills guarantee. Lifelong learning enables people to have greater success in employment—and ensures that we have a skilled workforce that meets the needs of our economy—and can support brain health, thereby possibly preventing some forms of dementia. It will also be vital in the context of longer and changing working lives. Research by the International Longevity Centre UK suggests that people aged 50 and over earned 30% of total earnings—£237 billion—in 2018. This could rise to 40%—£311 billion—by 2040. That could significantly support the economic recovery, but only if people are equipped with the right skills across their working lives.
The Government have made £95 million available, meaning that 11 million adults now have access to a free qualification. At present, this qualification is at level 3, which is an A-level equivalent. I look forward to seeing this programme expanded so that we can provide reskilling opportunities to all adults at a time when there are significant changes to the labour market. I also welcome the lifelong loan scheme, which the noble Baroness, Lady Berridge, mentioned in her speech, and look forward to the Government’s promised changes to employment legislation. That was not mentioned in yesterday’s Speech, but it should be a priority for the Government at this time.
Lastly, not mentioned in yesterday’s Speech was the Government’s manifesto commitment to support people to live five extra healthy and independent years of life by 2035. Do the Government still stand by that commitment? As already alluded to in my comments on dementia research, prevention and early action can play a crucial role in delivering the vision of a healthier nation, as set out in the Queen’s Speech yesterday. Here, I declare my interest as chief executive of the International Longevity Centre, whose 2020 paper found that time spent living with largely preventable health conditions is set to increase by 17% over the next 25 years unless the Government move upstream and invest in preventive health interventions.
Ten years on from the Dilnot report, the Queen’s Speech once again offered only general commitments to social care reform, without giving any detail. Part of the social care reform debate must consider the importance of prevention in healthcare, including dementia prevention, to reduce future pressure on the social care sector and to address the increased suffering of many thousands of people.
Baroness Blake of Leeds (Lab) (Maiden Speech)
My Lords, it is an enormous pleasure to be making my maiden speech today. I am conscious of the extraordinary circumstances the House has been working under since March last year. I pay tribute to Black Rod and her team, the Clerk of the Parliaments, doorkeepers, attendants and police officers, who have been so helpful and supportive, as well as patient with my repeated requests for directions.
May I also say how grateful I am to my supporters, my noble friends Lord Kennedy of Southwark and Lord Blunkett, for their unfailing support and advice? Our paths have crossed many times over the years, and it is a privilege to have their wisdom and great expertise to guide me.
My background and experience before taking up my seat here has focused on local government and other public sector organisations. I feel huge pride in having, and it is an honour to have, the title of Baroness Blake of Leeds, my home city and the city where I was first elected as a councillor in 1996. I became leader of Leeds City Council six years ago, the first woman to lead the council. Of course, although I cannot claim personal credit, I am beyond thrilled that Leeds United chose my last year in office to gain promotion to where they belong: in the Premier League.
Leeds has achieved much success over recent years but has been held back from realising its true potential by the overcentralisation of government in England. Much of my time in the past few years has been spent working on devolution with my colleagues in the other four districts of west Yorkshire. We achieved our goal with the election of our first directly elected metro mayor at the elections last week, and achieved another first as Tracy Brabin, the successful candidate, is the only female metro mayor in the country.
There is now consensus about the growing scale of spatial inequality in the UK. We need a mature debate on how we are going to address the imbalance in the economy, followed by a clear plan of action owned across the political spectrum by all different sectors and, crucially, empowering local and regional devolved Administrations. We urgently need to address the low productivity of our towns and cities outside London and better understand the cause. Estimates suggest that if our core cities alone performed at the levels of similar cities internationally it would add over £100 billion to our economy.
I listened with interest to the Queen’s Speech and the proposed legislation designed to lead us into recovery from the impacts of Covid—the most challenging time that we have faced for generations. The response of so many people across our country has been phenomenal. The city council in Leeds, along with town halls across the country, rose to the challenge magnificently and our gratitude to our front-line workers and NHS staff knows no bounds. However, the whole sector has been left with the knowledge that so much more could have been achieved if the necessary powers and resources had been devolved down to a local level. We have a great opportunity if proposed legislation addresses this and the levelling-up agenda of the recovery allows places to take charge of the necessary programmes of work. Local areas need to be able to run their own jobs and skills programmes. They need to secure the investment to develop their transport infrastructure, long promised and long overdue, and essential to unlocking the economies of so many communities. They need the freedom to invest in the growth of new and creative industries to bring benefit to their areas.
Covid-19 has exposed vulnerability in the cruellest way. It is no accident that those communities suffering the highest levels of health inequalities, poverty and overcrowded housing have suffered worst during the pandemic. All these factors must be addressed if we are to achieve the economic recovery we need, bringing benefit to everyone, wherever they live and whatever their backgrounds. I look forward to the proposed legislation covering skills, education and early years—a vital component of the levelling-up agenda. I know that many Members of this House have a great deal of expertise in these areas, which will be invaluable. I look forward to contributing my experience to the debates at the appropriate time.
We have an enormous task ahead of us. I am keen to start working with all noble Lords to secure the best future we can, especially for those who have sacrificed so much over the past year.
Lord Knight of Weymouth (Lab)
My Lords, it is a real pleasure to follow that excellent maiden speech from my noble friend Lady Blake. There is no doubt that the House will benefit from her rich experience of local government and I look forward to debating the merits of Leeds United with her in the years to come. Let me also start by reminding noble Lords of my interests as entered in the register, in particular my education interests and my work with Purpose on climate education.
The pandemic crisis has held up a mirror to our country. It has shown the extraordinary resilience, community spirit and capacity for innovation and compassion of the British people. It reinforced our love of our NHS, while showing the impoverished state of the care sector. It has also shown us crushing levels of food poverty and the new phenomenon of digital poverty.
The mirror of the pandemic can also be held up to this gracious Speech. Why is there no care Bill? Just putting the words “social care” in the title of the health department does not mean that the problems go away. They include the lack of PPE for care workers, infected patients discharged into care homes during the pandemic and families having to go to court so that their relatives could get out without requiring two weeks in solitary confinement. All this and the omission from the gracious Speech show a blatant disregard for this critical sector that now needs answers from this Government on how it is to be funded sustainably, thereby enabling a universal lifting of quality for patients and staff. I say to Ministers: time is running out. This is such a difficult problem and the political window for making difficult decisions is closing before the next election becomes too imminent.
Like others, I was also expecting to see an employment Bill, as promised. There is no sign of it or of doing something about workers’ rights that, in the age of zero-hours contracts and the gig economy, are so sorely needed. If they are serious about levelling up, Ministers need to rediscover that priority. If there is to be substance beyond the levelling-up rhetoric, we need a place-based approach to skills and proper funding for employment outcomes, not just qualification outcomes. Instead, we have a Bill offering debt for skills to the least qualified. We have a Bill that puts a cap on one’s ability to access that funding if one has already achieved a level 3 qualification. This flagship Bill in the legislative programme ignores the realities that more disadvantaged people are more nervous of taking on debt, and that technology will be deskilling plenty of people with A-levels, BTECs, higher-level apprenticeships and degrees. We need instead to properly delegate funding and strategy to a local level, as my noble friend just said—as did the noble Lord, Lord Bridges, in his fine speech. That funding and those strategies should be delegated to mayors or local economic partnerships to allow them to integrate skills and employment policy, and build talent pipelines for the sectors of the economy that those areas are choosing to target.
I welcome the setting in law of the target to reach carbon emissions of 78% per cent of 1990 levels by 2035. That means we are rapidly moving towards all jobs being green jobs and we need our skills and schools to reflect that. A child starting school this September will leave school in 2035. By that time, she or he will need the knowledge, skills and mindset of carbon zero so that when they enter that workforce in 2035 they are good to go in what will be a very different world, in which we are consuming food, travelling and working differently.
Just pretending that the same knowledge-based curriculum that we have had for the past 70 years—the same pedagogies and the same qualifications—is sufficient would fail our young people. A better and fairer school system is not achievable through just catch-up of learning loss. That can be done only through significant root-and-branch reform that develops cognitive intelligence equally with social, emotional, physical and technical skills—starting, of course, with the early years.
This gracious Speech reflects the Government’s priorities. They prefer to put disenfranchising electors over fixing the care sector. They put curtailing the right to protest over secure jobs for low-paid workers. They put attacking judicial review over a coherent approach to regeneration through education. I look forward to the debates in this Session.
Baroness Tyler of Enfield (LD) [V]
My Lords, I congratulate the noble Baroness, Lady Blake, on her excellent maiden speech.
Like other noble Lords, I must start by registering my profound disappointment that, despite all the promises made, there is nothing of any substance in the gracious Speech on the long-awaited reform of social care. The pandemic has cast a devastating spotlight on this long-neglected, fragile and much underfunded sector. During that time, tens of thousands of care home residents lost their lives. The questions of who pays for social care, how much funding is needed and how it is delivered are not easy but they are urgent. This is the area, above all, where the Prime Minister should be applying his rocket boosters. We owe it to all those who have died and their families to find a workable and sustainable solution.
Turning now to the health and care Bill, the emphasis in the White Paper on greater collaboration and integration between the NHS, local government and other services is to be welcomed. However, to achieve their ambition of improving the health of the nation, the Government must also prioritise action on the wider determinants of health and address the key public policy challenges largely absent from the White Paper. I have already referred to fixing and reforming social care, one of the biggest policy failures in a generation.
Secondly, the NHS and social care workforces have been placed under enormous strain during the pandemic and continue to face chronic staff shortages. The proposals in the White Paper to improve workforce planning are simply inadequate. A fully funded workforce strategy that includes mental health is needed to address staff shortages and boost retention by improving working cultures.
Crucially, the Government must tackle the health inequalities that have been cruelly exposed and exacerbated by Covid-19. If they are serious about their commitment to levelling up, they must address the deep and widening gap in health outcomes between our richest and poorest communities.
There is a real risk of distraction from tackling the most important issue. The NHS has just faced the most difficult year in its history, and the scale of the challenges facing it after Covid is formidable; those challenges include addressing the growing backlog of unmet health- care needs, as the noble and gallant Lord, Lord Stirrup, pointed out. Creating new organisations is easier on paper than in practice, and the experience of past reorganisations shows that merging and creating new agencies can cause major disruption.
The proposal to bring the NHS under closer ministerial control will warrant close scrutiny in your Lordships’ House. The Government should articulate clearly why these additional powers are needed and how they will be used, and outline the checks and balances that will be in place to ensure that they are used as intended. I will be watching this area closely.
The Government should also consider how the new legislation can be used to improve the lives of people with a mental illness. Despite a national commitment to parity of esteem, mental health services still struggle to meet demand—a situation that has only been exacerbated by the pandemic. To ensure that mental health is given an equal focus in the proposed new system, we need to see three things. First, there should be a legal requirement to have on the unitary integrated care board representation from an NHS trust with responsibility for mental health, alongside representation from other types of trusts. Secondly, the ICSs should be legally required to achieve parity of esteem for mental and physical health in their decision-making and to report publicly on this annually. Thirdly, the NHS’s commitment to mental health should be explicitly included in its triple aim.
I turn briefly to financial exclusion. Although I welcome the focus on skills and education as part of the levelling-up agenda, much more needs to be done to tackle financial exclusion if levelling up is to become a reality and no one is to be left behind. It is deeply disappointing that legislation on protecting access to cash did not feature in the gracious Speech. Despite an overall decline in the use of cash, an estimated 8 million people continue to use and rely on it to budget and make payments. The pandemic has also highlighted the vulnerability of groups that want or need to make cash payments, as they have been affected the most by reduced bank branch opening hours, branch closures and a lower acceptance of cash.
As chair of the former Financial Exclusion Select Committee, I was closely involved in the Liaison Committee’s follow-up report on financial exclusion, which was published last month. It highlighted the importance to financial inclusion of access to cash. Will the Minister provide an update on the Government’s plans to bring forward measures announced in the 2020 Budget to protect cash and set out a clear timetable for such legislation?
Baroness Noakes (Con)
My Lords, I, too, congratulate the noble Baroness, Lady Blake of Leeds, on her excellent maiden speech.
The gracious Speech promised many good Bills that will contribute to the UK’s success. I congratulate the Government on an ambitious programme. Last week’s elections showed the strength of the Prime Minister’s mandate for building a better UK and levelling up. Our focus must now be on the practical steps to rebuild our country. In my allotted time, I will speak about the economy and what the Government need to do—and not do—to underpin economic growth.
The Government’s Covid-19 policy was to prioritise the healthcare response to the virus. Practically everything else suffered. The damage done by deliberately crashing the economy through lockdowns has left us with a significant loss of GDP, and debt and deficit levels that are in post-war record territory. I support what the Government have done to protect jobs and businesses, but it is vital that we start to move out of that cocoon as soon as possible. In particular, we must ensure that non-viable businesses are allowed to fail. Keeping them on life support with employment subsidies and soft loans will act as a drag on the economy in the medium and longer term if we do not let market forces do their job.
The Government’s infrastructure programmes will certainly support the economy as we rebuild, but the fiscal impacts are huge. History teaches us that Governments often do not spend money wisely. The out-of-control High Speed 2 budget is a case in point; I will not support the HS2 Bill that is planned for this Session. More importantly, taxpayer-funded infrastructure spending should not become a dominant part of economic management, because the danger of crowding out the private sector is very real. Only by letting our business sector have the space to grow will we be able to create the sustainable jobs and prosperity which, in turn, generate the tax revenues to support other priorities such as social care funding.
I hope that the Government will prioritise the things that create the best conditions for businesses to grow. I suggest three areas to focus on. First, the Government must use their Brexit freedoms to get serious about deregulation. We need to jettison committees, units and policies that fly under the oxymoronic flag of better regulation. We need a presumption of no regulation, particularly for small and medium-sized businesses. They should simply be allowed to get on with wealth creation, as long as they avoid a carefully defined list of harms.
Secondly, the Government must not forget that high tax rates drag economies down and discourage investment. Tax yields are not maximised by raising rates, as any number of examples of both raising and reducing taxation rates over the past 30 years testify. The Government need to look again at their plans for corporation tax and resist the temptation to raise income tax or capital gains tax rates.
Thirdly, a skilled and educated workforce is a foundation stone for business success and therefore jobs. I welcome the Government’s initiatives, including their lifetime skills guarantee. They must be ruthless about ensuring that school leavers are well equipped for the world of work and that universities are not allowed to churn out graduates with degrees that are not valued in the workplace in any way.
I will finish with a word of caution about the Government’s seemingly boundless enthusiasm for climate change action. Net-zero policies have huge costs and hit the poorest in our society hardest. Legislation to set binding targets will demand careful scrutiny, so that we do not pursue the empty glory of world-beating CO2 reduction at the expense of the economic well-being of our country.
Lord Lebedev (CB) (Maiden Speech) [V]
My Lords, for every one of us, it is a moving moment when we join this House. When we promise to be faithful and to bear true allegiance we know the pledge we make. We are making a vow to maintain this country’s freedoms and to keep our institutions strong. We are offering diligence and independence as we accept our duties as legislators. We are taking our place in the long line of those who have defended the values of our nation.
I am so grateful for the welcome that I have received from every Member. I did not take that warmth for granted. I am particularly grateful to my supporters, the noble Lords, Lord Bird and Lord Clarke, and to Black Rod and all the members of her staff for their help.
Everyone in this House brings something different. I hope that my charitable work, my international experience, my many campaigns and my varied business career will provide insights of use to my fellow noble Lords. I will also be able to teach the House how to make a small fortune: start with a very large fortune, and then buy a newspaper. Lord Thomson of Fleet is quoted as describing television as a licence to print money. Newspaper publishing also seems like printing money—and then giving it away outside Tube stations. Luckily, I passionately believe in the contribution that the press makes to public life. The cause of freedom is very dear to me, and one I want to champion in this House.
I will briefly contribute to the discussion on health. The pandemic poses two big questions. The first is how to prevent it happening again. Each noble Lord will have their own answer, but at the very top of my list is the need to end the illegal wildlife trade. This filthy practice, fuelled by greed and desperation, brings foreign species and germs into close proximity with humans. From the savannahs of Africa to the taiga of Siberia, I have seen the horrors myself. It is leading to the destruction of our natural world. China and south-east Asia must make sure that their markets—the vectors of zoonotic disease—are closed. Other countries must take action to end poaching and the trafficking of wildlife.
Then there is the other question: why has the UK experienced one of the worst death tolls in the world? It is partly the result of generations of poor health and nutrition. We have to take our own health in our hands, and the Government have to step up and support this. In this country, I have found one of the bleakest impacts of the virus to be the surge in hunger. This week, one in nine children sat in classrooms with an empty stomach, according to the latest data. Perhaps it takes an outsider to say this: we are a rich country, and children should not be going to school hungry.
I intend to play my part in building a healthier nation. The food redistribution charity the Felix Project, together with my newspaper, the Evening Standard, will open the largest social kitchen in central London this summer to offer tens of thousands of fresh, nutritious meals to vulnerable people across London. I have learned this over the past year: our health policy is part of the national security of this nation.
There are others in this House who, like me, were not born here. They will know what I mean when I say that this experience strengthens one’s ties and sharpens one’s understanding of what this country means. I was raised here for a large part of my life, went to state school and consider myself British, but I am also Russian, which means that I can never be casual about liberty, free speech or the rule of law. Freedom of expression needs its champions. In the post-war era it has rarely been as under assault as it is now. I intend to join hands with noble Lords who can see that and are determined to fight it. A democratic, liberal nation, strong, healthy and free: I pledge that everything I do in this House will be to defend and further these principles.
Lord Owen (Ind SD)
My Lords, it is my privilege to congratulate the noble Lord, Lord Lebedev, on his maiden speech. Like many, I am sure, I wish to hear more from him. Though a young man, he has an extraordinary range of experience of charitable and philanthropic action and as a proprietor of the Evening Standard—how many of us worry about evening newspapers all over the country surviving? The Independent has been a great newspaper for those who have broad views but no fixed political commitments. We wish to hear more.
This debate is taking place at a very opportune moment. I welcome one thing that I have been pressing for ever since the ill-fated reforms from the noble Lord, Lord Lansley, came before us. It is essential to return to the situation where the Secretary of State holds the democratic responsibility for the running of the National Health Service. I hope that when this power is restored it will be a duty of the Secretary of State to promote in England
“a comprehensive health service designed to secure improvement … in the physical and mental health of the people of England, and … in the prevention, diagnosis and treatment of … illness”,
and for that purpose to provide or secure the effective provision of services. I want a legal responsibility of answerability in this House, which we have not had for seven years, but we have had the largest quango in the world. This must come; I have been arguing for it in an NHS reinstatement Bill for seven years.
When we look at the Covid situation and the wonderful way in which the NHS and those who support it responded in a crisis, we need to understand the NHS’s unpreparedness following 20 years of structural vandalism, with hospitals no longer serving geographical areas. The incoherence and fragmentation of an unrecognisable NHS came about through four legislative Acts: in 2002, 2006, 2008 and, above all, in the ill-fated Health and Social Care Act 2012.
We must look back, post Covid, for reasons that have already been advanced. I do not have the massive criticisms of what has happened that seem to pour out, day after day. There have been many great achievements, but let us be clear about the problems and the predicted problems. In December 2016, at an international conference as a result of the Cygnus simulation exercise of an influenza pandemic a couple of months earlier, the then Chief Medical Officer, Sally Davies, made it clear that we could not cope with the excess bodies and faced the threat of inadequate ventilation. This was a Chief Medical Officer of health revealing the situation, four years before it faced us. Why was nothing done? Did she make representations to the then Secretary of State, Jeremy Hunt? Did she take these issues up right through?
What about the prevention of ill health itself, which has been neglected for years in the health service and constantly forgotten? It is all too easy to spend on the headlines—we have had enough headlines out of Sir Simon Stevens—but why was more not done to prepare? Why was NHS bed occupancy at 100%? It did not happen just with Covid; it happened way before that. There were levels of 98%. We used to think it was wise to have 75% bed occupancy. There is this whole idea that the NHS can be run like a marketplace, where you maximise your profits at all stages and run things at 100%. The NHS is very different. I urge the House to get to grips with it in a way that we never did seven years ago with the legislation that went through.
I also ask the House to look at some of the other problems that we will face. Mental health has been neglected for years—look at the fall in psychiatric nurse numbers. Yet speech after speech, whether from Ministers or health administrators such as Sir Simon Stevens, talks up new ideas and initiatives, when staring us in the face are basic deficiencies in how our mental health service is run and what it needs. We will face this ever more than before now that Covid has hit us. Post-Covid illness will affect the young in particular.
Baroness Morris of Yardley (Lab)
My Lords, I congratulate my noble friend Lady Blake and the noble Lord, Lord Lebedev, on their maiden speeches. They bring very different experiences and skills to this Chamber but, combined, they will enrich us by contributing to our debates. I thank them and wish them well.
I have some comments about education and the skills agenda, and a few questions about schools. I declare my registered interest as chair of the Birmingham Education Partnership. I very much welcome the catch-up programme that the Government have announced so far, but I am left feeling that we have not heard it all yet. The Government do not have a good record of acting in good time as far as schools are concerned during this pandemic. Can the Minister tell us when we will be hearing further information about the catch-up programme?
I have a second query on schools. The Minister referred to a speech which the Secretary of State made recently, on the expansion of multiacademy trusts. I will not comment on that, but the noble Baroness, Lady Morgan, will remember that in 2016, the feeling that the Secretary of State would require everybody to be a member of a multiacademy trust caused great disturbance in the school system—and that is what I am hearing from those in schools to whom I talk. They are unsure whether the Secretary of State was saying that schools will have to be part of multiacademy trusts. I am not arguing whether it is right or wrong, but they need to know, because otherwise their attention will be focused on that and not on getting the children back to studying.
My main questions are on the skills part of the gracious Speech. I welcome the emphasis that the Government have put on skills, and the fact that further education is at the top of the list of Bills that are part of the Speech. It does not happen often, so let us try to make the best of this opportunity. In that respect, I have questions on three areas where we can make improvements. First, who can study? Who can access the money under the lifetime guarantee? Apparently, only those without a level 3 qualification. There are millions of people in this country with a level 3 qualification who need or want to retrain, and they are not in the group that will be able to qualify.
Secondly, what is study? The Government in London have decided which courses will be funded, not the locality. I bet that some towns, villages and cities have local industries which will be excluded from that list. I am not sure why we would do that: why we would say what cannot be studied as well as what can be studied. My additional question is: why study? I am in favour of employers being a key part of our skills agenda, but the government document says that the agenda will be built around the needs of employers. I am not sure that that is right. I am not sure that employers are any better than anybody else at guessing what the skills needs of the future will be, or in working out what industries will be the industrial backbone of our country.
Skills do other things, and there are other jobs that further education colleges have. They help build communities by giving people skills that will be used locally. They help build civic strength by building up skills and experiences, and they help motivate people who will not go on a work training course but will go back to do pottery, art, singing or playing an instrument and will then move to a work training course. None of those is in that list.
There might be places in our country where who can study, what is studied and why you study are absolutely met by the requirements that the Government have set out—but that is not true for all communities everywhere. I worry that some of our left-behind communities will not have their needs met because the Government have decided that it is they who will be answering these questions.
My concerns, which I will want to raise during the passage of the Bill, are: why is there no mention of mayors? Why are we not building on the devolution agenda? Why are we not empowering these left-behind cities, towns and communities to say, “What skills do you want, who do you want to get the money for retraining, what is your priority?” The skill of politics here is getting both those things in place; the needs of the nation to drive us forward and the needs of localities, local people and local communities who have not always fitted into a national agenda and national structure, which is why they have been left behind. During the passage of the Bill, we want to explore with the Government why we cannot do more with a devolution agenda, alongside the skills agenda set out in the gracious Speech.
Lord Ribeiro (Con) [V]
My Lords, it is a pleasure to take part in this debate on the humble Address to Her Majesty. I wish to cover issues around social care, alcohol abuse and the Healthcare Safety Investigation Branch.
During my 10 years in your Lordships’ House, the issue of social care and how it should be provided and funded has been debated continuously. It started with the Dilnot commission’s report in July 2011, of which the noble Lord, Lord Warner, a co-chairman, was a formidable champion in this Chamber. Now, 10 years on, we are still waiting for concrete proposals, and the Queen’s Speech was relatively silent on this, merely noting:
“Proposals on social care reform will be brought forward.”
The pandemic has taught us that good public health systems are key to developing confidence in the public to follow government guidelines. The successful vaccination programme is testament to that approach. We should draw on the lessons learned from the vaccination programme, including the ability to cut through red tape and to create joined-up services, where all disciplines in hospitals rolled up their sleeves to take on new roles. The creation of new intensive care beds and high-dependency unit beds with ventilators, both in hospitals and on other sites, was a revelation in peacetime and a tribute to the leadership of the NHS during the pandemic.
One sentence jumped out at me from the Queen’s Speech:
“My Ministers will bring forward legislation to empower the NHS to innovate and embrace technology. Patients will receive more tailored and preventative care, closer to home.”
For that we need a truly integrated system of care, and the lessons of the pandemic must act as a catalyst. The Bill aims to remove bureaucratic and transactional processes that do not add value, thus freeing up the NHS to focus on what really matters to patients. The health and care Bill should provide the legislative basis for establishing integrated care systems as statutory bodies. Integrated care systems will include health and care partnerships, thus bringing multiple patients from the NHS, public health, social care and other stakeholders together, rather than having them work in silos.
I welcome the banning of junk-food adverts before the 9 pm watershed on television, and the total ban online, but I would like to see the Government take the same tough line on alcohol advertising. Remarkably, just 9% of people with alcohol dependency account for the 59% of in-patient alcohol-dependent admissions. These 54,349 patients account for some 365,000 admissions, and have more than 1.4 million bed days, at an estimated cost to the NHS of £858 million. According to Public Health England, alcohol treatment is cost effective. Every £1 invested in alcohol treatment yields an immediate £3 of social return, rising to £26 over 10 years.
There has been significant pressure on the workforce during the pandemic, and, while it was reassuring to read in the Times today that recruitment numbers in nursing and midwifery and for health visitors are expected to rise, the Royal College of Psychiatrists has warned that the future of addiction psychiatry may be put at risk through the shortage of trainees in that specialty—a point made by the noble Lord, Lord Owen.
The Government must ensure that the Bill provides a mechanism for alcohol treatment and a workforce to sustain it in the long term. The purpose of the Bill is to prevent illness, tackle health inequalities and enhance patient safety: something that the charity that I chair, CORESS—Confidential Reporting System for Surgery—tries to do by reporting incidents of near misses in surgical practice. Through these reports, surgeons can learn from others and avoid repeating the same mistakes. I am delighted that the Health Service Safety Investigations Bill, to which I drew attention in the Queen’s Speech debate of October 2019, has finally been put on a statutory footing as the Healthcare Safety Investigation Branch, with the power to investigate patient safety risks and to support a learning culture—something that we can all benefit from.
Lord Patel of Bradford (Non-Afl) [V]
My Lords, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their maiden speeches and I greatly look forward to working with them both. I am grateful to be speaking on the gracious Speech, and I will focus my time on the health and care Bill. In doing so, I declare my interest as chair of the Independent Healthcare Providers Network.
I shall make three short points. First, there is an urgent need to tackle the elective backlog that has built up during the pandemic. Secondly, the proposed new integrated care systems need to be open and inclusive, with good governance in place to avoid potential conflicts of interest. Finally, we must avoid any further delays in addressing the critical issues for social care.
Tackling the growing backlog of elective care is the public’s number one priority for the NHS according to recent polling. If not effectively addressed, this issue will dominate political and health debates in the years to come. Over recent years, NHS waiting lists have steadily been rising, and we now have a situation where more than one-third of patients, around 1.7 million people, are waiting longer than 18 weeks, with almost 400,000 people waiting more than one year. Behind these numbers are heart-breaking stories of people who have had to give up their jobs and livelihoods while they wait in extreme pain and of those who have completely lost their independence and quality of life. Given the level of current suffering and the build-up of long-term chronic health problems, I am sure that noble Lords will agree that the success of this Bill must at least in part be judged on whether it can reduce this backlog. I would welcome the Minister’s thoughts on how the proposed changes in NHS structures will support local areas better to prioritise patient access to the care they need now.
The response to the pandemic has undoubtedly shown how health is best served through a system of interconnected agencies from across different sectors, including local government, pharmacies, the voluntary sector, social enterprises and independent providers, and that effective healthcare is not something that can simply be addressed by the NHS alone. The move towards integrated care systems is therefore an opportunity to entrench the benefits of greater partnership working and collaboration. However, talking to colleagues across the independent, voluntary and social enterprise sector and particularly to the mental health and pharmacy sectors, there is much to do to ensure that ICSs are not too NHS-centric with too little consideration for the wider system with which the NHS seeks to integrate. This is key if we are to tackle health inequalities, with local voluntary, social enterprise and independent providers very often being much closer and more responsive to the local communities they serve than the statutory bodies. We must therefore see integrated care systems established on an inclusive and transparent basis, with good governance, clear accountability and safeguards against conflicts of interest.
While new ICSs should support the NHS and its partners to deliver joined-up care to local populations, there are real risks that the current proposals could lead to conflicts of interest around those who are commissioning and those who are providing healthcare services. For example, ICS partnership boards are likely to be led by NHS provider organisations, but blurring the lines between who is procuring and who is being paid to deliver public services poses a danger of a lack of due process and transparency. I would welcome thoughts from the Minister on how such conflicts of interest will be identified and managed in ICSs to ensure that their decisions are based entirely on the needs of local populations, not on specific providers.
Finally, while I welcome the mention of the much-heralded plan for settling social care once and for all, as noble Lords have already said, we have still to see further details of what this will entail. Given the importance of this issue to so many people, all that we have learned about the problems faced by the social care sector during the pandemic and the incredible efforts that have been made by providers to keep people safe, can the Minister assure me that there will be no further delays in bringing forward some concrete plans and that we will not have to wait until the next Queen’s Speech to hear about them?
Baroness Bowles of Berkhamsted (LD) [V]
My Lords, the gracious Speech does not hit the height of the 1945 moment, which is what the country needed. Overdoing austerity was a mistake in the past, and it looks as if it will take hold again, however disguised. Here and there, a few lines capture the headlines, but we need detail to measure up to the billing, and there is much absent that is overdue to be done, not just because of the pandemic. The example I want to focus on is long-term care.
I was part of the Economic Affairs Committee under the chairmanship of the noble Lord, Lord Forsyth, when it produced its report on social care, which is still very relevant. More than half the spending on adult social care is spent on people under 65, but a lot of focus has rested on the unfairness for people, who are not only unlucky in needing social care but end up with catastrophic costs, who have to sell their homes and then find they have to pay more than what is charged for those funded en bloc by local authorities.
The fact is that we need care to run on the same principles as health, where risk is shared. This is a Treasury issue, not just about funding but to agree mechanisms that allow risk sharing. If the economic future of the country is to be enhanced by innovation and risk-taking, boasted of in the gracious Speech, this is one place where the Treasury could practice what is preached whether by restoring the Dilnot proposals or finding other ways.
Aside from funding, we should also start to think differently about care. Social care is one of the largest and growing business sectors that we have. The over-75s will increase by 60% over the next 20 years, and it is time to think about how to harness the economic benefits that could generate rather than just bemoaning the economic drain.
The notes to the gracious Speech state:
“We will turn Britain into a science superpower, building on the extraordinary work of our life sciences sector during the pandemic, which has led the world in everything from vaccine development to genomic sequencing. We will invest record sums in Research and Development and create an Advanced Research and Invention Agency to help ensure that the breakthroughs of the future happen in the UK.”
I think we have Vince Cable to thank for helping life sciences into that position.
If we can see economic advantages of frontier and improved technology in health, including in related industrial aspects, then surely the same should apply in the care sector. That market is not going away, and it does not need a pandemic to keep it relevant. It is time to be creative, innovative and scientific about it rather than condemn it to run on cheap labour as the health service’s poor cousin, doing the same work for less pay. Innovation and technology should be at the heart of enabling more people to stay at home and more people to work at home and so, too, can be better ways of building.
I do not want to get involved in cross-departmental squabbles, but BEIS should be as interested in the science and technology opportunities around the care sector as it is around life sciences or robotics, and I put that as a challenge to the Minister. Will we be in the vanguard of these developments, sharing in the profits, or will we end up buying it all in from Japan or elsewhere?
Baroness Finlay of Llandaff (CB)
My Lords, somewhat unusually, before I start I would like us to record that Her Majesty commanded ever-greater respect, renewed admiration and deep affection in the hearts of all who witnessed Her Majesty’s presence here with us yesterday. Turning to today, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their speeches and welcome them to this House. The right reverend Prelate the Bishop of Portsmouth, who is about to give his valedictory speech, has brought greatly appreciated insights and will be missed across the House.
On the contents of the gracious Speech, I will focus on some aspects of health and social care, obesity and addictions, and professional regulation. The pandemic has certainly taught us a great deal. We ignored obesity for years, pretending that it was even discriminatory to attempt to tackle it and the poor nutritional status of many in our population. Covid revealed that just being overweight is a highly significant predictor of developing complications from Covid-19, including the need for intensive care support, and a predictor of death. By the end of February this year, 2.2 million of the 2.5 million Covid deaths reported worldwide were in countries where more than half the population is classified as overweight.
Obesity, mental health problems and domestic violence all feature in the gracious Speech, but the common underlying factor of alcohol harm has been ignored. So I ask: why is there no alcohol strategy? Last week, the Office for National Statistics reported a 20% increase in deaths caused directly by alcohol. Alcohol-fuelled domestic violence has also risen alarmingly during the pandemic. The Commission on Alcohol Harm, which I chair, recommended calorie labelling, minimum unit pricing and measures to decrease harms in off-sales. We must tackle root causes. Talk of personal responsibility from the industry ignores the addiction behind alcohol misuse.
Our health and social care workforces are exhausted. Supporting people through post-Covid recovery and rehabilitation will mean more professions and practitioners need to be brought into the scope of an updated regulatory framework, as proposed by the Health and Care Professions Council. Voluntary registers are not adequate. Regulation needs to focus on tasks and function. The public need the assurance that all practitioners are trained to agreed standards and can access the care that they need. The Medical Act 1983 was written for a different age; the General Medical Council wants legislative reform for complaints to be resolved more quickly, to support good practice and for the registration framework to fit today’s needs, bringing physician associates and anaesthesia associates into regulation.
Even before Covid, both the health and the social care workforces had staff shortages, chronic excessive workloads and high levels of stress, absenteeism and turnover. Covid revealed the importance of integration and collaboration for managing every aspect of the pandemic. That must not slip back into bureaucratic silos that demoralise and blame, rather than foster initiatives and support. For care in the community, especially for those in the terminal phase of illness, there must be better out-of-hours support, with seven-day services and access to specialist expertise. That is why I am entering my access to palliative care Bill into the ballot again. As we invest in research and innovation, we must also invest in the infrastructure so that the systems through which care is delivered will avoid overcrowding, reduce waste and drive public health improvements.
True levelling up of public health requires decreasing the drivers to addiction, gambling, alcohol, tobacco and violent pornography on the internet. It also means improving nutrition and understanding the social determinants of health. Our future prosperity depends on an agile, healthy population, with skills and adaptability in the face of future challenges. This requires legislation that understands problems in depth and drives policy for long-term stability and social responsibility, not short-term quick fixes on paper.
The Lord Bishop of Portsmouth (Valedictory Speech)
My Lords, it is more than seven years since I first spoke in this House. It is a long time since I was a maiden like the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, whom I congratulate on their arrival and their speeches. Today, my name has “Valedictory” next to it. Three weeks ago, I said an emotional godspeed to the people of the Portsmouth diocese at a cathedral service: scaled-down but intensely moving, for me and my wife Sally, at least, as we thanked so many.
That service also gave me the opportunity for a bishop’s equivalent of “Desert Island Discs”, choosing the music sung wonderfully well by the cathedral choir. This included my favourite hymn among very many, “There’s a Wideness in God’s Mercy”. It praises God’s gentleness, mercy and justice and how those qualities are rooted in His radical inclusion. It is something I touched on in my valedictory sermon: that the Church is its congregations, but it is far more its communities. We must always keep our doors open, especially to those who have no figurative or literal shelter—so I am interested, and not a little intrigued, by the Government’s talk of levelling up. The phrase suggests that those who already have will not have to give up anything and that those who need a hand up will be propelled upwards—but by what? Well, that is the question: how does the rhetoric become the reality? It is a dilemma that the Christian Church understands. We proclaim the kingdom, but find building it challenging.
Much of what a Government do does not depend on the contents of their legislative programme but that is the flesh on the bones of the grand narrative that they tell, and levelling up provides a very grand narrative indeed. That is against the backdrop of an economic situation that remains uncertain. Last week, bullish briefing suggested that the economy will grow back quicker than ever before. That may be true, to a point, but if we grow back 7.5% after a drop of towards 10% then we are, at least in the book of this former economist —and the much more to be trusted economist, the noble Lord, Lord Eatwell, earlier—very much still behind.
Who benefits from the growth will be critical. After the 2008 crash, it was those at the sharp end who suffered most, while those responsible for the crisis walked away with barely a scratch. The diocese I serve has many at the sharpest point of the sharp end, including the third of children on the Isle of Wight who live in poverty. That is 7,000 children whose lives and life chances are being blighted. I find myself asking what in the programme will benefit them or the people of Charles Dickens ward in Portsmouth, which is among the 1% of most deprived wards in the country. Their lives are already far from easy and they have been hard hit by the pandemic.
I then find myself regretting the continuing absence of anything meaningful on social care. We are a decade on from Dilnot and still there is no timescale for action. Surely, the urgency is even clearer than ever. To tease vulnerable and elderly people, saying that there is a plan—ready or perhaps not—or putting off action, is cruel.
I am astonished that, with a focus on levelling up, there is nothing intended to address the injustices of those employed in the gig economy or on zero-hours contracts. I cannot imagine how we can achieve levelling up without addressing the circumstances of the workplace. To claim that the pandemic demands delay is evasive if there is truly a commitment to levelling up. What the Speech proclaims is hopeful, but the signs that these measures will deliver are scanty.
I conclude my speech with something central to faith: thanksgiving. I give thanks to the staff of the House for their unfailing courtesy and service to us, this Parliament and our nation. I give thanks to my colleagues on these Benches. Our presence here may sometimes be contested, but we bring a distinct voice to this place, not least because of where we are rooted and whom we serve.
I give thanks to Members of this House past and present for all their kindness and encouragement, especially to the late and much-missed Lord Judd, who, when I spoke, often sent me from that Bench a scribbled supportive note—often on the most extraordinary scraps of paper. By virtue of my office I have been called Portsmouth; he was Portsmouth to the very marrow of his bones as he stood up for and spoke for those left behind.
I give thanks to the people of the diocese of Portsmouth—a diocese of great diversity but none the less a people of very distinct identity and culture. I may not be “Portsmouth till I die”, as they will soon sing again at Fratton Park, but I hope I have spoken for them, for their God and for the wideness of His mercy.
Lord Griffiths of Burry Port (Lab)
My Lords, what an honour it is to be given the opportunity to address a word on behalf of all noble Lords to the right reverend Prelate the Bishop of Portsmouth—the ex-Bishop of Portsmouth, as he takes his leave from us today.
I would like to use the occasion to give voice to an instruction John Wesley gave to all Methodists in his day and to all sensible people thereafter. Speaking of the responsibility that goes with faith to address the plight of the poor and oppressed, he urged his followers:
“Go not to those who need you but to those who need you most.”
It seems to me that Bishop Christopher has done just that, both in the diocese where he has been revered for his pastoral skills and in the proceedings of this House, as we have just heard, where he has consistently striven to highlight the lot of the poorest people in our land.
In saying farewell in our customary way, therefore, I would like our “Hear, hear” to carry the tones of a commitment on our part to continue to fight the good fight that has mattered so much to the right reverend Prelate. I hope noble Lords will forgive me if I end this adieu by flaunting convention and changing from the third person to the second as I say:
“Well done, thou good and faithful servant”,
exit now from the joy of the Lords. Go forth and build back better in your beloved Birmingham.
Lord Griffiths of Burry Port (Lab)
It is the easiest thing in the world to segue from this tribute to the right reverend Prelate to the remarks I wish to share with the House today.
We heard from my noble friend Lord Eatwell—not now in his place—words to the effect that education and health belong to the infrastructure upon which we build any notion of a good society in our land. The other subject areas competing for our attention today—the economy and business—should note the fact that health and education undergird anything we may have to say in developing those themes.
Unfortunately, education, where I want to specialise now, is often seen as a draw on the Exchequer rather than an investment in the future. Just think of that: if we could manage to think of it as an investment in the future, how would we look at early years? What happened to Sure Start and children and family centres and their benefits to families and the NHS? We have heard of a commitment to the best start in life for children: we had that and demolished it in the last 15 years.
What about child poverty—brought to light in recent debates on free school meals? It is good to hear that the noble Lord, Lord Lebedev, intends to have the largest kitchen to provide children with food during the summer. That will take some of the weight off the Government’s back, I suspect, and we congratulate him on it.
What about the effect of Covid on children in all schools, especially those taking exams, and the way the Covid pandemic has so disproportionately affected those living in less well-off areas or particular groups of people as opposed to others? It has been so unequal. We hear that emphasis on teacher training needs to improve. Teachers are at a premium. They must be well trained for the exigencies of the moment and, as children leave school, career advice becomes crucial. What about the welcome emphasis on further education and lifetime skills? It is only going to undo a shortage of investment in this area—a sad shortage over the last decade or two.
Now we hear that university students of all sorts can go back to face-to-face learning on 17 May. A young friend of mine has just gone back ahead of time—perhaps I should not reveal his identity—to find that all face-to-face teaching has finished for the academic year and that 17 May, when he is officially allowed to be back, is the date of his first examination for his finals. So, what on earth does 17 May mean to university students? It is just nonsense.
In all these ways and across this entire area, education lies at the heart of everything else—oh for an Act of Parliament here that would serve, as in Wales, to future-proof legislation, concentrating on the needs of a generation that is to come.
Lord Garnier (Con)
My Lords, I cannot compete with the noble Lord, Lord Griffiths, a former president of the Methodist Conference, in his tribute to the right reverend Prelate. I will just add this: when my forebears were respectively the Dean and Bishop of Winchester, a little up the road from Portsmouth, they wore gaiters and were very old. I am now looking at a right reverend Prelate who is retiring from here and yet he is younger than I am; I find this extremely confusing.
I also congratulate the two maiden speakers: the noble Baroness, Lady Blake of Leeds, and the noble Lord, Lord Lebedev. Both gave truly excellent speeches, and the noble Lord gave what, to me, was a delightfully surprising speech. I had never heard him speak before and I was fascinated by what he had to say. I hope we will hear from both of them frequently in the future.
Time does not permit me to run through all that is in the gracious Speech, but there is much in it that your Lordships’ House can welcome. However, there is a good deal of legislation that we will need look at with care, not least the Government’s intentions with regard to judicial review.
Despite the intentions behind the Queen’s Speech, there is something missing from it. It is a matter that has been mentioned quite recently in this House: we need legislation to control and outlaw the predatory and immoral activities of quack counsellors or psychotherapists. There is, on the evidence laid before your Lordships several times already, a pressing need to criminalise controlling or coercive behaviour by persons providing psychotherapy or counselling services to vulnerable adults.
We protect children; we protect those with an intellectual incapacity or those suffering from mental illness; and we protect those suffering from the infirmities of old age. But we do not protect those over the age of 18 who, although ostensibly of an age to make up their own minds about how to live their lives and outside any definition of incapacity, are exploitable by charlatans offering them a service they are not qualified to provide and often for a large fee.
In the last Session, the noble Lords, Lord Marks of Henley-on-Thames, Lord Alderdice and Lord Hunt of Kings Heath, the noble Baroness, Lady Jolly, who I see in her place, and the noble Baronesses, Lady Mallalieu and Lady Finlay, all raised the issue—first, in a debate in early 2020, initiated by the noble Baroness, Lady Jolly, and then again in debates on the Domestic Abuse Bill earlier this year. My noble friend Lord Astor of Hever also played an invaluable role. The majority of contributors to those debates wanted either proper registration of these informal therapists or, in my case, a criminal offence similar to those enforced in Belgium, France and Luxembourg, to deter these charlatans.
Although there was support in principle from the Government, we were told by my noble friends on the Front Bench that progress on this entirely laudable and worthwhile project was hampered by two things. Either we were asking for change at not quite the right time or we had not quite found the right Bill to amend the law. In Committee on the Domestic Abuse Bill two months ago, I explained why the provision encompassing how we proposed to deal with quack counsellors would work, theoretically and practically, as an addition to the criminal law. Although not an exact replica, it was similar to laws in force in Belgium, France and Luxembourg, countries that adhered to the European Convention on Human Rights. Nothing that we are proposing would adversely affect citizens’ rights to free assembly, religious freedom, freedom of expression or private life. However, it would affect these rogues’ ability to predate on emotionally vulnerable young adults for malign purposes—to take their money and break up their families, and even to brainwash them. It would prohibit them pretending to be something that they are not—academically and practically qualified psychiatrists, psychologists and psychotherapists.
The Government, using the “wrong Bill” argument, made two points against the amendment in Committee. It was said that a new offence would alter the “dynamic” of a Bill specifically about domestic abuse and would upset the Bill’s “architecture”. It was also said that there were other remedies more suited to dealing with these issues, such as registration or accreditation by existing and respected professional bodies. No doubt requiring psychotherapists to be professionally qualified and accredited members of a professional body would enable well-motivated counsellors to gain standing and proper recognition, but to reinforce the value of membership of those professional bodies and accreditation by the law would make it a criminal offence for someone not qualified, registered and accredited to hold themselves up as being so. I refer, for example, to the Medical Act 1983 and the Solicitors Act 1974.
It was accepted in the last Session that we have been slow to appreciate the scale of coercive behaviour. The Government acknowledged that most noble Lords who supported our amendment to the Domestic Abuse Bill had pointed to evidence and, indeed, to specific cases that fraudulent psychotherapists and counsellors were taking advantage of their position to supplant friends and families in the minds and affections of their clients, using ill-gotten ways to turn them against friends and families. The law is deficient; there is a lacuna, but it can be filled, and we can possibly get hold of a provision in the professional qualifications Bill referred to earlier. I urge the Government to get on with it.
Lord Hain (Lab) [V]
My Lords, I also enjoyed the two excellent maiden speeches today, and I reassure my noble friend Lady Blake that, even as an ardent Chelsea fan, I too think Leeds should be in the Premier League.
By the end of this year the economy will still not be back to where it was at the beginning of last year, even according to optimistic forecasts such as that from the Bank of England. We will not know till next February how far short of its pre-pandemic level GDP fell in 2021 and how much lost ground we still have to make up. But breaking free from lockdown and bouncing back to pre-pandemic levels of economic activity sometime in 2022 present a far simpler challenge than delivering sustained growth between now and 2030.
Right now the economy is suffused with spare capacity and eager to get back to work. What is missing, as the Resolution Foundation think tank has pointed out, is a clear path to prosperity. The Queen’s Speech presented platitudes about freeports, planning reforms and new rules for public procurement, but could not conceal the fact that our starting point is weak, the legacy of decades of inadequate investment.
The evidence on productivity, skills, infrastructure and superfast internet links tells its own sad story. Following Labour’s investment 10 years ago, the number of new apprenticeships in England exceeded 520,000; last year it was only 320,000. In the World Economic Forum’s latest league tables Britain came 21st for the quality of its port infrastructure, 36th for road infra- structure, and 79th for its number of fibre internet subscriptions. This is not a firm foundation on which to develop a strong economy, one able to generate faster, fairer, greener growth. It smacks more of make do and mend, not a 21st-century economic powerhouse. Like once proud Premiership clubs that spent big on property but failed to invest in new players and suffered repeated relegation—names such as Bolton Wanderers and Wigan Athletic come to mind—the British economy has been steadily slipping down the league table. Yesterday, Canary Wharf; today, “Canary Dwarf”.
The lack of clarity about Britain’s economic prospects is reflected in claims made by Ministers. The Chancellor says that his March Budget gives the economy a big boost this year; what he has really done is to slow the rate of fiscal withdrawal in 2021 and speed it up in 2022. Only in Tory Treasury-speak does withdrawing fiscal support at a slower rate count as a bigger fiscal stimulus. The Chancellor still plans to withdraw 90% of the 2020 stimulus by the end of 2022, and he intends to begin pulling the plug on the furlough scheme and the business rates holiday for hospitality businesses only nine days after the end of the Government’s road map. That will be six weeks before he learns from the Office for National Statistics what happened to GDP in the second quarter of this year.
Whatever happened to the Prime Minister’s pledge to lead a “data-driven” Government? What became of the Chancellor’s claim to be “going long” by backing recovery well beyond the end of the road map? Perhaps events will prove the Bank of England’s latest forecasts right. The economy might make a relatively quick recovery over the next 18 months, but the Office for Budget Responsibility expects growth to drop below 2% per year after 2022. This would simply mark a return to the pathetically poor performance of the austerity years of George Osborne and Philip Hammond.
The Queen’s Speech lacks clarity and ambition. Ministers talk a good game about levelling up and increasing capital spending on public infrastructure for years to come, but when the Institute for Fiscal Studies points out that the March 2021 Budget made some £16 billion of cuts to current public spending relative to the Chancellor’s pre-Covid spending plans, Ministers hide behind a smokescreen of technical mumbo-jumbo about inflation. The Government’s efforts to turn the economy around and set it on a new growth path pale in comparison with the audacious stimulus measures taken by President Biden. His is an example well worth following—but, sadly, this Government’s miserly economic agenda fails miserably to do so.
Lord Dodds of Duncairn (DUP)
My Lords, I pay tribute to Her Majesty the Queen, who, in her 96th year, delivered her 67th gracious Speech in this place. In a year of great loss, once again her great courage, commitment and dedication to this kingdom have shone forth very brightly.
I add my congratulations to those noble Lords who made their maiden speeches and wish the right reverend Prelate the very best on his retirement.
The gracious Speech rightly began with reference to the national recovery from the terrible pandemic that we are still going through. It is right that we should recognise the immense success of the vaccine rollout and enormous amount of economic and financial support that has been poured in to sustain jobs in all parts of the United Kingdom. That has to be acknowledged and welcomed, and the Government deserve enormous credit for what they have done on both those fronts, with £352 billion of economic support for 1.7 million jobs.
To many people across the United Kingdom, this reinforces once again the value of the union—of being part of the fifth biggest economy in the world. I gently ask those in Scotland, Northern Ireland and Wales, and elsewhere, who advocate separation to reflect very strongly on where they might find themselves were they not part of this United Kingdom, which has done so much, I believe, to rescue so many people’s livelihoods at this very precarious time.
I very much welcome those parts of the Queen’s Speech that talked about levelling up, strengthening the economic ties across the union and ensuring that support for business reflects the United Kingdom’s strategic interests and drives economic growth. Those pledges and commitments from the Government in the gracious Speech apply throughout the United Kingdom —and rightly so.
However, I would be failing in my duty to the people of Northern Ireland today if I did not reflect that many of these objectives will be hindered in their application and enforcement if the Government do not rapidly deal with the problems that arise from the Northern Ireland protocol. There are two aspects of this: the trade and economic disruption to communities, businesses and people in Northern Ireland, and the damage that is done to the constitutional settlement and to devolution as a result of the application, across vast swathes of the economy of Northern Ireland, of laws on which no one in the Northern Ireland Assembly or in this or the other place will have any say or vote. In the 21st century, in a modern democracy, that is absolutely scandalous and cannot be allowed to endure.
Yesterday, and in recent days, the noble Lord, Lord Frost, and the Secretary of State for Northern Ireland have listened to businesses and communities in Northern Ireland on the challenges of the operation of the protocol. They heard about the level and complexity of paperwork required, even on goods remaining in Northern Ireland, notably in the agri-food sector. They talked about disruption to supply chains from Great Britain and the consequent diversion of trade, and they talked about the risks associated with the expiry of the grace period and the introduction of even more processes as a result.
At the moment, Northern Ireland carries out two and a half times more checks on goods coming in from Great Britain than the Port of Rotterdam does for the entirety of imports across the world. We carry out 20% of all the checks in the European Union—more than all French ports combined. As the noble Lord, Lord Frost, said, this is unsustainable; it cannot operate in its current form for long, and rapid solutions need to be found. I heartily endorse that call by the noble Lord because, if we do not deal with these issues and the democratic deficit that is at the heart of the protocol, the Government and all the parties in Northern Ireland will not be able to build the economy.
We have a wonderful vision for the Northern Ireland economy over the next 10 years, which was set out yesterday—I declare an interest in that my wife is the Minister for the Economy in Northern Ireland, but she did it on behalf of the whole of the Executive and all the parties. However, we will not be able to fulfil that and restore democratic stability to Northern Ireland unless the issues that have arisen from the application of the protocol—for which no one in Northern Ireland voted—are dealt with very swiftly.
Baroness Jolly (LD)
My Lords, I join others in congratulating the noble Baroness, Lady Blake of Leeds, and the noble Lord, Lord Lebedev, on their maiden speeches. I will miss the wise words of the right reverend Prelate the Bishop of Portsmouth.
We must prevent injuries in the home. The Grenfell Tower tragedy should be a watershed moment that makes us reconsider the adequacy of existing standards for the safety of all homes—not just from fire but from any injury due to flaws in building design. We know that people have been spending more time at home because of Covid, and it is expected that increased home-working will be a long-term trend. This is the moment to focus on home safety, and, given that for every single fire-related hospital admission there are 235 from falls on stairs, it is essential that stair design is included in this.
In the homebuilding industry, it has been clear for some time that stair safety is a serious issue. In 2010, an evidence-based, robustly tested code of practice for safe stairs was introduced. These stairs can be easily incorporated into new-build housing and have a huge impact. On stairs that are designed to the British standard, falls decrease by over 60%, significantly reducing admissions to A&E—so why would we not take this simple action? There is a respected evidence base and an outcome that is preferable to the status quo, so I shall table an amendment to the building safety Bill to see if we can move this on.
I would like 2021 to be the year when the Government get serious about carers, who were sadly omitted from the gracious Speech—I refer both to those unpaid carers who care for family and friends and to those who are paid for their work. Without England’s millions of paid and unpaid carers, our health and social care systems would have collapsed in the last year under the impact of Covid. A light has been shone on the importance of their work. In the first Covid lockdown, you may remember that, on Thursday evenings, we applauded the efforts of carers, NHS workers and others.
In my own area, the south-west, there are 168,000 jobs in adult social care: 145,000 of them are in the local authorities, and the remainder are in the independent sector. It will not surprise noble Lords that these are not paid very well. England’s local authorities pay more than the independent sector by just under £2 an hour. Some 17% of these jobs are zero-hours contracts, and the turnover rate is just over 35%. By contrast, in Scotland, care workers get at least the living wage, of £9.50. Again, in Scotland, free personal care has been available to those over 65 since 2002, which can include help with personal hygiene, at mealtimes, with medicine and with general well-being. It is regulated by the Scottish Social Services Council. COSLA, which is the Scottish equivalent of the LGA, has agreed to pay care workers at least the real living wage of £9.50 an hour.
Most care workers are not unionised, and, in England, they are not even regulated. Their Welsh and Scottish colleagues have a regulating body: the Care Council for Wales and the Scottish Social Services Council. A review is long overdue for care workers in England, but support for unpaid carers must not be forgotten. I would be grateful if the Minister could indicate if this could be included in the health and social care Bill.
The Prime Minister promised to sort out the care system “once and for all”. The noble Lord, Lord Forsyth of Drumlean, has described the position that we are in as a “national scandal”, and a Select Committee that he chaired determined that to provide free social care to those who are eligible would save enormous pressures on the NHS and would effectively pay for itself. As such, I hope that, when we have sight of the forthcoming health and social care Bill, provision for all carers and free care for all those who are eligible will be there—but somehow I doubt it.
Baroness Morgan of Cotes (Con)
My Lords, it is a pleasure to speak in today’s debate. We have heard many fine speeches, but I think that it is right to congratulate those who have given their maiden speeches and the very fine valedictory speech that we heard. I wish the right reverend Prelate a very happy retirement from this place. I also draw the House’s attention to my interest on the register as a board member of the Careers & Enterprise Company.
As other noble Lords have mentioned, the gracious Speech has, of course, been given in the context of the last 14 months of the pandemic. In the time available today, I will touch on four issues arising from, and related to, yesterday’s Speech. First, one of the lessons from the past year is that our economic recovery should not just be about growth but about growing our nation’s overall well-being. I am privileged to serve on the Covid-19 Committee with the noble Baroness, Lady Chisholm, and the noble Lord, Lord Hain, whom the House heard from earlier. Our first report, released last month, talked about the impact of the growth in our digital life on our well-being. As we think more and more in the course of this year about the recovery of the public finances—and, we hope, a multi-year spending review, which is much needed by the government departments within which the Bills announced yesterday will be delivered—I hope that the Treasury will finally embrace the move towards looking at the economy in terms of overall well-being, not just the hard numbers.
My second point is that we have heard much, quite rightly, about the Government’s desire to level up, which is often pitched in the context of infrastructure. We hear a lot about road and rail connectivity, and I do not doubt that those are important. I certainly know that the delivery of 5G infrastructure and gigabit broadband is extremely important in light of the experience of the past year. However, we do not hear anything in the context of infrastructure about childcare. Women’s employment has been hit hard by the pandemic; more women than men have been furloughed in many cases. Without accessible, affordable and easy-to-find childcare, many working parents will find it hard to get back into the labour market after the pandemic. Without them and their involvement in the labour market, it will be very hard to grow our economy in the way we all want.
The third point, as has already been highlighted by the Covid-19 Committee, is the rapid growth of digital technology and living our lives online. While, as a former Digital Secretary, I would of course champion the important contribution that all tech businesses can make to our economy, we also have to recognise that the proliferation of illegal, and legal but harmful, content is causing psychological harm which undermines the well-being of our nation, particularly of children. I therefore firmly welcome the Government’s commitment to bringing in the online safety Bill and welcome its publication in draft form today. I also welcome the fact that online scams will be tackled. However, the Bill has to be about more than just picking out the content that we do not like; it has to be about changing the culture within the platform companies that offer opportunities for user-generated content to be shared. When the Bill reaches this House, the Government will find that many noble Lords want enforcement action against individual senior managers of those companies to be on the table from the start, not just subject to a two-year review.
My final point is on the skills and further education Bill, which has already been mentioned. As a Member of Parliament, I valued my work with the excellent Loughborough College, even when the students gave me a hard time about my work as their local MP. The noble Baroness, Lady Morris of Yardley, who is not in her place now, highlighted the important part of the Bill about employers being involved in working with colleges to assess local needs. I perhaps differ from the noble Baroness’s response to that—I think it is a very good idea—but I hope that Ministers will be able to set out more clearly, either tonight or in the course of debating the Bill, how local needs are to be assessed and defined, because that is going to be very important. We clearly have a very changing labour market, as a result of the pandemic, new technology and, as other noble Lords have mentioned, things such as green jobs. We will also be able to see the impact on the labour market once the furlough scheme has finished. That will be a key feature of this forthcoming Session and beyond, because employment is one of the key drivers of our well-being, which is where I started my remarks, and I think it is what the Government’s focus on levelling up is all about.
Lord Winston (Lab)
My Lords, I join my noble friend Lord Griffiths in his lovely remarks about the right reverend Prelate the Bishop of Portsmouth and his wonderful work. We wish him all the very best for the future. I also welcome our two maiden speakers. I declare an interest as an employee of Imperial College, where I research aspects of human development. I also supervise PhD students who measure the impact that universities can have on encouraging the aspirations of school students. As the university president’s envoy for outreach, I visit and speak to school students all over the United Kingdom, wherever requested. This has, sadly, been mostly remotely this year.
The gracious Speech contains laudable hopes to improve education and we congratulate the Government on the emphasis on early years, but there are major gaps if we are to offer better opportunity. Each week, my own outreach includes visits to some of the most deprived parts of England, including the coastal towns, the south coast, the West Country, South Yorkshire and the edges of Derbyshire, the north-west and north-east. If you go to towns just 15 or 20 miles away from one of our greatest universities in the world, you see massive deprivation in East Anglia. There is no question that this hugely affects aspiration; there is no awareness at all of what children could achieve, and this applies to both further and higher education.
Many children in deprived Britain have no idea what their huge potential actually is. This is not because they have bad schools or teachers; on the contrary. Their background, environment and diet, their parents’ employment or lack of it, their housing—perhaps with a TV set but no books—and the squalor in which they often live lead to intellectual and social impoverishment which cannot be corrected by a few hours in schools, with teachers stretched beyond belief with administrative necessities, academic targets and assessments, and a national devotion to a prescribed curriculum. This may discourage attempts to enthuse children with a delight in learning. The best that some teachers can hope for is no disruption.
Achievement goes far beyond education but depends on the enrichment of society. If we want to change society and improve its health, behaviour and economy, we need to invest much more in primary education, when the brain is most plastic and ready to absorb all experience. If we do not inspire children to wonder and encourage joy at learning, we lose so many later. The Government have promised £4,000 per child in primary education and £5,000 per child in secondary. This is not merely inadequate for A-level courses; it is totally inadequate for the most important time of our lives—when we start formal education. It is all very well to commit to increase teachers’ starting salaries to £30,000 a year, but the rewards for undervalued teachers are insufficient to attract enough of even the most committed and able individuals. I know of many professionals who seriously consider dropping better paid jobs to teach, but retraining and inadequate financial rewards still prevent young families purchasing housing. We also need to attract far more male teachers into primary schools. Male role models are equally important as female ones.
The Government hope that the UK will become a science superpower and admit that too few women enter science. However, the great majority of those teaching science in primary schools have no science qualifications. Excellent teachers and role models though they are, most of them do not have a science degree and very few even have one A-level in science, so they are teaching in an unconfident way. This is particularly the case when it comes to one of the most important aspects of primary school, which is practical education, which attracts interest and has a lifelong effect on so many children.
In one primary school that I visited just before the pandemic, I did an experiment with 180 children, showing them how we could exhaust 20% of a gas from a glass bottle—the gas being oxygen—and create a partial vacuum. I will not go into the result of this experiment, but they loved it. When I asked those children what the commonest gas in the air around them was, most said “carbon dioxide”; some hesitantly said “hydrogen”—fortunately, that was not the case of course. Eventually a number said “oxygen” and, finally, one little boy put his hand up and rather tentatively said, “nitrogen?” Immediately, the science teacher shut him up and told him not to talk nonsense. Of course, the problem is, thereafter, what do you do in a school like that? I had a very gentle chat with that child before I left, but I could not say that the teacher was wrong.
We have gone through hard times and we must not leave the experience of education to a Gradgrind approach to facts. Education must engender a delight in learning, and it should not be a process but a journey to discover, to wonder and to delight.
Lord Bichard (CB) [V]
My Lords, I also congratulate the noble Lord, Lord Lebedev, and the noble Baroness, Lady Blake, on their maiden speeches and bid farewell to the right reverend Prelate the Bishop of Portsmouth, whose contributions I have always enjoyed. He will understand that, as a Southampton man, I am not easily persuaded that anything good can come out of Portsmouth but, today, I will happily make an exception and I wish him well.
For seven years, I was privileged to be vice-chancellor of the University of the Arts London, the largest and still the best centre for art and design learning in Europe. It is not surprising, therefore, that I am speaking today about the need to protect funding for the arts at all stages of education, but not least in higher education. I do so because of the Government’s recently announced proposal not to prioritise subjects such as music, dance, drama, design and performing arts in HE funding allocations. This is misguided and ill judged and will do incalculable damage not just to the arts but to the future prospects of the UK at this critical juncture. That is not just because of the massive contribution our creative industries make to our GDP, but because our future economic success and our capacity to tackle unprecedented challenges like climate change and an ageing population will, above all, demand innovation: innovation from business to stay ahead of the competition, and innovation from the public sector to ensure that the efforts of science and industry are not wasted.
That kind of innovation requires people who are creative, who challenge accepted wisdom and think outside the box—the very kind of people that our art and design schools have produced in abundance down the years. Yes, our art schools produce great artists and great performers but, above all, they develop creative thinkers who are worth their weight in gold. They also produce a seemingly endless supply of great designers. People like Jonathan Ive, who transformed Apple, the late, great Terence Conran and the likes of Richard Seymour and Dick Powell, have all taken ideas and scientific discoveries and turned them into world-beating projects which, it is no exaggeration to say, have changed the way we live our lives. Time and again, we have seen how great science needs great design to realise its potential—and time and again, we seem to turn a blind eye to all the evidence.
At a more human level, for many people art and design education offers the only route to fulfilling their personal potential. For me, the greatest gift that education can offer is the opportunity for someone to realise their particular talent. Many of the brilliant students I worked with at the university had not found traditional academic subjects easy and had struggled in their studies at school. Alexander McQueen—one of our greatest ever fashion designers—would have told you that this was his experience before he went to Central Saint Martins. Why should we deny people such as Lee McQueen the chance to make their unique contribution and to enrich our lives so wonderfully by so doing?
There is more. A year or so ago, the noble Lord, Lord Howarth, chaired an APPG that demonstrated the powerful contribution the arts is now making to our physical and mental health. Social prescription, in one form or another, is now accepted by the vast majority of medics as an effective way of treating many debilitating conditions. But we need a pool of trained providers to deliver treatments, and we need them now as we exit the pandemic.
I know that some of us feel that the term “world-beating” has been devalued, but there is no doubt that Britain is world-beating in the world of art and design. We did not achieve that by chance, but because of the excellence of our learning centres—envied around the world—and their ability to recruit students from all social classes and many different cultures to create a melting pot of talent. Why on earth would we want to endanger that? Why on earth, when we need to build and market a brand that is unique to the UK, would we turn away from something that has long defined us in the eyes of the world? I know that we will be told that these cuts will not have that impact, and we can spend hours debating the numbers, but the most depressing aspect of this affair is that it suggests that the Government still do not understand the critical contribution that the arts make to our national endeavour.
Lord Bichard (CB) [V]
Even worse, it suggests that the Government think we have to decide between the arts and science in the way we allocate our resources.
Baroness Donaghy (Lab) [V]
My Lords, I welcome the maiden speeches of my noble friend Lady Blake and the noble Lord, Lord Lebedev, and I join in saying farewell to the right reverend Prelate the Bishop of Portsmouth. He will be much missed.
Despite the Government’s pledge to support the National Health Service, I do not see how it will succeed. An announcement that there will be an announcement about social care will do nothing to help the NHS. There is no indication that NHS staff will be supported with improved pay and conditions, or that their exhaustion will be addressed and their morale improved.
I have spent the last couple of days rereading the debate from 2011-12 on the then Health and Social Care Bill. The noble Earl, Lord Howe, promised streamlining, integration and an improved health service. Only the noble Earl could have steered that ghastly Bill through. I should be delighted to see the back of it—but now we hear the noble Baroness the Minister promise a “landmark” health and social care Bill. Guess what? It will reduce bureaucracy and improve the safety of patients. I will be reminding the Government of what they said during that 2012 debate.
A four-year commission of inquiry by the London School of Economics and the Lancet medical journal has identified that an extra £102 billion is needed to catch up with many high-income countries, and they have a detailed blueprint for paying for it. The report also says that the Prime Minister should drop his planned reorganisation of the NHS in England because it will be “disruptive” and bring no benefits. I agree with everything that the noble and gallant Lord, Lord Stirrup, said in his powerful speech: drop this Bill and concentrate on staff morale and job security.
Turning to the general employment situation, the TUC has pointed out that the Prime Minister has repeatedly promised to protect and enhance workplace rights after our departure from the EU. The Government have rowed back on their promise to boost workers’ rights in not bringing forward their long-overdue employment Bill. Frances O’Grady, the TUC general secretary, has said:
“We need action now to deal with the scourge of insecure work … We can’t build back better from this crisis unless we improve pay and conditions”.
One in five employees experienced depression this year, and the ONS finds that the lowest earners have the worst mental health. Businesses should be prioritising the training of line managers in supporting employee well-being.
ACAS commissioned some independent research backed by the CIPD estimating the costs of conflict in the workplace. Sue Clews, the chief executive of ACAS, said that
“conflict was suppressed during the height of the pandemic … But as working life returns to some form of new normality in 2021, it is likely that insecurity, rapid change and continuing economic pressures will lead to a re-surfacing of conflict between individuals”.
This can be an opportunity, but it can also lead to increased resignations, sickness absence and presenteeism, which leads to lower productivity. An essential ingredient in good management is to be conflict-competent. This saves time and money. The ACAS analysis estimates the overall total annual cost of conflict to employers at £28.5 billion. It points to a clear link between the well-being of employees and organisational effectiveness.
Finally, the use of mini umbrella companies allows employers to avoid their national insurance contributions and costs the taxpayer hundreds of millions of pounds a year. We have seen unusual payroll patterns in the test and trace workforce, with workers shunted from one company to another every few months, given P45s and new job contracts despite no change to the work. At least 30 different payroll companies in test and trace fit the mini umbrella company definition. HMRC must get to grips with these scandalous loopholes and protect vulnerable workers. I look forward to the continuing debate.
Baroness Garden of Frognal (LD)
My Lords, I wish to speak on the skills Bill and agree with everything which my noble friend Lord Storey said. First, perhaps I may add my congratulations to those offered to the maiden speakers and say how sorry I am that we will not be hearing again from the right reverend Prelate the Bishop of Portsmouth—Bishops have to retire so young; it is outrageous, really.
I remind the House of my interest as a vice-president of City & Guilds, for which I worked for 20 years on what we were then allowed to call vocational qualifications. City & Guilds and BTEC qualifications were and are recognised and highly valued by employers, students and parents, so it was perverse of the Government to ignore all that had been achieved over more than 100 years and assume that the invention of their T-levels would be able to replace the years of value from the recognition of employer-led skills that these two organisations command.
We have generations of academic superiority to overcome if we are to allow work-based skills to have the respect and importance they deserve. With A-levels and universities seen as the gold standard, we have allowed the very skills that the nation needs to survive to become underrated. We must make every attempt to rectify this if the country is to recover from the blows inflicted by Brexit and Covid.
In the giddy days of coalition, when I was a Minister in the education department—among a variety of other departments; such is the exciting life of a Government Whip in the Lords—I was struck by the fact that Ministers and officials had pretty well all come via the university route; they had no direct experience of further education colleges or of vocational education, training and qualifications. If the Government are intent on diversity, may I suggest conscious recruitment from among non-university officials? Although a university product myself, I had taught from time to time in colleges in the happy times when they offered free programmes in languages, which I was teaching, as well as in carpentry, floristry, basket weaving, computing and—truly important—ESOL, or English for speakers of other languages, which were life-changing, particularly for those women from cultures where women were not encouraged to do anything outside the home, particularly not to study. There are still some free courses online, but most college courses have gone because government funding has been cut by 60%. We saw ethnic minority women blossom when they were able to communicate with their neighbours, their children’s schools or their shops. It has been woefully short-sighted that these programmes have been cut back so severely.
There is encouragement in the development of apprenticeships, where young people are being recruited into government departments without the all-important degree; it is also encouraging that the Skills Minister, Gillian Keegan, is the product of a comprehensive school who started her career as an apprentice.
We Liberal Democrats believe that it is essential that more is done to ensure that people at all stages of life are supported to access education and training opportunities. We have proposed skills wallets, which would give adult learners access to £10,000 to spend on education and training throughout their lifetime. We recognise that mature students are likely to be more averse to taking on debt, as the noble Lord, Lord Knight, reminded us; a lifelong loan may not be attractive. To ensure that people can access the opportunities outlined in the skills Bill, the Government should look at introducing proposals along the lines of skills wallets.
The lifetime skills guarantee at level 3 is welcome but too narrow. In the Bill, we would like to see a much wider array of qualifications and flexible credentials made available at all levels. There needs to be more support for achievement at levels 1 and 2; these are often the stepping-stones which enable those who have not found school study easy to gain confidence and interest in learning. We saw at City & Guilds, when NVQs were introduced at level 1, that many adults with no prior qualifications were incentivised, proud and honoured to receive a national certificate. For very many, that changed their approach to learning, and they continue to learn because of that elementary encouragement.
We would fully support better pay and conditions for further education teachers. Their pay has fallen woefully below that of schoolteachers, so if the Government are serious about skills, they must do something about those who teach and tutor them.
Finally, I agree with the noble Lord, Lord Griffiths, that it is essential that careers information, advice and guidance are offered from primary school onwards. Small children must see the full range of futures possible for their interests and enthusiasms before they are brainwashed into thinking there are boys’ jobs and girls’ jobs. Women make exceptionally good engineers, fire officers, pilots and plumbers, just as boys can make exceptionally good nurses, child carers, primary school teachers and hairdressers. We shall support to the hilt any steps the Government take to enhance skills but will seek to steer them into wiser waters where we feel their methods and decisions are ill informed or counterproductive. On these Benches, we look forward to a world where work-based skills are given the respect and encouragement from teachers, parents, employers and fellow students which they richly deserve and which the country urgently needs.
Lord Rooker (Lab) [V]
My Lords, I welcome both maiden speakers today and I wish the right reverend Prelate the Bishop of Portsmouth a long, happy and busy retirement away from the House.
It looks like another year lost for the reform of social care, and I make no apology for concentrating on that issue. It is another year when people who are self-funding their care pay well over the odds for care —by which, I mean 40%—compared with those funded by local authorities in the same care home with the same services. This means that the family home is likely to be sold earlier than if there was a fairer system. It is surprising that more is not made of this, but I think it remains unchallenged due to the circumstances involved in securing care in the first place.
The situation completely undermines the 2019 Tory manifesto claim that
“one condition we do make is that nobody needing care should be forced to sell their home to pay for it”.
Furthermore, there has been no action on that manifesto commitment to
“build a cross-party consensus to bring forward an answer that solves the problem”.
No work has been done; there has been no reaching out; no one wants to be accused of the death tax allegation which snuffed out earlier attempts. The Government claim that they are talking; the Opposition claim that they are not. We are not being told what is going on in any detail by either the Opposition or the Government. In short, we are not being told the truth.
The Lords Economic Affairs Committee report, Social Care Funding: Time to End a National Scandal, set it all out in mid-2019. The opening words of the debate on that report, on 28 January this year, from the chair, the noble Lord, Lord Forsyth, said it all— I shall quote just four sentences:
“We published our report in July 2019, and yet, 18 months later, we still await the Government’s response … ‘With each delay the level of unmet need in the system increases, the pressure on unpaid carers grows stronger, the supply of care providers diminishes and the strain on the care workforce continues.’ Just 20 days after our report was published, the Prime Minister stood on the steps of Downing Street and said ‘we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.’ Now, more than ever, urgent government action is required”.—[Official Report, 28/1/21; cols. GC 235-36.]
In fact, the Prime Minister was more specific than his now famous quote indicates, because he actually said:
“My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care.”
That was a very carefully crafted first speech as Prime Minister, not a one-off, off the cuff ramble. Was he telling the truth?
The Chancellor claims that lack of consensus over funding is a significant barrier to reform—an excuse that the noble Lord, Lord Forsyth, translates as,
“I don’t want to spend the money”.—[Official Report, 28/1/21; col. GC 237.]
As with healthcare, we need to share the risk, because no one can be sure or certain whether they will ever need social care. So it is a requirement to help those who can help themselves as well as those who cannot. And, of course, it needs a new stream of funding, such as national insurance payable on all incomes and for all ages—because, like many people, I had many years after the age of 65 still working on PAYE and not paying national insurance—or a small step up in taxes, say 1%, when you reach the age of 40. Without a specific financial cap on self-funding, it is impossible to remove the fear the Prime Minister spoke of.
Social care may have featured in the Queen’s Speech, but not in a positive way: the Peter Brookes cartoon in today’s Times says it all. The reality is that care homes are going to go bust. Some care homes will move to being available only for self-funders. Caring is therefore not a career option. There is no structure and it will always be on low pay. The failure to act is, indeed, in the words of the report of the House of Lords Economic Affairs Committee, “a national scandal”.
Lord Holmes of Richmond (Con)
My Lords, it is a pleasure to take part in this adjourned debate on the gracious Speech. In doing so, I declare my interests in technology as set out in the register. I congratulate our two maiden speakers and the valedictory speaker, the right reverend Prelate the Bishop of Portsmouth. I sat behind him when he came in and I sit behind him as he departs. What I have learned, not least from the right reverend Prelate, is that we all do well when we put on our armour of light.
Three words in the gracious Speech: “Build back better”. Three words, one alliteration, but it must be the alliteration that underpins our economic recovery. Right now, rightly, our economic strategy is our vaccine strategy; likewise, our vaccine strategy is our economic strategy. But “Build back better” must be the bedrock as we move forward. I shall touch on just three points to this end—digital ID, fintech and digital payments.
When it comes to digital ID, does my noble friend agree that we have to have a system of distributed digital ID—my credentials in my hand to manage, to deal with, to choose how to deploy? What is happening inside DCMS? What greater acceleration can be put on our digital ID strategy as a nation? Because it is not just about security, being safe in cyberspace, important though that is; there is a real economic opportunity to be had if, as a nation, we nail it when it comes to distributed digital ID.
Similarly, for fintech, does my noble friend agree that we have a unique opportunity in the United Kingdom, not just in London, great though the fintech sector is, but right across the nations and regions, with the 10 identified flourishing fintech clusters? Similarly, we need the UK to be the best place to start up, scale up, build and, yes, potentially sell a fintech business. Does he also agree that there is a key role for fintech when it comes to financial inclusion? Exclusion has dogged our nation for decades; fintech offers the opportunity to reconsider risk, lines of credit and all elements of financial services in a way that can deliver for individuals and businesses alike.
That takes me to payments. Much great work has been done on access to cash, not least Natalie Ceeney’s perfect review on the matter. I was also delighted that my noble friend the Minister Lord True helped with the passage of an amendment to the Financial Services Bill on cashback without requiring a purchase. Does the Minister agree that the next logical step is to look at digital payments and ensure that these are accessible and inclusive for all, and that more analysis, research and review is required in this area?
Distributed digital ID, fintech and digital payments are but three stars in the constellation of new technologies we have in our well-washed, Covid-recovering hands as we move forward. Does my noble friend agree that, if we get it right, it will be about human-led talent and technology, human-delivered inclusion and innovation, and that, yes, if we get it right, we will not just build back better, but we must, we absolutely must, build back better together?
Baroness Bakewell (Lab) [V]
My Lords, I add my congratulations to those of others to the two maiden speakers today and to the retiring right reverend Prelate the Bishop of Portsmouth, not only on his speech but on his contribution to the House.
At the beginning of this debate, the Minister, the noble Baroness, Lady Berridge, paid tribute to the NHS, and I do, too—but I wish to challenge the assertion that the Government protect the NHS. In fact, without the public either knowing or consenting, they are putting it at immediate risk. How? They have allowed, indeed encouraged, the takeover by the American health insurance company Centene, through its subsidiary Operose, of 69 NHS surgeries, and the further invitation into healthcare provision around the country. The proposed health Bill, with its plans for integrated care, will facilitate this further, raising the prospect of American profit-making interests shaping the future of the NHS. This will involve the prospect of hospital closures if they are not profitable, fewer referrals of sick patients to specialists and, most particularly, the major risk of the selling of our NHS personal data for profit around the world. Will the Government pledge to protect our personal health data from American commercial exploitation?
We all know that the NHS is one of the most popular, cost-effective and efficient public health services. It is a national treasure, admired around the world. Operose is a loss-making subsidiary of Centene. It pays no UK tax and its declared policy to its shareholders is
“to exit contracts that have not historically fulfilled profitability targets.”
Centene is a giant of American health insurance—the 42nd company in the US listings—and it is currently being sued by the state of Ohio for fraudulently overcharging. It stands in vivid contrast to our NHS, a vast and effective public health service, serving all our citizens equally, offering the best in medical treatment and consistently free at the point of delivery. We treasure it. We want any reforms to retain its true and precious identity. Now, without due parliamentary scrutiny, American company Centene is a growing player in the NHS integrated care system. In January this year, Samantha Jones, its former chief executive, became special adviser on health integration to Boris Johnson.
Those in favour of Brexit talked often about taking back control. I am urging us to take back control of our NHS in its entirety. The health Bill coming before us consolidates the market paradigm developed during the pandemic, when contracts worth £10.5 billion were awarded without competition. In normal times, tendering is the check against corruption and cronyism within a market model. The outsourcing of a track and trace policy was the weakest of the Government’s pandemic initiatives. Will the Government pledge to retain tendering within NHS provision?
This Session of Parliament offers us the chance to scrutinise and debate major changes in the NHS. We must examine the Bill with particular care, making sure that America’s medical insurance provision, a system that tried to derail Obamacare, does not deprive our country of its major post-war achievement—the creation and maintaining of the NHS.
Lord Scriven (LD)
My Lords, like other noble Lords, I welcome the two maiden speakers to your Lordships’ House and wish the right reverend Prelate the Bishop of Portsmouth an exciting new chapter in his work outside this House.
I live in a city where, if I get on a bus outside my house and go six stops, life expectancy decreases by 10 years. The people in those communities are not left behind; they have been neglected for generations. Trickle-down economics has not worked; allowing people to become filthy rich has not worked or met their needs. These issues are deep-seated and deep-rooted, so it is commendable that the Government want to improve health inequalities and concentrate on population health as outlined in the health and care Bill. But focusing on what is required to improve health and well-being would not lead people to conclude that another structural reform of the NHS is the solution in either the short or the long term. The most urgent need, if we are to save lives and improve health, would be to deal with the backlog of 4 million people waiting for care and treatment. Time spent trying to replumb a complex NHS bureaucracy is going to take effort and resources over the next two to five years. It is not only the wrong solution; it is the wrong solution at the wrong time.
For me, as a former NHS manager, this yet again raises the million-dollar question: how do you move resources out of acute and ambulatory care, which account for over 80% of NHS spending and are mostly a sunk cost, to a health service that is focused far more on poor health prevention and keeping people healthy? Will the Minister explain, in simple terms, how this structural reform of the NHS will move the whole system to a more preventive one and move resources to that end? If the Minister cannot answer that question and convince the House and the nation on this fundamental question, this is a reform of fantasy rather than one based on the reality of what is required to improve the nation’s health.
Of course, when we talk about healthcare, we are really talking about the staff, who provide outstanding care, who have gone above and beyond the call of duty over the last 14 months, sometimes at great personal sacrifice for them and their families. The Minister cannot stand at the Dispatch Box and say with sincerity that the Government value the NHS if they refuse to value the NHS staff’s contribution in getting the nation through one of its most difficult peacetime episodes. That is why a decent pay rise is required and not the odd token clap on the doorsteps of official residences.
The aim to deal with health inequalities is welcome, but the solution presented by government, of integrated care systems looking at population health, is totally impractical and will not deal with the real underlying causes that lead to the inequality. Some 80% of the root causes of poor health and lack of well-being have nothing to do with the healthcare system. They are based on cold, damp, inadequate housing; on generations of families not having the opportunities to meet their full potential; on the Government feeling that punishing people on benefits, and offering tax breaks to those on the highest incomes, is the way to balance the nation’s books; and on the only measure of success being growing GDP and not including measures of well-being and fairness as part of growth.
I see very little in the Queen’s Speech that will get under the skin of these issues and tackle them in the sustained way that is required. Slogans such as the vacuous “levelling up” are not going to solve the issues —the same as with the previous slogan of the “northern powerhouse”. Fundamental changes to government need to take place, including stopping ministries working in silos, believing they have the power, through structural change, to improve people’s health and well-being. This means a more federal way of governing the UK, including England, so innovation and creative local solutions are delivered to deal with long-standing local and regional issues, backed up with significant fiscal resources and flexibilities. It also includes how we measure the success of the nation. It cannot be all about GDP but needs to include measuring fairness and well-being for the areas and people of the UK.
The life chances and life expectancy at the end of that six-stop bus journey will be the real indication of success, not new slogans or reorganisations of the NHS.
Lord Monks (Lab) [V]
My Lords, I, too, add my congratulations to our two new colleagues on their effective maiden speeches, and I wish the right reverend Prelate the very best for the future.
Not long ago, when the Cameron-Osborne team led the Conservative Party, the party clearly believed in small government. Indeed, sometimes, they seem to have embraced austerity not just to pacify financial markets but as an opportunity to roll back the frontiers of the state and create extra spaces for entrepreneurs to prosper. All this was in line with the Thatcherite creed. Also in line with that creed were: the new anti-trade union law; public sector pay freezes; rising levels of inequality; deep cuts in local authority budgets; inaction on the growing gig economy; and an end to the important initiative of Sure Start. Equally importantly, NHS funding in real terms was cut and left the service rather weak to face the onslaught of Covid-19. Noble Lords will get the drift. A smaller state was very much the goal.
Now that is changing, if we can believe the Prime Minister’s promises, as many certainly did at last week’s polls. The Government are spending heavily and promise to spend a great deal more. The furlough scheme, in particular, has made a huge difference—imagine the unemployment situation without it. My noble friend Lord Hain was quite correct to warn of the dangers of its sudden withdrawal. The Prime Minister promised the voters of Hartlepool and elsewhere that there would be this powerful levelling-up agenda and new investment in the NHS. As the noble Lord, Lord Bridges, has spotted, the small state is in full retreat in Biden’s America, for sure, and now over here. If the Government deliver on their promises—which is quite a big “if,” given some of the promises that have already been broken—we will see a return to one-nation Toryism for the first time in many years.
There are big weaknesses in the Government’s approach, with a major question being: how is it all to be paid for? The damaging effects of Brexit on the economy are already very evident in Northern Ireland and in the fishing industry; less noticeably, perhaps, in other sectors that are dependent upon exports, but, undoubtedly, it is causing major dislocation. There is this big hole called social care, which many other speakers have referred to. There is no sign of a new employment Bill, without which levelling up could look more like levelling down and there could be a further spread of the gig economy, with all its abuses and insecurities for workers.
I acknowledge that the levelling-up agenda is extremely ambitious. I would like to be able to think that it will be delivered; I hope that it will be. Of course, we have seen big transfers in the past to hard-hit regions and nations. They certainly created jobs but too many of them were precarious and low paid, and they have been outstripped by deindustrialisation and structural and cultural changes.
Now, the pressure is on the Government to carry out their promises—especially their promise that the young can expect good-quality jobs in their hometowns without needing to move away to the big cities, with the little bit of extra glamour that they can impart. It is a bold and welcome promise; I hope that this House and others will hold the Government to it. I look forward to learning about how it will be delivered. Of course, there are scores, perhaps even hundreds, of towns and villages in the old industrial and seaside areas of this country. I hope that action will not be limited to where there happens to be a by-election.
Lord Baker of Dorking (Con) [V]
My Lords, I will speak on education. I welcome the speeches from the noble Baronesses, Lady Morris and Lady Garden, the noble Lord, Lord Griffiths, and my noble friend Lord Holmes.
In the Speech yesterday, there were just two sentences on education. I thought it might have merited a few more, because youth unemployment is now at 14.4% and is rising. It fell to my noble friend Lady Berridge to fill us in on the changes this afternoon. The most significant change is that the Government will bring in a Bill for them to take control of FE colleges and to ensure that, in each case, local companies are involved in the creation of the curriculum and the courses taught. I fully support that; it is an excellent idea. In fact, university technical colleges have been doing it for the past 12 years. The governing body of each university technical college is in the hands of a majority of local businessmen and the local university.
The other thing that the Government are clearly committed to is that technical education should start at 16. There, I profoundly disagree. In schools for 11 to 16 year-olds, youngsters should be given the chance to learn some technical, practical, hands-on subjects. However, the present Government have set their heart against this. Since 2010, they have introduced a curriculum of nine academic subjects, the EBacc and Progress 8. All schools have to follow it, so lots of them have dropped other subjects. The biggest drop—70%—has been in design and technology, which involves electricity, making projects, handling metal and using tools and machinery. All that has been dropped almost completely.
What beggars belief is that, in 2015, the Government dropped one of the computing exams at GCSE. As a result, the number of students studying computing at schools for those aged 11 to 16 has dropped by 40%. That is extraordinary in a digital age. Whatever happens to those students, they will have to cope with digital skills, knowledge of coding and AI. The Government have simply ignored that.
The Prime Minister has said that he wants to arrest the brain drain of youngsters in the north leaving their schools and going to universities in the south. Well, UTCs do not support the brain drain at all. Essentially, they are local schools. Each year, we measure the destination of each student when they leave at the age of 18. Last July, we found that 55% of our students went to university, usually a local university because it had been teaching them for four years and they knew about it. Another 20% or so became apprentices—usually local apprentices—and most of the rest got jobs locally. They were essentially not part of the brain drain. Without any shadow of doubt, we need more UTCs in the north.
In fact, I have been approached by five MPs in the north who want UTCs in their constituencies. With them, we are preparing applications for UTCs. We specialise in just two subjects and get the commitment of the universities. I have spoken to the vice-chancellors in each of the five places; they are strongly supportive. We will present these proposals to Ministers before the end of the summer. This will be a real test of whether the Government believe in levelling up, because there is no question but that you have to level up in education.
Finally, I want to say something about the Baker clause, which I introduced three years ago with the support of the Government. It allowed providers of alternative education, such as apprenticeship providers, FE colleges and UTCs, to go in and speak to youngsters aged between 13 and 14 and 16 and 18 to tell them what they were doing. It was a massive improvement in career advice. I urged the Government to make this a duty for schools, but they said, “No, we will depend on a Minister’s letter. When it goes out, the schools will automatically follow it.” Well, the letters have gone out and the schools have not followed. More than half the schools have not provided any such opportunity. The Government are now slowly limbering up to do something about it; I think they propose to impose some sort of financial penalty if they do not. I ask my noble friend Lady Berridge to make quite sure that she is capable of writing a letter this September to all schools, reminding them that they must write to the parents and must institute those opportunities for such bodies to go in. I hope that my noble friend Lord Callanan will draw that to her attention later tonight.
Lord Bassam of Brighton (Lab) [V]
My Lords, I declare my interest as the vice-chair of an FE college, which has some bearing on this debate. I join in both the general congratulation to our maiden speakers today and our thanks to the right reverend Prelate the Bishop of Portsmouth for his thoughtful and constructive contributions in our House over a long period.
The efforts of key workers in schools, supermarkets, the health service, care settings and all other areas of our society have been nothing short of heroic over the past year or so. We are now beginning to emerge from the Covid pandemic thanks to the personal sacrifices of the British public and the NHS’s fantastic handling of the vaccine rollout. This Queen’s Speech was the Government’s opportunity to show that they value this hard work and sacrifice and that they can deliver much-needed reforms for the public.
The Government have repeatedly committed to levelling up our country, but it is difficult to see much evidence of that in the forthcoming legislative programme. I support levelling up and a fairer distribution of opportunity. For me, levelling up is about fairness in the workplace; opportunities for all in education; a fairer distribution of income; equal access to health, public services, better housing and cultural activity; and the proper care and protection of our elderly. Levelling up will fail to be anything more than a slogan unless the Government are willing to confront the hard truth about deep-rooted structural inequalities that sap the health, prosperity and life chances from our most deprived communities.
Since 2010, further education and skills have borne the brunt of the Government’s harmful economic choices, with funding cut, access to learning restricted and maintenance support for younger learners abolished. This has resulted in fewer young people studying in FE and fewer workers able to retrain and upskill. We therefore welcome the Government’s change of heart and new commitment to helping people to retrain in the skills Bill. However, they must come up with a plan to create good-quality jobs that allow people to earn good money if the training programme is to have the desired effect.
For too long, this Government have relied on boosting job creation with unregulated part-time and low-paying jobs. These jobs often involve zero-hours contracts and exploitative working practices, such as fire and rehire. The Government have repeatedly promised the biggest upgrade to workers’ rights in a generation, yet we have no plan to deal with the scourge of insecure work and unscrupulous practices. With one in eight workers trapped in poverty and many hard hit by the pandemic, many will be in disbelief that there was no mention of a long-awaited employment Bill to protect them. Downing Street insists that legislation to protect workers’ rights will be introduced
“when the time is right”,
citing the pandemic as the reason for a delay. This logic is perverse, given that the pandemic has brutally exposed the terrible working conditions and insecurity that many of our key workers in retail, care and delivery face—demonstrating why the time is right now and why legislation is urgently needed to protect them.
The dither and delay in addressing employment rights is all the more exasperating given that the Government have found space in their legislation to protect free speech on campuses, despite little evidence of a problem, at a time when staff and students are coping with the fallout from the Covid-19 pandemic. It is the same with the imposition of ID cards for elections. I conclude that the Government’s focus on manufacturing an argument over free speech on campus is an attempt to distract us all from their failure to support students and universities through this pandemic and beyond. Students are seriously worried about getting the skills and experience they need for the workplace. Despite Labour’s calls, Ministers did little to support the graduates of 2020, who entered a shattered jobs market. They must do more to secure the futures of the class of 2021.
Levelling up is a great theme—but it needs real policies, with meat behind it.
Lord Lingfield (Con)
My Lords, I welcome entirely the Government’s aspiration to enhance the available provision of technical and vocational skills training so that first-class courses can provide a prestigious alternative to degrees for many young people. I remind your Lordships of my registered interest as chairman of the Chartered Institution for Further Education, which is—in shorthand terms—a growing, Russell-type group of the best FE providers in the country.
The Queen’s Speech mentions the lifetime skills guarantee; this comes at exactly the right time, as companies build back business as the pandemic comes to an end. The Government are right to emphasise that the system has to be realigned with the needs of employers, and a new workforce industry exchange programme will very much help to alleviate a serious problem which even our best colleges have. Let me take as an example a highly qualified automobile engineer who worked, say, until 2015 for a large car manufacturer and decided instead to lecture in further education. He or she liked the new job and became an excellent teacher. However, there is a good chance that the skills they impart today are five years old and getting more out of date each year, to the detriment of the students and the industry concerned. Some industries have first-class practical links with colleges to alleviate this; I pay tribute to the excellent partnership between Toyota and Burton and South Derbyshire College.
The new exchange programme will, therefore, be extremely important, but it is essential that three things happen to make it effective. First, it is important that as many small and medium-sized businesses as possible are encouraged to take part, as well as the large companies, which are always rather better at supporting such initiatives. These smaller firms often have skills which are in short supply and increase students’ employability. Secondly, it is crucial that this is not just a two or three-year project but that it becomes embedded for good in this country’s work practices, creating a much closer and permanent relationship between further education and the employers it serves. Thirdly, it is vital that FE teaching staff who take pains to update themselves by regularly revisiting the skills of their industries should have their professional development and experience recognised by an appropriate high-level award. By virtue of its royal charter, the Chartered Institution for Further Education is developing with a group of employers its associateship, licentiateship and fellowship this year, which will fulfil exactly that function.
We are all aware that the future will require most adults to return to learning throughout their lives to enable them to respond to an ever-changing economy. However, the state of adult education in this country is very worrying. A survey from just before the first pandemic lockdown reveals that government spending on adult learning, excluding apprenticeships, had fallen by 47% in the previous decade. In 2019, the engagement rate had fallen to a record low, with those lower down the social scale less likely to have been involved in any adult job-related training at all. These are exactly the people to whom we need to give opportunities. Many have not been in a classroom since their teenage years and are therefore often very anxious about a step back into education. From the new funds promised, we need urgently to spread the development of community learning centres, especially those linked to colleges of further education, for these can be a friendly and welcoming path back into gaining vocational skills.
I welcome the Government’s new commitment to further education, for which we have been waiting a long time. It is absolutely essential that we get this right if we are to develop here in the United Kingdom the flexible and constantly reskilled workforce that we shall need to meet the challenges of the post-Brexit commercial world.
Lord Bradley (Lab) [V]
My Lords, I first add my congratulations to the maiden speakers and wish the right reverend Prelate the Bishop of Portsmouth all the very best for his future outside the House.
In declaring my interests in the register, I am pleased to make a short contribution to this Queen’s Speech debate, with a particular focus on the legislation presented on health and especially mental health. First, the health and care Bill is underpinned by the NHS Long Term Plan, which sets out the ambition to achieve parity of esteem between physical and mental health. But despite this commitment, mental health services are struggling to meet demand, and this has been exposed and exacerbated by the pandemic. As the Royal College of Psychiatrists pointed out, there are record numbers of referrals to mental health services. The most recent figures for December 2020 show an 11% increase compared to the same time the previous year. Similarly, in parts of the north-west, calls to mental health crisis teams by children and young people have doubled during the pandemic, as BBC North West movingly reported this very week. Therefore, it is essential that the new integrated care system gives equal weight to mental health by making it a legal requirement that NHS mental health trusts sit on their boards, and that non-statutory bodies, allied health professionals—such as speech and language therapists—and the voluntary sector providing mental health and related services for people with complex needs should also have a statutory right to be on the boards of these bodies.
Further, the key policy paper, Integration and Innovation, makes it clear that the Bill will bring forward several measures to improve accountability in the system in a way that will empower organisations and give the public confidence that they are receiving the best care every time they interact with it. This is clearly welcome, but so far these measures seem extremely top down government-heavy, with an emphasis on the powers and responsibilities taken back to the Department of Health and Social Care and, specifically, to the Secretary of State. Crucially, it seems silent on how the views of the public will actually be represented on ICOs and ICSs. To ensure public confidence at a local level, their voice must be heard and have a direct role in influencing and determining the priorities in each local community, especially guaranteeing that mental health services and provision for people with learning disabilities and complex needs are given equal consideration. Again, I believe this should be explicit in the forthcoming legislation.
I turn briefly to the proposed mental health reform Bill, for which I hope the pre-legislative scrutiny of a draft Bill will be quickly brought forward by the Government. I will make two small but important initial comments on the interface between mental health and the criminal justice system. First, it is proposed that a statutory time limit is introduced for the transfer from prison to mental health settings for those requiring mental health care. I made a similar recommendation in my report in 2009 and therefore strongly support it. However, it needs to be emphasised that such transfers can be extremely problematic due to lack of appropriate beds. This can particularly affect women and lead to transfer far from home. The Government must invest quickly in appropriate, secure and specialist provision to ensure that they deliver on this statutory time limit recommendation.
Secondly, the Government have committed that by 2023-24, investment in mental health services, health-based places of safety and ambulances should allow for the removal of police cells as a place of safety. Again, it is essential that the gaps in current provision in health-based places of safety are addressed, perhaps with a specific capital allocation to honour the 2023-24 target.
I conclude by making the point that to ensure that the NHS can continue to develop as an integrated system and meet the growing demand for healthcare, particularly in mental health, sustained investment will be required, predicted to be over £100 billion over the next decade. The first test of this will be the comprehensive spending review in the autumn. It will set the direction of travel and will allow an early assessment to be made of whether the levelling-up agenda is real or just rhetoric and whether the repeated claims of the Secretary of State for Health and Social Care that this is a Government who deliver have any real substance. I look forward to further debate on these matters.
Lord Patel (CB) [V]
My Lords, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their brilliant maiden speeches and look forward to hearing more. To the right reverend Prelate the Bishop of Portsmouth I say thank you; like others, I will miss him and wish him well.
I will speak in relation to three areas mentioned in Her Majesty’s gracious Speech but will focus mostly on the health White Paper, with a brief reference to proposed legislation on education and research. The Health and Social Care Act 2012 passed into legislation despite a lack of consensus for it in the wider health service. This time there is a broader consensus, particularly in relation to a more collaborative approach to healthcare that the Bill proposes which includes local authorities, to help drive changes to benefit patients in the form of integrated care services driven locally. However, several areas will require very careful scrutiny.
These are unprecedented times for the NHS as it continues to respond to the pandemic and the worsening effect it has had on health inequalities, rising demand for services, an exhausted workforce and a huge backlog of care across acute, community and mental health services. The pandemic has shown how capable the NHS is when left to get on with the task of making rapid changes, creating partnerships and delivering world-class care. It is to be hoped that the Government produce a strategy to deal with the huge backlog in waiting lists for treatment and diagnostics before implementing any of the changes proposed in the Bill.
The proposed health Bill needs to be clear with regard to regulation, the nature of accountability, and avoiding duplication and increased bureaucracy. The proposals in the White Paper paint a picture of a very crowded field: health and care partnerships, the proposed integrated care system boards, NHS England, provider collaboratives, the commissioning groups, primary care networks, place-based working, and health and well-being boards, to mention but a few. The nature of the regulation, governance and accountability of these different bodies will need a great deal of scrutiny.
The Bill proposes sweeping powers for Ministers to direct and change at will the delivery of healthcare in 10 or more key areas. Such sweeping ministerial powers need transparent accountability to Parliament and the wider public. The House of Lords report The Long-term Sustainability of the NHS and Adult Social Care identified two key challenges facing the NHS: a clear plan to address the workforce problem and a long-term settlement to deal with adult social care, neither of which is being addressed in the White Paper. The Bill is an opportunity that should not be missed to put in legislation a long-term, costed, transparent plan for the health workforce to deliver safe, effective and high-quality care, including future projections. When it comes to the funding and delivering of adult social care, the gracious Speech said that the Government will bring forward proposals. As the health Bill is not likely to reach our House until the autumn, I hope that we will at least see a consultation document on social care by then.
I turn briefly to two other areas of legislation proposed in the gracious Speech: lifelong learning and research, including the creation of ARIA—the advanced research and invention agency. I support the Government’s plans to support further education colleges, which have long been deprived of funding. The plans in the further education White Paper, Skills for Jobs, need to guard against competition between higher education universities and further education colleges. Funding changes institutional behaviour but can also promote collaboration. For FE colleges to succeed and develop collaborations, they will need appropriate funding streams. I look forward to the debates.
Lastly, and briefly, I turn to proposals for research in life sciences and the creation of ARIA. While the Government have found the means to fund the UK’s subscription to Horizon Europe in the short term, I hope the Minister will confirm that future funding to Horizon Europe will not come from the current R&D funding. On ARIA, apart from its modest funding there are also issues of governance, independence and whether grants will be covered by the Haldane principle. There is also the issue to be explored in relation to government funding to take innovations to commercialisation. I hope the Minister will comment. I look forward to the debates.
Lord McColl of Dulwich (Con)
My Lords, first, I congratulate both maiden speakers and wish the right reverend Prelate the Bishop of Portsmouth every blessing in his retirement.
I will focus on some aspects of the Covid pandemic in particular and welcome the refreshing way in which the British electorate rejected the way in which the truth about medical aspects of the pandemic has been distorted by opposition parties, opposition scientists and opposition media.
It is accepted that the main reason for the high mortality from Covid in the UK and many other countries is population density, being a global travel hub, and having a high prevalence of obesity. Obesity impairs the immune system and makes people very susceptible to infections of all kinds, especially Covid-19. Opposition leaders in both Houses have vehemently shouted out the numbers of people dying of Covid-19, virtually accusing the Prime Minister of being responsible for thousands of Covid deaths in the UK. I refer to the House of Commons Hansard of 16 December last year at col. 264, as well as other references. They know very well that most Covid deaths are associated with population density, the obesity epidemic and being an international travel hub, so whatever possessed them to make such a terrible and deplorable mistake—or was it a mistake? The Labour shadow Minister in another place provided the answer to this question when she said, “We should use this Covid opportunity and not let a good crisis go to waste”. What a scandalous idea, to misuse the Covid crisis to further a political party.
It is of course the job of the Opposition to hold the Government to account, but it is certainly not the job of the Opposition to rubbish the Government every hour of every day with the help of the left-wing media. They had hoped that their propaganda would win over enough of the public. That is how Marxist regimes behave.
As far as the proposed Covid inquiry is concerned, will it concentrate on examining the effects on the pandemic of statements and actions by politicians, scientists and the media? That would be interesting. Will the Minister ask the usual channels to try to negotiate an end to scandalous accusations which bring Parliament into such disrepute? I hear from a sitting position that he is going to have a cup of tea.
As a doctor, I used to support aspects of the Labour Party, but I was driven away by the increasing tide of envy, hate, anti-Semitism and anti-democratic influence. It told the people that they were wrong to vote for Brexit, but the British people knew better. As a result of leaving the EU, we have achieved enormous vaccination success, unlike the rest of Europe, which has been left far behind. Our Prime Minister was so wise to appoint Kate Bingham, who deserves great credit for her outstanding success.
I was also delighted that the Prime Minister included in the Queen’s Speech his determination to continue with his campaign to reduce the obesity epidemic. Does the Minister agree that the Prime Minister should have the support of all politicians in his anti-obesity campaign to reduce the huge burden of obesity on the NHS and help to reduce the impact of future pandemics?
Baroness Bennett of Manor Castle (GP) [V]
My Lords, it is delightful to be back in your Lordships’ House after our brief break and to hear so many excellent speeches today. It is also delightful that so few of them were as partisan and inaccurate as the one that I now follow. It is particularly delightful since that break contained elections at national, regional and local levels, in which voters showed great support for the Green Party, with our candidates finishing a clear third in most mayoral races, and second in Bristol, and with 90 council seat gains, as well as eight MSPs in Holyrood. Unfortunately, however, our representation here today does not reflect those results. Respecting the topic divisions for each day’s debate, we will be putting out in the media the speeches Green Peers might have made on the days that my noble friend and I are not getting the chance to represent all those voters.
It is great to welcome the noble Baroness, Lady Blake of Leeds, who has joined our also underrepresented northern numbers today, and to echo her thoughts on the great damage done by the overconcentration of power and resources in Westminster. Changing that does not mean the Government deciding which voters will be rewarded with the occasional airdrop of pork barrels.
In my five minutes today, rather than skidding across the economy, business, health and education, asking whether Dilyn ate the oven-ready social care Bill, pointing out the fallacies of the freeport idea, welcoming the embrace of lifelong learning while echoing the concerns of the noble Baroness, Lady Morris of Yardley, about the Government deciding what people will study and adding my concerns about loading people with even more debt, I will focus on one missing Bill, under the heading of economy and business, and one grossly flawed Bill, under health.
Yesterday I joined the APPG for Future Generations hearing at which Nobel economics laureate Professor Angus Deaton demonstrated that, in the US, a four-year degree is as protective of death from Covid as vaccination. That is not because of knowledge but because of the jobs that the degree opens up. To put it another way, the poor quality, low-pay, insecurity and lack of respect that are attached to too many jobs in the UK, as in the US, are demonstrably deadly.
In the previous Queen’s Speech the country was promised an employment Bill. In 2019, the Government consulted on plans for workers to have a right to reasonable notice of their schedules and to compensation if shifts were cancelled without due notice. Plenty of Tory MPs have expressed support for the campaign group Pregnant Then Screwed, reflecting huge problems of gender discrimination in the workforce that urgently need legal redress. Rather than talking about creating good jobs, or just doing that, we need a law to ensure that every worker is in a good job, with a real living wage providing a secure income and certainty of working hours that allows planning for childcare, community commitments and life, ideally one that has a four-day working week as standard with no loss of pay. That requires legislation—the employment Bill missing in yesterday’s Speech. Many US jurisdictions have brought in fair work week laws. Just this week, Spain agreed to a law protecting delivery workers. On employment rights, as in so many other areas, we are not world-leading but are trailing the pack, even behind the United States.
I turn to one Bill that was in the Speech: the health and social care Bill. Its elevated pitch is that it is about integrating care. Who could argue with that? Well, beware buzz phrases. The direction of travel of the NHS—a direction already imposed without parliamentary scrutiny or decision—is Americanisation; the implementation of the world’s most expensive, least effective approach to health. NHS England’s chief executive told the Select Committee that the Bill will be
“a welcome recognition of where the health service will have moved to”.
I put a question to Members of your Lordships’ House particularly concerned with process: is that really how our national jewel, our NHS, is supposed to be run? Should not the law and democratic oversight come first?
What is meant by “integrated” is agonisingly clear. It is a cover for a level of funding that is less than is needed, and the centralisation of services under the cover of the need for increasing specialisation. Caroline Molloy, the editor of openDemocracy, expressed the feeling of many communities when she said:
“I get fed up with politicians telling me that I will have better care if they close my local hospital.”
I am sure the Government will not be saying it, but that is what this vision of the NHS means.
Noble Lords might notice that I have not talked about climate and nature, this not being the allocated day for it. But in the other place, and in the media, Green MP Caroline Lucas is showing more of what could and should have been in the Queen’s Speech: five Bills to allow our country and planet to thrive. As Greens, we work as a team, and I look forward to that team being much larger soon.
Lord Astor of Hever (Con) [V]
My Lords, I congratulate the Government on navigating so bravely and doggedly through the hellish coronavirus storm that we have experienced. Control of the virus has been achieved through teamwork and co-operation at local and national level between the National Health Service, Public Health England, academia and private and not-for-profit sectors of the community.
Since the start of the third lockdown in January, a combination of increased testing capacity, social distancing measures and a highly organised, speedy rollout of vaccinations has resulted in a dramatic drop in infections. This is something of which we should all be proud. Roughly one in three people had the virus without symptoms, so could be spreading the disease without knowing it. Broadening testing meant that the number of people testing positive for coronavirus at the end of April was 25 times lower than it was four months ago. The Government put in place the largest network of diagnostic testing in British history.
Regular, rapid testing has paved the way for businesses to reopen and for society to return to a quasi-normal existence. However, I understand that many of those testing companies are really struggling. By trying to squeeze out the small profits from those companies that are making travel happen, the Government will find that a lot of private testing providers will choose to cease trading due to the multiple costs involved. It is a vicious circle because then there will not be enough providers to service the number of tests needed, thereby forcing prices up. Reducing costs means reducing service and giving customers a less than adequate service, thereby causing unnecessary anxiety as to whether they will get results in time. There are lots of horror stories of people still not having results by the time they get to the airport.
Pricing for testing is a big factor for both the Government and the public in terms of ability to travel. A lot of medical devices and consumables are VAT exempt. Will the Government consider making a VAT exemption on Covid testing to help bring the price down? It is vital that testing be done properly. Home testing can be manipulated very easily, and I am told that many people run the swab under a tap to guarantee travel. As a result, many countries are now not accepting tests that have been performed by an individual at home. Other people are fraudulently changing a certificate that has previously been used by changing dates and times within the graphic software, and have got away with it. The companies doing the testing are therefore playing a vital role. It is important that we continue to support everyone involved in the struggle to minimize the impact of Covid.
Viscount Chandos (Lab) [V]
My Lords, I draw the attention of the House to my entry in the register of interests and, particularly in the light of what I intend to say on further and higher education, to my positions as a trustee of LAMDA and independent chair of the trade association, the CSA, which is also an apprenticeship provider.
I congratulate my noble friend Lady Blake of Leeds and the noble Lord, Lord Lebedev, on their excellent maiden speeches. The noble Lord referred to the late Lord Thomson of Fleet, who established the Thomson Foundation, of which I am currently the chair. That prompts me to add to the tributes paid earlier. The first rule of accepting any position is to choose one’s predecessor carefully. I had the immense good fortune to have had the noble Lord, Lord Fowler, as my predecessor at the foundation. The extraordinary work that foundation does in training journalists and developing sustainable independent media in challenging parts of the world owes so much to him.
Like other noble Lords, I welcome the Government’s stated intention in the Loyal Address to boost further education, lifelong learning and apprenticeships. Both the Economic Affairs Committee and the Committee on Intergenerational Fairness and Provision have in recent years argued for substantially increased resources for further education. While judgment has to await the details of the Bill and a better understanding of how the Government will implement their plans, the positive reception to that part of the Loyal Address is understandable.
If only, as many other noble Lords have said, the Government had also shown any sign of action on adult social care, on which the Economic Affairs Committee also published a report in July 2019. After 22 months, there has still been no government response, even though the committee pressed the Chancellor of the Exchequer when he appeared before it a year ago. It seems as if not only did the Prime Minister not have an oven-ready plan, but the hot potato of this issue is being lobbed from one arm of government to another.
Reverting briefly to education, the welcome and promised commitment to FE must not be at the expense of the higher education sector. We all owe our gradually increasing freedom in large part to the excellence of our universities. Our economic recovery is also dependent on them, as well as on the significant improvement in the provision of lifelong learning. In turn, within the higher education sector, it is simplistic and wrong to think that STEM subjects alone prepare the next generation for the workplace of the future, however important it is to maintain and enhance our universities’ provision of degrees in STEM subjects. Sir Michael Moritz, arguably the most successful technology investor of his generation, graduated in history from Oxford University. When increasing resources for STEM subjects, the Government must not impoverish the liberal arts, which continue to prepare students for successful careers in every walk of life.
My noble friend Lord Eatwell and other noble Lords have surgically exposed the poverty and inconsistency of the Government’s overall economic policies. Political commentators have suggested that the Conservatives have occupied Labour’s ground in terms of public spending commitments. In the interests of the country at large, even if that were against my party’s electoral interest, I would be delighted if that proved to be the case. However, the measures adopted by the Government in response to the pandemic do not indicate a conversion to the values and policies of the Labour Party. The noble Lord, Lord Bridges, at the same time as dissecting the Government’s paucity of imagination, still expressed unease at the level of spending needed to fund even the current policies. If there had been a truly deep change of heart on the part of the Government, how could they continue to resist maintaining the £20 increase in universal credit, at a time when our unemployment benefit is at 15% of average earnings, in contrast to the 80% of earnings that the furlough schemes provided?
Baroness Buscombe (Con) [V]
My Lords, I wish to focus on two aspects of our economy—the costs of green energy and our financial settlement with Scotland. I reference both those issues following many months of government departments announcing extraordinary public spending commitments that lack context and detail. Indeed, there is increasing alarm among taxpayers that many of those commitments have been made in addition to the phenomenal public spending on tackling the virus. According to the Economist, the UK has a balance of payments deficit of 4.2% of GDP or some £85 billion. The gracious Speech hails yet more big government and more spend, spend, spend.
With regard to green energy, while there is overwhelming support for reducing carbon emissions, there is growing public concern that the excessive costs of new green targets will further increase the UK’s balance of payments deficit. That concern could be partially met if we bring onshore and build our own green industries and the related supply infrastructure and skills for the longer term. Despite the UK having the most favourable conditions for wind-powered generation in Europe, as a result of our major investments to date, not one manufacturer of wind turbines and blades fully manufactures, rather than assembles, in the UK.
The vast majority of electric vehicles sold here are manufactured outside the UK, with the exception of the Nissan Leaf and the Mini Countryman SE. Even after £500 million of loan guarantees were provided to Jaguar Land Rover in 2019 to encourage the company to build electric vehicles in the Midlands, the company decided to postpone Midlands production and is still outsourcing production of the leading I-Pace to a Toronto-listed manufacturer in Austria.
That said, there are positive developments towards making electric vehicle batteries in the UK, and some promising electric commercial vehicle start-ups. So, rather than giving all our business orders for these green initiatives to foreign car companies that are mainly in Germany and France or wind turbine manufacturers based in Germany and Denmark, why not substantially increase public investment alongside private investment in the manufacturing, not just assembly, of all the wind turbines, batteries and electric vehicles we need for the UK market?
The gracious Speech references crucial initiatives to upskill our workforce. However, we must allow several years before we can reap the benefits for our manufacturing base. In the meantime, we lack a clear strategy for manufacturing in the UK that actually translates into increasing productivity, given that some 80% of our GDP is in services and we do not yet have a comprehensive financial services agreement with the EU. Unless we have this in place, we will cede further services jobs to the EU without ensuring enough value-added green jobs to offset this trend. Therefore, while some of our post-Brexit global trade agreements are, of course, welcome in the short term, what agreements are we putting in place now to improve our balance of payments? After all, if the Netherlands can have a balance of payments surplus, so should we.
Briefly, on Scotland, we will never buy the affection or respect of the SNP, yet each time there is a threat of a referendum for independence we give it more money and increased powers, which delivers greater political and economic advantage to Scotland. We did this following the last referendum—but why? This is no longer tenable, given that Scotland has been receiving around 130% per capita compared with England for years. Why, for example, do we continue to ignore the financial discrimination against English students studying in Scotland? Why do we not all move to Scotland for free social care? This gross imbalance has not gone unnoticed, given that it is now hard to find anyone beyond Westminster who supports the union with Scotland beyond our Armed Forces and shipbuilding presence. It is time to make it clear that if Scotland leaves the union it should be required to take on a share of the UK’s outstanding national debt, including state and public sector pensions on a per capita basis. The UK should also have security over Scottish Government assets in the event of a default—which is not unlikely given the scale of the deficits.
We can build back better if we focus on real economic growth through increased productivity, coupled with a fair apportionment of public expenditure across the UK.
Lord Davies of Oldham (Lab)
My Lords, I wish also to congratulate our two maiden speakers in this debate. We look forward to their future contributions to our deliberations. I also appreciated the contribution of the right reverend Prelate the Bishop of Portsmouth. He will know that he had a distinguished predecessor quite recently whom we all greatly admired here. We very much appreciated the right reverend Prelate’s contribution over recent years, and we hope that he enjoys his retirement.
Why do we need to look into a crystal ball when we have the record before us? The Government have a track record on economic provision in this country: a decade of austerity, after which Prime Minister Cameron and Chancellor Osborne failed to clear the public deficit to the extent that they had promised the nation over that period. It was the great target that they set for the economy, and they freely recognised that it ended in failure. The price was paid, of course. Austerity bit deeply into the very weak positions of many of our children in poverty, and we began to become the disgrace of Europe in our provision in this area.
This debate is meant to emphasise aspects of education, one of which suffered most from austerity. The further education sector suffered the deepest cut, at a time when all thinking people knew that we had to consider the issue of how to improve the skills of the nation. We must congratulate the Government, and I do, on making this dramatic change with regard to further education. Both sides of the House have emphasised this in the debate. Many very useful contributions from Conservative Peers emphasised that further education has a critical role to play—and it starts from a very weak base because of the past decade.
Another public service also displayed just what austerity had cost. A decade of a Conservative Government looking after the health service meant that our medical staff were ill equipped with protective equipment when they came to tackle the epidemic. Of course, we all recognise that the epidemic produced demands on the Government that were very difficult to respond to and that there were areas of achievement. There were also areas of conspicuous failure. There is no doubt that the health service was in a weaker position than it ought to have been in when the epidemic broke.
We also need to recognise that the Government’s other great priority was distinguished by the fact that the noble Lord, Lord O’Neill, came to our House as a Minister for a period of time. I was very grateful to have the opportunity to debate issues with him. He was there to ensure that the Government’s objective of improving Britain’s productivity was realised. But it was not, was it? It was a conspicuous failure. Britain has been near the bottom of the G7 group of countries for productivity over the last decade. So let the Government not think that we do not identify areas where there are real weaknesses and where they will have to not just indicate that they are prepared to invest but actually produce the right investment in the right places.
It is certainly the case that the Government have produced a shop window of possibilities. The Queen’s Speech is, of course, not an economic debate but an outline of the Government’s proposals—but large numbers of those proposals have an impact on the economy and nearly all of them will cost a few pence. We will all be very interested when the prices are put on this level of investment in the economic development that the Chancellor will produce in a few months’ time.
It is certainly the case that the Government are already shying away from some tough decisions. They do not offer any commitment to deal with tax havens, which Europe is prepared to move on and we are not; nor do they indicate that they are prepared to tax the very big American companies that pursue tax-free trading. It is a challenge that the Government have to face. Their first challenge will come very soon, and this House will be keeping a wary eye on them.
The Deputy Speaker (Lord Duncan of Springbank) (Con)
The next speaker is Viscount Bridgeman. Viscount Bridgeman? We will move on to Baroness Walmsley.
Baroness Walmsley (LD) [V]
My Lords, the gracious Speech made a very brief mention of the Government’s intentions on health and care, but the recent White Paper was a little more helpful. Today I ask: why this and why now? There are three key reasons why I would rather have seen a draft Bill for consultation than the immediate introduction of the forthcoming health and care Bill.
First, to integrate health and care, desirable although that is, without previously carrying out the long-awaited reform of social care is partial and unwise. It is like refurbishing one wheel of a bicycle while the other wheel is bent and rusty. For years, we have had a social care crisis. Provision is fragmented between public, private and third-sector providers, which makes consistency of standards and access to information difficult. It has been chronically underfunded for years, which makes for a lack of confidence on the part of both those who invest in it and those who need its services. Meanwhile, self-funders overpay to cover the shortfall in fees from cash-strapped local councils. This is unfair.
Worst of all, because many settings have closed, there are fewer services available for those who need them. Those who may need services in future fear, as the noble Lord, Lord Rooker, put it—yes, really fear—what might happen to them, especially if they get dementia. About a million older or disabled people are already unable to get all the support they need. There have been many opportunities to work cross-party to correct this, sort out the funding and give a decent living wage to those who work in social care, but successive Governments have failed to grasp that nettle. In the gracious Speech, we were given nothing more than another promise to deliver what the Prime Minister told us two years ago was a ready plan.
Secondly, a Bill that plans to reform a health and care system that is struggling to recover from a pandemic, without considering what state it is in and what lessons can be learned, is precipitate. One of the biggest issues, as I see it, is the staff. They are stressed and exhausted, yet they face an uphill struggle to deal with the backlog of treatment needs. The number of people now waiting more than a year for treatment has risen from 1,600 before the pandemic to almost 390,000. I welcome the recent NHS announcement of upfront money for a few integrated care services that present a cogent plan to increase their elective treatments to 120% of pre-Covid levels. This will help a few ICSs, but it is not universal.
We started this pandemic with too few beds, too few doctors and too few nurses, and no more than a five-year staffing plan for the NHS. No wonder the staff struggled. Today, on International Nurses Day, I welcome the record number of students joining the nursing profession and those returning, but we now need an independent 10-year staffing plan for NHS and social care. Will the Minister please consider the necessity for that?
Thirdly, we have a crisis in mental health. Demand was not being met before the pandemic; there were long waiting lists, especially for young people. Because of the pandemic, the situation is now much worse. I hope that, when deciding on the policy to reform and fairly fund social care, the Government will consult the sector, users and across parties.
Implementation is another challenge, but here I think we have a good example. People have rightly praised the vaccine rollout. The Vaccine Taskforce and the thousands of NHS workers and volunteers who have delivered the vaccines so brilliantly invented by Oxford University and other scientists have done a wonderful job. I believe the vaccine rollout has been a success because of two things from which we can learn: mission focus and a “whatever it takes and whatever it costs” attitude from government. That focus and that investment are needed to sort out the three crises of social care, mental health and the waiting lists. It will be cost-effective in the end, because it will reduce the pressure on acute hospitals. We need this before we try to implement the reforms in the Bill, many of which I would probably happily support at the right time. I ask the Minister whether the Government will withdraw the Bill for consultation and bring it back when they have sorted out the crises in social care, mental health and NHS and social care staffing.
Lord Aberdare (CB)
My Lords, I shall speak about the skills and post-16 education Bill, and briefly on the building safety Bill. The skills Bill will legislate for a number of important and valuable initiatives outlined in January’s Skills for Jobs White Paper, such as putting employers at the heart of post-16 skills, including through local skills improvement plans, creating a lifetime skills guarantee and a lifelong loan entitlement, and providing greater support for further education. These are welcome extensions of existing policies on apprenticeships, T-levels, careers education and guidance and the Kickstart programme, which seems to get less attention than it should.
What really matters, as we have seen from the vaccination programme, is the actual delivery—whether all these initiatives succeed in delivering the right skills at the right time in the right places and to the right people, especially for young people seeking to enter the jobs market at this challenging time. An overarching skills strategy is needed to ensure they complement and reinforce each other, rather than creating a complex and confusing tangle of options through which those seeking new skills, upskilling or reskilling struggle to find a suitable route.
First, there need to be clear, flexible and well-defined pathways allowing learners to follow different routes according to their interests and abilities, with options to combine academic and technical elements and to include short, modular courses where appropriate. A well-resourced, well-qualified cadre of professional careers advisers will be essential to help individuals to identify and navigate the best pathways for them, and needs to be part of the strategy. Why could there not be a UCAS-like online service providing information about the whole range of technical and vocational training available and how to access it?
Secondly, the apprenticeships levy should be made more flexible. A significant proportion of levy funds is apparently going unspent. As part of an overall skills strategy, the scope of the levy could be broadened to cover a wider range of much-needed skills training activities —a skills levy, rather than just an apprenticeships levy.
Thirdly, much more needs to be done to promote the Skills for Jobs strategy, especially to three groups: parents, who are often the most important careers advisers; schools and teachers still not aware enough of the technical options available and, as we have heard, not complying enough with the Baker clause; and employers, large and small, who play such a crucial part and are among the greatest beneficiaries of a better skilled workforce.
SMEs need more specific help to play their part in skills training. They are particularly subject to the vagaries of cash flow and depend heavily on being paid for their work promptly and in full. Without that, their ability to invest, including in training, work experience and apprenticeships, is threatened—as, indeed, sometimes, is their very survival.
The practice of retentions in the construction sector, whereby larger contractors withhold a proportion of payments owed to their, usually smaller, subcontractors—ostensibly as insurance against possible defects in their work, but often it is an unreasonable sum or for an unreasonable period—is damaging to the performance and quality of the construction sector as a whole. Dame Judith Hackitt’s report following the Grenfell Tower tragedy, which the building safety Bill aims to implement, states:
“Payment terms within contracts (for example, retentions) can drive poor behaviours, by putting financial strain into the supply chain. For example non-payment of invoices and consequent cash flow issues can cause subcontractors to substitute materials purely on price rather than value for money or suitability for purpose.”
The Government have been promising for some years now to address the issue of retentions, on which there has been numerous consultations and reports but no action. In fact, I find myself sitting next to the noble Baroness, Lady Neville-Rolfe, who committed to provide one of those reports during the passage of the Enterprise Bill in 2015. It is high time for the Government to act, and I hope that the building safety Bill will prove to offer the legislative vehicle that is needed.
Baroness Blower (Lab)
My Lords, I congratulate my noble friend Lady Blake on her excellent speech and the noble Lord, Lord Lebedev, on an interesting one. I add my good wishes to the right reverend Prelate the Bishop of Portsmouth as he leaves this House.
I echo others in regretting the absence of proposals on social care and workers’ rights from the gracious Speech, both urgent issues to which this Government need to turn their attention. I am pleased that the Government have turned their attention to education and talked of an ambitious and long-term package of measures to ensure that pupils have the chance to make up their learning over the course of the Parliament. Sustainable recovery may take some time. I endorse the remarks of my noble friend Lady Morris, who highlighted the absence of detail about this package.
To date the Government have, I believe, set aside only £250 per pupil, according to the Education Policy Institute. This compares rather poorly with proposed investment in the Netherlands of £2,500 or the United States of £1,600, for example. It must be borne in mind, too, that schools, already underfunded before the pandemic, have had to bear significant costs over this period, with the result that many may face financial difficulties and possible cuts to staffing. This is not a desirable situation, as children need more attention and smaller classes.
Your Lordships’ House has debated the issue of remote learning and the difficulties some families—including perhaps as many as 1.7 million children—have faced due to their lack of hardware and access to broadband. There is an acknowledgement that online learning of this kind may continue to have some place after the pandemic so this digital divide needs to be addressed, as do questions on the appropriateness of the curriculum and, in particular, the place of oracy within it.
A recent report carried out for the Oracy All-Party Parliamentary Group found:
“The absence of oracy education hampers children and young people’s long-term opportunities and capabilities”.
Teachers, employers and young people themselves recognise that oracy skills support young people’s transition into further and higher education and into employment—as they do, of course, during earlier stages in education. During the pandemic, many children have missed out on language development. Two-thirds of primary and nearly half of secondary teachers say that during the period of school closures, their negative effect was noticed on the spoken language development of students eligible for the pupil premium, compared with advantaged pupils. Against this background, and in line with levelling up, will the Government reconsider the change to the pupil premium census dates, which I understand will take £150 million out of school budgets for the most disadvantaged pupils?
Many pupils have missed out on language development but they have also missed out on learning collaboratively, and on opportunities to participate in physical, practical, cultural and creative activities. Catch-up should not just be about literacy, numeracy and the academic curriculum. The gap between the advantaged and the disadvantaged has widened and it must be narrowed by a focus on reducing, and ultimately eradicating in short order, child and family poverty.
I want to say a word about the summer break. First, we must ensure that no children go hungry but, secondly, if local authorities are properly resourced they can provide excellent programmes so that children, especially those from disadvantaged backgrounds, can enjoy an exciting and fulfilling time engaging in sporting, recreational, cultural and creative activities, and regaining some of their childhood, which, as an earlier speaker said, has perhaps been lost in lockdown. A contribution to this might well be engagement with the Reading Agency’s Summer Reading Challenge. This is not about phonics and testing; it is an opportunity for children and young people to enjoy reading for pleasure, so that children can begin to develop those skills which will take them into adulthood with reading as a pleasurable activity. I look forward to engaging in further debate on this issue.
Lord Choudrey (Con) [V]
My Lords, I thank the noble and noble and learned Lords before me for their contributions. I refer your Lordships to my entry in the register of interests.
Her Majesty’s gracious Address to your Lordships’ House set out the Government’s priorities for supporting local communities and building a fairer, stronger economy for the future. Although the Covid pandemic has had a profound impact on our economy, our robust vaccine programme continues to improve the economic outlook for 2021, with independent forecasters expecting the economy to grow by 5.7% during the current year.
I would like to showcase the success of our local pharmaceutical industry, a sector of the economy that has benefited from the Government’s investment in research and development, financial incentives and encouragement. In the initial days of the pandemic, in December 2019, the Government provided a grant of £20 million to the University of Oxford. This research grant helped spur innovation and research into the Covid virus, which in turn led to the development of the Covid vaccines. Such timely measures, coupled with long-term investment in manufacturing capacity by successive Conservative Governments, meant that by the time the vaccine was approved the manufacturing infrastructure was already in place and could be scaled up quickly, which resulted in three vaccines being made domestically, giving ready access to much-needed and timely supplies. This has led to the development of a world-renowned pharmaceutical industry—an industry that is today the envy of the world and an example of the brand “Global Britannia”.
The success of the pharmaceutical industry highlights the case of the Government, the private sector and academia working together in partnership to create an enabling environment. The Government’s desire to reinforce this by legislating for the establishment of the advanced research and invention agency is a welcome step; I fully endorse the record investment which the Conservative Government are putting into R&D.
Complementing the good work of our pharmaceutical industry are our community pharmacists. In the immediate aftermath of the pandemic, pharmacies played a key role in reducing the burden on our NHS by meeting the urgent care needs of local communities. As GPs closed their surgeries, pharmacists became the only primary healthcare professionals who patients could see in person. I endorse the call of the Company Chemists’ Association and urge the Government to use the legislation announced in the Queen’s Speech to fully integrate community pharmacies into the emerging health and social care landscape. By embedding our local community pharmacies within the NHS, we can extract multiple benefits for patients and practitioners. It is vital that as we come out of the pandemic, these capabilities are recognised and embedded within the NHS.
According to the British Medical Association, the shutdown of most non-Covid services in the first wave, combined with drastic changes in patient behaviour, means that the NHS is now facing a large backlog of non-Covid care, storing up greater problems for the future. The BMA estimates that, between April 2020 and February 2021, there were 3.25 million fewer elective procedures and 20 million fewer outpatient attendances.
According to the Pharmaceutical Services Negotiating Committee, community pharmacists dispense over 1 billion prescription items every year and deliver 48 million healthcare advice consultations a year. To put that in context, this saves nearly 500,000 million GP appointments and 57,000 A&E visits every week. According to Royal Pharmaceutical Society research, the cost of treating a patient for a minor ailment, such as a cough or sore throat, is £29 in a community pharmacy, but nearly three times higher, at £82, if the same patient is seen by a GP, and nearly five times higher, at £147, in a hospital A&E department. The statistics speak for themselves; your Lordships would surely agree that community pharmacies offer good value for money and play a vital and integral role in delivering NHS services to the local community. I therefore recommend to the Government that they transfer more NHS services to community pharmacies where they have already demonstrated their capabilities, through flu jabs and Covid vaccination. This will free up NHS and GP capacity and help them to tackle the backlog of outstanding non-Covid care procedures and consultations.
As a trustee of multiple community charities, I whole- heartedly welcome the changes—
Baroness Penn (Con)
The noble Lord may want to take note of the advisory time limit of five minutes for Back-Bench contributions.
Lord Haskel (Lab) [V]
My Lords, I too welcome the maiden speeches and say farewell to the right reverend Prelate.
In thanking Her Majesty for the gracious Speech, I have to say that it consists of an unco-ordinated mixture of ideas—some good and some bad, but with no clear, integrated plan to deal with the problems resulting from the pandemic. Nor does it say how change will be delivered; it just gives the impression of government by announcement. Indeed, there are conflicting proposals. For instance, there is a Bill to increase the housing stock while leaving in place financial incentives which we know have the effect of raising house prices, making the new homes less affordable, an effect that entrenches and enlarges the existing inequalities, stimulates a housing bubble and encourages speculation—exactly the wrong sort of growth.
What is required is a comprehensive strategy to address the challenges set by the pandemic and the causes of inequality such as low productivity, low investment and skill shortages. Yes, there is an industry strategy challenge fund but, as the Public Accounts Committee pointed out, it is too focused on inputs, ticking boxes and distributing funds rather than on outcomes. This can be rectified by reinstating the industrial strategy board to monitor and measure the progress of a strategy and measure what we have achieved year on year; to achieve our long-term objectives, that is what we will have to do. Without it, the Government are marking their own homework yet again.
The speech offers free ports with special low-tax zones, but experience has shown that all they do is shift jobs and investment around the country, rather than generating high-value new business. We should remember that exports from free ports to the EU and many other markets are restricted, and this kind of activity does little for skills training, raising productivity or increasing our R&D expenditure up to the government target. The share of national income paid out in wages, salaries and benefits has been in steady decline, while the returns on capital investment have been steadily increasing. An industrial strategy should even this out and, together with an employment Bill, that would make the outcome much more equitable.
An important part of our industrial strategy would seek to develop our own domestic industry but, where this is unfeasible, our strategy should prioritise co-operation with our allies. This means that we must seek equivalence and mutual recognition of standards, particularly in services, technology and manufacturing. This will make it easier for overseas and European firms to invest in UK industry and for UK industry to become integrated in their supply chains.
A special part of our strategy must be our concern for the young. Job insecurity is a common complaint among young people, a complaint caused by temporary contracts, agency work, zero-hour contracts and a lack of training. The training Bill is welcome, but will be less effective unless the apprenticeship levy is sorted out and an employment Bill accompanies it.
It is easy to make plans and mark them yourself, especially when the Institute for Fiscal Studies warns that current plans show an 8% cut in most departments, while NHS spending needs a big rise. Yes, some elements of this strategy appear in parts of the gracious Speech, but it needs to be drawn together. Will the Government create a strategy that we can all unite behind and will make progress instead of sliding back to where we were?
Lord Razzall (LD) [V]
My Lords, it is no surprise that there are a number of key omissions from the gracious Speech. We all have our favourites. First, where are the detailed proposals to level up? The Tories won the election in 2019 and did well last week because the electorate believed that they had a plan to turn this slogan into action. Why do we have to wait until later this year to discover what that plan is?
Secondly, as other Members have said, why have the Government’s proposals for social care been reduced to one sentence?
“Proposals on social care … will be brought forward”,
the speech says. We have been many times through the history of the majority Tory Government since 2015, ducking the implementation of the Dilnot recommendations from 2009. As other speakers reminded us, the Prime Minister said in 2019 that he had a detailed plan for social care. Where is it? Is it that he is frightened by the reaction to Theresa May’s proposals in the 2017 election campaign?
Thirdly, there is no reference to what steps will be taken to ameliorate the effect of Brexit. Where are the sunlit uplands promised in the referendum campaign? Both the Bank of England and the OBR expect negative long-term effects on the UK economy from the trade deal signed with the EU; the Bank estimates that, in the long term, UK trade will be 10.5% lower and GDP and productivity 3.25% lower than with frictionless trade. Of course, it is SMEs who are the worst hit.
I have given examples in the past of businesses seriously damaged by the effect of the trade deal, such as the SME selling second-hand combine harvesters, which has to pay inspectors to produce complex certificates for the machines, causing significant cost and delay. There is also the bike manufacturer struggling to cope with different VAT regimes across 27 countries; the Scotch whisky producers with labelling requirements that often require small companies to set up a distribution company in Europe, significantly reducing profit; and the Nottingham company—it makes synthetic hairpieces for cancer patients—whose essential just-in-time supply chain in Germany has now collapsed. These examples are not indicative of the teething troubles that the Government talk about. They are examples of real damage that Brexit has done to many SMEs without any apparent economic advantage.
As the noble Lord, Lord Bridges, told us, the major omission from the gracious Speech is any reference to a credible fiscal framework to ensure the smooth reduction of the gigantic government debt, now in excess of £2 trillion, albeit with a significant proportion held by the Bank of England. A recent report from the National Institute of Economic and Social Research, funded by the Nuffield Foundation, with participation from the noble Lord, Lord Lamont, and Lord Darling, has five key recommendations. First, the date of fiscal events such as the Budget should be fixed well in advance, not decided on the whim of the Government, and should be subject to greater parliamentary scrutiny. Secondly, the OBR should publish reports ahead of these events, addressing key issues and numbers, not just giving them privately to the Treasury. Thirdly, the Chancellor should outline fundamental fiscal choices under different scenarios to be assessed by the OBR—
The Deputy Speaker (Lord Alderdice) (LD)
We will move on as the noble Lord has lost his connection. I call the noble Lord, Lord Lucas.
Lord Lucas (Con) [V]
My Lords, I congratulate the Government on the gracious Speech and am proud to be a supporter of a Government in such good form. I have two suggestions for advantages that we might take from the disruption that we have all suffered through Covid.
First, we should keep and build on the online verification of the right to work. This has been a great success for the Home Office’s Covid response. It works well, there are no known systemic problems and it promises substantial advantages to the Home Office over time. It enables employers to professionalise online verification, locate it centrally, support their own skills development, and securely recognise unusual documents. Also, the potential to integrate with other information systems will further increase security performance. It has been a great success for the Home Office and for building back better. Employers can hire remote workers easily, which supports the move to working from home and makes lots more jobs available in unemployment black spots. The process is faster and more secure. There is no posting of passports around the UK, much less vulnerability to fraud, and costs are much lower. Employers reckon that there has been a 75% reduction in costs compared with the previous manual system.
What is the Home Office doing to build on this great success? It is terminating it, except with EU nationals who have the right to remain; they will now be much cheaper to employ than us Brits. This is a daft decision, to do so well and have nothing significant go wrong, to offer so much to the building back better agenda, and then to junk it because the department is frightened of its own shadow. Ministers in the Home Office and in the departments whose interests will be damaged need urgently to intervene. I have hope. The Home Office announced today that the turn-off will be postponed from next Monday until 21 June. There is now time for it to change its mind.
My second suggestion is that we should take advantage of the mess that the pandemic has made of exams and assessment, to build back better. The grading system we currently use has a broad inherent spectrum of error. The comparative outcomes application of that grading system to maths and English GCSE creates hurdles that must be leapt to qualify for further education and exciting employment. It demands in its structure that 40% of our children should be branded as failures.
We know how to do better. We can move away from grades to rank order, as used in Switzerland. We can adopt the comparative assessment strategy championed by Daisy Christodoulou, which is so well adapted to an online world. It has the great virtue of easily incorporating previous examinations and so lends itself to the maintenance of standards. Most of all, we can move to criterion-referenced assessments for whatever hurdles we feel the need for.
We already use this system on a large scale to verify that overseas candidates have sufficient command of English to benefit from their university courses and for such systems as the TEFL qualifications. In these applications, criterion referencing works very well. Iceland uses criterion-referenced termly reading-age tests to great acclaim from its teachers and unions. The trick to making criterion referencing work is to keep the assessment focused. If you try to use it on a broad front, it becomes impossibly complicated.
We need hurdles for maths and English because we want employers and educators to know that candidates have the basic level of skills they need. This is a criterion-referencing task. Let us establish what is needed to demonstrate the level of competence that we—that is, us and especially employers—want everyone to have to succeed in life. Let us make a short, simple specification of it and create criterion-referenced tests to examine it.
That would build into our system a drive for us to achieve a 95% success rate in equipping our young people for the world. That is absolutely what we should be aiming for. We should not, as we do now, have a system that requires us to accept that 40% of our children are failures. The pandemic has loosened the chains of precedent and caution. Let us not put them back on again until we first make sure that they fit.
Baroness Bryan of Partick (Lab) [V]
My Lords, I would like to speak to an issue that crosses two areas in today’s discussion: health and business. The pharmaceutical industry has for decades been problematic even for the most dedicated supporter of capitalism. It is heavily dependent on public spending as it is often assisted by government funding to develop vaccines and medicines and then, once these become available, it needs government spending to buy them. Across the developed world, big pharma has produced life-saving vaccines and medicines, but at times some companies have put profits before safety.
The reputation of big pharma companies is probably higher now than it has been for decades. Their ability to produce several successful vaccines during the Covid pandemic has been remarkable, but their attitude to sharing information and spreading the production across the globe has not developed at the same speed. The case for temporarily suspending intellectual property rights for coronavirus vaccines has growing support, including from Pope Francis and President Biden. While this issue was not mentioned in the gracious Speech, we must hope that the UK Government will pursue this policy.
However much rhetoric there is about making the vaccine available worldwide, the vast majority of stock continues to be hoarded in wealthy countries. They are retaining far more than they can possibly use. COVAX aimed to vaccinate all high-risk people and health workers everywhere, rich and poor equally, during 2021. But better-off nations have gone beyond vaccinating people at high risk and are now determined to vaccinate their entire populations, leaving COVAX struggling to reach only 20% of the most vulnerable during 2021.
The important lesson from this pandemic is that poorer countries cannot rely on the largesse of richer ones; for the future they need their own vaccine capacity. They need access to raw materials and technology, and the waiver of intellectual property rights. We know the well-rehearsed arguments against waiver. First, it is bad for innovation; companies must retain intellectual property rights because without monopolies there would be no incentives. We should remember that it is scientists who develop vaccines, not businesspeople. In the US, $112 billion of public money was spent on Covid vaccine development. In the UK, at least 97% of the funding for the development of the Oxford/AstraZeneca vaccine came from taxpayers or charitable trusts: less than 2% came from private industry. The Prime Minister is in danger of believing one of his own myths if he thinks that the fast development of Covid vaccines was because of capitalism.
The second concern is about quality assurance. This was a common argument during the early days of AIDS treatments that was proved wrong. The technology and knowhow exist and can be further developed, particularly as Covid and its variations will not disappear any time soon, and other epidemics will follow.
Increased capacity across the globe would allow scientists and technicians to target the health issues that are of immediate importance in the developing world, rather than prioritising illnesses prevalent in more developed countries. Cuba is an example of how innovation can be driven by something other than profit. It is a global leader in the South-South transfer of technology, helping low-income countries develop their own domestic biotech capabilities, providing technical training, and facilitating access to low-cost, life-saving medicines. This model puts health before profits and is one where greed is not the driving factor. It should be the example that the developed world follows.
Baroness Cumberlege (Con)
My Lords, we are fighting the first Covid world war and we hope that Britain is emerging victorious and ready to help liberate the rest of the world. What is so uplifting is that we are emerging bursting with ideas for our future innovation, invention and investment—and that is our future. The huge debt that we have accumulated must not crush our aspirations. We should all, with a deal of compulsion, contribute to a massive war loan: a government bond which will not be popular and which we will all hate and object to, redeemable at some time, as were other war loans, but paid by our generation, not left to the next and the next.
I declare an interest: for 50 years I, with many others, have sought and achieved sweeping changes to the delivery of healthcare to people, and I am determined to continue that progress. We have proven that, in the Covid war, we can act and achieve at an exhilarating speed. That momentum must not now be thwarted by debt, as we build a new economy for the post-Covid war era. We can infuse energy into our people and approve new products and better ways of delivering that will not just benefit Britain but reach worldwide.
It may seem a small thing, but I note that a report from a review that I chaired on the harm done to women and children has, in modern parlance, gone viral worldwide. Setting new standards for childbirth is ongoing; it is not trivial but part of a revolution sweeping the world. We must not scoff at doing these small things, leaving our world a better place for future generations: that is our mission, and no debt, unnecessary bureaucracy or lack of investment must stand in the way.
I know that many noble Lords have delivered reports to the Government. Civil servants take them in hand; their job is to be cautious and consult widely and wisely with every party that might have an interest—to give due consideration to all facets of the problem. With the vast changes and challenges of Brexit, overlaid with Covid, and a Government who promise to deliver now, for the sake of the country, we must from time to time throw caution to the wind and act decisively in order to win. This year marks the 220th anniversary of the Battle of Copenhagen, when Admiral Lord Nelson put his telescope to his blind eye. There really is a lesson for all of us there.
Baroness Lawrence of Clarendon (Lab) [V]
I congratulate the two maiden speakers and the right reverend Prelate the Bishop of Portsmouth on his retirement. I bring the House’s attention to my interests in the register.
There have been loads of speeches today, and I congratulate all those noble Lords who made them. I always see myself as somebody who has come to this House without the experience of the majority of noble Lords here. As I sit here listening to the speeches today, I note that much has been said about the Government and the lack of impact within the Queen’s Speech.
In the last 12 months and more, the country has been in the worst pandemic it has seen since the Second World War. The gracious Speech of the Government was short of impact in addressing the Covid-19 disease, which has taken so many lives. I understand that, in the gracious Speech, the Government needed to address the overall health and care of the nation—but, on issues such as the pandemic, I would have expected there to be mention of an inquiry into the loss of so many lives and the disproportionate impact that it has had on certain ethnic groups.
The disproportionality in the deaths is caused by the structural racism that has existed in the NHS for decades. Moving forward, this will need to be addressed by a public inquiry, which would lay it bare to the nation for all to see. I know that yesterday the Prime Minister did mention in the House of Commons that there will be an inquiry. Not much was said about the date this would take place—no date was mentioned. The Government may not want to look back, but by doing so they will help to prepare for future generations.
On the issue of the take-up of the vaccine, there is a background reason for the vaccine hesitancy in the black, Asian and minority ethnic group. Its mistrust of vaccinations is historic, and the Government need to do more to reassure people from this group that the vaccine is safe and will save lives—and they must not, like before, blame this group for spreading the virus.
The percentages for take-up of the vaccine are 98% for white British, 71% for Indian, 87% for Bangladeshi, 71% for black African and 67% for black Caribbean. The take-up has increased. I believe the local community is best placed to support the Government in going forward with the vaccine rollout.
The work of NHS nurses and doctors, before and during the pandemic, is to be commended, as is their dedication and commitment to the profession. I finish by thanking the scientists for their sterling work in developing the vaccine, which has saved lives and given us a future, so that we can move forward.
Lord Smith of Hindhead (Con)
My Lords, I am grateful for the opportunity to speak in this debate on Her Majesty’s gracious Speech. I will limit my comments to hospitality and, in so doing, ask your Lordships’ House to note my register of interests.
I welcome Her Majesty’s Government’s focus on support for business. I commend and thank them for what has already been put in place to support the hospitality industry, which is particularly poignant considering the challenging times during which these decisions were made. The Government’s quick thinking and implementation of schemes such as the 2020 lockdown grants, the subsequent tier grants for closure and the current reopening grants—not to mention the furlough and Eat Out to Help Out schemes—have all made this past year just about manageable for a significant part of the hospitality industry.
Together with business rates relief and the reduction of VAT to 5% as applied to goods and services in the hospitality, accommodation and attractions sector, the Chancellor has created a safety net that has been vital in supporting an industry which, pre Covid, was the third-largest private sector employer. Over 3 million jobs were directly supported through UKHospitality—some 9% of all UK employees.
However, in spite of this support, many establishments are in rent and loan debt, and are unable to contemplate the costs of reopening or bringing back staff post furlough. While I very much welcome the announcement that the reduction of VAT to 5% will continue until September this year, and thereafter will be at a transitional rate of 12.5% until March 2022, the hospitality industry would benefit hugely from the 5% rate being extended to April 2023, where significant savings could be made for the industry and consumers. This would be a lifeline to all sorts of businesses across the country, from pubs to restaurants and hotels to cinemas, providing breathing space for the sector to fully recover, saving businesses and jobs, and allowing the economy to bounce back faster.
A society which socialises together is a stronger and healthier society. The UK’s pubs, clubs, bars and restaurants put that into practice every day. Hospitality has always provided social cohesion, but it is also an industry which brings so many people of different backgrounds and abilities together as a workforce, which benefits the UK on many different levels. I hope my noble friend the Minister will consider this suggestion.
Lord Adebowale (CB)
My Lords, in commenting on the gracious Speech, I will limit my remarks to matters relating to health and social care and the proposed Bill that will come before this House in due course. I declare my interest as chair of the NHS Confederation, which represents the leaders in health and social care across the country—the people who will be running the integrated care systems, the primary care networks, the acute trusts, the mental health trusts and the community trusts. It was in talking to my members that these remarks were formulated.
There is general welcome for the direction of the proposed health and social care Bill. The principles that have been set out in the gracious Speech in reference to this Bill—the notion of population health and of reducing both the inequality and the inequity gap that currently exist in our health and social care provision—are most welcome. It cannot be right that the active life expectancy—the expectancy of when your body and functions will start to break down—of a woman in Barking and Dagenham is 55 but in Richmond upon Thames is over 70. We must address that; it is both immoral and a poor use of public money.
My colleagues in the confederation welcome this Bill generally. However, given the warm words, there are four things that I wish to draw the House’s attention to, in the hope that, when the Bill comes to the House, we can take a deep dive into these issues to improve it and ensure that the intentions in the Bill are brought to fruition. I will say a bit about each of the issues, which are: the powers of the Secretary of State; the time for scrutiny; inclusion, about which I might not say what noble Lords think I will; and social care.
The first issue is the powers of the Secretary of State, which appear to be increased in their presence in the Bill and which are comprehensive in their ability to intervene in a way that flies in the face of the very principles of local flexibility that are required to improve health outcomes and address the health inequalities that we all want to resolve. The fact of the matter is that statutory allowances and accountability to Ministers in the current framework allow for many of the issues that need to be resolved in the reconfiguration of health and social care to be dealt with locally, and we cannot understand how the powers of the Secretary of State will add any value. There is indeed a risk that such powers will undermine the very intentions of the Bill, and that the priorities and powers of the statutory integrated care systems will be undermined by central intervention, especially where these interventions are on service changes that those very ICSs should be making. We have one of the most centralised health systems in the world, and we would urge Ministers not to legislate to further centralise it. In short, let local leaders lead.
Let us be clear about the interventions from the Department of Health and Social Care, NHS England and NHS Improvement. These interventions should be only when strictly necessary, and we should have transparency around how they occur. It would be useful to understand, perhaps through examples, where and when the Department of Health and Social Care or the Secretary of State believe intervention might be necessary. Just to be clear, we currently have independent reconfiguration panels that, following local authority referral, provide clear mechanisms for resolving disputes around local service reconfigurations. Let us have some clarity around the Secretary of State’s interventions. A requirement to make a public direction in writing, with a public interest test, might be something that the House wishes to discuss.
There is also some confusion around appointments to the powerful bodies that will be in the new health and social care structures. The Secretary of State will, I am sure, want to avoid these key posts being in any way politicised, and to confirm that local NHS organisations already have clear processes for the appointment of senior leaders, supported by good governance and, of course, the Nolan principles. Within the new powers, the Secretary of State can change the breadth of the powers of the arm’s-length bodies. I accept that the Secretary of State may need to change these powers, but we need to do so with transparency and with clear explanation, not through secondary legislation. Surely they should be discussed in this place and the other place.
The second point is about time. While the Bill is generally welcome, it needs sufficient parliamentary scrutiny. Judging by the number of emails I have had from the public, this Bill is of great public interest and should be given proper scrutiny. The time given for ICSs to be ready—by April 2022—is incredibly tight. There is understandable concern about aligning boundaries with uppity local authorities, for instance. According to clinical commissioning group leaders, given the time allowed, we would need to start appointing critical executive positions in these new bodies in September 2021.
Thirdly, on inclusion, it is critical that we include the voluntary community and social enterprise sector in the new structures, as 38% of community services are delivered by the social enterprises and the voluntary sector.
Fourthly and finally, I echo the concern and disappointment expressed at the total lack of mention of social care restructuring. We will shackle the future of the NHS and the great hopes for this Bill that are held across the health and social care sector unless we reform and properly fund social care. We need to do so in order to pay tribute to the leadership and hard work of my colleagues across the NHS and social care system. Let us not shackle this Bill; let us free it to do what the public and my colleagues want it to do.
Baroness Ritchie of Downpatrick (Non-Afl) [V]
My Lords, I congratulate the two new Members who have made their maiden speeches today and offer my best wishes to the right reverend Prelate the Bishop of Portsmouth on his retirement.
I welcome the opportunity to speak in this debate on the gracious Address. I would like to concentrate on healthcare, the economy and employment and to point out what I feel the Government should be addressing and have omitted to do. I believe that the focus must be on the needs of people who have been battered by the pandemic, which has exposed the weaknesses in our health and social care services and our economic structures.
It is important that the UK has a strategy for rebuilding the NHS, the social care sector, our economy and our high streets, through a revitalisation programme, and for an employment framework. All these require an integrated strategy focused on the needs of communities coming out of the Covid-19 pandemic. It is regrettable that the Government have not brought forward concrete proposals for health and social care in the gracious Address. As the TUC said yesterday:
“The cost of inaction is failing those who rely on the care system and those who work within it.”
One area where the Government have failed is dementia care. They need to look at that again because there are rising levels of need for dementia care and it became much more acute during the pandemic. That sector requires certain investment in terms of social care provision. Imaginative ideas about how we fund elderly care in general and dementia care specifically are required as the numbers continue to grow year on year. The gracious Address indicates that proposals for social care reform will be brought forward. Will the Minister indicate when that legislation will be forthcoming and what the Government’s thinking is regarding content? Will they ensure that our weakest people are properly protected in a timely way? What steps will be taken to ensure that there is an urgent and long-term boost in funding if we are to deliver a resilient and fully integrated health and social care system?
As other noble Lords have said, the gracious Address does not include any references to an employment Bill. To build back better from the combination of this pandemic and Brexit, we need to see improved pay and conditions of work. In this respect, will the Minister indicate why there is an absence of an employment Bill at this stage and whether this is being contemplated for inclusion at a later stage?
Finally, I will mention two aspects that relate to Northern Ireland. Will the Minister indicate, when he responds, what support will be provided to the aviation sector? It is quite a major sector around the city of Belfast both in terms of aircraft building and of aviation, which is a main tool of connectivity in our tourism industry.
The other aspect is something that has not been addressed today but relates more to justice. I am pleased that the Prime Minister issued an apology this afternoon to the victims of Ballymurphy and their families—that is, the 10 victims who were killed, nine of whom, as it was proved yesterday, were killed by British forces; namely, the Parachute Regiment. The 10th one was inconclusive but they were all entirely innocent; that finding was declared yesterday by Mrs Justice Keegan after a detailed forensic report.
In that respect, I urge the Government to look at the legacy and terms of the Stormont House agreement. First, there should not be any amnesties for people who committed heinous crimes, irrespective of their position. Secondly, any legacy legislation that is being proposed—we need to see the flavour of it—should be based on the Stormont House agreement, which was agreed by the majority of parties and both Governments back in 2015.
Lord Jones (Lab) [V]
My Lords, I offer my congratulations on the maiden speeches and say farewell to the right reverend Prelate.
Britain needs a clear-eyed, long-term, ruthlessly executed industrial strategy. Surely early 21st-century Britain still needs manufacturing industries. We are certainly post-imperial but not necessarily post-industrial—not yet. So, I say yes to AI, the smartphone, cyber, the computer, the drone and the leading edge. However, my hope is that the Government will promulgate with conviction an industrial strategy that, at its core, proposes to save, sustain, protect, enhance and invest in what remains of our manufacturing. To be fair, no Government can wish away the impact of global influences, but Britain’s future prosperity and her front-line defence require our much-depleted manufacturing to be protected from further shrinkage.
I instance the steel industry. Steel is a foundation industry. Today, it is in a very shaky condition. Surely it should not be on the brink of being eroded away. This national industry should not be the creature of sleight of hand, of chance, of boardroom ambition or of money. A great nation requires a sound steel industry. Shorn of steel, Britain would quickly be of less consequence in the eyes of its international partners and rivals. National defence requires steel. Steel is war. It happens. Today, our magnificent Navy has a nuclear-powered, nuclear-armed fleet of submarines. Without the foundation industry of steel, that mighty deterrent would look increasingly ineffective. In 1970, when I entered the other place, British manufacturing approximated 20% of GDP. Today, it barely makes 10%. The nation that lets its seed-corn industries fail will perish.
Today, Britain’s steel industry survives largely on the south Wales coast, on the north-east coast and in my homeland of Welsh Flintshire. When the smokestacks fell in the late 1970s and early 1980s, redundancies rained down on our busy, prosperous steel communities. For example, male unemployment in some of the Shotton steelworks communities reached 20% or more. Huge sacrifices were made by many thousands of good people. What remains there at Shotton is leading-edge and profitable. Let us remember that, in yesteryear, these steel communities helped us defeat both the Kaiser and the Führer. They deserve the best of outcomes and their industry should be prioritised. Our remaining manufacturing needs more research grants, better-prepared school leavers, more effective world-class skilling and ever more enhanced links with our universities.
To conclude, the citizens of Hartlepool have made a devastating electoral statement. Let us heed it.
Lord Sharpe of Epsom (Con)
My Lords, I also congratulate the noble Baroness, Lady Blake of Leeds, and my noble friend Lord Lebedev on their maiden speeches and wish the right reverend Prelate the Bishop of Portsmouth the very best in his retirement.
I am delighted that the gracious Speech focused so much attention on rebuilding and improving all parts of the United Kingdom in the wake of the pandemic. The latest GDP figures are very encouraging, and it is good to see the majority of commentators revising up their forecasts, but, as Bobby Kennedy famously noted, in isolation, GDP measures are somewhat crude. As he said,
“it measures everything in short, except that which makes life worthwhile”,
so it is also very encouraging to see the Government commit to addressing so many other areas which do make life worth while, particularly in education, health and the environment.
If there is a positive to take from the pandemic, it is that it has accelerated innovation in the world of work. I particularly welcome the Prime Minister’s commitment to harness, in his words, the “extraordinary spirit” that has been on display, particularly with regard to our world-leading vaccine development and rollout programme. I confess that, before the pandemic, I may have been somewhat cynical about the Government’s abilities in this area, but having seen the rollout, I am persuaded that, when carefully managed and thought through, government can play a collaborative role with science and industry. I therefore welcome the fact that R&D spending is now at its highest level in four decades. It is perfectly possible to argue that this level of spending has been thoroughly stress-tested in the pandemic and, obviously, lessons have been learned, but I also welcome the fact that the economic benefits of this spending are clearly laid out: on average, every pound of government spending leverages an additional £2 of private investment and delivers £7 of net benefits. Those numbers need to be carefully monitored and not allowed to slip, but there are strong grounds for optimism that this government commitment will deliver.
I therefore also welcome the commitment to establish the advanced research and invention agency. I listened very carefully to the noble Lord, Lord Eatwell, on this subject, but I think that international examples of similar organisations, including in the US, more than validate this initiative. It is also appropriate that the Government maintain an arm’s-length process, set a high tolerance of failure and, more generally, launch a review of business bureaucracy to advise on practical solutions to reduce unnecessary bureaucracy.
My final point relates to bureaucracy and its bedfellow, regulation. I note that the Government are committed to improving regulation—indeed, regulators will be getting new powers through this legislative programme, including Ofcom, particularly in relation to online activity. I was particularly pleased to read that the Prime Minister has established a Better Regulation Cabinet Committee, chaired by the Chancellor, to ensure that the Government drive through an ambitious programme of reform that enables and supports growth and innovation across the economy. As we have now left the EU, that is both welcome and necessary, and there are many obvious improvements that can and should be made to take into account this country’s particular areas of interest and skills.
We need to return to two issues that were given a lengthy airing in your Lordships’ House during the passage of the recent Financial Services Bill. First, improving regulation also requires ensuring that the regulators themselves are properly resourced, both with money and personnel, particularly in the area of financial markets. Since the passage of that Bill, there have been more failures. I do not mean business failures, which are inevitable and should be tolerated, as the advanced research and invention agency will do, but failures to perform basic regulatory functions appropriately. There have been far too many of these and I therefore hope that my noble friend will encourage and indeed exhort the Cabinet committee to instigate a thorough overhaul. These agencies are responsible for the foundations of global Britain’s future success.
To that end, I return to a theme explored by my noble friends Lord Hunt of Wirral and Lord Trenchard, among others: that our regulators must have regard to our global competitiveness. This is not an argument for less regulation, but for nimble, topical and agile regulation that maintains and, in some cases, re-establishes our place as a global exemplar. I hope the Cabinet committee will also commit to that.
Lord Parekh (Lab) [V]
My Lords, every event that has occurred in Britain during the past two years must be seen through the prism of the coronavirus, and the Queen’s Speech is no exception. The virus has highlighted certain deeper facts about our society, some of which were known but ignored while others were unknown or half-known.
One of those important facts pertains to ethnic disparities in health and other areas. The first 10 NHS doctors to die belonged to the ethnic minorities. Sixty-eight per cent of the NHS staff who have died came from within the ethnic minorities. I could go on producing statistics, but they are too well known to be rehearsed. Why is this so? The reasons, again, are fairly straight- forward and have been commented on. They include the fact that many from within the ethnic minorities are front-line workers; they work in high-risk places; they had no or inadequate PPE; they live in cramped houses; and they do not enjoy positions of power and influence, so their complaints go unheard or are unattended to. These are many of the factors which have led to the kind of disparity that I talked about. The Government took some time to recognise their importance, but when they did, they did not do enough, and the ethnic minorities continue to pay a disproportionately heavy price for the disaster that struck us.
It is therefore important that drastic steps be taken not only to level up people but to create a society in which there is a sense of solidarity and common belonging. It is important that the ethnic minorities should not feel that they are under the sufferance of the wider population, or that their problems are only their own and nobody is going to help them.
In that context, we are going to need a massive investment of resources, not only to deal with the ravages of the virus but for those things which have been left undone because of our obsession with it. The backlog of surgeries in our hospitals is enormous and will call for unimaginable sums of money. Therefore, taxes will have to rise. The rich will have to pay far more than they have done so far. But are tax rises enough? Are there other ways in which we can raise resources?
I want in passing to emphasise two points. First, the NHS, which obviously has to have money, should find ways of reducing its expenses. Secondly, it should find ways of increasing its income. Reducing its expenses is important. There are lots of ways in which it can be done, some of which have been talked about earlier, but one way would be to look at schemes such as the merit award, which consultants get. I have raised this issue in the House from time to time and do not quite understand why the award is given. If I as an academic am awarded the Nobel prize, I do not get a penny more from my vice-chancellor. Let us not give merit awards, with all the attendant disadvantages and resentment caused among those who consider themselves equally good but do not get them.
Likewise, on raising revenues, I do not understand why we have not developed a culture of philanthropy—I may be wrong, but I think I am not—in relation to hospitals and the NHS. When people die, they bequeath large sums of money to their schools and their universities, but I am told that the amounts given to hospitals or medical-related institutes are comparatively small. This is not the case in Germany, and I wonder why. Why do we not leave much money to hospitals? Why do we not even think it proper to express our gratitude in these and other ways? I am not saying that the NHS should start charging people. Of course, it depends on two principles: that the Government are responsible for the health of their citizens and that medical services should be provided free at the point of delivery. Those are unchallengeable principles, but consistent with that, a culture of monetary contributions to hospitals should be encouraged.
The last point I want to raise in this connection is the adult dependent relative visa rule, which states that doctors and others in this country are not allowed to bring their parents from overseas unless they meet certain very strict conditions. In the light of this, some of our doctors are leaving the country, or they tend to come here and then migrate elsewhere. The result is that we tend to suffer from the absence of their contribution. I therefore suggest that we take a second look at the proposals from BAPIO, especially the ones that Professor Keshav Singhal and Dr Ramesh Mehta have made, not accepting them in their current form, but with some modifications—
Lord Parkinson of Whitley Bay (Con)
My Lords, I am sorry to interrupt the noble Lord, but I draw his attention to the fact that he has been speaking for six minutes now and we have an advisory limit of five minutes. If he would not mind bringing his remarks to a close, it might be appreciated.
Lord Addington (LD)
My Lords, I will try to get what I want to say into five minutes. What attracts me to the Speech are the things that are not there and one thing that is. The thing that is is the attention given to further education.
I was told when I first came to this House, well over 30 years ago, that we have a major problem with skilled staff at what I think was called executive or technician level—levels 4 and 5, in modern parlance. We have always had the problem that this group is not taken seriously because it does not fit into the regular strands of where we think people should go. We have always thought that there was up to decently skilled craftsmen and then there was A-levels. Our education system has pushed people in those directions.
There is no real argument here. The fact is that we spent so long saying that we must get more people into university—up to 50%—then we said we had slightly too many. We then rediscovered apprenticeships, which really do not have a good penetration rate at levels 4 and 5. We now have something that is addressing a real problem and it has taken us only several decades to get there.
To get this working properly we have a couple of things we have to address. The first is making sure that those people who should apply for these training programmes know that they are not a second-rate option. This can be achieved only by making sure that not only our careers service but parents and teachers know that decisions about levels 4 and 5, generally post A-level, are realistic and will actually get you fulfilling employment. They should be seen not as university-lite but as something different and worth while. This will take a structural change in the way that we educate our educators to pass on this information. We have to make sure that someone says that it is a valid way forward, that people get something out of it and that it is not a second option.
The Government have an idea about having a package—okay, it is not a loan. Just about everyone else who has spoken has said that it would be better if it was some form of grant or entitlement, or a package of money to spend on training, but it has to fit into a structure. The Government are talking about this, which is good.
Indeed, before I go on to this, I must declare that the Government have asked me to become an FE ambassador, I think due to my experience in special educational needs. I have something from this group, which has already had an initial meeting to feel out the ground. I mentioned special educational needs. It recognises that it has duties and commitments there, but there is one big problem: we are not even identifying most of those with moderate special educational needs in our system. There is no argument about this. The current set-up in schools—you have a budget that you can take out of the school once you identify a need—is working against this. To get an idea of what we are saying, 10% of the population are dyslexic. I am dyslexic. There are many other issues, such as dyspraxia, dyscalculia and autism. Those at the moderate end, who do not stand out and do not have the tiger parent ripping at the system, do not get identified because the system has very little incentive to make sure that they do.
To show how just how bad that is, there are lots of specialist legal firms to make sure that one gets the identification, but they struggle to get the education and healthcare plans that give one legal status to achieve it. When we put the legislation through the House, we assumed that many people would not need it in order to get assistance. Now they do. The Government lose between 85% and 95% of the appeals which local government spends more than £100 million fighting to achieve identification. There is a horrible hole here. I do not know how many of the population—perhaps 15% or 20%—are covered in this area but those groups will underachieve.
If further education is to get the best out of the system, one has to make sure that it works properly in order to get those people identified. If that does not happen, one runs into problems. It is a pity that the noble Lord, Lord Nash, is not here but we went through great pain, which I inflicted on the House, to make sure that, in order to get an apprenticeship, if one was dyslexic one received assistance in getting an English qualification. One had to write to get the qualification; and that could not be done by voice recognition technology because people did not know about it. I shall stop there.
Baroness Foster of Oxton (Con)
My Lords, it is a great honour for me to respond to the gracious Speech.
The key to delivering back better for Britain will hinge on a buoyant economy. Like many across the UK, I waited with bated breath for the announcement on international travel last week, not least because the aviation, tourism and hospitality sectors have been decimated by the pandemic. Hundreds of thousands of small businesses in the supply chain are hanging on by their fingertips. In normal times, those industries provide more than £200 billion to the Exchequer—the budget of the NHS. Together, they secure more than 4 million jobs, many highly skilled and all well trained. In addition, our aerospace sector is critical in this equation, with more than 50,000 scientists and engineers. In truth, the entire supply chain, large and small, waited nervously for that update and it is obvious why.
Our airports in the UK are losing £83 million a week. British Airways, part of the International Airlines Group, has posted losses of £6.5 billion. EasyJet, Ryanair, Jet2 and many others are losing millions of pounds every day. That does not include tour operators, hotels and SMEs—in fact, the entire supply chain. We have a problem. The statement on international travel was extremely disappointing and, without wishing to let rip or undermine the challenges, which none of us does, I had hoped that the green list would have been more extensive. Notwithstanding Portugal, Israel and Gibraltar, which were already pretty booked up, it was a toss-up between Tristan de Cunha, the Falklands or South Georgia, as well as other far-flung territories, which had me rather stymied—not least because you would probably need a private jet or at least several days to get there.
Not everyone is focused on a holiday. Many have not seen their families abroad for over a year. Businesses need to start meeting face to face because Zoom is not the answer. Even its creator said that he was tired of Zoom meetings and could not wait to sit down and have face-to-face meetings. That brings me neatly back to abroad. The Greek islands, the Balearics and many other European destinations should be on the green list—or be on it soon, at least. Vaccinations are going well and it has to work both ways. We also need to welcome the tourists back to the United Kingdom as soon as possible.
The cost of the tests is also punitive. I cannot understand why, if each household can have two free lateral flow tests per week, they cannot be used for holiday purposes. Either the lateral flow test is fit for purpose or it is not. The travel industry has bent over backwards to accommodate safety measures. It has spent millions but needs more commitment from government. The DfT needs to look again at this matter with urgency, as do the other departments involved.
I conclude by saying that it is time that the majority of people got back to work, because working from home is not a solution. It is fine if you have a garden or you are on full pay, but for the majority it has been purgatory: solitary, depressing and much more. Work is not just a job. It is socialising, it is your well-being, it is going to the pub or for a meal or to the cinema as well as moving up the ladder. If you are not there, you will miss out, in my view. A work/life balance is hugely important but, if you are a haulier, a shopworker, a factory worker, a healthcare worker or in energy or transport, you have no choice: you have to go to work.
So realism now needs to take hold. Confidence is the key to getting back to normality, and it has to be led by all of us. Life is about managing risk. The vaccination programme has been absolutely phenomenal, but now we need to be bold. Our economic recovery is in our hands, and at present it needs all the help it can get.
Lord Triesman (Lab) [V]
My Lords, I draw attention to my interests as set out in the register and add my congratulations on the two maiden speeches and the valedictory speech of the right reverend Prelate the Bishop of Portsmouth, whom I also will miss.
This is the time to consider the likely developments in our economy. With luck and care, we should emerge from the pandemic. We are now in the first phase of our economic lives post-Brexit. We may be, I fear, in a renewed phase of seeking the break-up of the United Kingdom. The threats of uncontrolled climate change and opaque ethics are now fully upon us. There is probably an undercurrent of rising inflation. My point in saying this is not about gloom, despite the fact that we are at the bottom of the recovery league. I accept that it is possible that we may not face a long-term depressed outlook. The IMF’s world economic outlook suggests faster recovery in advanced economies, with stronger data than anticipated, greater health resilience, which we are enjoying in this country, and a growing impact from the scale of the US fiscal stimulus.
However, it, and I, fear that it is probably not all going in the right direction for our economy. Past impediments to growth following a crisis could have less impact this time. In particular, growth pre-crisis was weak, not unsustainably strong, and government measures have limited, to some extent, supply-side damage. I believe that there are still massive headwinds, but with appropriate legislation they may be mitigated a little. With care about Covid and its mutations, we may avoid permanently damaging GDP to a huge extent, but we will none the less have to navigate with crucial trade partners who are less successful in containing the pandemic.
What should we watch out for? For much more, I fear, than is in the gracious Speech, because we are in a bad place and a Biden-style stimulus package could have been meaningful. First, I strongly commend DIT and BEIS and the noble Lord, Lord Grimstone, personally. I have seen the quality of the efforts to bring major green manufacturing to England. They are thorough and energetic and, with the right incentives, they could be successful—but businesses must play their part with equal energy.
Secondly, in the difficult box, the first day of business after the transition period saw $7.9 billion in daily trading—about half of London’s pre-Brexit average—move to EU stock exchanges, and that is a continuing problem. It is a major trauma in anybody’s book. Negotiations to recreate equivalence recognition is mission-critical if London is not to lose its crown permanently.
Thirdly, we would be foolish, perhaps mad, to ignore the fault-lines between the home nations. Our economic and defence infrastructures, not just the tally of parliamentary seats, should tell us that this is an existential threat. The Prime Minister is surely wrong to describe devolution as a disaster; both the home nations and the English regions want their hands, at least to some extent, on the steering wheel. It is our job to help design the best approach to doing that.
Fourthly, I welcome every effort to build back greener by exceeding targets. There is no time to lose on targets and climate repair, but there is yet to be a comprehensive UK plan. Along with my noble friend Lord Browne of Ladyton, the former Chief Scientific Adviser Sir David King, and Martin Bellamy of Salamanca Group, I have had the honour of creating the Clean Growth Leadership Network, which brings together scientists, businesspeople, policymakers and academics, not just to think outside their silos but to do the job together.
Finally, as important as shareholders’ interests are, the new environment—not least the risks to climate—demands that we focus legislation also on stakeholders. Trust and value must be delivered to a spectrum of stakeholders. What we bequeath cannot be defined simply in terms of shareholders. We are not, after all, aspirant members of the European super league. Economic realities touch the lives of everyone in every community. If we value the future, let us now look at it through this lens and reorientate. We will fail abjectly if we continue to conduct ourselves to the standards set by Greensill or some of the Covid PPE procurements. I hope that simplifying procurement in the public sector will not knock us off the ethics ladder altogether. We are famous in this country for the rule of law, not for an ability to massage it out of shape. Ethical businesses will not come here and invest if we demonstrate indifference to ethics. Unethical businesses will come, and they will harm us. Government integrity is not an optional extra.
Lord Shinkwin (Con)
My Lords, I welcome this Queen’s Speech. Some noble Lords may lampoon levelling up; I do not. Some in the Westminster bubble may deride the Prime Minister for his vision, but the people of the West Midlands do not, as Andy Street’s fantastic victory demonstrates. One way in which, to his huge credit, the Prime Minister is personally leading the charge is in his national disability strategy that he has promised will be
“the most ambitious and transformative disability plan in a generation.”
The Prime Minister should be lauded, rather than ridiculed, for nailing his colours to the equality of opportunity mast. Many disabled people are pinning their hopes on it, and I am one of them. We have got one shot at this; we need to get it right.
That is why I was delighted to chair the CSJ Disability Commission and to recruit my noble friend Lady Grey-Thompson, as well as other distinguished individuals from business, academia and the voluntary sector, to serve on it. We recently published our submission to the Prime Minister’s forthcoming strategy. Covering education, housing, transport, access to goods and services and, of course, employment, the submission is appropriately titled Now is the Time. For, more than a quarter of a century after your Lordships’ House passed the Disability Discrimination Act into law, and five years since its ad hoc Select Committee conducted its authoritative inquiry on the Equality Act 2010 and disabled people, the time for warm words—for non-disabled people to tell disabled people what is good for them—is over. I believe the PM gets this, and appreciates both the scale of the challenge and the urgency of meeting it with tangible, visible proof of how his levelling-up agenda will make a difference to people’s lives.
I appreciate that some may ask why now should be different. After all, we have been here before. As many noble Lords will know, this is not the first strategy for disabled people—but the difference, I believe, is in the business appetite for change. Nowhere was that more evident than in the amazing list of business leaders who signed the open letter to the Prime Minister in the Times last month, welcoming the launch of the commission’s submission to his strategy and urging him to show in his strategy that he has given careful consideration to its recommendations.
Time does not allow me to list the blue chip companies that signed the letter, as I did in the debate on the economic recovery on 20 April, at col. 298 of the Grand Committee, but I will touch on some of the commission’s employment recommendations. They include extending mandatory gender employment and pay gap reporting—which a Conservative Government introduced and which Ministers in this Government have said is working —to disability and other protected characteristics; creating more supported routes into employment through supported internships; leveraging government procurement, worth some £292 billion, to drive up the number of disabled people in employment; and reforming both Disability Confident and Access to Work to make them fit for purpose. The signatories were clear in their message to the PM. They said that
“Disabled people have waited long enough; now is the time for action”.
They are right.
In conclusion, equality of opportunity is a business imperative, so let us unleash the power of business to level up through enterprise, talent, and equality of opportunity. That is the way to make the Prime Minister’s promise a reality.
Lord Sikka (Lab) [V]
My Lords, I welcome new Members to the House and offer my best wishes to the right reverend Prelate the Bishop of Portsmouth for his retirement.
Adam Smith said:
“No society can surely be flourishing and happy, of which by far the greater part of the numbers are poor and miserable.”
Yet economic justice and redistribution are absent from Her Majesty’s gracious Speech. The wealthiest 100 people in the UK have as much money as the poorest 18 million people. This concentration of wealth and related power is damaging to every aspect of our society. Even before Covid, 14.5 million people, including 8.1 million people in working families, were living in poverty. Some 4.5 million children live in poverty. It is the highest number of people living in poverty since figures were first collated in 2002, and the numbers are expected to rise. It is a matter of national shame that people have to rely upon food banks and charity to survive. Do the Government even care about this?
In 1976, the workers’ share of GDP in the form of wages and salaries was at 65.1%. Zero-hour contracts, anti-trade union laws, a low minimum wage, wage freezes and job insecurity have reduced that share to 49.4%. This decline is unmatched by any other democratic country on this planet. Millions of people are denied access to good housing, food, healthcare, education and pensions, and are condemned to an early death as a result, yet the Government have no policies for improving workers’ share of GDP.
People on low incomes will inevitably rely upon state pensions in later life, yet despite the triple lock the average UK state pension is around 29% of average earnings. It is the worst in the OECD countries. Thousands of retirees die each year due to lack of heating. Nearly 3 million Brits are malnourished, and 1.3 million of these are retirees. If the Government care, they need to align the state pension with the minimum wage. Why should the state pension be less than the minimum wage?
Regressive taxation has deepened social injustices. The poorest 10% of households pay, on average, 42% of their income in direct and indirect taxes, compared to 34.3% by the richest 10%. VAT, council tax and national insurance are examples of regressive taxation and there is no reform in sight, yet the Government continue to shower more gifts upon the rich.
There is no qualitative difference between earned and unearned income, but capital gains are taxed at rates between 10% and 28%, compared to earned income which is taxed at marginal rates varying from 20% to 45%. Most of the beneficiaries live in London and the south-east of England, and the capital gains tax regime has exacerbated regional inequalities.
Tax relief of around £40 billion a year is provided on contributions to pension schemes. Most of it goes to individuals paying income tax at the rate of 40% and 45%. Just 10% of taxpayers receive 50% of the tax relief. Some 1.3 million individuals with earnings below the tax-free personal allowance receive zero help with their contributions to pension schemes. Why are the Government content with this?
The Government have increased tax-free allowances, though they will be frozen until 2026. The increase in personal allowances has not changed the burden of tax on the poorest, as I stated earlier. It does absolutely nothing for the 18.4 million individuals whose annual income is less than £12,500 a year. No doubt the Government will claim that they are providing £4.8 billion for their levelling-up fund for local infrastructure. However, this investment simply goes into the pockets of corporations, while workers remain poorly paid, insecure and disempowered. I would welcome a detailed reply from the Minister.
Lord Cormack (Con)
My Lords, in common with my noble friend Lady Fookes, I can look back at over half a century of Queen’s Speeches, and they have various things in common. They all remind me of that Punch cartoon of the curate’s egg: they are good in parts. They are rich in aspiration, prolific in generalisations and generally fairly poor on detail.
I had proposed to speak about the constitution, on which there is that wonderful sentence:
“My Government will strengthen and renew democracy and the constitution.”
Well, you cannot object to that, but detail is there not. I was going to talk about that tomorrow, but my noble friends will understand when I say that that my wife has her second jab on Friday morning and the LNER trains are all to pot, so I cannot go back to Lincoln later than tomorrow, and so I will have to try to entertain your Lordships tonight.
The whole of this Queen’s Speech is, of course, in the shadow of Covid. I direct my brief remarks to two aspects, one general and one specific. First, on the general, I am sorry that my noble friend Lady Foster has left the Chamber, because she was very eloquent on the subject of travel. I believe that we have to concentrate on this country and making it safe. With all these variants in various parts of the world, we must be excessively careful as to how we compile any green lists. We have to make sure that, in this particular case, it is the United Kingdom first. It may be sad if people are not able to have the holidays they normally would—but not half so sad as a fourth lockdown, which would be totally devastating to our economy. I beg the Government, and my noble friend in particular when he replies, to reassure us that there will be ultra- caution on the travel front.
My specific point is one I have raised in your Lordships’ House before, and it concerns some of the most vulnerable people in our country. I refer to those who live in our care homes. I have raised several times with my noble friend Lord Bethell, and indeed other Ministers, the question of those who work in care homes. I have cited one example of a great friend of ours, whose mother is 99 and in a care home. Of course, she has had her vaccinations. Our friend has to put on, very properly, protective clothing and all the rest of it when she goes to see her, and she was not able to hold her hand until very recently—and yet, at least 30% of the workers in that care home have declined vaccination. I believe that the Government have to be a little bit authoritarian here. After all, they have been authoritarian in many other ways—we have not been allowed to have people in our homes or to do many things we would ordinarily do. It is crucial that we make sure that this sector of the community is given the full protection it needs and deserves.
I agree with something else my noble friend Lady Foster said earlier, when she talked about getting back to normal. There is nothing I want more than getting back to normal in your Lordships’ House. It is absolutely appalling that so few of us can be in the Chamber. I understand that the Commons intends to be normal after 21 June—well, so should we. The place of a parliamentarian is in Parliament, not on Zoom. Although I warmly congratulate both the maiden speakers today and hope to see much more of them, I was delighted that the noble Baroness, Lady Blake of Leeds, spoke in the Chamber and I was sad that the noble Lord, Lord Lebedev, delivered his excellent speech on Zoom. We are colleagues; we are parliamentarians. We have to be together, working together. It is essential that we do, because otherwise the country suffers. Parliament is essential to the well-functioning democracy talked about in that vague sentence. I say to my noble friends in government: we have to get back to normal to hold you properly to account. If we do not, the country will be the poorer. If there are people working in Parliament who have not been given their jabs, they should be given them as a matter of total priority.
Lord King of Lothbury (CB) [V]
My Lords, after such a long debate, can there be much to say, especially—in deference to the noble Lord, Lord Cormack—on Zoom?
The gracious Speech contains many items of proposed legislation, but their success will depend on one overriding factor—the economy. As we slowly emerge from the pandemic, I believe there is one key challenge: the need to change the structure of our economy and to shift spending and production from low to high-return activities.
Last week, some headline writers became rather excited over the latest Bank of England forecast that the growth rate of the UK economy this year would be the fastest in over 70 years. But even if that forecast were to materialise, the level of GDP at the end of this year would be no higher than at the end of 2019. The level of output is far more important than is suggested by excitable comments about record rates of decline in 2020 and then record rates of recovery this year, as the noble Lord, Lord Eatwell, pointed out at the outset of this debate.
Although levels of GDP are more informative than growth rates, the real challenge ahead concerns the structure of the economy. We need to prepare for and support changes in the composition of total spending and output. For over a decade, an extraordinary degree of monetary stimulus has failed to generate sustained growth, not just in the United Kingdom but in the industrialised economies as a whole. Interest rates close to zero have permitted zombie companies to survive. As a result, excess capacity has built up in some sectors, while others have been held back. In the United Kingdom, the task now is to rebalance the economy away from private consumption and toward investment and exports. That will not be easy in a world still suffering from the economic consequences of the pandemic, and when sterling’s trade-weighted exchange rate is actually higher today than it was a decade ago. In addition, the proportion of our national income that we save and invest remains well below the average for other advanced economies.
All this was true before the arrival of Covid-19, but the pandemic has underlined the significance of changes in the structure of our economy in two ways. First, we can now see that resilience is just as important as efficiency. We learned that lesson in the banking crisis more than a decade ago, but we did not apply it to the rest of the economy. Resilience of healthcare systems, the risks posed by “just in time” delivery systems and the susceptibility of economies to border closures all suggest that economic activity will be organised differently in future.
Secondly, the pattern of demand for services, ranging from air travel to hospitality and digital services to entertainment, will change in ways that are simply impossible to quantify today. There will be a period of trial and error before we settle on a new pattern of spending and output. The furlough scheme was crucial to protect viable businesses and jobs in sectors vulnerable to the short-term consequences of lockdown. Retailers, restaurants and entertainment venues forced to close their doors needed fiscal support. But as restrictions are relaxed, so fiscal support should be withdrawn, and we will then discover which sectors will survive and thrive and which will not.
Aggregate monetary and fiscal stimulus cannot correct a structural misallocation of resources. If the gracious Speech is to achieve its objectives, a much broader range of policies will be needed in the years ahead. Some of the aspirations in the address—to promote research and development, and to support training to enhance lifetime skills—go in the right direction. However, we have some distance to travel, and it is to the structure of our economy, rather than the macroeconomic outlook, that we should pay most attention.
The Deputy Speaker (Baroness Fookes) (Con)
My Lords, I will call the noble Lord, Lord Young of Norwood Green, in the hope that he has been reconnected. Lord Young. No? In that case, I will call the next speaker, the noble Baroness, Lady Uddin.
Baroness Uddin (Non-Afl) [V]
My Lords, it was indeed an honour and a privilege to be in Her Majesty’s presence at a distinctive State Opening of Parliament, and I wish to convey my earnest respect for her dedication and service to our country.
I wish to make some general points today, to warmly congratulate my noble friend Lady Blake and the noble Lord, Lord Lebedev, and to sincerely thank the right reverend Prelate the Bishop of Portsmouth for his service to our House.
As we end the blessed month of Ramadan, I accept glad tidings from wherever they come, hence I welcome many aspects of the gracious Speech. However, I note with regret and disappointment the lack of any meaningful indication of what is to happen to social care and employment rights. This will further expose many vulnerable adults, particularly those living with disabilities, to more pressures, pervasive poverty and gross inequalities, depriving them of access to dignified care and independence, directly contravening the Government’s own levelling-up and equality obligations, which, by their design, acknowledge that inequality is embedded within our communities.
The pandemic also held up another grotesque horror: increased violence, particularly against women, signifying pernicious gender divisions. It was indeed an honour to participate in debates on the Domestic Abuse Bill, but the Act’s full implementation will require not just law but full funding. A number of distinguished noble Lords have highlighted the imminent danger of the Government overlooking young people’s mental health and well-being, as well as the millions who are in low employment and suffering hopelessness. I echo their sentiments. I hope that the noble Baroness, Lady Berridge, will acknowledge and address the desperate situation of sexual harassment, rape and stalking within higher education establishments. Notably, those in charge have been slow to protect victims and survivors and to address these safeguarding matters, which are equally pervasive within secondary schools, as was reported this week by the BBC.
Violence against and harassment of women and girls are indicative of our societal and structural norms of acceptance that violence and discrimination are okay. A lack of gender equality remains persistent within our political parties, which continue to accept that the lack of diverse women’s leadership in public office and leading institutions is permissible. Government Ministers also persist in not recognising the detrimental impact of racism and Islamophobia within our institutions. What steps will the Government take to ensure that our institutions and public spaces are reflective of all parts of our society and communities? Does the Minister agree that gender balance and inclusive diversity are essential for a successful country and economy?
Time allows for only a brief reference to the desperate plight of the many families who are living in substandard homeless accommodation. Like other noble Lords, I am concerned that the proposed housebuilding could lead to further divisions among our communities unless there is due attention to developing safe and good-quality family homes.
It would be remiss of me not to salute the resilience of our communities, many of which have suffered the terrible heartache caused by over 128,000 deaths. Equally, I give my respect to all the community and charitable organisations whose selfless acts have meant that families had access to basic food where government could not provide it. None did more than Sir Tom Moore and our own East End equivalent, centenarian Dabirul Islam Choudhury OBE, who continues his efforts for the NHS and other charities.
Finally, Muslims across the world will tomorrow celebrate Eid ul Fitr, following a month of fasting; they have also continued to donate millions to charitable causes. My best wishes go to all Members and staff who will also be celebrating.
We live in an interdependent world. We witnessed the critical collaboration that was necessary during the pandemic and which restated how we need to work together for the betterment of humanity. We are promising to educate 40 million girls—like Malala—across the globe, on the basis of valuing their human rights. I ask our Government to be fair and just to the plight of Palestinians who have suffered enough from the brutal occupation and repression of the Israeli Government. None of us can feel safe and secure anywhere unless we are safe in all corners of our world.
Lord Roberts of Llandudno (LD) [V]
My Lords, in spite of every assurance that the NHS is “safe in our hands”, we find that, especially in England, we are seeing an erosion of it in so many ways. I am so grateful for what the noble Baroness, Lady Bakewell, said—I am so grateful that I am living in devolved Wales and Scotland, where health powers are in their hands, because we must be sure that they will keep the health service safe there. However, in England, there is privatisation by stealth.
Recently, at least 59 GP surgeries have been sold to giant American insurance companies. Half a million patients have been handed over to American financial interests. We have wealth put before health, and reports state that one company has made a profit of £35 million in the last five years, so I ask the Government to look very carefully at whether this should continue. Some leaders in the health community wrote to Matthew Hancock, asking for an investigation by the Care Quality Commission into the whole situation, which has transformed and can undermine so much if we allow it to continue.
I am old enough to remember the doctor’s bill coming to our house and those of the people in Llewelyn Street in Conwy—and how some could not afford to pay. On the other side, I remember my profoundly deaf mother receiving the first hearing aid—what a day that was. We all celebrated because she was able to hear the tick of the clock for the first time since her childhood. I want people to continue to be able to receive the benefits of an NHS that is safe in our hands and those of all who are in any needy position at all.
The Deputy Speaker (Baroness Fookes) (Con)
The noble Baroness, Lady Stroud, has withdrawn, so the next speaker will be the noble Lord, Lord Campbell-Savours.
Lord Campbell-Savours (Lab) [V]
My Lords, I will address the issue of agricultural training. Some 12 weeks ago, I heard that Newton Rigg College, a prominent agricultural college in the north-west, was being systematically run down by a predator college—Askham Bryan College, in York—behind a wall of limited financial reporting. We were witnessing the appalling betrayal of a 125 year-old historic county land-based educational institution by a team of Yorkshire accountants to pay off Askham Bryan College’s escalating debts.
It turned out that Askham Bryan College, which was in financial difficulty and had an overstretched policy of acquisitions, had, behind closed doors, been methodically stripping Newton Rigg College of its student body, assets, equipment, reputation, apprenticeships, land bank, excellence, high-quality staff and national reputation. Those who have been responsible for this outrage should hang their heads in shame as they now proceed to sell off its assets through estate agents Savills in a grand fire sale.
It was only when documents were leaked that we finally learned of the duplicity involved in this whole disgraceful affair. I say to those who are interested in feasting on our tragedy by destroying Newton Rigg College’s assets: we do not want you. What was once a viable institution, paying its way, has been driven through neglect into financial difficulty and ruin by Askham Bryan College.
Askham Bryan College’s only interest has been the value of Newton Rigg College’s £12 million 1,000-acre land bank. To it, it is no more than a saleable asset that it acquired for nearly nothing in 2010 and that it is now proposing to use to pay off the substantial debts incurred on its operations in York. Its claim to have invested millions is totally misleading: it includes student income raised in York from students in Cumbria; money spent on a farm and other projects, in part grant-aided, which was used to boost its balance sheet; and over £3 million in rents, which it received from the new University of Cumbria.
These transactions have all taken place in the name of a charity, thereby enabling them to hide Newton Rigg accounts from public scrutiny. They claim to be open and transparent. This is not true. The financials governing Newton Rigg’s relationship with Askham Bryan’s operations are seemingly opaque and clouded in secrecy. There is no one in Cumbria who knows the full truth, although the whole story is now beginning to unravel. They paid almost nothing for the whole Newton Rigg property estate in 2010, which they now hotly deny with a play on words and dates. When questioned on this deal of the century transaction, they always respond in their press releases by referring to post-2011 transactions. Well, we are not fooled. We now want our assets back, so that we in Cumbria can rebuild what they have destroyed through a combination of commercial greed and incompetence.
Last month, after considerable struggle, we managed to secure a parliamentary Select Committee inquiry. The inquiry exposed their hollow case, as MPs rendered them speechless when they were confronted by hard questioning. What we now know is that Askham Bryan, after discounting for grant aid, seems able to account for only a few million of net expenditure on Newton Rigg. We are still working on the figures. Reports suggest that they want up to £12 million in their asset fire sale. I await with interest their similarly discounted expenditure figures. We are witnessing a huge profit on the back of incompetence, and Cumbria is paying the bill. My noble friend Lord Clark of Windermere, who will follow me in this debate, will advance an alternative approach later. Askham Bryan needs to listen to him; he has a convincing case to make.
Lord Sarfraz (Con)
My Lords, your Lordships’ House is full of one thing—semiconductors; computer chips. They are in our cell phones, in our laptops, in those screens, in the audio system. They are also in our vehicles outside, in our microwaves and washing machines at home and in every ventilator and every operating theatre across the country. We are a nation addicted to semiconductors, we cannot live without them, yet we are in the middle of a major global semiconductor crisis. There are simply not enough semiconductors being manufactured to meet global demand. This has very real implications.
Last month, BMW was forced to stop production in its Oxford Mini plant, and Jaguar Land Rover stopped production in two of its plants, in both cases because of a lack of semiconductors. Thousands of individuals work in these facilities. While we look ahead to a promising, packed legislative agenda outlined in Her Majesty’s gracious Speech, we must remember one thing—that all our ambitions in green technology, fintech, space ports, free ports and electric vehicles cannot be achieved without security of semiconductor supply. We design some of the best semiconductors here in the UK, but we do not make them. For the most part, semiconductors are made in east Asia. The two major UK chip designers are owned by Asian businesses. We are entirely dependent on a supply chain over which we have no control. This needs to change.
Today, a coalition of technology companies in the US has launched an alliance to promote domestic semiconductor manufacture. It has joined the President of the United States in asking Congress for $50 billion of funding to boost semiconductor manufacturing in the US. So, as we debate the Queen’s Speech, we must make sure we have the raw computing power we need to grow our economy. This is a matter of independence in technological sovereignty, just like energy security or food security, and should be recognised as such.
Lord Etherton (CB)
My Lords, I congratulate the two maiden speakers and offer my good wishes to the right reverend Prelate the Bishop of Portsmouth.
I will focus on the proposals for mental health reform in the Queen’s Speech. No details were provided, but it seems clear that any proposals will be based on the White Paper that was published in January of this year. As a former chair of Broadmoor high-security hospital, a former chair of the West London NHS Trust, which incorporates high, medium and low-security facilities and also provides local services, and a former chair of what was then the mental health review tribunal, I agree with many others that there was much to be welcomed in the Government’s reform of the Mental Health Act 1983, set out in their White Paper.
The White Paper was followed by a consultation, which ended last month. No details have yet been published of the views of consultees on that White Paper, or of the Government’s response. Would the Minister please confirm whether, and if so when, the results of the consultation and the Government’s response will be published? It will not be possible to examine properly any proposed new legislation without knowledge of those matters.
It is noteworthy that some important matters in the White Paper were said to be more appropriately contained in a revised Mental Health Act code of practice rather than in legislation. It is important that the House has the opportunity to consider revisions to the code at the same time as considering proposed revisions to the Act. This would enable the House to be satisfied that the appropriate vehicle is used for any revisions to law and practice and that nothing slips between new legislation, on the one hand, and the revised code on the other hand. Can the Minister confirm when the revised code of practice will be made available and how it is proposed to co-ordinate revisions to the code and consideration of the new legislation?
This is important because, to take one example, the White Paper does not address at all issues relating specifically to high-security facilities. The chief executive of the West London NHS Trust and clinicians there say, for example, that the proposed increased frequency of automatic referral to tribunals—which is a government proposal—may have a deleterious and traumatic impact on the well-being of Part III secure patients. This point was also made a week ago by some patients in a meeting with Rethink, the mental health campaigning organisation. Another feature of ongoing significance for patients who have come through the criminal justice system is the perennial difficulty and delay in obtaining places in prison to which they can be returned on completion of in-patient treatment.
There are other matters relating to children and young people that are said to be better placed in the code of practice rather than in legislation, illustrating the importance of the code and why any revisions to it must be read alongside proposed legislation. Will the Minister give the assurance that that will be possible?
Lord Clark of Windermere (Lab) [V]
My Lords, my noble friend Lord Campbell-Savours has explained in his usual robust and graphic manner the plans to close Cumbria’s agricultural college—proposals that have resulted in widespread anger, right across the county. I continue to pursue that discussion on Newton Rigg, with its 1,000 acres of land, including a state-of-the-art dairy training farm and the National Centre for the Uplands—the only hill farm in the whole country owned by an agricultural college.
Askham Bryan College in York, which acquired Newton Rigg for just £1 about 11 years ago, has found itself now in dire financial straits and is on the verge of bankruptcy. It is hoping to avoid this by putting Cumbria’s Newton Rigg up for sale, expecting a windfall of £12 million. The young people are having their land-based college stolen from them.
But it does not have to end in tears: there are solutions. First, the Government must step in through the Education and Skills Funding Agency and sort out Askham Bryan’s debts. This may involve spending money—but far less than if they do nothing and let the closure of Newton Rigg and the asset sale proceed.
With Askham Bryan and its staff and students safeguarded, the assets of Newton Rigg, including the two farms, should be transferred to a Cumbrian educational trust to be held in perpetuity for the people of Cumbria and their future education. Trustees and governors would come from local authorities, relevant interested local businesses, the Cumbrian LEP and educational experts of Newton Rigg Ltd.
Short-term arrangements for further education training have already been made in conjunction with Myerscough College in Lancashire, but this might be enhanced in conjunction with Newton Rigg Ltd, which is working to become an independent FE college as soon as the system allows. It has carefully costed plans for modern apprenticeships, agricultural tech and a rural business village. This vision will take time to realise but will return Newton Rigg to its proper place, serving the people of Cumbria and the north with a modern, rural college providing a wide range of education—agriculture as well as environment, equestrian as well as gamekeeping—and a whole range of rural activities. But be in no doubt that the preservation of the facilities at Newton Rigg is vital to the success of this scheme. The solution is then clear and the cost relatively small—a tiny fraction of what it would cost in the future to set up a replacement college from scratch to fill the gaping hole in the wide-ranging rural education in the north.
We should not be encouraging one failed college to pay off its debts by ruining another college in a neighbouring county. That is indefensible, and one can understand—and I share, as does my noble friend Lord Campbell-Savours—the anger of the people of Cumbria.
Viscount Trenchard (Con)
My Lords, I congratulate the noble Baroness, Lady Blake of Leeds, and the noble Lord, Lord Lebedev, on their maiden speeches and the right reverend Prelate the Bishop of Portsmouth on his valedictory speech. We shall miss his wise counsel. It is an honour to have this opportunity to welcome the gracious Speech delivered yesterday by Her Majesty.
I am delighted the people have given such a ringing endorsement of the Government’s policies, as shown by the results of elections held last Thursday. The Government’s build back better strategy has hit a chord with voters up and down the country. They are also happy that the Government have got Brexit done and made such a great success of the national vaccination programme. I particularly welcome the Prime Minister’s lifetime skills guarantee. Advances in healthcare and medical treatment enable people to enjoy longer working lives, and this means changing careers and training afresh for the next stage in a working life.
The skills and post-16 education Bill should enhance skills and training through reformed technical education and apprenticeships, particularly in sectors where employment will increase, such as construction, digital, clean energy and manufacturing. However, to ensure this increase is realised, the Government must capitalise on our recovered freedom to regulate better as well as build back better. Nowhere is this more true than in the life sciences sector, where the MHRA can now adopt a less bureaucratic and more proportionate regime than that applied by the EMA. This is necessary to ensure the UK can continue to lead the world in pioneering new treatments—a “science superpower”, in the Prime Minister’s words.
It is also essential that we do not throw away the advantage gained by the most successful vaccine programme by unnecessarily extending Covid restrictions on opening up the economy, and I warmly welcome the Prime Minister’s more upbeat and optimistic approach to an early end to the debilitating restrictions that we have endured for so long. This is by far the most important precondition for economic recovery. As my noble friend Lord Lilley pointed out in the debate on the economy on 20 April,
“the recovery will come as soon as we end the lockdown.”—[Official Report, 20/4/21; col. GC 268.]
I agree with him. The Bank of England is now forecasting that GDP is expected to grow by 7.25% this year, the biggest spurt since 1941. The bank’s chief economist has expressed concern that household and company spending are now surprising significantly and persistently on the upside.
I strongly welcome the Government’s policy to introduce eight freeports, and ask my noble friend the Minister what discussions he has had with the devolved authorities to ensure that all parts of the United Kingdom will benefit from this initiative.
The Government face an enormous challenge in disentangling Britain from the EU state aid regime. It is of course true that we have been much more reluctant to deploy state aid in support of declining industries than have most of our erstwhile EU partners, and it is good that the subsidy control Bill will enable us to design a state aid regime tailored to the UK’s needs.
To achieve the Government’s avowed intention to level up opportunities and make the country more prosperous than before, it will be important to reverse the unwelcome freezing of the income tax personal allowance and higher rate threshold and the increases in corporation tax rates as soon as the recovery permits because, as has been shown time and again, reducing taxes attracts new investment and produces a net benefit to the Exchequer. In this regard, I cannot agree with the noble Lord, Lord Newby, who yesterday advocated significant tax rises just at a time when businesses need to be encouraged to grow and create new jobs to ensure greater prosperity for all.
It was good to hear Her Majesty’s confirmation that the public finances will be returned to a sustainable path once the economic recovery is secure. Can my noble friend confirm that he agrees that the sustainability of the public finances will be best assured by reverting to an attractive tax regime which will maximise new investment, the creation of new jobs and prosperity across the whole country? I strongly agree with what my noble friend Lord Bridges said on this subject.
The measures to strengthen the economic ties across the union by investing in national infrastructure are welcome, but the gracious Speech was silent on the UK infrastructure bank, which the Chancellor said in March would be put on a statutory footing as soon as the parliamentary timetable allows. I have no time to comment on other measures, but I look forward to hearing my noble friend’s winding-up speech.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, the Queen’s Speech promised yet another major structural change in the NHS. Well, it is no surprise that the Government want to do away with the wretched Health and Social Care Act 2012, which cost billions and wasted years, but I question their timing. Right now, the NHS, local authorities and the voluntary sector are still battling Covid-19. In implementing these proposals, the risk is that health and care services will be distracted from dealing with the crisis at hand and the tremendous backlog of patients who need urgent treatment.
Nothing in the legislation will address the chronic staff shortages, deep health inequalities and urgent need for long-term reform of social care. The proposals represent a marked shift away from the focus on enforced competition that underpinned the coalition Government’s 2012 changes. That is welcome. At the heart of the changes is the proposal to establish integrated care systems—ICSs—as statutory bodies made up of two parts: an ICS NHS body and an ICS health and care partnership. The ICS NHS body will be responsible for NHS strategic planning and financial allocation decisions. What is not clear, as NHS Providers has reported, is how the accountabilities of all parts of the local health system will align without duplication, overlap or additional bureaucracy.
It is even less clear when it comes to the ICS health and care partnership, which will be responsible for developing a plan to address the system’s health, public health and social care needs. It appears to have no authority, with the ICS NHS body and local authorities required merely to “have regard to” what this new body says. Why has local government not been brought more into the core of decision-making and accountability? Why are the largely ineffective health and well-being boards to continue to operate separately?
NHS Providers has also spoken of its concern that the Government’s planned powers of direction for the Secretary of State are too far-reaching. Many of the proposals give Ministers far greater powers over NHS England and other arm’s-length bodies, including the power to intervene earlier in local decisions about the opening and closure of NHS services.
I certainly worry that the forthcoming Bill gives too many powers to Ministers through secondary legislation. The White Paper argues that these are needed to enable the Secretary of State to respond more flexibly to rapidly changing circumstances, such as those seen during the pandemic. Yes, but those powers are not needed outside the pandemic, and it is not clear why reducing parliamentary involvement in this way is merited. If Ministers insist on seeking direct control of NHS England, that means they can no longer hide behind the decisions of a quango and will have to report and account to Parliament on many more detailed issues than now. I hope they realise that.
The proposals predominantly aim to reform the NHS. However, the NHS does not work in isolation—public health, social care and the NHS are closely connected. There is clearly a risk that, in setting out fixed plans for the NHS, the options for public health and social care reform become limited.
What about the needs of non-acute services? It is noticeable that the White Paper has not made it mandatory to have representatives of mental health and community trusts represented on each ICS board. Why not? What about community pharmacy, optometry and dental services?
It is also clear that the restructuring has little to say about the real challenges facing the NHS and social care. On social care, we are told virtually nothing. After decades of reviews and failed reforms, the level of unmet need rises, the pressure on unpaid carers grows, the supply of care providers diminishes and the strain on the undervalued care workforce ever increases. Social care remains severely underfunded, with the most deprived areas being worst hit. More than a million adults who need social care are not receiving it—the system is riddled with unfairness. There is no confidence that the Government will come up with anything near a coherent and funded plan. Until they do so, the promised NHS Bill can be only a pale shadow of what is required.
Lord Griffiths of Fforestfach (Con)
My Lords, it is a great pleasure to take part in this debate. The gracious Speech outlined a number of policies, but what hit me particularly was that it underlined a great vision—for jobs, full employment, lifelong training, the younger generation moving from Generation Rent to Generation Buy, and prosperity.
On the economy, let us not forget that we are in a very fortunate position. Last year our economy was devastated by Covid. We faced the most serious loss of output for 300 years, and the real prospect of mass unemployment. The Government acted promptly and quickly; we can now expect growth this year of over 7%—just in the Budget, it was forecast at only 4%. This is an extraordinary achievement. I believe the Chancellor of the Exchequer and the Governor of the Bank of England deserve great credit and our thanks for their courage and judgment.
I am the 85th speaker in this debate and I wish to be brief. I strongly agree with the levelling-up agenda in the Speech. It provides a lifetime skills guarantee and massive investment in further education and improving communities, not just providing ladders to escape but reviving those communities. There are certain things which only the Government can deal with and which the private sector cannot: one is climate change; another is the pandemic. Much as with national insurance, which we introduced at the beginning of the 20th century to cover unemployment benefit and then the creation of the NHS, people welcome greater public resources being moved into training and rebuilding communities, almost as a form of social insurance. We may well be at a turning point in our society, much as we experienced under Prime Ministers Attlee and Thatcher.
However. getting the public sector right is only half the story. The other half is getting the private sector right. As the infrastructure is rolled out, we must ensure that we have a private sector of investment and businesses ready to take risks. For that, we must ensure that we have a market economy that is in good health, in which markets are transparent but not overregulated and certainly not subject to high taxes. Low taxes, as has been mentioned by a number of speakers, are key to an enterprise economy. The great challenge facing the Chancellor is how to restrict the growth of public spending without increasing taxes at the same time, which will undermine it.
My second point concerns the importance of the detail of policy implementation and not simply policy in terms of ideas, framework, and design. This was mentioned in the context of further education by the noble Lord, Lord Addington, and by my noble friend Lord Cormack, who is not in his place at present—
Lord Griffiths of Fforestfach (Con)
He is behind me. Thank you—the invisible man.
If I learned one lesson being in No. 10 for five and a half years as head of the policy unit, it was the difference between the design of a policy, the ideas in a policy and the implementation of a policy. I saw it in the privatisation of gas, electricity and so on, and in education reform. In the gracious Speech we have a terrific statement of intent. To make it happen, we need implementation.
Are there any risks which could undermine everything in the gracious Speech? There is one: inflation. The Bank of England and the Office for Budget Responsibility are quite relaxed about it, but I am not so sanguine. Globally, we are seeing a tremendous boost to the economy. We are seeing bottlenecks and shortages, as was mentioned. The monetary aggregates are increasing too much, and the fiscal and monetary boost is enormous. Inflation is not mentioned at all in the Queen’s Speech, but a pick-up in inflation such as that which we saw in the 1970s is the one thing that could undermine the great economic proposals in it. It is therefore time to tackle that subject, and not to delay.
Baroness Grey-Thompson (CB)
My Lords, I am delighted to speak in person in this debate. This is my first opportunity formally to thank all the staff who have worked tirelessly to get us online and to welcome some of us back. I declare my interests, as set out in the register, as chair of ukactive, vice-president of the LGA, a member of the Centre for Social Justice’s disability commission and chair of the Duke of Edinburgh’s Award. My interests cover many of the areas to be debated over the next few days.
I am delighted that Her Majesty’s Government recognise that, while they are delivering a national recovery programme, our nation being healthier is seen to be of vital importance. This is an issue close to my heart. There is an incredible opportunity to encourage and support people to be active in a different way, but the real test is the support that will be offered to gyms, pools and the leisure sector, both public and private, and to the millions who depend upon them.
I would like to pick up on the comments of the noble Lord, Lord Shinkwin, and his disability commission. Disabled people face many inequalities that have only been increased through Covid. The pandemic has shown that there are many opportunities for everyone to work differently, but I urge Her Majesty’s Government to look closely at the recommendations that the commission made specifically in relation to work, which will fundamentally help improve the lives of disabled people in a number of areas. Equality of opportunity is a business imperative and disability policy should not solely be in the hands of the Department for Work and Pensions.
I was delighted to see mention of improving connectivity by rail and I will be seeking an assurance from Her Majesty’s Government that they will make a serious commitment to step-free access. That will help not only disabled people into work but the economy—we should not forget that the purple pound is worth some £12 billion a year. Such help would also transform the ability of many people to travel independently. I do not want to have to wait until 2070 for accessible rail to happen—that is the latest estimate, which has been moved back from 1 January 2020. Another 50 years is surely too long.
I return to the safety and security of citizens. I hope to see legislation introduced that will cover positions of trust, making it illegal for a coach to be in a sexual relationship with a 16 to 18 year-old. Given that such relationships are illegal for teachers, many assume that it is the same for coaches. We have to protect coaches. This is not about criminalising a 21 year-old in a relationship with an 18 year-old, but about stopping the predatory and potentially repeated behaviour of those in a position of power. I also seek the introduction of mandatory reporting to not allow others to turn away and pretend that they have not seen something or to hide behind the excuse of, “Well, they’re a good coach”. There must be, across every sport, appropriate reporting mechanisms to allow this change to happen. Our children’s safety is imperative.
There is much work to be done on elections, and I know that there is a lot of strong feeling in this area. I hope that as much as possible will be done to make voter registration easier, to enable everyone to have their say.
I am delighted that education and the amount of time that young people have missed due to Covid are part of this debate. Again, we have another opportunity to think about extracurricular activities—perhaps a way in which to bring in physical activity—as well as about non-formal education. I am already discussing further education and increased opportunities for young people with the Department for Education, and I look forward to continuing that discussion.
Finally, I welcome this Queen’s Speech debate and look forward to working with the whole of Her Majesty’s Government in this Parliament across a number of different areas.
Baroness Massey of Darwen (Lab) [V]
My Lords, at the end of a long and fascinating debate, I wish to speak about children—those under the age of 18. I echo the words of one of the first speakers, the right reverend Prelate the Bishop of Durham, who spoke about child well-being. Many other speakers have mentioned child development in a very moving way, and it is reassuring to know that that concern in very much alive in your Lordships’ House.
The Local Government Association report in relation to Covid, A Child-centred Recovery, speaks of working together to achieve change and development, following a crisis that has had a disproportionate impact on children’s lives. If this is not addressed in an inclusive way, many children will be damaged and will not achieve their full potential, thereby making levelling up almost impossible. A holistic approach to the problem would involve local authorities and services, the voluntary sector, communities, families, children and government departments talking and acting together. We have seen how a lack of consultation and working together is more costly and less effective. Systems must work together. Head teachers, while welcoming extra money for schools, have pointed out that more should be spent on the underlying causes of problems such as child poverty. Levelling up has to start way before children become adults.
With Covid-19, we have had a situation of monumental complexity and distress. Children have faced family bereavement, isolation, increased poverty, loss of public services such as in health and education, increased domestic violence and increased child abuse. Some services were inadequate before Covid struck due to lack of funding, giving rise to inadequate structures and severely overworked professionals. Child and adolescent mental health services are an example, and now we will need them more than ever, as Covid has given rise to enormous increases in the number of children needing mental health support.
Schools have gone through crises of indecision and have had to adapt teaching methods, including online learning. Parents have had to pick up the pieces, and many have found this difficult. Children have not been able to socialise, and speech and language development has suffered, with the potential for poor reading skills. Babies have had less interaction with other adults, including grandparents. Access to sport, the arts and culture has suffered. Catching up on education must consist of not just academic inputs but a broad range of educational experience, both for its own sake and to open up opportunities for young people, to enable them to gain social skills, confidence, empowerment and resilience.
What can the Government learn from the specific example of children during Covid? Well, children are the future and, if they do not function well, the future is bleak. And we need to create a society that functions well. I suggest emphasising the following. We need to ensure a minimum level of income for families, as well as sustainable resources for services dealing with children and adequate salaries for professionals dealing with children, especially vulnerable children. We need to consult professionals and communities, including children, about the best ways forward. We need to carry out longitudinal surveys that show how children are affected by Covid and how they develop over the next few years of their lives, and then act on that learning. We need to ensure that children have a voice, as they bring fresh perspectives, and we need to ensure that all legislation has a child impact assessment attached. We need to identify good practice; there are many wonderful efforts involving children, but who knows about them? We need a Cabinet Minister responsible for children who would co-ordinate all action for children in a visionary development plan and identify good practice. That is now accepted by parents, children, the voluntary and statutory sectors, and many politicians. I hope that the Government will listen to those pleas.
We must look at what comes next, building on deficiencies revealed by Covid and looking for new ways to work and treat people, paying particular attention to the future of our children.
Baroness Kramer (LD)
My Lords, this has been an absolutely fascinating debate. I can say with confidence to the Government that they can expect the Bills that they bring to this House to be extensively amended and, of course, improved.
I begin with the two maiden speakers that we had today and our sadly retiring speaker, because each raised a point that I would particularly like to pursue. The noble Baroness, Lady Blake of Leeds, talked about productivity outside London. She absolutely hit on this issue—productivity, which we find so difficult to shift and change, has to respond to local needs and local opportunities. I hope very much that, as we look at the various skills and other agendas that the Government pursue, they absolutely recognise and home in on that, because I have great fear of a much more centralised approach that will do nothing, just as it has done nothing over the past decade.
I have to say that the noble Lord, Lord Lebedev, and I probably look at life rather differently, but he talked about hungry children. I hope that I am not putting words into his mouth, but I think that he seemed distressed that it required a generous charity to make sure that some children actually get a decent meal on any day. If he was implying that it is right that, in a country like ours, every family should be able to feed their children properly, I hope that he will take that message back to the Government, as it has such implications for universal credit, job structures, educational opportunities and public service funding. I hope that he takes that message strongly back to the Prime Minister.
The right reverend Prelate the Bishop of Portsmouth, whom we will miss so much, said something that I think no one else has picked up in the House today and which was central to our discussions. If we are to achieve levelling up, we have to come to terms with and deal with the abuses and uncertainties in the gig economy. For that reason, I am particularly sad that the employment Bill, which we expected to find in this Queen’s Speech, did not make it, because that would have been the opportunity.
Indeed, it would have been an opportunity to deal with the even broader issue of self-employment. This House will know that I have been so frustrated that 3 million self-employed contractors have not been supported in any way throughout the Covid process. We are going through extraordinary change. Around this House, people have acknowledged the digital change that will come with the fourth industrial revolution and the change that will sweep through as we try to cope with getting to net zero and confronting climate change. All of that will drive a significant increase in self-employment. It has been creeping up on us year after year. The pursuit of a proper framework that follows on from the Matthew Taylor report has often been promised in this House and in the other place. The employment Bill would have been such an opportunity to deal with these issues and create that framework for the future.
Let me turn to the two issues that have occupied much of the time in this House. I will deal with them only briefly because they were covered so well by others. On social care and the NHS, the noble Baroness, Lady Walmsley, put her finger on the key issue; indeed, the noble Lord, Lord Adebowale, echoed and filled out some of what she said. We cannot sort out the NHS until we deal with social care because the problems in and inadequacies of social care spill constantly into the NHS. Therefore, creating the reform of social care as something to follow NHS reform is entirely the wrong way round.
I want to pick up on another point made by the noble Baroness, Lady Walmsley—not just by her, in fact, but by a number of other speakers. We are facing a crisis. Right at the beginning of our debate, the noble and gallant Lord, Lord Stirrup, pointed to the extraordinary clinical backlog that the NHS is trying to deal with. The noble Baroness, Lady Bowles, put a number on it: 395,000 patients. Noble Lord after noble Lord talked about that clinical problem. A state of crisis is not the moment to start carrying out organisational reform. I very much hope that the Government will think through that timing and order again.
Of course, there are a lot of other issues, whether it is the shift of power to the centre or the workforce strategy that we do not have. I am desperate that, after all these years of discussion, we still do not give parity to mental health issues. Then there are all those unpaid carers who have been utterly neglected; in fact, most of them did not even benefit from Covid protections because they were on legacy benefits.
The other big issue is that of lifetime skills. I come from a party that has wanted a lifetime skills strategy for years, and we have only part of one coming through here. I share the concerns that the lifelong learning scheme is based on a loan mechanism. It seems that the group of people at whom it is targeted is the least likely to want to take on additional debt. We need a scheme that entices people to use it and to increase their skills. I agree with others, such as the noble Baroness, Lady Morris, that excluding people who already have a level 3 qualification undermines the scale of change that we need in our skills base. I think it was the noble Lord, Lord Knight, who talked about the problems of loans.
In my remaining time, I want to focus on the issues raised by the noble Lord, Lord King of Lothbury, and to expand beyond them, because the underlying problem that we are dealing with is structural and economic. We have the fourth industrial revolution coming down the track, climate change, the issues of the self-employed and the problems of productivity, but we also have the impact of Brexit and are watching a slow bleed in many of those businesses and industrial sectors, particularly financial services but far from that alone, that have been the backbone of our economy for years—and, frankly, I do not think that free ports provide anything like the answer; they are just a way of shifting business from one area to another. We have to be honest and say that most of the new trade agreements that we have seen have been inadequate to make up the export opportunities that we desperately need.
I am concerned about the problem that sometimes dare not speak its name and the noble Lord, Lord Griffiths, finally did. We are at risk from inflation driving up interest rates. We have an overwhelming level of public debt. I join others in saying that I hope we can gradually roll that off over time—such luxury—but in my lifetime there have been so many economic shocks. I remember Gordon Brown thinking that he had ended boom and bust and that all kinds of flexibility were therefore available to him. How we think this through is fundamental. I agree with the noble Lord, Lord King, that turning to money supply as the way to manage or stimulate growth is now well demonstrated as completely inadequate; we have to use fiscal forces if we are to be able to achieve it. The noble Lord, Lord Bridges, addressed this issue to some extent, as did the noble Lord, Lord Eatwell, the noble Baroness, Lady Noakes, and my noble friend Lord Razzall. I probably would not agree with the solutions that they came to. We may have to turn to taxes as one mechanism to help us bring the debt under control. I do not believe that a low-debt environment is a constant stimulus to economic growth. We went through a period of very low corporate taxes and it did us no good at all, frankly; we saw investment fall rather than rise.
In the environment that we are in now, where we have the shocks of Brexit and of Covid, the fundamental challenges of climate change, the fourth industrial revolution and an underlying problem in productivity, we need a long-term economic plan. My fundamental criticism of everything within the gracious Speech is that there is no long-term plan. There are bits; there are pieces; there are ideas. There is not even a replacement for the cancelled industrial strategy, which, ironically, delivered us the vaccination programme and the capacity in life sciences that we have lauded so much. That is my main and deepest concern about the programme which the Government have put forward.
Baroness Thornton (Lab)
It is our first day discussing the gracious Speech and we have had almost 90 speakers, so the first thing I need to say is “good luck” to the Minister responding to the outstanding contributions and pertinent questions that have been put to him.
I welcome the two maiden speakers. As I expected, my noble friend Lady Blake drew on her huge experience. We are confident that my noble friend will be a huge asset to our Benches and to the House. I am sure that the noble Lord, Lord Lebedev, speaking from the Cross Benches, will gain much from joining the distinguished ranks of outstanding expertise and independence of party alignment that he will find there. I am sure that we will also miss the right reverend Prelate the Bishop of Portsmouth, whose forthright and—if I might say—sometimes progressive views have been greatly appreciated in your Lordships’ House. I wish him all the very best in his retirement.
I am grateful to my noble friend Lord Watson and other noble Lords—my noble friends Lord Winston, Lord Bassam, Lord Monks, Lady Morris, Lady Blower and Lady Massey—for their high-quality and comprehensive questioning of the Government’s education and training proposals, apprenticeship schemes and the lack of an employment Bill in the Queen’s Speech.
I realise that lumping together the economy, business, health and education in this debate is the Government’s idea of playing to their theme of levelling up, mentioned by many noble Lords. The problem is that the levelling-up agenda seems to be faltering and to be inconsistent; it is jargon without substance. Will it really tackle the inequalities of our country—the inequalities of race, poverty, distribution of wealth, and gender—and the sorts of problems that my noble friend Lady Lawrence outlined? Is it the case that Downing Street briefings suggest that financial constraints mean that it will be impossible to deliver?
Indeed, there is no doubt that this crisis has pulled back the curtain on the Conservatives’ insecure economy. It did not create opportunities for people across the country and left us badly exposed to the virus. We have had one of the worst death tolls in Europe and, while Covid has closed much of our economy, as my noble friend said, the Conservative Government have crashed it. This has been recognised by the OBR, which believes that a short-term initial recovery will quickly revert to the sluggish GDP growth of recent years, with an unemployment level that might reach 6.5%.
I was confident when I saw that my noble friends Lord Davies, Lord Eatwell, Lord Haskel, Lord Triesman and Lord Hain were all speaking today that they would be putting the important questions to the Minister. They certainly have, by saying that the only way to get the public finances back on to a firm footing is to secure the economy and get Britain on the road to recovery. I think my noble friend Lord Eatwell summarised in five minutes what the Government need to do.
Does the Minister agree that transforming social care must be treated as an economic priority, because the sector is as much a part of the economic infrastructure as roads and railways? The Labour Party recognises this, as does the US President, Joe Biden, who has included an investment in home care as part of his post-pandemic infrastructure plan. Will the Government do the same?
The Government’s sticking-plaster approach to supporting businesses has left firms hanging by a thread. Will the Government stand by their commitment to do “whatever it takes” to help businesses and workers through this next phase and recovery? Part of doing so involves the contents of the public procurement reform Bill: reforms to public procurement to help SMEs get better access to government procurement, which is absolutely right. Can the Minister guarantee that social enterprises, mutuals and co-operatives will not be excluded from this legislation and that due regard to social value regimes will be there?
I will pick up on a point made by my noble friend Lord Haskel about free ports. It appears that the Government have made a catastrophic blunder by signing trade agreements with 23 countries which include clauses that prohibit manufacturers in free-port zones from securing these perceived benefits. Is this indeed the case? What are the Government going to do about it?
I turn to health and social care—on International Nurses Day. I have, at least once a week while your Lordships’ House has been sitting in the last year, praised and thanked our NHS for getting us through the last 14 to 16 months of the pandemic. To our scientists, the volunteers, the auxiliary staff, the porters and those who have delivered the vaccine, we have all registered our thanks. This has been the public sector delivering what we needed it to deliver, in sharp contrast to the appalling waste of public money in the early days of track and trace. I welcome the Prime Minister’s commitment to a public inquiry into Covid.
The test of whether this Queen’s Speech genuinely delivers for the people of Britain is whether it brings forward a proper rescue plan for the NHS and delivers a social care solution, as the Prime Minister promised on the steps of 10 Downing Street almost two years ago. What is the timetable?
I was very dispirited reading the blurb the Government published alongside the gracious Speech, which says:
“The Bill will include provisions to allow us to get much better data and evidence about the care that is delivered locally.”
What nonsense! What evidence? What more evidence do we need that social care needs to be reformed? It sounds like kicking it into the long grass again.
Can the Minister confirm that we will see a draft mental health Bill very soon and it will go into pre-legislative scrutiny? Perhaps he could tell us what the timetable for that will be.
There are so many neglected areas in our health system—for example, dentistry. Millions of people have struggled to access NHS dentistry as the pandemic hit. Will the proposed reforms ensure that both primary and secondary care dentistry will be protected?
Public health, where we need a focus on tackling health inequalities, has been alluded to, but, with the creation of a new body in the middle of the pandemic and the previous 10 years of funding starvation and neglect of what were very effective public health services, can the Minister confirm how much the Government intend to invest to support public health services in the UK? How will they be integrated into the new proposals for health and social care?
Ten years ago, many of us attempted to persuade the Government that the then Health and Social Care Bill—the Lansley Bill—was a bad idea. I was very pleased to see that the noble Lord, Lord Owen, was in his place today, because he joined us in trying to persuade the Government to change their mind on that Bill. Well, we told you so. The promised NHS Bill has at its core the reversal of key aspects of the Lansley Act. The cost, both monetary and in terms of wasted opportunity, runs to many billions. The NHS must not repeat this waste—so why a Bill now? The noble and gallant Lord, Lord Stirrup, and my noble friend Lady Donaghy said it. Why is the NHS Bill being presented when recovery from the pandemic must have priority? It is far more important that the NHS recovers from Covid, that there is a solution to social care, that we invest in mental health, that we repair the destructive break-up of public health and that we have a sensible long-term workforce plan—to name just five priorities that must be ahead of reorganising the NHS. However, we can agree that competition for care services does not work and has not worked in the interests of patients, staff and often even the providers of care—so good riddance to that.
As my noble friend Lord Hunt said, there are some serious challenges in the White Paper proposals, with a complexity and multiplicity of bodies involved in planning and commissioning. Almost nothing is said about the vital role of patients, carers, families, voluntary organisations and communities in shaping how services are provided. This is a major weakness.
We can all agree that integrated care is better than disintegrated care, but structures alone do not produce integrated care. A culture change, robust accountability and strong governance—these will be what we examine when the Bill reaches your Lordships’ House. We will be strong in our scrutiny of how the new provider selection regime is set out in statute and guidance. It must eliminate pointless competition while not making crony contracts and outsourcing easier.
The new regime must bring total transparency, with no commercial confidentiality nonsense. The cost of doing business with the NHS should be to be a decent employer and a taxpaying and honest organisation. My noble friend Lady Bakewell flagged up in her speech the dangers we face here.
I look forward to the Minister’s response, but I ask that his noble friend the noble Lord, Lord Bethell, might address some of the questions he might not be able to.
The Parliamentary Under-Secretary of State, Department for Business, Energy and Industrial Strategy (Lord Callanan) (Con)
My Lords, it is a pleasure, privilege and—as the noble Baroness, Lady Thornton, pointed out—somewhat of a challenge to respond to today’s excellent debate on Her Majesty’s gracious Speech, opened so eloquently by my noble friend Lady Berridge. She spoke in her opening remarks of many of the priorities that this Government will focus on over the next Session and gave us a snapshot of the breadth of work that the Government will deliver on. Consequently, we have heard from numerous speakers today—almost 90 of them, in fact—engaging with different topics and making very valuable contributions to this debate.
I begin by thanking the noble Lord, Lord Lebedev, for his maiden speech, and the noble Baroness, Lady Blake, for her excellent maiden speech. They both join this House with valuable experience, and I look forward to engaging and debating with them both. The noble Baroness, Lady Blake, spoke of Leeds United. I am a Newcastle United fan, and it gives me no pleasure whatever to admit that Leeds have scored seven goals against Newcastle this season, and the less said about our respective positions in the league, the better—although I am comforted that we will both be returning to continued competition in the Premier League next year, and I am sure that we will give them more of a challenge next season.
I also congratulate the right reverend Prelate the Bishop of Portsmouth on his valedictory speech and associate myself with all the remarks that have been made by many noble Lords about his considerable contribution to the business of the House during his time in office. I know that he has been particularly focused on welfare reform and poverty and has given considerable service to the people of his diocese for over 10 years. I understand that he is now into his third week of retirement, which was particularly well timed with the end of lockdown and which will give him an opportunity to enjoy a well-deserved break and retirement. I am sure we wish him all the best for the future.
With so many topics to cover, it might indeed be easy to miss the forest for the trees. As we talk of building back better, climate change, green recovery, skills training, education, recovery and opportunity, it is important to remind ourselves of the dramatic context in which we are operating. There are of course huge challenges all around—there can be no doubt about that. However, I hope that there will be equally little doubt about how committed the Government are to tackling them. Our ambitions for the next Session are therefore not solely about recovering from the pandemic; they are about recovering in the right way, so that what comes after is greener, fairer, more resilient and more productive than what has happened before.
As our economy reopens, our schools get back to normal and our freedoms expand again, the Government have a legislative agenda to make the most of each of those challenges, whether that be embedding green options into our recovery, investing in skills and education, supporting the life sciences sector or continuing to support workers and businesses across the whole of the UK as they look for life to return to some kind of normality. In all of this our vision is both optimistic and realistic: built on the strengths of our four nations and a belief in our diverse people. When we talk about levelling up, that is indeed what we mean: uniting everyone behind a shared vision of a brilliant, pioneering United Kingdom, believing in the people of this great country and giving them the means to build their success in their own particular way so that, when we look back at this crucial moment in history, we will be able to say that this country led the way.
When it comes to leading the way, this country has been a true pioneer in the fight against Covid-19. I agree completely—for a change—with the noble Baroness, Lady Thornton, when she talked about the work of the NHS, our researchers and pharmaceutical companies. Their work has really been outstanding this past year and I am sure I speak on behalf of the whole House across all Benches in offering my heartfelt thanks to those heroes.
Surely the most welcome news of the last 12 months has been that more than two-thirds of the UK adult population have now received a first dose of a vaccine—myself included. That is entirely to the credit of the groups that the noble Baroness, Lady Thornton, and I have mentioned. They have shown what can be achieved when our health sector is given a clear goal, a lot of support and the freedom to think for itself.
The noble Lord, Lord Owen, asked about our preparation. For many years the UK has held and kept up to date preparedness plans for pandemic influenza and other infectious diseases, which provided a solid foundation from which we elaborated our response to the Covid-19 pandemic. As the noble Baroness, Lady Thornton, also just mentioned and as noble Lords will be aware, the Prime Minister today announced a full independent inquiry to begin in spring 2022. That is the right place to examine the response and learn the lessons that we will need to learn for the future. We now need to turn to the continued recovery of the bedrock of health services which the NHS is world renowned for.
A number of noble Lords spoke directly about the waiting list for patients. We are committed to recovering from drops in services caused by the pandemic, but it will of course take time. This year we are investing over £1 billion to help the NHS recover further and faster from the latest wave and to begin to address backlogs in elective care.
Many noble Lords made valuable contributions to the debate on health and social care—I probably lost track of all of them, but they included the noble Baronesses, Lady Brinton, Lady Tyler, Lady Bowles, Lady Walmsley, Lady Blower, the noble Lord, Lord Knight, my noble friend Lord Ribeiro, the right reverend Prelate the Bishop of Portsmouth, and many others. In particular, the noble Lord, Lord Patel, asked—as did, I think, the noble Baroness, Lady Thornton —about the contribution of the health and care Bill and how it will help local areas prioritise patient access. The Bill puts forward proposals for integrated care partnerships, bringing together NHS and local authorities to design and prioritise services for patients and the public, ensuring that they get the care and support they need.
In response to the second question from the noble Lord, Lord Patel, integrated care boards will have to set out how they will manage conflicts of interest. Moreover, in response to the point made by the noble Lord, Lord Scriven, in his question about how NHS reform will keep people healthy, integrated care boards and integrated care partnerships will give the NHS the means to identify priorities, including around prevention.
The noble Baroness, Lady Finlay, asked why there is no alcohol strategy. This is because the Government are already committed to publishing a new, UK-wide, cross-government addiction strategy. This provides opportunities to do more work on alcohol, particularly for those drinking at high-risk levels. We are considering the emerging evidence on the increased alcohol harms and alcohol-related health inequalities which have been seen during the pandemic and what further action is needed as we develop the scope of the addictions strategy.
My noble friend Lady Chisholm rightly spoke of the challenge of the recovery of diagnostic services; this is a priority for the NHS. Additional capital and revenue funding has been made available to deliver additional diagnostic capacity through new community diagnostic hubs and pathology and imaging networks.
The noble Baroness, Lady Donaghy, and the noble and gallant Lord, Lord Stirrup, spoke about the welfare and morale of NHS workers; they were right to raise this important issue. As we emerge from the pandemic, it is vital that staff have time to recover and to receive the ongoing support that they need. For some people, time off will be enough; others will need more specialist support and interventions. The NHS has established a people recovery task force to develop a framework and a set of interventions to support this. Local organisations can implement this framework flexibly, depending on their own particular situation.
I pay tribute to all noble Lords who raised the issue of mental health, which is so important. The past year has been tough for many people. The public have shown great resilience during these challenging times, but we know that the pandemic has had an impact on the mental health and well-being of many people in this country. The Government have published our mental health recovery action plan, backed by a one-off, targeted investment of £500 million, to ensure that we have the right support in place over the coming year.
The noble Baroness, Lady Greengross, spoke of funding for dementia research. We are strongly committed to supporting this vital work. The Government are currently working on ways to significantly boost further research on dementia, to meet commitments made in the Conservative Party manifesto.
The noble Baroness, Lady Bakewell, spoke about tendering in the NHS. The Cabinet Office is reviewing the full range of legislative proposals set out in the White Paper and is in discussion with the Department of Health and Social Care to ensure that we work together to shape procurement across government. The Government are clear that health and care data should be used and/or shared only where it is used lawfully, treated with respect, held securely and where the right safeguards are in place. Noble Lords should expect nothing less. The UK’s high standards of data protection will be maintained; trade agreements will not undermine—and have not undermined—the safeguards that we have in place for health and care data.
The noble Lord, Lord Astor, asked whether the Government would consider making Covid-19 testing VAT exempt. VAT is a broad-based tax on consumption, and the standard rate of 20% normally applies to most goods and services, such as testing kits. However, medical testing administered by registered health professionals is exempt from VAT. The Government continue to offer free Covid-19 testing to those with relevant symptoms and everyone in England, including those without symptoms, is able to take a free rapid coronavirus test twice a week.
Many noble Lords, including the noble Baronesses, Lady Tyler, Lady Bowles and Lady Jolly, spoke about social care. The Prime Minister has been clear that long-term social care reform is a top priority as we emerge from the pandemic. We will be working with local and national partners, including those with direct experience of the sector, to consider how we deliver the sustainable improvements that we all wish to see.
There can be no doubt that, without the efforts of our health sector, this country would be in a far worse state than it is in today. The same can be said for many of our businesses, which have shown extraordinary resilience over this past year. From businesses forced to close to those finding new ways for employees to work from home, employers have had to adapt as never before.
At the same time, many workers faced the prospect of losing their incomes as high streets ground to a halt and offices closed their doors. This has been a challenging time for millions of our fellow citizens and for businesses across the country. I am proud to say that the Government have been there to help them, every step of the way. The Prime Minister has already announced that step 3 of the road map will go ahead as planned next Monday, bringing a further degree of normal life that will be welcomed by all—although, of course, he also stressed the need for us all to remain vigilant. Alongside this, the Government’s package of support has evolved with the path of the virus and will continue to do so.
The noble Lord, Lord Hain, spoke about the choices of how long to continue this support. As an example, the Government’s policy to extend the CJRS until the end of September goes beyond what many businesses have called for. The CBI asked for an extension until the end of June and the British Chambers of Commerce asked for an extension until the end of July.
A number of noble Lords, including the noble Lords, Lord Griffiths, Lord Lebedev and Lord Sikka, and the right reverend Prelate the Bishop of Portsmouth, talked about the important subject of child poverty. The Government are committed to helping vulnerable families and have acted swiftly to provide support during the pandemic through their package of welfare measures. Her Majesty’s Treasury’s analysis published alongside the recent Budget shows that government interventions have supported the poorest working households most as a proportion of income. The Government have also recently extended the subsequent winter package to provide further support for children and families beyond winter until 20 June this year.
Many noble Lords, including the noble Lords, Lord Monks, Lord Haskel, Lord Bassam and Lord Watson, and the noble Baronesses, Lady Blower, Lady Ritchie and Lady Kramer, asked about the employment Bill. Given the profound effects that the pandemic is having on the economy and the labour market, we do not think it is right to introduce an employment Bill while the pandemic is still ongoing. In the interim, the Government have taken unprecedented but necessary steps to support working families and businesses and to protect jobs. We will continue to do so.
On the gig economy, which the right reverend Prelate the Bishop of Portsmouth asked about, the Supreme Court judgment upheld employment law status as it stands. Other operators in the gig economy will undoubtedly be looking at the Uber Supreme Court judgment, and should also ensure that they are fulfilling their legal responsibilities.
The noble Baroness, Lady Brinton, asked about flexible working. The Government have committed to consult on making flexible working the default unless employers have good reason not to. This consultation will be launched in due course.
While building back better, we also have to build back greener. My noble friend Lord Bridges spoke about the need for government to help businesses to go green. I completely agree. Andrew Griffith MP has been appointed by the Prime Minister to be the UK’s net zero business champion ahead of COP 26. Indeed, I have spoken alongside him at a number of events on this very subject. He is energetically encouraging UK businesses to sign up to climate action via the Race to Zero science-based targets initiative, championing the actions that businesses are already taking, and helping them to exploit the many opportunities of the transition to a low-carbon economy.
Finally, I say to the noble Baroness, Lady Uddin, that I completely agree that inclusive diversity is crucial to a successful economy, and Eid Mubarak to all those who are celebrating this week.
On top of the challenges that come from working at home normally—lack of access to colleagues, working from the kitchen table and so on—many parents have faced an additional hurdle: taking on responsibility for home-schooling. Some people prefer to educate their children this way, but for the vast majority it is not a choice that they have made. Education is the foundation on which our society and economy are built. It is vital that we ensure that it is inspiring and as consistent as it possibly can be, which means supporting schools, colleges and universities, giving young people the opportunities and the access to the ideas that they deserve.
Recovery is a vital. The noble Baroness, Lady Morris, speaking with the benefit of all her experience, asked when further information would be forthcoming about the schools catch-up programme. The Government are working with the Education Recovery Commissioner, Sir Kevan Collins, to develop an ambitious long-term plan that builds back a better and fairer education system. We will make an announcement on the long-term recovery plan in due course.
The noble Lords, Lord Storey and Lord Winston, spoke about support for schools. This Government are delivering the biggest funding boost for schools in a decade, which will give every school more money for every child. We increased core schools funding by £2.6 billion in 2021 and we will increase it by a further £4.8 billion and a further £7.1 billion by 2021-22 and 2022-23 respectively, compared with the 2019-20 baseline. This includes additional funding for children with special educational needs and disabilities.
I always welcome comments on disability, including from my noble friend Lord Shinkwin. The Government have an ambitious agenda on disability We are investing in a range of provisions to help people with disabilities get or stay in work, and we will publish a national strategy for disabled people shortly, which I hope will reassure the noble Baroness, Lady Grey-Thompson.
The noble Lords, Lord Clark and Lord Campbell-Savours, raised the issue of Newton Rigg. We are aware of the many challenges faced by Askham Bryan College and its Newton Rigg campus and have been working to identify a sustainable solution for its future. But it is important to bear in mind that further education colleges are independent of government, and the decision to close the campus was taken by the governing body of Askham Bryan College—but we have taken careful note of the comments from both noble Lords.
Also important were the points on freedom of expression raised by the noble Lord, Lord Lebedev. The Higher Education (Freedom of Speech) Bill will ensure that universities in England are places where freedom of speech can thrive for all staff, students and visiting speakers, contributing to a culture of open and robust intellectual debate.
The noble Lords, Lord Patel and Lord Eatwell, spoke about R&D funding and European schemes, including Horizon Europe. The Government will make available an additional £250 million in 2021-22, and £400 million of the funding announced at the spending review 2020 will support the Government’s priorities and help to pay for association to the Horizon programme. As a result, UK scientists will have access to more public funding than ever before.
The noble Lord, Lord Patel, also asked about ARIA. With ARIA, the freedom to make its own decisions will be central to its success, and that means scientists, not the Government, setting its research priorities. I hope the noble Lord will agree that the Bill balances that necessary independence with good governance, and as that is a Bill I will be taking through, I look forward to debating this matter further with him.
Of course, one of the principles underlining this Queen’s Speech is lifelong learning. As I am sure many noble Lords with children and grandchildren have learned in the past year, you are never too old to learn something new, whether that means getting to grips with video calling—remembering to unmute yourself, which is my problem—and seeing a familiar face from afar, getting to grips with algebra to help with homework, or learning how to exercise better, paint, play an instrument or even to just relax. We never stop being capable of adapting and improving, and the Government recognise that.
As we strive to take our economy in a greener, more productive direction, we have a duty to ensure that no one gets left behind. While our growth will be built on many of our existing strengths and skills, where new skills are required, we are committed to providing the training and education that people will need to attain them. On this topic, the noble Lord, Lord Watson, and the noble Baroness, Lady Morris, asked about sectors not covered by the lifetime skills guarantee. The Government are of course keeping the list of qualifications and the sector subject areas in scope under review to ensure that they adapt to the changing needs of the economy. Qualifications not included in this offer will, of course, still be eligible for advanced learner loans.
Finally, my noble friend Lord Baker, with his immense experience of education policy, asked about careers provision. We will introduce a range of measures to incentivise schools and colleges to prioritise careers guidance and to hold them to account for the quality of their careers programmes, including a strong statutory framework, tougher enforcement and an Ofsted review of provision.
While I acknowledge that this is a debate that could—and, I am sure, will—carry on into the months and years to come, I am afraid that it is time for me to draw my comments to a close for today, before I get the Whip’s warning. In doing so, I again thank all noble Lords who have contributed to this enlightened and important discussion. I trust that the noble Baroness, Lady Morris, will cross-examine my spelling and grammar with the same vigour that she has deployed in today’s debate.
The gracious Speech sets out a clear, confident vision for the United Kingdom’s path ahead: high tech, open for business, conscientious and inclusive. As we leave this most difficult of years behind, we are seeing the opportunities in the challenges and, I hope, in our people. We will build back quicker, greener and better than before, and I sincerely believe that in this parliamentary Session, we can set this country and this place on a path to a brighter future.