(2 years, 7 months ago)
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Lord Sherbourne of Didsbury
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 was addressed to both Houses of Parliament”.
The Parliamentary Under-Secretary of State, Foreign, Commonwealth and Development Office and Department for Work and Pensions (Baroness Stedman-Scott) (Con)
My Lords, on behalf of all noble Lords, I thank Her Majesty for her gracious Speech. I am grateful for the privilege of opening today’s debate on the Motion for an humble Address. I would like to take this opportunity to thank Her Majesty for the outstanding service and dedication to our country over these last 70 years. Her Majesty is deservedly held in the highest regard and deepest affection across the country and around the world, and it is an honour to serve in her Government.
Today, I will outline the Government’s plans regarding education, welfare, health and public services. These are at the heart of our mission to level up: to spread opportunity right across the country so that no matter where someone lives, where they were born or who their parents are, no matter what their background, health condition or circumstance, they can access excellent public services to improve their quality of life and realise their potential.
To deliver this levelling-up agenda, our public services and the Civil Service need to be set up in the right way so that we can deliver in an efficient and timely way for all parts of the UK, while we also focus on delivering front-line reforms that will improve lives: such as the Schools Bill that will level up standards in schools so they deliver for every child; by strengthening the academy trust system and supporting more schools to become academies; reforming attendance measures; and delivering the long-standing commitment of a direct national funding formula. Alongside this, it will improve the protection of children across a range of educational settings, making sure that the most vulnerable are not falling through the cracks.
The Government will also introduce a Bill to ensure our post-18 education system promotes real social mobility, is financially sustainable and will support young people to get the skills they need to meet their career aspirations and help grow the economy. In addition, the Government are fulfilling our 2019 manifesto commitment by taking steps to strengthen academic freedom and free speech in universities in England. The Higher Education (Freedom of Speech) Bill will strengthen existing freedom of speech duties and directly address gaps within the existing law, including the lack of a clear enforcement mechanism. This will help ensure that, as a country, we have the skills our economy and employers need for the future while providing young people with the very best start in life, so they can pave a solid path towards their future. Developing the right skills is key to unlocking greater prospects and prosperity for young people and adults alike. That is why the Prime Minister introduced the lifetime skills guarantee, so adults have the opportunity to gain new qualifications for free to help them to gain in-demand skills and secure great jobs.
We understand that there are some people in this country who, for a variety of reasons, cannot work and we are committed to providing the support these people need. That is why we are spending £242 billion overall on welfare and £64 billion on benefits to support disabled people and people with health conditions in Great Britain this year. Understanding people’s personal circumstances is an integral part of the universal credit system. Each claimant signs a claimant commitment, which is a mutually agreed contract between the claimant and the department. Sanctions are at very low levels and will be administered only when a claimant fails to comply with a requirement in the commitment, which is tailored to each claimant’s circumstances.
We know, however, that for those who are able to, work is the best and most sustainable route to raising living standards and lifting people out of poverty, and we want as many people as possible to take advantage of this and stand on their own two feet. The evidence shows that working-age adults in a job are around six times less likely to be in absolute poverty after housing costs than those not working. The latest data from 2019-20 shows there were 100,000 fewer children in absolute poverty before housing costs compared to 2010, with nearly 1 million fewer workless households and almost 540,000 fewer children living in workless households than in 2010. During this time, we have placed a sustained focus on making work pay—for example, through universal credit, and we entered the pandemic with the highest levels of employment this country has ever seen.
Since then, our plan for jobs, together with the great work of our jobcentre work coaches across the country, has been hugely successful in supporting, creating and protecting jobs and helping people get the skills and experience they need to move into, or back into, work. For example, sector-based work academies have supported people to move from struggling to surging sectors such as social care and engineering. Our job entry targeted support programme, which we have extended to September, supports the recently unemployed with specialist advice on how people can move into growing sectors, as well as with CV and interview coaching. Restart is providing intensive support for claimants unemployed for more than nine months and we aim to help 1 million people by June 2024. Kickstart has enabled over 162,000 jobs to be started by young people. Unemployment is now back to low levels, as we saw before Covid. In fact, today’s labour market stats show that the unemployment rate fell to 3.7% in the first three months of the year, which is the lowest since 1974.
In 2017, the Government set a goal to see 1 million more disabled people in employment between 2017 and 2027. The latest figures show that between this quarter and the same quarter in 2017 the number of disabled people in employment increased by 1.3 million, meaning that the goal has been met in half the time set and demonstrating just how much progress has been made. Through our disability and health White Paper, which we will publish later this year, we will set out our plans to help even more disabled people to start, stay and succeed in work where possible, and to live independently through a more effective health and disability benefits system.
We are committed to improving the nation’s mental health by modernising the Mental Health Act and will shortly publish a draft mental health Bill for pre-legislative scrutiny. It will contain draft measures that will allow for greater patient choice and autonomy, help us address racial disparities that currently exist within the Act and make it easier for people with learning disabilities or autism to be discharged from hospital.
We also need to focus on education. The special educational needs and disabilities—SEND—Green Paper, for example, aims to deliver a more inclusive education system with excellent local mainstream provision providing targeted support at the right time for those with special educational needs.
Through the Conversion Therapy Bill, we will continue our commitment to ensuring the safety of individuals by bringing forward a ban that protects everyone from attempts to change their sexual orientation. Recognising the complexity of issues, we will progress work to consider the issue of transgender conversion therapy further. Our actions to protect people from conversion therapy extend beyond legislating. We will deliver a support service for victims via a contracted helpline and website, which will provide initial pastoral support and signpost to services such as counselling and advice about emergency housing. This support service will be open to everyone who has been through, or is going through, conversion therapy, regardless of their background or identity.
Although it is a huge achievement to have the lowest unemployment since 1974, after the last two years we have been through, we know that many people up and down the country face huge pressures at the moment with the rising cost of living. We are keeping measures under review and doing all we can to help people, while maintaining a responsible fiscal position to ensure that we can continue to provide support in the longer term.
As we heard from the Bank of England, there is absolutely no room for complacency about unemployment and the wider economy. Alongside this, we are taking action to cushion the impact of price rises on people’s pockets, providing £22 billion of support. The Chancellor’s £9 billion energy package provides a £150 discount on council tax for those living in properties in bands A to D and the £144 million discretionary fund is available through local councils. The £200 rebate on energy bills this year will help spread the costs of the expected increase over the next few years. We have also extended the household support fund, providing a further £500 million to help households most in need with the cost of essentials: £421 million is being made available to households in England, as well as £79 million for the devolved authorities.
With more than a million vacancies available in the labour market right now, filling these posts means fulfilling potential and providing help with a pay packet. That is why the DWP is pulling out all the stops to get more people, including disabled people, moving into jobs and, importantly, progressing in them so that they can boost their pay, prospects and prosperity. For example, through our Way to Work scheme, we are getting people into jobs more quickly, with the aim to get 500,000 claimants into work by June. Way to Work is helping people move into any job now, to get a better job tomorrow and build a longer-term career.
To help people progress at work when they land a job, we are rolling out a new national in-work progression offer to provide extra support for claimants to build the skills, confidence and contacts they need to get on at work and move up the career ladder. This is underpinned by the stronger work incentives we have introduced as a result of lowering the universal credit taper rate from 63% to 55% and increasing the work allowance by £500 a year, which means people can keep more of what they earn.
As well helping people progress in the labour market, DWP also helps some of the most vulnerable people in society. That important work is about helping improve people’s quality of life, including those going through the most challenging of times. To improve their lives, we need to continually look at how we can improve the system.
The Social Security (Special Rules for End of Life) Bill will ensure that thousands more people nearing the end of life can access benefits sooner, without needing a face-to-face assessment or waiting period. The Bill extends eligibility so that those expected to live for 12 months or less, rather than six, will get fast-tracked access to three disability benefits: personal independence payment, attendance allowance and disability living allowance. It builds on changes we have already made to universal credit and employment support allowance. It will ensure a consistent end-of-life definition across the NHS, and health and welfare services more broadly, and introduces easily understood criteria which support implementation. The changes will ensure that we have a system that works—a system that gives those affected the support they need when they need it, and one that clinicians and charities can engage in with confidence. Above all, it is the right thing to do to help those facing the end of their lives with earlier and faster access to financial support.
At the heart of policies, processes and procedures are people. If we are to deliver on levelling up and break down the barriers people face, we must make sure that the government services on which people rely meet their needs.
That is why I am proud of the landmark British Sign Language Act. It legally recognises British Sign Language and requires the Secretary of State for Work and Pensions to report regularly on what each relevant government department has done to promote or facilitate the use of British Sign Language in its communications with the public. This will give us a much better understanding of how British Sign Language is being used across the Government, and how we can continue to improve communication for British Sign Language users.
More widely, the Government are bringing forward Bills to improve the way services are delivered and accessed by the public. The pandemic has shown how important it is that people are able to access government services online. Noble Lords will remember that, as a modern, digital and dynamic system, universal credit successfully stood up at the start of the pandemic when it faced a case load that almost doubled in the first year. Through the OneLogin programme, we will make it easier for more people to use a range of government services online. This will provide a single account for any member of the public in the UK to log in, prove their identity and access all central government services.
Through the procurement reform Bill, we will replace the bureaucratic EU regime for contracting services with a simpler, more flexible commercial system that is better and meets the needs of our country, while also complying with our international obligations.
That is in conjunction with various government initiatives to improve IT systems, such as the modernisation of the Child Maintenance Service. This feeds into the overall reform Bill and underlines the Government’s commitment to continually improve how they operate.
A key part of that is addressing the regional imbalance in where public sector roles are and where government operates from. Through our network of jobcentres, DWP has long forged deep and wide connections to communities across the country. Since the pandemic, we have increased our presence in even more towns and high streets, having opened 194 new jobcentre sites, 160 youth hubs and recruited 13,500 new work coaches. This is helping us to help more people in all corners of the country. Across government, we know we need to do more. That is why we are committed to moving 15,000 civil servants who design and make decisions about public services out of Greater London by 2025 and rooting them in more of the local communities they serve across the country.
Her Majesty’s gracious Speech reflects this Government’s commitment to levelling up across the United Kingdom, underpinned by our focus on changing the way public services are designed and delivered—looking beyond London to all parts of the UK. The reforms to education will spread opportunities and level up standards, ensuring that everyone can get the best from, and out of, school and higher education so that people can thrive in work and have the talent and skills our economy needs for the future.
Together with DWP’s expert support and focus on improving people’s quality of life, we want every person and every community to have hope, pride, opportunities and the satisfaction and dignity of knowing they achieved their potential and are not forgotten. My noble friend Lady Barran and I look forward to hearing all noble Lords’ valuable reflections on the measures I have outlined.
Baroness Wilcox of Newport (Lab)
My Lords, today’s debate covers some of the most important issues to a well-functioning society. I am delighted to be speaking to them on behalf of Her Majesty’s Official Opposition.
Arguably, education, welfare, health and social care and public services are critical and central to the Government’s latest populist phrase, levelling up. That is why it is so regrettable that the measures announced in the Queen’s Speech do precious little to make a real difference—if any—in these areas.
Schools and universities across the UK have been profoundly impacted by the pandemic. It is well documented that there is a disparity in this impact between schools in deprived areas and in the most affluent, yet despite the scale of the challenges schools are facing—indeed, the Sutton Trust found that one in three headteachers are using pupil premium funds to plug general budget gaps—this Government’s response is a desperately sparse Schools Bill.
It is a gaping hole of a Bill and consists mostly of one-size-fits-all academisation—we do not have it in Wales, that is why I cannot say it—on which the data is lacking or mixed at best, and formal naming and shaming of truant children through imposing compulsory attendance registers for schools. It is narrow in scope with little ambition and sparse policy, with 32 clauses on the governance of academies and 15 clauses on funding arrangements. It gives it an ideological approach rather than looking at the evidence.
How many more times are the Government going to rearrange the classroom desks, hoping for a better outcome? Where is the wide-ranging, substantiated plan to support children’s pandemic recovery? Where are the proposals to improve teaching standards or tackle the absolute exodus of burnt-out school staff? Where is the vision to equip our students with the skills they will need in the industries of the future, in an ever more globalised and technologically advanced economy?
In stark contrast, Labour is ambitious for every single child and every single precious teacher. Our children’s recovery plan would train up to 6,500 new teachers and give them ongoing professional development. We should not settle for less than world-class standards of teaching. We would introduce breakfast clubs, as we have in Wales, so every child starts the day with a proper meal. We would have afterschool activities, so every child gets to learn and experience art, music, drama and sport, as enjoyed by pupils in the private sector on Wednesday afternoons. We would introduce mental health support in our schools, because every report tells us that children’s development has fallen behind in the pandemic.
There would be targeted and funded continued professional development for teachers, which is absolutely vital for the workforce. There would be extra investment, right from early years through to further education, to support those children at risk of falling behind, because attainment gaps open up early and they need tackling early. Gains made in the early part of this century imploded during the savage cuts to public services imposed by this Government over 12 long years. In order to address this appalling deficit, we would go further to lock in the gains of a recovery programme for the long term. To ensure that education readies pupils for a rapidly advancing world of work, we would provide professional careers advice and work experience for all.
In the Government’s plans, higher education fares no better than schools. Instead of introducing measures to alleviate universities’ challenging financial contexts or reduce the record high number of student complaints in 2021 about their courses to the OIA, the Government have seen fit to give struggling universities two baffling, and in places troubling, Bills.
The higher education Bill will consider minimum qualification requirements for student finance and a cap on student numbers. Both are vehemently opposed by universities. As well as its huge adverse impact on social mobility, which expert bodies such as the IFS have pointed to, it is coupled with a worse still carryover—the Higher Education (Freedom of Speech) Bill. Your Lordships may remember that my party in the other place voted against this Bill at Second Reading, such was our concern about its enabling of hate speech and the potential financial implications for universities. Culture-warmongering and wedge-issue politics, again unsupported by any evidence, simply do not deserve a place in any Queen’s Speech—not when so many real problems for higher education remain.
The Government’s approach on social care goes alongside their failure on childcare. It is not fair and is unworkable, because the least able will pay the most. If your house is worth £150,000, you will lose almost everything while the wealthiest in society are protected. As for social care, on which the Government have not planned for any new legislation, I can assume only that they think the measures contained in the recent Health and Care Act are sufficient to deal with soaring care costs and a staggering staffing crisis. There is no mention of dentists, so critical to people’s quality of life, who are leaving the NHS in droves. This week is the Alzheimer’s Society’s Dementia Action Week, and the focus is on the theme of diagnosis. An acute diagnosis is the current state of our social care. Do the Government even mention the forgotten and undervalued millions of unpaid carers?
When it comes to welfare, Labour is on the side of working people. That is why we have set out our plans to reduce the taper rate when we replace universal credit, to allow those on low incomes to keep more of what they earn.
I regret having to give such a pessimistic speech, but I am afraid I have little positive to say about the Speech’s health Bills or, I should say, its solitary Bill. We do, however, welcome the long-overdue overhaul of the Mental Health Act.
After 12 years of Conservative underfunding, the NHS went into the pandemic with record waiting lists, 100,000 staff vacancies and 6 million people waiting for treatment. For any of this to work, the commitments are dependent on a sustainable workforce—our fantastic front-line staff, of whom there are simply too few right now. My dear late mother suffered greatly with mental health issues and we were entirely dependent on the wonderful NHS service we had available to us to support her in-patient and out-patient recovery; I dread to think what would be available to us now. Crucially, Labour wants to guarantee mental health treatment within a month for all who need it, and to place specialist mental health support in every school, resulting in over 1 million more people receiving support each year.
There is also the lack of a women’s health strategy, which was promised by the Government at the end of last year but has yet to appear. This is coupled with the latest announcement of the Government’s delay to restricting advertising on foods high in fat, salt or sugar. The department’s own impact assessment shows that these promotions result in additional spending for an average household—in an acute cost of living crisis.
I hope I have begun to shine a light on where the Government are falling far short on our public services. I must point out that, if their party had the last Labour Government’s record on the growth of the economy, there would be £40 billion more to spend on them, without having to resort to punishing tax rises.
In conclusion, I have spent my life as a public servant—as a teacher, a councillor and the leader of a council. I genuinely despair of the Government’s legislative plans for health and social care, education, welfare and public services. They are lacking in ambition and vision, and I would have hoped that, out of a total of nearly 40 Bills, we might have seen one Bill of true substance in at least one of these critical areas that are so crucial to a well-functioning society. As it is, it will fall to us parliamentarians to probe and push and negotiate our way to legislation that delivers real outcomes and some hope for the public. If that means sitting here in this House until the early hours of the morning to defend the indefensible, so be it. After too many years of a Conservative Government, it is our duty, and we will willingly fight for what is right and proper for the people of Britain. We will continue to seek Labour’s vision that this is the best place in which to grow up and to grow old.
Baroness Brinton (LD) [V]
My Lords, I declare my interests as a vice-president of the Local Government Association and as a vice-chair on the All-Party Group on Adult Social Care. I start by echoing the Minister’s tribute to Her Majesty the Queen and will add how good it was to see her using her Oyster card today on the new Elizabeth line.
A Queen’s Speech is obviously about legislation, the economy and finances, and the priorities of a Government. But it is also an indicator of the attitude and approach of a Government to how they are going to govern. The last five years have meant that they have had to face some extreme challenges; some of this Government’s own making—Brexit—and some external ones—Covid and Russia’s invasion of Ukraine—to which our Government have had to respond. The cost of living crisis, energy costs, food costs: millions of people are struggling to pay their bills, and with inflation currently at 7%, a 30-year high, this is likely to increase. Public services become even more critical when individuals and families are struggling, and they, too, are finding it difficult.
The Minister referred to the managed migration to universal credit, which has caused real problems for claimants. The Government’s own documents say that of the 2.6 million households still on legacy benefits,
“we estimate around 1.4 million (55%) would have a higher entitlement on UC, 300,000 would see no change and approximately 900,000 households (35%) would have a lower entitlement.”
But the poorest in our society already face impossible pressures on their costs, and for nearly 1 million households to face a lower entitlement because of a migration to a new benefit is a disgrace.
The Government say they understand the problem, but unfortunately there is no real offer of help for the people who are already having to choose between heating and eating, and who are not in a position to take on extra work, as one MP suggested yesterday, or to cook better. Instead, this Government will raise an additional £13.8 billion through personal taxes this year. That is why from the Liberal Democrat Benches we say that VAT should be reduced immediately, saving the average family £600 a year, and there should be an emergency Budget: these families need action right now.
The Social Security (Special Rules for End of Life) Bill, extending the period of terminal illness from six to 12 months to be eligible for special provisions, is also very welcome, but I hope that Ministers will also guarantee a speedy decision within a few days of notification, rather than using the extra time to delay implementation.
I am looking forward to my noble friend Lord Storey’s contribution on the Schools Bill, but I want to make a brief point on Part 3, to do with the register of children out of school. While it is absolutely vital that there is a record of where school-age children are, the Secretary of State announcing the naming and shaming of children not in school and their parents, as well as increasing the criminal penalties for parents, is very worrying, including for those parents who wish to home school.
Criminalising parents and naming and shaming children is completely inappropriate when a child, for example, has been so severely bullied that they are traumatised and waiting for a CAMHS appointment to start therapy, which currently can take 18 months to two years. It is also completely inappropriate that children who are immunocompromised, for example on chemotherapy, are currently forced to go into school without special measures and ventilation, even though their consultants say that these children cannot live with Covid. Parents of some of these children are currently being taken to court and fined.
Any register must record why a child is absent, and specialist advice, such as that of a hospital consultant, should be followed. This means alternative provision online may be needed and should be both provided and fully funded. Covid has also laid bare the inadequacies of too many school buildings, whether in terms of ventilation, appropriate space to learn in, or safety features, so we need an urgent investment in our school estate.
I have talked already about the increase in living costs, but many disabled people need much more heating than most families, and there are some who need to run life-saving equipment, such as ventilators and heart monitors, overnight. I have had family experience of this with my granddaughter. People in this particular group are very easy to help, because they are registered with their local energy supplier for emergency help in the event of a sustained power cut—so why cannot these disabled people be given grants to cover the extra costs that they face through no fault of their own?
More generally, disabled children cannot access the healthcare and other services that they have a right to. Forty-three per cent of families with disabled children have waited more than a year to get respite care, and more than four in 10 disabled children have waited more than a year for an operation.
The lack of funding available in local councils means that more parents of disabled children have had to take their local authority to tribunal to get the support they are entitled to. Lest you do not believe me, in 96% of hearings, the tribunal supports the parents. These children deserve that support, and frankly our local authorities deserve the funding that they need to deliver it.
Disabled people still face problems with transport and I am grateful to the noble Lord, Lord Borwick, who in his speech last week reminded us that when the Disability Discrimination Bill of 1995 was in Committee, the Minister said that
“taxis newly licensed must, as a condition of licence, be accessible to all disabled people, including those who use wheelchairs.”—[Official Report, 15/6/1995; col. 2035.]
In addition to that, we heard only two days ago of BBC correspondent Frank Gardner being stuck yet again on a plane because Heathrow’s disabled service had failed. There are many other problems. Nearly three decades after the Disability Discrimination Bill was passed, our taxi service can still opt out of carrying wheelchair users, and people can still just sit and wait on aeroplanes.
I turn now to working disabled people. NHS England has just reported that, even in the NHS, disabled staff are nearly twice as likely to face formal capability questions about whether they can do their job properly. NHS England is now asking trusts to look at whether they are doing that unfairly.
From these Benches, we have concerns about the Bill of Rights. We believe that it will further take away the rights of those with protected characteristics, including disabled people, who can currently rely on the positive obligations placed on public authorities by the European Convention on Human Rights. The Bill of Rights will cut those positive obligations and severely weaken people’s ability to access their rights under the convention.
Banning conversion therapy is absolutely the right thing to do. However, it is not right to exclude trans and non-binary people from the ban, thereby allowing conversion abuse to continue to take place against two groups of people with protected characteristics.
I am pleased that the mental health reform Bill is coming into the process this year. It is a very important Bill and the Minister was right to say that. People definitely need a stronger say in their treatment. However, the Royal College of Psychiatrists, the Local Government Association and many other stakeholders make the vital point that mental health reform must also include fully resourced funding for mental health services on the front line, training mental health professionals, workforce planning and community services. It is also vital that those with learning disabilities are not kept in secure accommodation. This is a scandal of which we should all be ashamed and which I hope will be ended by the Bill.
Mental health is part of a wider health crisis. This is undoubtedly partly as a result of Covid, but many of the current problems are long-standing and point to a lack of investment over the last 10 years and an unwillingness in Ministers to tackle them honestly. The NHS is undoubtedly in crisis and doing the best that it can, as it always does, while its staff is exhausted, understaffed and demoralised. The most visible points are the ambulance crisis leading to an A&E crisis, the lack of clinical staff and the cuts in capital spend, resulting in too many NHS trusts delivering services in poor buildings.
Today, a paramedic noted that her first patient of the day in her ambulance was now in a queue at the local A&E department. She commented that if today was like her last shift, she would spend the entire shift with this one patient in this one car park. This is not a one-off; it is happening all over the country every day. A&E departments are stuck because beds cannot be freed up, since patients cannot be sent from other wards into residential or nursing care—or even to their own homes—if there are no carers to look after them. The social care sector continues to see staff leaving for better paid jobs, including in the NHS, without being in a position to charge more for their services. Instead of real help, Ministers and the press continue to attack the NHS and the care sector. They attack the NHS for having too many managers, but the NHS’s 2% compares well to the German and French healthcare systems, which have more than double that figure.
From these Benches, we hoped to see more about tackling the inequalities in our health system. Whether they are based on deprivation, ethnicity or disability, we need to address the social determinants of health. Instead of cutting public health budgets, as happened to the UKHSA last month, we should be investing in food reformulation, tobacco bans and social prescribing. Until this happens, the focus will be on those already ill, rather than preventing them becoming ill.
Above all, everyone involved in the health and social care sector is looking to the Government to plan and invest in the workforce. The NHS staff survey published as recently as March found that 52% of staff said that they cannot do their jobs properly because of staff shortages. Vacancies across the NHS are now back to their pre-pandemic levels, with over 110,000 full-time-equivalent empty posts. Some 48% of advertised consultant posts are unfilled; this needs to be addressed urgently.
Finally, I ask the Minister why unpaid carers’ leave is once again not in the Queen’s Speech, despite it being a Conservative Party manifesto commitment. Over half of working carers say that they needed unpaid carers’ leave to help them juggle work and care. Despite commitments to help carers at the end of the passage of the Health and Care Bill, the Government have once again let carers down. Ministers talk of levelling up, but I fear that the Government are not listening to the evidence of how the current cost-of-living crisis and the cuts to our public services are affecting the most vulnerable in our country.
Lord Fowler (CB)
My Lords, I declare an interest as an unpaid ambassador for UNAIDS. I would like to concentrate upon health, particularly public health.
I remember intervening on a Question on HIV/AIDS three or four years ago. As I sat down, the Member next to me on those Benches said, “Of course, no one dies from AIDS any more”. The campaign of the 1980s was a distant memory, and AIDS no longer dominated the headlines—but, of course, his statement was not true then, and it is not true today. AIDS has been a deadly scourge, which has lasted for at least 40 years. Over 33 million people have died from AIDS-related illnesses since the start of the epidemic. Even today, 700,000 people a year die from AIDS—men, women and children, particularly young girls. It is an appalling toll, and one which this country must make every available effort to reduce and eliminate. We are now relatively fortunate in the UK but, even so, there are still well over 100,000 people living with HIV and all the problems that it brings: ill health, isolation and, above all, discrimination.
Other countries have not been so fortunate. If you take Ukraine—which I visited a few years ago to study its position—before the Russian invasion, it faced one of the worst and most serious HIV problems of any country in Europe, mainly from injecting drugs. Russia itself was much worse. However, in the last years the position in Ukraine had improved—thanks to the work of local and international organisations, including some from this country—but is now dramatically under challenge. The conflict has put the improvement at risk. Ukraine now faces formidable difficulties, including the dangers involved in getting drugs through and the risk to life that this entails, and the plight of those who are displaced and have become refugees.
The basic point I wish to make in this very short contribution is that although public attention may have drained away from HIV and AIDS, they still pose an enormous challenge to this country and the world—one that can increase because of new events such as war. In these circumstances, the question is: what can Britain do to help in this challenge?
Prejudice is a very serious issue. Perhaps we should say that although there have been Acts of Parliament that do away with the outright persecution of people such as Alan Turing—they are behind us—that does not deal with the whole problem. Changing law does not mean that all attitudes have changed, and individual examples become more important. At this point, may I say that I think the footballer Jake Daniels of Blackpool, who has taken a lead by coming out as gay only a day or so ago, is a magnificent example to this country?
However, we as a country need to be generous not only inside but outside. I remind the House again of my interest in the UN. In my view, our record over the past few years has been deficient. Frankly, it was a hell of a time to cut back on overseas aid. Yesterday, the Foreign Secretary published a new strategy. One part of that will be to make aid delivered more directly—we assume, by the Foreign Office—and a large slice will be taken away from organisations such as the United Nations and, I assume, UNAIDS that have undoubted experience, expertise and commitment. “Aid for trade” may make a convenient political slogan, but it is not, I suspect, a banner under which the small army of volunteers that we have in this country march. Let us be absolutely clear: if it was not for that contribution, this country would be in serious difficulties.
I am sceptical about what the Foreign Secretary is announcing. The banner that young people would march under would be one concerned with saving lives and preventing illness rather than some connection with trade. I say to the Government that I need to be convinced that the strategy set out by the Foreign Secretary at this stage is the right one to take this country forward.
The Lord Bishop of London
My Lords, it is a pleasure to speak in the debate on the Motion for the humble Address. I declare my interests as outlined in the register. There is much in Her Majesty’s gracious Speech to commend it to your Lordships’ House. However, it is unfortunate that it did not include any detailed remarks on the relationship between health disparities and the levelling-up agenda. While there was a valid emphasis on restoring the strength of the economy, it was a shame to hear so little detail on the circumstances that will enable us to economically bounce back: namely, our health.
Thankfully, the actual levelling-up report highlighted health as one of its mission areas, stating:
“By 2030, the gap in Healthy Life Expectancy … between local areas where it is highest and lowest will have narrowed”,
and that, by 2035, healthy life expectancy will rise by five years. The measurement of these missions, along with an independent body to ensure that they are seen through, will be vital to their success and essential in the wider context of health inequalities which we are facing post pandemic. Without these metrics and this accountability, we may well miss the goal of levelling up entirely.
The Health Foundation’s analysis shows that it will take 200 years to meet the goals named in the levelling-up White Paper, meaning that we are at least two generations away from a more equitable society. This is if we maintain what we are currently doing—and we are not. We are losing our healthcare workforce faster than we are replacing it. With a falling number of GPs, dentists and nurses and increasing pressure on the NHS, we are overlooking prevention of ill health and, by not investing sufficiently now in health coverage, we are storing up increased expenditure in the NHS in future. We need a comprehensive and integrated approach to restoring our collective well-being. To achieve the ambitious and worthwhile health missions of the levelling-up White Paper, we must be direct, pragmatic and specifically work them into legislation.
Last year, I launched a Health Inequalities Action Group, bringing together parliamentarians, interfaith leaders, health specialists and civil society leaders to explore how we can improve health outcomes across London and the social circumstances that surround them. In 2022, we hosted a series of community consultations to capture the different experiences. Through this work, we have found that faith groups, if sustainably supported, can continue to improve the work of statutory and civil society organisations to action complex health and social interventions. The action group is drawing out case studies of public health interventions that are modelled on relationships, trust and the mobilisation of resources.
One case study was the visionary community health worker pilot initiated by Westminster City Council. These public health professionals are trusted, permanent and regular visitors who are integrated in the community and connected to the local primary care teams and other relevant bodies necessary for community flourishing. This pilot was modelled after the Brazilian family health strategy, which began in 1994 and is now the primary care system in Brazil.
Brazil shares many of our disparities; research in this area by British GPs who have worked in Brazil laid out a rationale for why we should use this system in the UK. A national study in Brazil, featured in the British Medical Journal, showed that residents in areas with a long-standing coverage of community healthcare workers had a 34% lower cardiovascular disease mortality rate compared to areas without them. The benefits of such an approach to community care, and arguably the entire levelling-up programme, are clear.
I have said before that the vision we should be striving for is one of mutual flourishing, generosity and abundance. This is also known as the Jewish and biblical concept of shalom, which can be summarised as experiencing wholeness or a state of being without gaps. Together with those working for a more whole and healthy society, I would like this Government to act in line with the NHS long-term plan, which focuses on prevention and early intervention to reduce healthcare costs and the burden of disease. I would like this Government to adopt models and practices that embody efforts to design a more holistic health service—this is in effect aimed at achieving shalom—not just the absence of disease. It is an approach that needs to happen if we are to take the levelling-up agenda seriously.
Lord McColl of Dulwich (Con)
My Lords, I am grateful for the opportunity to speak about health again in this debate.
One of the many things that transpired from the Covid epidemic was the many acts of kindness, thoughtfulness and active help that the people of this country gave to each other. Lonely people were sadly deprived of company, but they received from kindly neighbours food and encouragement within the restrictive social distancing measures.
The country is now facing a number of huge crises, including the obesity epidemic, inflation and huge increases in the cost of heating our homes. More than ever, huge swathes of the public need help, encouragement, compassion and love. What is needed is an even greater increase in the already many acts of kindness and love shown to those who need it most. We cannot expect central and local government to supply all the answers, but we know that the vast majority of people in this country are willing to help one another in this great time of need.
There are so many practical ways in which help can be delivered, such as visiting lonely people, helping them with their food shopping, generally befriending and comforting them, and being cheerful friends. There are other activities, such as babysitting, childminding and transporting people to and fro, especially to GP surgeries and hospitals. Then there is encouraging families in wise shopping and cooking at home, and helping them to discover cheap sources of food that are more nutritious and healthier than a lot of the junk food presently on the market. My friend the noble Lord, Lord Boateng, reminds us of the Zulu exhortation, “Vuk’uzenzele”. In case any of your Lordships are not familiar with the Zulu language, it means, “Just get on and do it”.
One of the impacts of these crises is that some people are having to skip one meal every day. This may be all right for some of us, but it is a very difficult situation to be in when it is forced on hard-working people with few resources. We really need to work together to show compassion and practical help for the many who need it.
We need to avoid blaming one another for these disasters and problems. Being angry and blaming other people does not harm those so attacked, but it does a great deal of damage to those who indulge in the blame game, the anger game, the paying-off-old-scores game and revenge. These emotions tend to wreck the immune system and lead to more illness, more hospitalisations and greater strains on an already stressed health service.
We have a long tradition of Christian service and the service given by many of different faiths or no faith. The Church has a very important role in setting an example in these areas. After all, it is from our Christian foundations that this country’s hospitals and schools were set up in the first place and its welfare system developed. It is to be hoped that the bishops will support a unified vision to encourage us all. Of course, this may require putting aside personal party politics for the sake of being of one in spirit and of one mind.
When a politician was being badly treated and repeatedly interrupted on a television programme, he said, “Excuse me, sir. When you entered this BBC building at Langham Place, did you notice the advice inscribed in stone on the wall of the entrance?” The interviewer shook his head; he had not seen the exhortation, which had been there since 1922. It reads, from the New Testament,
“that the people, inclining their ear to whatsoever things are beautiful and honest and of good report, may tread the path of wisdom and uprightness.”
What the noble Lord, Lord Boateng, said in Zulu bears repetition: “Vuk’uzenzele”—just get on and do it.
Lord Sharpe of Epsom (Con)
My Lords, we had a small issue with the timer that has now been resolved, so perhaps this is a good opportunity to remind noble Lords that the advisory Back-Bench speaking time is five minutes.
Baroness Morgan of Huyton (Lab)
My Lords, I draw attention to my entries in the register—in this case especially as master of Fitzwilliam College and a trustee of the Education Policy Institute, because I will talk briefly about the Government’s priorities in education in the Queen’s Speech.
Many noble Lords all around this House have served in government, as Ministers or in No. 10. I suspect that many of us have the same view: that in government, the overwhelming priority should be to work to meet the needs of the whole country and not to govern with the party in power’s electoral interests as the paramount concern. I suspect that, at least privately, many share my real anxiety, and indeed distress, for the functioning of our democracy that that approach seems to be no longer functioning. Instead we have a sort of permanent campaign, dividing lines, political games and token gestures to appeal to elements of the electorate or the media, not serious programmes of government.
I am not naive—I was in No. 10 for eight years—but I maintain that for many Members across this House, of whatever party or none, the broad approach to government, if not necessarily the policies, is the same. But that priority—that governing principle, if you like —does not now seem to be paramount. By the way, that is not to say that individual Ministers do not work in that way, but everyone knows that the overall direction, priorities, purpose and principles come from the top.
We are told that the flagship policy is the Levelling-up and Regeneration Bill, and it sounds utterly laudable and much needed to improve productivity, boost economic growth, encourage innovation, create good jobs and enhance educational attainment. What is not to like? Unfortunately, the devil is in the detail: a combination of inadequate, small measures and a few political pieces of gesture politics.
Other days will have covered the vote on verandas, so let me talk about education. First, early years education: where is it? We have known for the past several decades that high-quality early years provision is essential. It is why many of our competitors are flying educationally. Sustained quality investment gives a strong grounding for school and beyond. We also know that the gap widened during Covid and is likely to get worse as a result of the cost-of-living crisis. So far as I can see, the only conversation at the moment confuses early years education with childcare and the only measure relates to the cost of childcare provision per child.
If you look at schools, we all know what the problem is. We all understand that there is a widening gap between advantaged and disadvantaged pupils. There is the effect of Covid, low aspiration, poor results, and poorer teaching and leadership in the poorest parts of the country. We all know that. What has to be done is not rocket science—we saw it in London Challenge and in other areas: a very clear dedicated team, sustained delivery, a focus on performance and leadership, and tackling teachers to make sure that we get the best to the poorest schools.
I agree with new governance where it is helpful—and I was certainly involved in city academies—but not for the sake of it. It should genuinely bring new skills and energy, a mixture of carrot and stick. We know that that leads to better outcomes, so we know that there is a blueprint. The Government’s response in the Queen’s Speech, frankly, is pretty pathetic. There is no proper recovery plan. There is no coherent levelling-up agenda; bits of little measures are scattered around the place but there is no real long-term interest or investment to make change happen. There are just little initiatives such as joining a MAT by 2030. That is about structures, not quality. We have got to have sustained progress, not headlines.
To be clear, I never excuse failure and poor outcomes but the deal has to be proper, practical support, sustained policy and investment. Frankly, for many years there has been a level of consensus across the parties about the priorities, and that is now being or has been broken.
On HE—that potential engine of economic growth and levelling up, a massive route to push productivity and improve skill levels, regionally and sub-regionally—at the moment, we have the leftover Higher Education (Freedom of Speech) Bill. I will not go there because I know we will spend time on that on other occasions. I look forward to the promised HE Bill that the Government have still to bring through. I hope they are serious about promoting practical policies.
Finally, I wait with real interest to see what advice will now be given to the Office for Students after the Secretary of State’s interview in the Times. Are we really saying that investment does not matter? Are we really saying that we are going to stop encouraging poorer applicants? I do not doubt the need for a sophisticated approach to admissions to good universities. That, frankly, would be very welcome. But a simplistic exams grade only approach will not be fair, will break well-established focuses on realising potential and especially will not encourage disadvantaged students, those with huge ambition and potential, and will not be good for the UK economy. Please let us together stop the campaigning and talk about governing.
Baroness Thomas of Winchester (LD) [V]
My Lords, I declare that I receive disability living allowance. I shall make just one point, but it is an important one for disabled people and must be looked at in the light of the cost-of-living crisis. It is the unacceptable delay in the waiting time for PIP—the personal independence payment—which helps people with long-term conditions manage their day-to-day living costs and get around. The delay I am talking about in the whole application process is now about six months and is particularly tough with the cost of living rising so fast.
PIP is a most welcome benefit as it is not means-tested and not taxed. It is an in-work as well as out-of-work benefit. Put simply, it helps to enable thousands of disabled people to keep going. To apply for PIP, either by phone or online, an extensive form must be filled in. An assessment is then undertaken by one of the DWP’s outsourced companies, usually either face to face or by phone. A DWP decision-maker then reviews the claim and either awards the benefit for a certain time or turns it down. At the height of the pandemic, there were understandable delays in this whole process, but it is not acceptable that the delays seem to be getting worse rather than better.
Making an assessment is not always straightforward, and this is especially true for those with fluctuating conditions, who must be affected more than 50% of the time to qualify for the benefit. At this point, I welcome the new Bill, which extends the right of those at the end of life to apply for disability benefits in a fast-track procedure. But for those who have a progressive long-term condition, such as a muscle-wasting disease, this is not a fluctuating condition but one that will progressively get worse. However, even those with progressive conditions are having to wait a very long time to receive an award.
Being disabled is very expensive. As well as perhaps needing extra heating or special food, many disabled people have appliances such as a hoist, an electric bed, a stairlift or a through-floor lift, all of which need power. As for help getting around, a Motability vehicle would be available if a claimant received the enhanced rate mobility element of PIP. Yet thousands of PIP claimants are waiting six months for a decision and cannot lease a Motability vehicle until the award is given.
I urge the Government to take immediate action to address the delays in the system. Why is it getting worse? Has the DWP recruited enough staff to deal with PIP assessments? Are there any plans to deploy DWP staff instead of using outsourced companies? We know that the population is getting older, so more people are likely to need disability benefits in the future. But we need to be sure that the whole process is working properly, which it clearly is not at the moment. I look forward to the Minister’s reply or a letter if that is more appropriate.
The Lord Bishop of Durham
My Lords, I declare my interests as chair of the National Society and co-chair of the Archbishops’ Commission on Families and Households.
A key question for evaluating the legislative agenda laid out in the gracious Speech is: are we, as a nation, prioritising the holistic well-being of all our children? I welcome the forthcoming Schools Bill. I pay tribute to the Secretary of State’s approach in constructively working with us to enable churches to have confidence in moving towards a system where all schools can be in a strong academy trust, maintaining their own ethos. The whole system must provide an education not solely pursuing the ends of maths and literacy but enabling children to be the best people they can be and to contribute to transforming the schools in which we live.
Small, rural schools pose a particular challenge. The Church of England provides around 65% of rural primary schools in England. The key to their flourishing is not simply the means for academic achievement; it also requires investment in rural economies so the whole community flourishes. I echo the emphases made to that effect in an earlier day of this debate by the noble Lord, Lord Cameron of Dillington, and the right reverend Prelate the Bishop of St Albans. For us, strong trusts are those where the vision, character and ethos promote an education that is, as our national Vision for Education explains,
“Deeply Christian, Serving the Common Good”,
where the vision for every child is that they have
“life in all its fullness”,
which is rooted in wisdom and not simply knowledge.
There are currently 1,250 Church of England academies, but moving to a system where all 4,700 schools are in strong trusts will require significant structural capacity and proper investment in teachers and leaders. Sustaining a culture of teacher excellence is transformative for pupils’ outcomes from the most disadvantaged backgrounds, so I hope that the Minister’s department will be sufficiently resourced for this through a budget which shows commitment to children’s holistic well-being through education.
Speaking of children’s well-being leads me to note the lack of action in the gracious Speech to alleviate the cost of living crisis. Those worst affected are families with children. In the north-east, almost half of families with children under five are in poverty. This is unconscionable. There are also significant concerns about inflation. The complexity in finding solutions requires openness to different routes on all sides to what is, I hope, a shared goal. It is vital that the voices of those who are the most vulnerable are heard and heeded.
My opposition to the two-child limit remains. I am disappointed that the Government have disregarded the overwhelming evidence documenting families being pushed into poverty. Sadly, often direct questions asked in this House regarding its justification have not been answered. It is crucial that we have an opportunity to focus on this, and for that reason I have tabled a Private Member’s Bill to abolish the two-child limit.
Every child is of great value and, as education is prioritised, we must recognise children as whole people whose welfare needs are inextricably linked to their education. I add my voice to the many who have raised their concerns about the progression of the managed migration to universal credit plan and the many unanswered questions regarding the uncompleted pilot, support for claimants and the consequences of failing to navigate the process. Concerns continue about the impact of the five-week wait, up-front childcare costs and accessibility issues. Concerns continue too about the treatment of some child refugees and asylum seekers.
Our children’s flourishing cannot be achieved in a one-dimensional way or only for some. We must ensure that children in larger families, in poverty, in families with no recourse to public funds, victims of trafficking and refugees can flourish at home, at school, in their neighbourhoods and online. I will engage with legislation this year with children’s holistic well-being in mind.
Lord Lingfield (Con)
My Lords, I refer your Lordships to my registered interests as chairman of the Chartered Institution for Further Education, the English Schools’ Orchestra, and several other charities and bodies connected to education.
I welcome greatly the emphasis in the Queen’s Speech on school education and particularly want to mention two potential measures: first, the promise to allocate funding fairly and consistently to all schools; and secondly, the determination to remove the current barriers for some schools to become academies.
First, many of us have had the experience of leaving the school gate, driving up the road for a mile or two, crossing a county border and coming to an almost exactly similar school serving a similar population of young people and discovering that, for almost forgotten historical reasons, the funding of the second school differs from the first by possibly hundreds of thousands of pounds—with all the knock-on effects that this has on the standards of education on offer. That is why a direct funding formula is required and I am very pleased to see that the further development of it is a priority.
This is to continue work begun in the early 1990s by the former Funding Agency for Schools, of which I was vice-chairman. Per capita funding allocated using the same criteria for wherever a child lives in the country is vital and fair. Wholly transparent exceptional adjustments should be made only when it is clear that they are deserved and necessary. Of course, a move to a nationwide formula for resources has to be carried out over a considerable period and with great sensitivity, as there will clearly be winners and losers as a funding increase in one area might lead to a decrease in real terms in others.
On my second concern, I have had meetings with governing bodies of some first-class and well-established schools that would like, in principle, to become academies. They tend to be church schools, voluntary aided or controlled, and selective schools, many of them with long histories that pre-date the introduction of state education. Some date from the 18th and early 19th centuries. They usually have a distinctive ethos; for some, this is a particular faith. The schools are usually owned by boards of trustees and not by the state or local authorities and will have a trust deed. The foundation governors are legally appointed for the purpose of ensuring that the school is preserved and developed in accordance with the trust deed. Their governors, while often attracted in principle to academy status, have expressed to me two major anxieties that often prevent them taking their interest further.
First, the present regulations for converter academies are too restrictive and often require the appointment of governors by outside bodies, unwelcome to a particular school, or the alteration of governance traditions that are centuries old. There should be much more accommodation in the current arrangements to take this into account. The Government should look back at the conversion regulations for grant-maintained schools—these were the precursors of academies. They were allowed to convert largely “as is”, or rather “as was”, as far as their governance arrangements were concerned. So, the current, often inflexible rules should be changed if more voluntary schools are to become academies.
Secondly, these schools have often been used to a special kind of independence within the system and would not wish to be thrust by law, as the recent White Paper seems to imply, into a multi-academy trust with other schools, although they often welcome loose federations with others in their localities. Some governing bodies greatly fear the loss of their autonomy to the bosses of multi-academy trusts and, in my view, with some good reason. Often, these voluntary schools are among the country’s best performing schools and there should be as few impediments as possible to them becoming stand-alone academies. They certainly should not be required to change historical governance traditions in order to accommodate a one-size-fits-all approach.
I look forward to the Second Reading of the new Schools Bill next week and the opportunity of further debate on these important subjects.
Baroness Warwick of Undercliffe (Lab)
My Lords, I want to address the role of higher education in the Government’s levelling-up agenda. I also want to mention housing issues raised in the Queen’s Speech, and I hope the Minister will be willing to pass on the points I make to her ministerial colleagues.
There is a university in every part of the country, and they are well placed to play a hugely important role in the levelling-up agenda. The role of these institutions in their local communities is often overlooked. In fact, universities are central to the local, regional and national growth effort. They are vital partners to local authorities and have huge networks including schools, big business, SMEs, charities and community groups. Quite rightly, the Government want universities to do ever more, recognising the role they could have in the levelling-up and the skills agendas, but they need adequate funding to do all this. Tuition fees are now frozen until 2024-25; they have reduced in value each year and are now worth in cash terms only two-thirds what they were 10 years ago. It is reasonable for the Government to expect efficiencies from universities, but they are reaching a point where they will have to consider reducing many of these very activities rather than enhancing them, or, where they have the choice, potentially recruiting more international and fewer domestic students, which seems a perverse outcome for bodies that could contribute so much to our national renaissance. I hope the Minister can reassure me that the Government will recognise the need to support the social and economic benefits that universities provide to the country. As the levelling-up directors are appointed, will she confirm that the Government will encourage them to speak to their local higher education institutions and utilise the expertise they will find there?
I now turn to housing. I declare an interest as the chair of the National Housing Federation, the trade body for England’s housing associations, and as the chair of the Property Ombudsman for the private rented sector. I welcome the introduction of the Levelling-up and Regeneration Bill last week. It is crucial that, through this important legislation, the Government ensure that affordable homes are available throughout the country for those who need them.
The Levelling Up White Paper rightly emphasised the central role that housing must play in closing the stark gaps in regional equality. For many, social housing would be the only suitable and affordable type of home for their families. That is why it is also vital that any changes to the planning system introduced through the Bill are designed to increase the number of homes for social rent in communities up and down the country. Can the Minister give me assurances on this matter?
I also warmly welcome the Government’s aim to improve the quality and regulation of social housing and strengthen tenants’ rights through the social housing regulation Bill. Since 2017, the National Housing Federation has been working with social housing residents on the Together with Tenants initiative to establish a new set of standards for housing associations, including a four-point plan for change and a new charter that sets out what residents can and should expect from their landlord. This work has already begun to deliver the new paths of accountability and influence for residents mapped out in the Social Housing White Paper.
The energy Bill should enable us to deliver the manifold benefits of decarbonising Britain’s homes. It will enable us to tackle fuel poverty and the climate emergency together, boost the economy and create jobs, as well as creating healthier, warmer homes and healthier, cleaner air. It is vital that we insulate and retrofit homes throughout the UK. I welcome the Government’s Social Housing Decarbonisation Fund, to which housing associations can directly apply for funding, but if we are to be truly transformational in our approach to tackling the climate crisis, we need a longer view. I ask the Minister whether the Government have plans to provide funding for making social homes more energy efficient beyond 2025.
Currently, Ofgem energy price caps apply only to individuals and not organisations. Many housing associations manage energy bills for housing schemes through heat networks. Residents who receive their energy this way will be the hardest hit by rising costs. I urge the Government to take action to ensure that emergency support is put in place for customers on heat networks.
Finally, I welcome the commitment to introduce a renters reform Bill and the establishment of a landlord ombudsman to allow tenants to seek redress and resolve disputes against their landlords. As chair of the Property Ombudsman, I know that our inquiries team takes time to talk to tenants on a daily basis, providing advice, guidance and signposting where we are unable to investigate a complaint. While there are many forms of dispute resolution, this is a service that only ombudsmen provide. Will the Minister confirm that the intention is for the landlord ombudsman not only to deal with complaints that fall within its remit but to provide an accessible advice, guidance and signposting service to help both tenants and landlords understand better their rights and responsibilities?
Lord Roberts of Llandudno (LD)
My Lords, if we are not able to rely on Ministers and other parliamentarians to tell the truth, then reliable and acceptable government is impossible. The recent police notices to those who had previously denied breaking the pandemic control laws lead millions of people to question the truth on matters of greater importance like, perhaps, the crises in Ukraine or Afghanistan—those that are matters of life and death.
We all know of broken promises. Putin was adamant: “We are not going to invade Ukraine”—we remember that—in spite of a procession of tanks stretching 40 miles, the distance from Chester to Colwyn Bay. Ukraine is in the midst of being invaded in spite of Putin’s denial, creating a hell for millions of children, men, and women. Putin’s assurances are as meaningless as denying being at gatherings that broke Covid laws. Government and the safeguarding of democracy cannot continue if those who lead cannot be trusted or believed. Mr Rees-Mogg tweeted over the Easter weekend, “Christ is risen, Alleluia”, a greeting of hope, while at the same time supporting deporting asylum seekers to Rwanda—a destruction of hope.
The consequences of these lies are the distancing of millions of ordinary people from government. If you cannot believe a word they say, there is no use voting for any of them. Turnout at general elections has fallen from 83% in the 1950s to less than 67% in 2019. We have grown increasingly apathetic about the democratic process, and nature abhors a vacuum.
The Government must change in order to show the British people that the Government can be believed and are engaged in the democratic process. Failing to do so will only increase apathy and sow distrust—something which, because of the unbelievability of the present time, continues to do immense harm. The United Kingdom can serve as an example to others, but not by refusing parliamentary scrutiny—for example, of the deal with Rwanda regarding asylum seekers or the continued lying about parties in gardens during the pandemic. We undermine democracy itself.
At the Liberal Party conference I used to sing the “Land Song”, which goes:
“Why should we be beggars with the ballot in our hand?”
and
“God gave the land to the people!”
Now we have to restore this trust. We must restore the value of ordinary people and their worth and influence in what is a democratic society.
Finally, Paddy Ashdown said:
“The one thing that unfailingly gives me satisfaction in politics is to watch those who have been taught they are the subject of others’ power, rise to meet the challenge of power in their own hands—and then be unbelieving at what they are able to do. To believe in this and make it happen is, for me, the great passion of politics.”
Baroness Greengross (CB)
My Lords, the gracious Speech had some very welcome announcements in it relating to the levelling-up agenda that will have a profound impact on health and care. Previously, I have expressed concern in this Chamber that levelling up is little more than a glib slogan. However, there are now some positive reforms on the agenda that could have tangible and important outcomes.
I declare my interest as set out in the register as patron of ARCO, the association representing retirement community operators. This model of housing, often referred to as “assisted living” or “housing with care”, allows people to live independent, healthy lives while living in a housing complex where care and support are provided if needed. Allowing people to live independently in this way reduces pressure on both the health and social care systems, and is greatly needed.
To date, fewer older people have moved into housing with care complexes in the UK compared with other countries. This is for two reasons. The first is a greater reluctance in this country to leave the family home, and the second is that it is costly and very slow to build this style of housing, in large part due to the current planning regulations. The announcement in the gracious Speech that the planning system would be reformed as part of the levelling-up agenda is a huge opportunity to remove these barriers. The government task force looking into housing for older people can help feed into this.
In countries such as New Zealand, where integrated retirement communities have become rather popular, there is specific legislation making it easier for developers to meet growing demand. This policy area is relevant to both health and social care, and indeed to planning, so having specific legislation could be a useful way to address this. I hope the Government might consider it. I was also delighted to learn recently from the Minister, the noble Lord, Lord Greenhalgh, that the Department for Levelling Up, Housing and Communities will be working with the Department of Health and Social Care to provide capital funding for older people to incentivise supply. Can the Government provide more information about this initiative—specifically, how the funding will be used to incentivise supply?
One of the biggest challenges we face as a society is a population that increasingly is living longer in very poor health. It was with great sadness last month that the charity Care and Repair, of which I and the noble Baronesses, Lady Andrews and Lady Eaton, were patrons, had to close due to lack of funding. The charity focused on home repairs and adaptations for older people living with disabilities. We can no longer rely on the charity sector to see that older people and others living with disabilities are living in suitable homes. Instead, the Government’s levelling-up agenda, in conjunction with the Department of Health and Social Care, will really need to turn their attention to this. I would be grateful if the Government could outline any plans that they have to address this.
I was pleased to hear that the Skills and Post-16 Education Act had received Royal Assent. This is a good start, but there is still a lot to do to see that we have a lifelong education system that will meet the needs of the 21st century. I declare my interest as chief executive of the International Longevity Centre, which recently projected that the UK economy could see a shortfall of 2.6 million workers by 2030. Investment in education across the life course will be one important way to address this. I hope the Government will respond positively to this important challenge.
Finally, I draw attention to recent comments by the Prime Minister, who expressed the view that 90,000 civil servant jobs should be cut. Civil servants play an essential role in helping government deliver in areas such as levelling up. I hope the Government will think carefully before making any more major changes to Civil Service numbers, because the Civil Service is so important to all of us.
Lord Goodlad (Con)
My Lords, I welcome the Government’s commitment in the gracious Speech to bring forward a draft mental health Bill. I hope that the consultation, ending in June, will be followed by early legislation. I particularly hope that the provisions of the Bill will address dementia, which is the fastest-growing health condition in the UK and, apart from the suffering and distress it causes, is set to be the most expensive condition by 2030.
Almost 1 million people in the country are currently living with dementia, costing the economy £25 billion a year. Among the leading causes of death, dementia is the fastest-rising health condition, with the number of sufferers expected to increase to more than 1.6 million by 2050. Despite this, no new treatments have been approved in the UK to prevent, slow down or cure the diseases that cause dementia in nearly a decade. I hope that the Government will deliver on the manifesto commitment to the dementia moonshot, to double funding for dementia research and speed up clinical trials, as soon as possible. We should establish a dementia medicines task force to drive dementia research and clinical trials, as has been done in other fields—most recently Covid.
I also welcome the Government’s commitment to publish and implement a women’s health strategy, which would be closely integrated with the promised forthcoming dementia strategy. Dementia has been the leading cause of death for women for more than a decade. In 2020, around 46,000 women died from dementia, compared with 33,000 from Covid-19. Women are at greater risk of dementia than men, although dementia was the third most common cause of death in men in 2020, after Covid-19 and heart disease. Nearly two-thirds of dementia sufferers are women. The lifetime risk of developing dementia for women is one in five, compared with one in 10 for men. Nobody yet knows why this should be.
I welcome also the Government’s commitment to invest £2.3 billion to increase diagnostic activity and to establish 160 community diagnostic centres. Dementia is seriously underdiagnosed and should be specifically included—I hope in the legislation—in the scope of the community diagnostic centres. In the long term, the Government should in my view provide the resources, infrastructure and clinical workforce to build adequate diagnostic capacity. Dementia is a condition directly or indirectly affecting nearly every family in the land. I hope that the Government will now give priority to research into its causes, diagnosis and treatment.
Baroness Morris of Yardley (Lab)
My Lords, I welcome the opportunity to speak today on the part of the Queen’s Speech debate that addresses public services. Quite frankly, it is probably the most important area because, without success here, none of the other areas of government and activity within the community can thrive and succeed. This is about giving people skills, and about giving them both support and opportunity; it is also about setting the values against which our society ought to operate. These are key debates.
On higher education, briefly, I may find myself out of step with my own party on the freedom of speech Bill; I shall see. I look forward to seeing the details. I will have to consider whether the Government’s suggestions are the way to solve it, but I take the view that there is a problem to be solved and that it is not acceptable that many academics have found themselves hounded because they have spoken their view. I worry about the context of the other higher education proposals. There is a worrying trend at the moment to say that we have too many young people going to university. That is not true—we want more, not fewer—but yes, we want good standard courses and good routes to employment as well. I read in the proposals a bit of that format of, “Hang on, we’ve gone too far. Quite frankly, too many kids ought not to have gone to university. They used to do apprenticeships; they ought to go and do them again.” That would mean closing down the doors that have taken so long to operate.
As I said, I look forward to thinking about that piece of legislation, but the Schools Bill is what I mainly want to address. Gosh—there is not much there, just as there was not in the White Paper. It is the first schools Bill since 2016. If you said to any teacher or anyone else who knows about education, “Come on, it’s been six years without legislation. What’s on your list?”, it would be things like teacher recruitment and retention, and changes to the curriculum to meet the changing demands of society. Lots of smashing thinking about new forms of assessment is going on among schools, and lots of people have done good work on the new accountability structure. None of that is in this Bill, yet those are the things that need to be addressed. The reason it matters, as I know from my own experience, is that when a Bill is being implemented, the whole energy and resource of the Department for Education and its Ministers is about implementing the Bill. Other things get swept off the agenda—and that measure goes down to the schools. We already have teachers beginning to worry about whether they will have to become an academy this year, next year or in 2030. That is not a good message to give.
What is the Bill about? What is there? Quite simply, it is the same as the 2016 Bill. It has the same measures trying to do the same things. The difference is that the noble Baroness, Lady Morgan, wanted to do it by 2022 while this Government now want to do it by 2030. Let us be clear about this. The Bill is about trying to remedy the effects of the 2010 Bill created by the coalition when it came into power. The result of that has been terrible fragmentation of the school system, underperforming academies with no measures to deal with it, and lack of accountability of the academies through the funding agreements.
Every single one of those problems was predictable; go back through the debates in 2010. It is clear that both the Liberal Democrats and the Tories have to take responsibility for this. They were predictable consequences of a policy that deliberately went out to favour only academies but did not have the courage to make all schools academies, so it settled on 10 years of incentivising. A bit—in fact, a lot—of me wishes that the Bill from the noble Baroness, Lady Morgan, had gone through. I am going to look carefully at this new Bill because the way things are now with this fragmented system is not good; it is not helpful position for us to have been put in. However, I make my position clear: I have never been against academies. How can you be against a good school just because it is an academy, or because it is a local authority school or a church school? It is not about the structure or the governance. It is about the quality of teaching, the leadership and all that—none of which is in this Bill.
I cannot find one thing in the Queen’s Speech that will help raise the quality of teaching and the standard of school leadership. The energy of the department will all be away from that and all about implementing something, and we have eight years of uncertainty before we actually reach the objectives. I would very much like the Minister to explain why 2030 has been chosen. The only other vehicle on the road at the moment as regards schools is the catch-up programme; I do not have time to talk about that. However, if this empty Bill and a fairly discredited catch-up programme are how we are trying to take forward our joint wish to raise standards and do well for the children, then I am worried. I very much look forward to the debate.
Lord Addington (LD)
My Lords, it is always a challenge and a privilege to follow the noble Baroness, Lady Morris. Following up on one point, I would say that she is absolutely right: I do not think many people care whether their school has the label of “academy”, “maintained”, or “run by the small green men from outer Mars”—as long as the damn thing works. If you get the children through with the grades, the incentives and what they need for the next stage—and enjoying the process, I hope, or at least some of it—everybody is reasonably happy. I hope that this will be acknowledged when we get down to the joyful little slugfest that will be that Bill.
The main thrust of what I want to say is to ask the Minister for a little context about how the work that we are doing to review special educational needs will fit into this Bill. The first clause of the Bill suggests that the Secretary of State will do lots of things and set standards. I remind the House of my interests, particularly that I am dyslexic and president of the British Dyslexia Association. Special educational needs include a huge range of subjects, all requiring slightly different approaches to get the best out of the people who fall into these categories. Usually, they are not by themselves; usually, there is another factor behind the real, serious problems.
The weirdest thing about the system we have is that very severe problems stand a better chance of getting through because they are spotted. The students concerned may have greater problems in life et cetera but, if you have something obvious, you will normally get help. There will be many dyslexics but they are not just dyslexic; you can add in dyscalculia, dyspraxia, attention deficit disorder and high-functioning autism. These are people who will be within the normal classroom; how are possibly five such students in every classroom to be accommodated? Two or three children may have all these conditions combined; it is not that uncommon. How do we make sure that there is enough flexibility in our teaching approaches to ensure these children will get through?
Am I overreacting about this? Well, systematic synthetic phonics—if I have the term right; I often manage to get it wrong when talking to people—is supposed to be the way you teach people English. That is great, but it does not work for dyslexics because it puts too much pressure on one of the areas of short-term memory that we are bad at. So we have a fundamental problem; we need to use something else, another way to get through. How are we to institute that?
If we have a system where the Secretary of State says, “This is the way we’ll do it”, will we ensure that he is advised so that we get enough information and flexibility, and enough training into the normal classroom—I emphasise “the normal classroom”—to allow these people who are there in considerable numbers, reckoned to be 20% of the school population, to function?
What use are we going to make of technology? I know that the noble Baroness is doing some work on this, and I appreciate that, but it should be written into the Bill that you will need, for instance, flexible choices to get the best out of technology. I have yet to see somebody who would object to me word-processing by speaking to a computer—as is my day-to-day existence—as opposed to tapping a keyboard. Nobody cares. You are still communicating using the written language, so who cares? That is just one example of how you could use technology. Are we going to take that on board and build the flexibility in?
I hope that, over the next few months, we will get a system where, whatever comes out of this, we will have instituted the fact that one size does not fit all, even if fits most. We have a bit of change and a little give will be in the system. We will help ourselves and have more people getting through. Whether that will be enough to hit our 90% target, I know not—and I suspect not —but we may do better than we are at the moment.
Baroness Cumberlege (Con)
My Lords, it is always a great pleasure to follow the noble Lord, Lord Addington, because he always says something of real interest; today was no exception, and I congratulate him on that. I declare my interests, which are in the Lords’ register.
I will be brief. I want to focus on one issue that is related to our healthcare system. As we know, the NHS is under great pressure, with a workforce crisis, the impact of Covid and a huge backlog of patients awaiting treatment. Yet we also know that the NHS is capable of great things: it saves and improves lives, and it enables us to live our lives, day in, day out. But sometimes things go wrong, and I do not mean isolated incidents. I am referring to avoidable harm on a sustained and widespread scale. That is what my team and I discovered when we undertook the Independent Medicines and Medical Devices Safety Review.
Thousands of women’s and children’s lives have been turned upside down by two medicines and a medical device. Warnings and patients’ concerns were ignored. The system seemed unwilling or unable to listen, let alone respond. It was unwilling or unable to stop the harm. The harm these women and their families have suffered is irreversible and lifelong: children with physical and cognitive damage from the anti-epilepsy drug sodium valproate; women in agony due to the cavalier attitude on inserting pelvic mesh; and women who took the hormone pregnancy test Primodos, and miscarried or had children who were physically damaged.
Things do go wrong, and when they go wrong on this scale lessons really have to be learned. We have to learn to prevent similar tragedies in the future, but that is not all. We must also accept that in any decent society we have a moral and ethical duty to provide help to people whose lives have been ruined and who suffer constant emotional turmoil through no fault of their own. They did nothing wrong. The system failed them and we have a duty to help them. We must not turn our backs on them.
This principle of providing redress is not new and has been applied in this country—for example, in the case of Thalidomide and in variant CJD, where a fund of over £67 million was allocated by the Government for victims of the disease. There was no need to go to court or to prove negligence or liability. This is not compensation. Going to court is costly and stressful, and it has not helped the families affected by sodium valproate, Primodos and pelvic mesh. They need redress schemes. Just like Thalidomide victims or those diagnosed with variant CJD, they need and deserve our support—not just financially but with practical, non-financial help as well. Other Governments are acting—in France, for example—and it should happen here. We should ensure that redress schemes are established.
Even now, two years after we finished our review, I am regularly contacted by affected individuals who tell me of their suffering and what they need. I know their lives would be improved immeasurably by the support that such a redress scheme would offer them—a new wheelchair, a respite break or additional help at home, for example. They cannot currently access these things from existing state providers.
There is widespread cross-party support for this in this House and the other place. The patient groups support us, of course, and the Sunday Times is calling for it. The Government have so far refused to help, saying that their focus is on preventing future harm. This should not be a choice between reducing the risk of future harm on the one hand and helping those who have already suffered on the other. We should do both. We must do both.
Baroness Pitkeathley (Lab)
My Lords, it is a pleasure to follow the noble Baroness. Many patients past, present and future have reason to be extremely grateful for her work.
I was listening with half an ear to the opening debate on the gracious Speech in the other place, when I thought I heard the Prime Minister say that the Government were giving confidence to people so that they knew they would be looked after in old age by fixing social care. I did a bit of a double take and thought, “I can’t possibly have heard that right—he can’t have said that”. So the next day, I got the Hansard of the debate and, sure enough, there it was in black and white: the Government are “fixing social care”. Well, you could have fooled me.
Most people in employment, including of course many of those actually providing social care, will have noticed the effects of the health and social care levy on their pay last month—their contribution to the £12 billion that is set to improve health and social care. Most of those of us who worked in the social care field for years were always pretty cynical that any of the £12 billion would reach the front line, as it was always going to be used first to clear NHS waiting lists. Social care is, after all, used to being the tail-end Charlie in these matters.
Given that waiting lists now stand at 6.5 million, the highest figure since records began, and seem to be growing exponentially—perhaps reaching 14 million by 2024—I do not hold out much hope of any of the money reaching social care. Yet why are people waiting so long for a knee replacement? Why are they waiting more than 12 hours for admission via A&E? Why are paramedics stuck in queues for a whole day, as we have heard, instead of answering emergency calls? The answer is so obvious that it beggars belief it does not drive the policy.
The answer is that patients are not being discharged at the other end of the process. And why not? Because there is inadequate social care to receive the discharged patients and care for them so that they are not readmitted to hospital, thus starting the whole sorry process all over again. Is it any wonder that the usual suspects who speak in your Lordships’ House on social care are weary, disillusioned and angry?
When it comes to social care, I always remind your Lordships that the main providers of this care are not public services but the millions of unpaid carers who do most of the heavy lifting. With regard to carers the Queen’s Speech was a bitter disappointment, as the noble Baroness, Lady Brinton, reminded us. In 2019, the Conservative Party manifesto committed to introducing a right to one week’s unpaid leave—I repeat: one week, unpaid—to help with caring responsibility. We expected an employment Bill to contain this provision but it was notable by its absence. That the promised employment Bill has been excluded from the Government’s commitments for the next year is a severe blow to unpaid carers and a huge missed opportunity.
The Government had been very keen to stress the introduction of a right to carer’s leave, as support for unpaid carers, as an important part of their delivery of social care reform, hospital discharge and staying in work. It is essential, given the pressures on families as the cost of living crisis deepens. Are the Government now back-tracking on their manifesto promises to carers? This is such a missed opportunity to value carers and to ensure they have the support to continue to juggle work and care.
With severe social care shortages and pressures on the NHS, families simply cannot do it all. Many are at breaking point. This is precisely the time when the Government should be investing in carers and their families, as well as employers, by bringing in the right to one week’s unpaid carers leave, and a right from day one to request flexible working. It is a modest enough request, surely. Five days unpaid leave might just stop you having to use all your holiday leave to take the person you care for to their endless hospital appointments and would be a small step towards helping employed carers stay in employment as long as possible. Why do we want them to do that? To help them stay solvent while they are caring, and to stop them building up poverty for the future by losing access to pensions from employment.
As I have been so disappointed in the gracious Speech, I must pin my hopes on a Private Member’s Bill. Three times over the last few years we have had success for carers through this route, and if any Member of the other place wishes to take up the issue—I hope at least some of them are listening—I earnestly hope that the Government will commit to support it.
Baroness Jolly (LD)
My Lords, my heart sank somewhat when I saw that the noble Baroness, Lady Pitkeathley, was ahead of my on the list, because I knew full well what she would talk about. My speech is all about carers as well, but we are coming at it from a completely different tack.
I looked at the Queen’s Speech and tried to work out what was missing. The subject of carers was completely missing—just not there. So, let us look at some hard facts. We know that many carers look after friends and family, juggling work and caring. One in eight adults considers themselves a carer; that is around 6.5 million people. Every day another 6,000 people take on a caring responsibility, which amounts to an increase of about 2 million people each year. Figures from the ONS suggest that just under 250,000 people under 19 are carers, and about 23,000 are under nine years old.
The Government say that schools have a key role in supporting young carers. I am happy with that, but who leads on determining this support, DfE or the NHS? I would be grateful if the Minister could clarify what this might look like. Over a million people care for more than one person. Carers save the economy £132 billion a year, which is just under £20,000 per carer. Five million people in the UK are juggling caring responsibilities with work; that is one in seven of the workforce. However, the significant demands of caring mean that 600 people give up work every day to care for an older or disabled relative. Carer’s allowance is the main carers benefit and is £67.60 for a minimum of 35 hours—the lowest benefit of its kind. This surely should be reviewed.
People providing high levels of care are twice as likely themselves to be permanently sick or disabled. Some 72% of carers responding to Carers UK’s State of Caring 2018 survey said that they had suffered mental ill-health as a result of caring; 61% said that they had suffered physical ill-health. Eight in 10 people who cared for loved ones said that they felt lonely or socially isolated. Can the Minister tell the House where carers can look for support and advice in these sorts of situations?
At present, people with a learning disability and/or autism can be admitted to an NHS in-patient unit under the Act, even if they do not have a mental health condition. Learning disabilities and autism are not mental health conditions, and the removal of this definition from the Act should go some way to reducing the number of people who are unnecessarily detained in in-patient units. Many noble Lords will remember the scandal exposed by an undercover BBC “Panorama” journalist at Winterbourne View Hospital. What happened there was criminal—and I do not mean that as a figure of speech; it was criminal. Six former members of Winterbourne View staff were jailed for the terrible crimes they committed against their patients, but the serious case review showed that there was a wider failure across the whole system.
There are still more than 2,000 people with a learning disability or autism trapped in in-patient settings, and the average time spent there is over five and a half years. People with either a learning disability or autism or both should be able to live with the support they need, where they want it, and be closer to family and friends. However, if the Government are truly committed to “transforming care” they must go further by getting the care right and ensuring that everyone with a learning disability or autism has their support needs met and can live where and how they want to.
Baroness Finlay of Llandaff (CB)
My Lords, this gracious Speech was interesting in part for what it did not contain, despite containing a large number of Bills. The noble Baronesses, Lady Jolly and Lady Pitkeathley, have focused comprehensively on social care. I will address issues for the workforce in health, including the impact of the war in Ukraine, preparation for adulthood of children and young people with learning difficulties or autism, and the importance of kinship care and our need for an alcohol strategy.
The Government have stated an intention to build 14 new hospitals by 2030 and upgrade another 70, including by providing new beds, equipment and technology, and they plan to set tight targets for elective recovery. We have just passed the Health and Care Act, and each statutory instrument for its 160 delegated powers will need to be debated. But the Government rejected legislated workforce planning, despite the deficits in staff at every level, including in social care.
Our intensive care bed capacity must expand, with highly trained staff to manage complex elective surgery and recovery from life-threatening illness, as well as increasing organ donation by those who have lost their lives in catastrophic circumstances, usually accidents. Our high-quality ethical transplant programme is hampered by a shortage of facilities. Here I should declare my interest as chair of the Commonwealth Tribute to Life UK committee, which has produced a memorandum of understanding for shared learning as a legacy from the Commonwealth Games.
My Lords, the war in Ukraine has resulted in many UK students returning to this country. Some 600 of these are medical students who had been unable to secure places in British medical schools originally and therefore went to study medicine, taught in English, in Ukraine. Most planned to return to practice medicine here, having secured GMC registration. Yet we have a fixed number of places in our medical schools and the current thinking is that these students will have to go back to the beginning and reapply through UCAS if they cannot continue their courses in Ukraine. Surely the Government can find a negotiated agreement between the General Medical Council and our universities’ medical schools to assess the learning needs of these students, who are at different stages of the course, and find a way to integrate many of them. We need new medical graduates; these are motivated students whose life experience from the war will have undoubtedly broadened their vision.
Just as the gracious Speech was silent on workforce planning, so it was also silent on tackling the problems that alcohol is causing in our society. I declare that I chair the Commission on Alcohol Harm. Alcohol is linked to 27 types of cancer, suicide, abuse and obesity. The Government have ducked developing a comprehensive alcohol strategy to tackle harm by addressing the affordability, promotion and inappropriate availability of alcohol. Alcohol causes more working days of life to be lost then the 10 most common cancers combined, yet where is the strategy on alcohol? Without tackling alcohol, the Government’s strategy on mental health, on crime, on obesity and on increased pressures on the NHS are, I fear, doomed to fail.
Drugs and alcohol are frequent antecedents to crises and trauma in children who enter care long term. There is good evidence that kinship care has better outcomes overall for those 180,000 children who would otherwise enter the care system and be cared for by strangers, but over half these children have additional educational needs or disabilities. Kinship care needs to be defined in legislation so that carers are properly recognised and can access the support needed, particularly in education for all ages and support for legal costs. This could result in far better outcomes for these children.
I turn briefly to the draft Mental Health Act reform Bill, in which much remains to be worked through and debated. The detention of those with learning disabilities and autism in mental health institutions has not supported people to live their lives as well as possible and has denied them opportunities, particularly as they transition from teenage years to adulthood. I had the honour of chairing the National Mental Capacity Forum until recently and I welcome the Government’s recognition that people need support to empower them to make decisions for themselves and avoid the inappropriate detention of those with unaddressed needs.
We recently had the shocking Ockenden report into maternity services, and the Government’s recognition of an urgent need for maternal mental health services is welcome, but I return to the important question of the workforce and where these teams will be drawn from.
Baroness Hollins (CB)
My Lords, I will focus on mental health and I declare an interest as the independent chair of a panel advising the Department of Health and Social Care on the use of long-term segregation for detained patients with learning disabilities and/or autism. I welcome the main elements of the draft Mental Health Act reform Bill, including the intention to amend the definition of mental disorder, so that people will no longer be detained solely because they have a learning disability or because they are autistic.
Long-stay hospitalisation and warehousing of people whose needs are poorly understood was intended to end when the long-stay asylums were closed—the last one for people with learning disabilities closed in 2009—but a failure to develop adequate community support, including adult social care and meaningful life chances, has simply led to the creation of new psychiatric hospitals, often in the private sector. The lack of an adult social care Bill in the gracious Speech is concerning. The noble Baroness, Lady Jolly, mentioned the number of people being detained for unacceptably long periods, but around 100 of these are cared for in long-term segregation. Commissioners lack the skills, knowledge and foresight to stop this happening, and this has to change.
The proposals have a laudable aim: to ensure that fewer people are detained involuntarily and that more people get better care, closer to home. But legislation is not enough; we need a significant culture shift across the whole health and care system. The medical model works well for cancer or infectious diseases, with its emphasis on treating symptoms. Serious mental illness is different; a focus on the social construct of recovery is key.
Everybody wants to live a meaningful life in their own home and to belong in their community, and the public discourse in recognising the dangers of loneliness is getting ahead of the legislative framework. In some hospitals today, there are still examples of the dehumanising culture that we associate with the past. My own research with social anthropologist, the late Dr Jane Hubert, evidenced some of this in a mental handicap hospital in the 1990s. Even though government policy demands personalised care, it is little understood. There have been too many recent high-profile cases where in-patient care has failed people and their families, and the Covid backlog has worsened already unacceptable barriers in access to health and social care for people of all ages who live with learning disabilities and/or autism.
Research by the Disabled Children’s Partnership identified a disproportionate impact of the pandemic on families with disabled children. In a May 2020 survey, 76% of families with disabled children said that the vital care and support they relied on had stopped altogether, leaving parents and young siblings taking on all care responsibilities around the clock, and in June 2021, the majority of disabled children were still unable to access pre-pandemic levels of therapies and health services. The SEND Green Paper has the tagline “Right support, right place, right time”. Practically, this means addressing everyday social and relational issues and developing meaningful community-based mental health support. Mental health support is needed in all schools. A distressed child cannot learn and there is much to be distressed about.
The Mental Health Act was last updated in 2007, but in many ways it still maintains its roots in the original Act of 1959. Since its last update in 2007, other legislation also impacts on the treatment of those with severe mental illness, people with learning disabilities and autistic people, including the Mental Capacity Act 2005, the Autism Act 2009, the Equality Act 2010, the Care Act 2014 and now the Health and Care Act 2022 and the Down Syndrome Act. I am hopeful about the impact of the commitments in the Health and Care Act to introduce a learning disability and autism lead for each integrated care board, and the requirement to make training mandatory for all health and social care staff on autism and learning disabilities. This reform of the Mental Health Act will also need to work hand in hand with the NHS long-term plan, and with the eagerly awaited “building the right support” action plan.
The reform of the Mental Health Act is an important opportunity for modernisation towards least restrictive practice that prioritises dignity and respect, while facilitating access to personalised mental health care in the community and, if admission is needed, ensuring that it has a clear therapeutic aim. The reforms announced in the gracious Speech have important implications for the freedoms and care of people with learning disabilities and autistic people, as well as people with serious mental illness.
Lord Naseby (Con)
My Lords, the noble Baroness has asked some searching questions. I too want to focus on health. I have had the privilege of being married to a medical practitioner for some 60 years, during most—in fact all—of her working life. She started her medical practice in Biggleswade and grew that into one of the largest practices in Bedfordshire, so I have been immersed in the medical world.
Additionally, it is right to point out to the House that I had the privilege of managing, as chairman, two public companies listed on the Stock Exchange. I mention that because, to me, one of the key issues that the health service faces is management. I am ashamed, quite frankly—and this is not party political—that our NHS, on the most common outcomes, and in contrast to Europe, comes 17th out of 18 countries. I am ashamed of that. But there is some good news, I think and hope, in the appointment of Sir Gordon Messenger to review the whole leadership of the NHS. My goodness, it needs it. It brings back immediately to me the 1984 Griffiths report. Noble friends will remember that that was the report that, in essence, removed clinicians from senior management and installed non-medical management. I suggest to your Lordships that that ought now to be reversed.
Issue number two has to be patients. Look at the original basis of the National Health Service: that it should be free at the point of need and the patient was to come first. Our objective, I suggest, must be the patient and not the system. That brings me back to GPs. Up to the point when Prime Minister Blair brought in his changes, your average GP worked for four full days—morning, afternoon, evening and a share of night calls—and every other Saturday. They worked pretty hard. Today, almost all that has gone. Today, many practices have perhaps one or two full-time GPs and perhaps five or six part-time GPs, and every day, we read in the papers about the challenges the patient finds in getting to their GP. Something is not working.
The third issue is medical school intakes; I have banged on about this a number of times. Ten years ago, there were 42,000 medical students—18,800 men and 23,365 ladies. Today, there are nearly 55,000 medical students, of which 21,000 are men and 33,500 are females. In my judgment, the policy should be roughly 50:50. While the vast majority of the men work full time, over half the women work part time. It is no good when you multiply it; there are not enough full-time equivalent GPs in the NHS. I suggest to Her Majesty’s Government something I have already raised several times: we should look long and hard at the Singapore scheme, whereby every medical student has to sign up for five years and promise to work in its national health service—in whatever discipline within in—and, if they do not, they pay back to society the cost of their medical education. I have given the details of that to the current Secretary of State.
The fourth issue is why the NHS has got itself into the situation of having the lowest numbers of diagnostic equipment. I suspect that the final issue is as crucial for others as it is for me: care homes and their improvement. On 21 April 2020, I asked HMG
“what has been the COVID-19 testing policy for hospital patients that have been discharged to nursing and care homes over the last four weeks”.
I received quite a long Answer from the then Minister, the noble Lord, Lord Bethell, who basically said that all patients who moved from the National Health Service to social care would be discharged in line with current policy—et cetera—and that they would be tested before being discharged from hospital to a care home. We have seen the seismic judgment from the High Court that those 25,000 patients who were discharged from hospitals to care homes in March and April 2020 were not tested. The answer to that question is: if you set a policy, you should check the results of that policy.
Baroness Andrews (Lab)
My Lords, this year, even more than most years, we expected and deserved a better Queen’s Speech than the one we got. Today’s debate does include some welcome Bills, including the mental health Bill, but the Speech falls far short of what we should have expected in meeting the risks and challenges that our public services face. In today’s debate, we have an opportunity to identify some of those risks and to raise some questions: what value do we put on public services, and what do we have the right to expect from them?
In the short term, some of the risks were totally predicable: the impact of Brexit on health, care and construction skills. Some were of course much less predictable: the impact of the war and of the pandemic on living costs. Nevertheless, these come after years of underfunding. It is not surprising, therefore, that people are beginning to falter in their conviction that public services are fit for purpose. An exemplar of this is the meltdown we saw in the Passport Office. What is really painful about this is missing the opportunity that the pandemic created to revalue and rebuild our public services, and to recognise the vital role that the care sector and care economy play in supporting the entire economic life of the nation. In fact, what this Queen’s Speech does, as many noble Lords have said, is to flag up the absence of policies which are capable of addressing the long-term infrastructure problems in education, health and social services, and the continuing and grave failure to plan for the skills of the future so that we can manage the existential problems destabilising the whole of our society and economy: an ageing society, artificial intelligence and climate change.
Many noble Lords—notably my noble friend Lady Pitkeathley—have spoken powerfully about the crisis in adult social care and the doubling of the number of people waiting for an assessment or a review for care to begin. The number has grown to 500,000 this year. A bounceback in the service has not happened because those people feel that they are not valued. Some 170,000 hours of care were lost last year and there is now unrelenting pressure on families and unpaid carers, who themselves could contribute so much more if they were seen as skilled workers and as key partners within the triangle of care. We are simply not valuing or mobilising the assets we hold as a country. We have a vicious, not a virtuous, circle. Perhaps the Minister can give us some assurances this evening that adult social care will get a bigger share of the health and social care levy. Without that, there is no way that the NHS is going to meet the backlog of care, let alone its other ambitions. This is because the NHS, as we have heard again across the House, is short by 110,000 staff, and this includes one in 10 nursing posts. The last health workforce strategy was in 2003. Can the Minister tell me when the next will come?
Where does the education service fit into this? My noble friend Lady Morris gave a wonderful speech on this issue this evening. Despite the optimism of the Minister, whom I respect very much, there is nothing in this Queen’s Speech or in the policy which will close the attainment gap between poor children and the rest. School funding levels have simply returned to the levels they were at in 2010. However, the crucial failure is not to have put in place measures to strengthen and stabilise the early years and childcare sector. The costs of childcare in this country are horrendous; the sector is increasingly fragile. We predicted this with the childcare Act of 2017, and I am sad to say that we were right. It bears down hugely on families, who are now facing horrendous cost of living issues. All that is offered is a review of childcare ratios—it is shocking. Can the Minister explain how this is going to improve access to high-quality care or help for poor children?
One solution the Government have offered is to cut civil servant numbers by a fifth because of Brexit. The Times demolished that assertion on Saturday, saying that
“many of the new jobs were driven by the longer term demands of Brexit”
and that
“departments expanded to take on regulatory functions previously carried out by the EU. The Department for Environment, Food and Rural Affairs … has trebled in size.”
In plant health, Defra has had to create 20 committees to replace the EU regulatory framework. Brexit is going to be a burden on the public and Civil Service for years to come. We need a new social contract between the public services and public servants in this country to ensure that, in the future, we have the public services that we need and deserve.
Lord Kirkham (Con)
My Lords, it is a great privilege to participate in this debate on the gracious Speech. As a working-class child growing up in the north of England, I never maximised my grammar school education and have devoted much of the last 35 years to levelling-up efforts on behalf of the younger generation. I have specifically helped the Duke of Edinburgh’s Award and Outward Bound in their work to fill the gaps that even supposedly good schools far too often leave in their pupils’ skillsets.
Absolutely nothing matters more for the prospects, long-term outlook and opportunities of our nation than the correct, proper, appropriate, no-compromise, world-standard education of our children. However, none of it can be achieved unless we have the appropriate and quality institutional framework in place to ensure the delivery of the highest educational standards across the whole country. That is why I fully welcome the new, full, visionary and ambitious schools White Paper, as it introduces much-needed coherence and offers a clear plan to complete the schools revolution started by Michael Gove back in 2010. The current system is neither fully academised nor fully local authority controlled; it is neither one thing nor the other. Therefore, it is sensible, appropriate and right that every school should join—or at least be in the process of becoming a part of—a family of schools by 2030. We have seen and experienced, through participation and involvement, that such families of schools can work exceptionally well. That enables them to share all the very best practices and the most effective proven experiences and ideas.
The point of it all is to elevate standards, so the Government’s intention to set a target of 90% of primary school-age children reaching the expected levels in literacy and numeracy by 2030 is welcome indeed, as is their ambitious goal to increase the national GCSE average grade in both English language and maths. However, let us not underestimate the poverty gap and the long tail of underachievement in this country. It is encouraging that 24 priority areas, many in the north, have been identified in the White Paper for extra support—I thank the Government for that—but the underattainment of children from lower-income backgrounds is widespread and persistent and exists throughout most of the country. Clearly, if all schools can perform at the level of the best, we will achieve our aims and aspirations, but it will undoubtably require major committed resourcing and priority in public expenditure to enable this to happen. We have in the White Paper the design of a world-class system but, for this to become a reality, we will need world-class resourcing too.
One of the great advantages of the academy system is the freedom that it gives trust leaders to make decisions and be accountable for them. However, I am forcefully told by those working in the field that, in recent years, a plethora of regulatory bodies have started to eat away at these freedoms. Academies are accountable to the DfE, the Education Funding Agency, Ofsted and regional schools commissioners, often reporting to them on overlapping areas. Consequently, the Government’s proposal to undertake a regulatory review to simplify the system is to be greatly welcomed, but we also need to streamline regulation and introduce a risk-based approach, targeting regulatory resource where it is needed most. The state does not need to become involved in overregulating high-performing, low-risk academies and trusts. We all know from bitter experience that bureaucracy has an ability to spread itself perhaps rivalled only by Japanese knotweed, and the greatest care is needed to keep it under firm control.
Finally, I want to comment on the proposal to allow good schools, in exceptional circumstances, to request to move between academy trusts. This has the potential, if not handled with great thought and care, to undermine all the gains that successful academy trusts have already made and could achieve in future. The best academy trusts take in failing schools and improve them rapidly by committing resources to and investing heavily in them. Such trusts then leverage these much-improved schools in their turn to develop underperforming new joiners. However, this virtuous circle risks being broken if improved schools can threaten to vote to exit their academy trust if they are asked to devote their own resources to helping newly joined underperforming schools. Any legislative change that might incentivise such an outcome must be avoided at all costs.
I believe that this is a vital caveat but, having made the point, I conclude by reiterating my strong support for the basic principles of the White Paper and urging that the proposed reforms be implemented as speedily and urgently as possible. Our nation’s children deserve no less.
Lord Bradley (Lab)
My Lords, I am pleased to make a short contribution to this debate on the Queen’s Speech. I declare my interests in the register, particularly as a trustee of both the Centre for Mental Health and the Prison Reform Trust and as an honorary fellow of the Royal College of Speech and Language Therapists.
I want to focus my remarks narrowly on the proposed publication of a draft Mental Health Act reform Bill, especially the parts of such a draft Bill that relate to the interface between healthcare and the criminal justice system. First, I want to make a general comment on the proposed draft Bill, which emanates from Sir Simon Wessely’s excellent independent review of the Mental Health Act 1983. I agreed completely with the Centre for Mental Health’s view in response to the Queen’s Speech when it said:
“The Mental Health Act needs to be updated to uphold people’s rights, minimise the use of coercion, put advance choice documents on a legal footing and ensure more people get access to advocacy. It needs to curb the use of Community Treatment Orders. The bill is a chance to enshrine children’s rights more clearly within the Act and to ensure that people in prison are not forced to wait for weeks and months for an urgently needed hospital bed.”
I ask the Minister, in closing this debate, to be more precise on when the draft Bill will be published and to confirm how this House will be involved in scrutiny of it.
Turning to aspects of the relationship between policing and the Mental Health Act, Sir Simon made a number of recommendations. They included:
“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 in the Act, and ensure that the majority of people detained under police powers should be conveyed to places of safety by ambulance. This is subject to satisfactory and safe alternative health based places of safety being in place.”
Crucially, he recommended:
“NHS England should take over the commissioning of health services in police Custody”—
a recommendation that I made in my independent report to the Government in 2009. There is no mention of these points in the commentary to the Queen’s Speech on the Bills issued by the Prime Minister, but I hope and expect that they will be included in the draft Bill for proper scrutiny.
Secondly, in relation to Sir Simon’s recommendations on patients in the criminal justice system, he made this clear:
“Prison should never be used as ‘a place of safety’ for individuals who meet the criteria for detention under the Mental Health Act.”
I agree. Again, this must be included in the draft Bill.
Further, Sir Simon recommended:
“The time from referral for a first assessment to transfer should have a statutory time limit of 28 days. We suggest that this could be split into two new, sequential, statutory time limits of 14 days each”,
the first
“from the point of initial referral to the first psychiatric assessment”
and the second
“from the first psychiatric assessment until the transfer takes place”.
This is a far more elegant proposal than the similar one I made in my report. It is pleasing to note that the Government have responded positively to this proposal but the devil will be in the detail; these and other recommendations must be fully scrutinised by this House, then debated when the Bill is introduced to Parliament.
I welcome the intention finally to introduce a draft Mental Health Act reform Bill. I echo the words of the Royal College of Speech and Language Therapists, which rightly pointed this out in supporting the reforms:
“Understanding and being understood is central to all four of the key guiding principles of the proposed reforms … Therefore, the communication needs of people accessing mental health services must be identified and supported. This must include them having access to speech and language therapy where required.”
I also echo the words of the Royal College of Psychiatrists, which stated:
“While RCPsych welcomes the proposed reforms to the Mental Health Act to improve patient care and increase safeguards, it cannot be emphasised enough that they are not deliverable without the required investment in the psychiatric workforce.”
The Government must continue to invest in stretched community services and ensure proper capital funding to fix the dilapidated, often unsafe buildings used for mental health services. They must also ensure that there are enough mental health staff to meet demand, equipped with the right skills and support. This will be the underlying challenge that the Government must face when we deliberate this proposed Bill.
Lord Etherton (CB)
The topic I wish to address is education, and in particular teaching about rights and responsibilities, and the constitution. I start with a question: what is it that binds the people of Britain together as a community? Yes, we have cricket, rugby and football, among others, as national sports. We have singers and entertainers of international repute and we have a wonderful National Health Service. Great Britain has a long history. None of these, however, can be said to be a defining feature of Britishness, in the sense of affecting and binding everyone in our community, whatever their background, ethnicity, cultural affiliations and personal outlook.
The one and only thing that binds us all is the collection of legal rights and responsibilities, and the institutions that together form or are derived from our unique constitutional settlement. They are the product of many things, including in particular the golden thread of our common law, the separation of powers between the legislature, the Executive and the courts, statute law and the international treaties to which we are a party. This is our unique heritage among the nations of the world, of which we should be very proud.
In December 2020 the independent review of the Human Rights Act, with Sir Peter Gross as its chair, was established by the then Lord Chancellor and Secretary of State for Justice, Sir Robert Buckland. The review’s report was submitted in October 2021 and was published in December 2021. The very first recommendation was that serious consideration should be given by government to developing an effective programme of civic and constitutional education in schools, universities and adult education, and that such a programme should particularly focus on questions of human rights and individual responsibilities. The report said that this was:
“A matter repeatedly and cogently emphasised in submissions and presentations to the Panel.”
The Government launched their consultation on Human Rights Act reforms and a Bill of Rights in December 2021, but they did not comment at all on that recommendation of the Gross review. That may be because such an educational programme requires interdepartmental co-operation between the Department for Education, the DCMS and the Ministry of Justice. The lead must surely, however, come from the Department for Education.
There is a high level of misunderstanding and a lack of knowledge among the general population, and indeed some public officials, about legal rights and responsibilities and our constitution. That lack of knowledge is a huge obstacle to public ownership of legal rights, which is what we should be aiming for in a properly functioning democracy. The Bar Council and the Law Society have promoted various voluntary educational initiatives, but what is in substance recommended by the Gross review, at least so far as concerns schools, is that there should be teaching about rights and responsibilities and the basic features of our constitution as part of the national curriculum in England. Discussions could no doubt take place with the devolved Administrations.
Will the Minister please say what is the Government’s response to the Gross report’s important recommended educational initiative and, if the Government do not yet have a view, will she give an assurance that the Department for Education will pursue the issue with such other Ministers and departments as may need to be involved?
Baroness McIntosh of Hudnall (Lab)
My Lords, one of the great things about coming this far down a long list of very distinguished speakers is that other people have done all the hard work. The only thing is that it has put considerable pressure on my editing skills—but we shall see.
I declare my interests as a member of the Middlesex Learning Trust and as a trustee of the Artis Foundation. I want to remind the House that the gracious Speech says:
“Reforms to education will help every child fulfil their potential wherever they live, raising standards and improving the quality of schools and higher education.”
It is pretty hard to argue with that as an aspiration, but what would it take for it to be fulfilled? Well, it might take a well-trained, well-motivated, well-rewarded and well-respected workforce. Do we have that? Statistical and anecdotal evidence suggests that we do not, and the recruitment and retention problems bear this out.
We might need students who are well supported outside the classroom, as well as in it, especially those with special needs or mental health issues, those from disadvantaged backgrounds, or all of the above. Do we have that? No, not nearly enough, despite upcoming new provisions for special educational needs and disabilities.
We might need a well-balanced, broadly based and flexible curriculum. I shall come back to that. We would need well-equipped, environmentally sound buildings and facilities, and I refer your Lordships to the words of the noble Baroness, Lady Brinton, on that subject. I do not need to add to them.
We would also need funding, both revenue and capital, sufficient to make these things possible. Do we have that? Well, numbers of people speaking in this debate have made it pretty clear that we do not, and that there is no such uplift in funding realistically in prospect. By the way, let us not forget the scandalously short shrift given last year to the Government’s own adviser, Sir Kevan Collins.
Does the Schools Bill focus on these issues? It does not, as my noble friends Lady Morgan and Lady Morris said so eloquently—and I genuinely have nothing to add to what they said about academies, so I will not say any more on that. On the curriculum, last year I had the privilege of serving on your Lordships’ Youth Unemployment Committee, which heard substantial evidence, a lot of it from employers and young people themselves, indicating, as the report says, that
“while the national curriculum plays an important role in guaranteeing minimum common provision and rigorous standards, it is too narrowly focused to ensure that it prepares all young people for the modern labour market … in particular for the creative, green and digital sectors.”
I, like many noble Lords, am particularly concerned about the drop in take-up of creative subjects, with music for example being dramatically down at both GCSE and A-level, despite growing evidence of the value to overall learning of engagement with these subjects, both within the curriculum and outside it. Does the Bill do anything to address that? No, it does not.
The Bill also brings in new provisions about teacher misconduct. Why is this necessary? I accept of course that teachers must be held, and hold themselves, to the highest possible standards, but what evidence is there that current arrangements are inadequate or that there is a newly significant problem about teacher behaviour? To choose this moment to focus on the small number of teachers whose conduct is unsatisfactory strikes me as frankly tin-eared when so much else is unaddressed.
Teachers and school leaders are under enormous pressure following the pandemic and most are working with extraordinary commitment to mitigate the effects on students of two years of disruption, including a massive increase in mental health issues. Now, more than ever, we should be reminding those in our education workforce how much they are valued, and offering them every possible support, not telling them off. That is what certain members of this Government—and I completely exempt the two noble Baronesses who are in charge of this debate, for whom I have great personal respect and affection—do best: tell people off. Not just in education but across most areas of public service, the tone from government is too often ungenerous and censorious. Civil servants have been told off, as have doctors, the police and universities, and, in my experience, you do not get the best out of people that way.
Baroness Tyler of Enfield (LD)
My Lords, I draw attention to my interests in the register, particularly as a non-executive director at the Royal Free London NHS Foundation Trust and as a member of the Financial Inclusion Commission. I wish briefly to highlight three areas today: mental health, carers and financial inclusion. I do not think that that last subject has come up yet.
Turning first to health, as we have heard, the main legislative plans are the long- awaited reforms to the Mental Health Act. However, the wider context cannot be ignored. Tackling the backlog of NHS care is a matter of life and death for many, or having to endure chronic pain, with growing waits for treatment, major workforce shortages and an unsustainable social care system following a decade of funding settlements that have failed to keep up with demand. Yes, these challenges have been accelerated by Covid, but they were leading to rising pressures on services well before the pandemic started.
I welcome, like others, the announcement of a draft Mental Health Act reform Bill; many of the reforms are urgently needed. I look forward to scrutinising the detail of the legislation relating to detention criteria, the offer of a mental health advocate for all in- patients, changing the definition of mental disorder so someone cannot be detained solely because they have a learning disability or are autistic, and a greater voice for all in-patients in detention in their treatment and care. However, I believe there are areas where the current proposals should go further, including by abolishing community treatment orders, addressing race inequalities and equity more comprehensively in the Act, and ensuring the reforms work for children and young people too. It is vital that the reforms are fully funded and that there is sufficient investment in mental health, particularly the workforce, to ensure that everyone can access the support they need when they need it.
Therefore, will the Minister answer the following questions, or perhaps write to me if that is easier? First, what is the timeframe for pre-legislative scrutiny, introduction of a Bill and implementation of the reformed Act? Secondly, are the Government proceeding with all the reforms included in the White Paper? Thirdly, will the Minister provide assurance that children and young people will benefit from the reforms at least as much as adults?
Of course, we also need a much stronger focus on preventing people reaching the point where they risk being sectioned. This means deeper and wider preventive mental health work in our communities, but the most important thing the Government need to do, as we have heard already, is to introduce proper workforce planning across both health and social care that is designed to meet both current and future demand for care, as so many of us argued for powerfully during the recent passage of the Health and Care Bill. What a pity those clarion calls went unheeded.
Like others speaking in today’s debate, I was particularly disappointed that the gracious Speech contained no reference to carers’ leave to help carers juggling work and unpaid care at a time when they most need it—not least because it was a Conservative Party manifesto commitment back in 2019. Responses to the Government’s consultation were positive, from carers and employers alike, with 53% of working carers saying they need unpaid leave in order to juggle work and care successfully. We are talking not about giving people leave so that they can sit in the garden, but giving carers the flexibility to ask for leave to attend medical appointments, provide short-term care and step in if care arrangements break down. Can the Minister explain the Government’s current position on carers’ leave and when we can expect to see proposals bought forward? Does she agree with me that support for carers is an integral part of both tackling health inequalities and levelling up?
I turn now to financial inclusion, which I see as a critical part of the levelling-up agenda. The financial services and markets Bill is potentially an excellent opportunity to redesign financial services regulation. It is a chance for the Government to ensure that both the financial regulator and the industry better serve the needs of consumers. However, I strongly believe that this can only be achieved by giving the Financial Conduct Authority a “must have regard to financial inclusion” duty as part of its overall remit. The soaring costs of living have only increased the importance of making sure that everyone has access to financial products and services that meet their needs; but low-income and vulnerable consumers still struggle to afford, are having to pay extra for or are unable to access appropriate services.
Finally, I turn to access to cash. Three years ago, the Access to Cash review warned that Britain was sleepwalking into a cashless society. This has been exacerbated by Covid. Recent research shows that 10 million people would struggle to cope in a cashless society. That is why I was pleased to see the announcement in the gracious Speech of the Government’s intention to legislate to protect access to cash, which is important to so many people. This must be seen as part of the levelling-up agenda.
Baroness Eaton (Con)
My Lords, I declare my interest as a vice-president and former chair of the Local Government Association, and as a member of Beckfoot Trust, which is a multi-academy trust, and the Leeds Diocesan Learning Trust.
I thank the Prime Minister for showing that this Government are serious about levelling up all areas of the country, as this Queen’s Speech seeks to enshrine the 12 missions into law. These missions will all be crucial if we are finally to tackle the inequalities in our communities. As a former council leader, I would like to put on record that councillors are as ambitious as the Government are for the people and places they serve. Given councils’ role in providing more than 800 different services to local communities, local government will be vital to ensuring that we can deliver on our promise to the nation.
As a former teacher, I am also passionate about ensuring that every child and young person has the best start in life. The Schools Bill seeks to achieve this by introducing measures that will deliver a higher-performing school system. The Bill rightly recognises the important role councils play as education partners. I know that the Local Government Association has commended the Government for that. In particular, the measures to allow councils to set up their own multi-academy trusts have been welcomed. Councils have an excellent track record in providing a high-quality education, with the highest proportion of schools rated good or outstanding. The plans to introduce a home schooling register have also been welcomed by councils, which have been calling for these reforms for a number of years. This shows that the Government are in listening mode and take action when they hear that things need to change. With this in mind, I urge the Government to listen to the call of councils that want to be able to deliver safeguarding checks on home-schooled children and hold the powers to take action against illegal schools. I would be grateful to hear the Minister’s views on this.
As the Government explore bringing the reforms in the SEND Green Paper forward, I urge Ministers to look at the complexities in the funding system that make it almost impossible for councils to transfer money for funding to the high needs block to best meet children’s needs.
I will briefly touch on the important issue of skills. Research commissioned by the LGA and carried out by the Institute for Employment Studies, published today, shows that in two-fifths of the country there are more vacancies than unemployed people. With the right powers, councils could do much more to ensure that everyone has access to targeted local support and the chance to learn new skills and find work. Locally led solutions are often the best way of fixing the national challenges we face. This is why I am pleased to see the Government introduce the Levelling-up and Regeneration Bill so quickly after the Queen’s Speech.
The UK remains one of the most centralised countries in the democratic world, so it can only be a good thing that the Government are seeking to pass power to local areas. All experiences of previous rounds of devolution deals have underlined the value of local collaboration and consensus. I trust that the Government will approach these new deals in the same way. In the same spirit, I know that those of us who sit on the devolution all-party parliamentary group would welcome engagement on how we can ensure that the Government’s plans reflect the diverse needs and aspirations of communities across the country.
Finally, I would like to touch on the women’s health strategy that has been announced. This presents an important opportunity to improve women’s health outcomes, particularly if the strategy adopts a preventive public health approach. I would also like to put on record the significant health and care challenges experienced by men. We know that 75% of deaths by suicide are those of men. In Mental Health Awareness Week, the Government demonstrated the importance of tackling poor mental health through their commitment to reform the Mental Health Act. Will the Government commit to addressing the very real male health issues by bringing forward a men’s health strategy?
To conclude, I share the Government’s ambitions to level up all parts of the country and look forward to working with the Government to deliver the proposals in this Queen’s Speech.
Baroness Greenfield (CB)
My Lords, as a neuroscientist I welcome the consideration of mental health in the gracious Speech and declare an interest as the founder of a biotech, Neuro-Bio, working towards an effective treatment for Alzheimer’s disease. However, in this capacity I was sadly disappointed that no mention was made of addressing the urgent issues relating to such a devastating health problem.
This debate is taking place during Dementia Action Week, so it is an especially pertinent time to highlight the needs of people living with this condition. Alzheimer’s is a neurological disease characterised by memory loss, disorientation and general cognitive impairment. It presents typically, though not exclusively, in older people: one in six over the age of 80 and as many as 70% of residents in care homes. The spectre of Alzheimer’s is one of the cruellest potential scenarios awaiting us in later life. While heart disease and cancer are serious, often disabling and sometimes terminal, you can still reminisce over old photographs and spend meaningful and precious time with your grandchildren. These life-enhancing moments are gradually closed off to an individual with dementia.
There are currently around 900,000 individuals living in the UK with dementia, a figure projected to rise to 1.6 million by 2040. The cost of care in the UK is currently £34.7 billion, and this is set to rise sharply over the next two decades to £94 billion by 2040.
Many noble Lords have spoken about carers, and this is particularly important with respect to Alzheimer’s. Imagine the impact of Alzheimer’s on the family, specifically the financial and mental health repercussions of giving up a job to care for a loved one—perhaps the love of your life—who then no longer even recognises you; that is a scenario I have heard described, on more than one occasion, as a living death.
Two other main issues could have been addressed in the gracious Speech and were omitted. One is the issue of obtaining a diagnosis. The reaffirmed commitment to invest £2.3 billion to increase diagnostic activity, with ambitions to roll out up to 160 community diagnostic centres, is obviously to be welcomed. However, this must include a specific commitment to improve dementia diagnoses. These are currently at a five-year low, with more than 30,000 additional people now living in England not formally diagnosed. The Alzheimer’s Society estimates that it would take four years to clear the current backlog without extra help. There are national strategies to deal with the backlog in elective care and cancer diagnosis, but nothing to fund or plan to deal with the specific backlog for Alzheimer’s. It will not go away on its own.
Memory assessment services are vastly overstretched due to the pandemic. This is largely caused by workforce pressures. Individuals are being referred to services, but the services cannot deal with referrals at the same rate. Memory services are seeing people come to them with much more advanced symptoms than previously. Just £70 million would allow the NHS to address the backlog in secondary care while making allowance for increasing primary care costs. Up to 65% of emergency hospital admissions for people living with dementia could be avoided if they had the right support.
The individual patient could then become more actively involved in personal decisions, including healthcare. They could use treatments more effectively, focus on what is important and make empowering choices. They could take advantage of resources and help advance research, perhaps by joining clinical trials. With more than 150 such programmes worldwide currently examining potential dementia treatments, it is more pressing than ever that we can identify suitable participants.
This brings us to the third issue: research and the development of new drugs. The Government need to deliver on their manifesto commitment and fund the dementia moonshot as soon as possible. As a scientist on the front line of research, I was saddened to see no mention of this in the gracious Speech, but such funding is urgently needed to deliver on our ambitions for dementia research and, crucially, to deliver new treatments. In parallel to increased research funding, the forthcoming national dementia strategy must set out a bold and ambitious approach from government to create new momentum and help push us over the finish line to the first wave of new treatments.
For example, Alzheimer’s Research UK is leading calls for the Government to apply lessons learned from the Covid-19 Vaccine Taskforce by establishing a dementia medicines task force. The task force would act as a catalyst to accelerate the development of new treatments. It would harness the existing strengths and leading initiatives in the UK, minimising gaps and tackling any duplication in current approaches. The goal would be to ensure that new treatments reach those who need them as soon as possible. It would drive progress in research and speed up clinical trials, as set out in the dementia moonshot manifesto. This would ultimately benefit current patients, while also creating a powerful offering for global life science investment.
Any one of us here could succumb to Alzheimer’s, and a significant number of us are likely to do so. It is one of the biggest health challenges we face, and as such it cannot, as it was in the gracious Speech, be ignored.
Baroness Blower (Lab)
My Lords, the Queen’s Speech was described as thin on education and so has proved the Schools Bill, as my noble friend Lady Wilcox said. At a time when there is so much to do in and for our education service, a more wide-ranging Bill would have been appropriate.
Both the Queen’s Speech and the Bill have ducked significant issues. Clearly, insufficient has been done to date to address Covid recovery. Like much else in education, this is about funding. As proposed, the national funding formula is both an attack on local democracy and a failure to provide adequate resources. Funding is a significant problem for a huge majority of schools, with the National Audit Office reporting that money will be redirected away from schools serving the poorest pupils.
Primary class sizes are now the highest they have been this century, and secondary class sizes the highest since records began. Much of our school estate—our school buildings—is in a terrible state, frankly. Investment is urgently needed to make these buildings fit to provide education for our children and young people. Good, qualified teachers, supported by teaching assistants and the whole school workforce at school level, are of course the biggest factor in ensuring success for all our young people. But, alas, teachers are leaving the profession in very high numbers and recruitment to teaching is missing its targets—not to mention the contested market review of initial teacher training and education, with so many high-quality institutions no longer in this field, as reported yesterday.
Throughout the pandemic, Ministers stood at the Dispatch Box and praised teachers for their work. That was very welcome, but fine words butter no parsnips, and what we see in schools is that around a quarter of new teachers leave the profession within three years. The loss of experienced teachers is a problem too, with barely 60% remaining in the profession 10 years in. OECD research clearly suggests that a mix of experience levels is a prerequisite for good outcomes for students, especially in areas of high poverty, but all too many schools are starved on a turnover of early-career teachers who leave within five years—and not, I am afraid to say, to go to other schools.
Many teachers who leave cite workload as an issue. Where is the Government’s response to this? If the answer is the Oak National Academy, I really believe the Government need to think again. Of course teachers value good, high-quality resources, but teaching is a creative profession, one in which teachers should have autonomy, agency and the ability to collaborate with colleagues in relation to curriculum design and pedagogy—it is not a place for pre-packaged lessons to deliver a curriculum wholly centrally determined. When teachers cite workload, they generally mean Ofsted-driven activities arising from performance measures that, as professionals in classrooms, they consider unnecessary and often unrealistic. We should bear in mind that the number of hours worked by teachers in England is significantly above the OECD average of 41 hours per week.
As to academisation, the Government’s ideological position of academising all schools by 2030—or at least having them on the route to academisation—has not met with enthusiasm or approval from within the profession. This is unsurprising when research by both the National Education Union and Birmingham University contradicts in stark terms the claims made by government of the alleged benefits of multi-academy trusts. I genuinely look forward to a detailed discussion with the Minister on this, as it is clearly a contested area.
The ostensible reason offered some 12 years ago for the emergency legislation on academy status was the independence and autonomy that such schools would enjoy. While that may be debatable, what is true is that such independence will be significantly eroded by the 20 areas in the Schools Bill in which the Secretary of State may set standards by regulation, with one such area being salaries and pensions. If such regulation were to be drawn up following sectoral collective bargaining, I am sure that would be welcome—but I am sure that the Minister will tell me that that is not what is intended.
The Schools Bill is not what is needed in the face of the challenges facing our schools and children, including underfunding and the Covid pandemic, so I really hope that during the passage of the Bill we can make some significant improvements.
Lord Aberdare (CB)
My Lords, I too shall focus on education and skills, which are fundamental to the stated priorities of the gracious Speech and to the whole idea of levelling up. Education and skills should be a central part of any Government’s aims and aspirations, so it is encouraging that the Queen’s Speech includes both a Schools Bill and a higher education Bill. The Schools Bill focuses on funding, academisation and attendance, but the Bill on its own will not be enough to achieve the laudable goal of helping
“every child fulfil their potential wherever they live”.
I will briefly address some of the other activities that will be needed but which are not covered by this legislation.
The first is the long-standing challenge of improving the quality and status of technical education. I am encouraged by the Government’s commitment to T-levels, apprenticeships and other initiatives, such as those in the recent Skills and Post-16 Education Act, and the planned lifelong loan entitlement, the introduction of which will be enabled by the higher education Bill. Successful delivery of these will be crucial, but more work is needed both to ensure that all the pieces of the complex skills jigsaw fit together—that Kickstart, for example, leads to apprenticeships—and to convince not just students themselves but their schools, teachers and parents of the value of technical education, such that it finally achieves the long-sought parity of esteem with academic routes. There is also a need for effective provision to allow students to mix and match, combining both technical and academic elements in their studies. Languages, for example, are an important skill in many technical careers, and my own experience shows how valuable classics can be in developing computer programming skills.
Secondly, every young person needs to be aware of the range of jobs and careers available and the routes they need to take to further their own aspirations and abilities. This calls for continuing enhancement of careers information, advice and guidance in line with the Gatsby benchmarks, including contacts with a variety of different employers and workplaces, as well as work experience opportunities. The enhanced Baker clause in the skills Act, specifying the number of meaningful employer contacts students must have, should be embraced as an absolute minimum and enforced when necessary.
Thirdly, it is surely time for the Government to address the persistent concerns of employers and others about the apprenticeship levy, introducing greater flexibility to make it more fit for purpose so that more young people are able to become apprentices, including 16 to 19 year-old school leavers; more small and medium-sized firms are able to offer apprenticeships; and more of the skills that are most needed are eligible to receive funding from the levy.
Other issues include recognising digital skills as a functional skill of comparable importance to English and maths and, as other noble Lords have mentioned, restoring creative and arts education to its proper status as an essential part of the curriculum, as indeed it is in most independent schools. Again, that would clearly qualify as levelling up.
Education and skills are fundamental to the Government’s priorities as set out in the Queen’s Speech. I hope the Minister and her colleagues, as well as meeting their heavy legislative commitments, as described by the noble Baroness, Lady Morris, will find the time and energy to press ahead on the other issues I have highlighted. What matters most is not so much the quantity of legislation—we already have rather too much—but the quality of delivery.
Baroness Lawrence of Clarendon (Lab)
My Lords, my contribution on the most gracious Speech, delivered by His Royal Highness Prince Charles on 10 May, will be very brief. I thank Her Majesty the Queen for her dedicated loyalty and send my warmest wishes to her on her Platinum Jubilee.
I wish to focus my contribution on the gracious Speech on education and the devastating impact of the global pandemic on young people’s mental health. The consequences of the pandemic have been vast and felt across society, but some groups, such as young people in education, have been affected more than others. Many noble Lords have spoken at length in this debate on the subject of education with more experience than I have, so I will not repeat what they have said. I will focus on Covid.
The Health Foundation’s Covid-19 impact inquiry draws on statistics from the young people’s future health inquiry, which focused on gathering evidence from a range of sources to understand the immediate and long-term implications of the pandemic for young people and thus the support needed as the UK moves through recovery.
During the Covid-19 pandemic, school closure restrictions during lockdown reduced young people’s participation in learning, which is an essential building block for a healthy future. The Institute for Fiscal Studies found that secondary school pupils spent 4.5 hours per day on learning in the first lockdown, compared with 6.6 hours before the pandemic. There was also a substantial difference in who was spending the most time on learning, with the richest third of pupils spending more time than the poorest third.
One of the most significant impacts of coronavirus was the exposure of the digital divide that exists in the UK. Class differences and social mobility meant that some of the most disadvantaged children were deemed more likely to be affected by a lack of access to remote learning because of technological issues. In 2019, a study by the Office for National Statistics found that 60,000 children aged 11 to 18 did not have internet access in their home, and around 700,000 children did not have a computer, laptop or tablet with which to access online learning. Therefore, schools will never be the same after being enlightened by e-learning and their new-found awareness of disadvantaged students.
While schools reopened in autumn 2020, disruption to learning was still common and access to in-person teaching was not consistent. By mid-November, 51% of teachers in private schools reported being fully open to year 11 compared to just 33% in state schools. School closures put educational outcomes at risk throughout the pandemic, especially for disadvantaged students. Existing inequalities and attainment gaps are already being aggravated, as opportunities for early identification of emerging learning problems have also been missed during the school closures. I have always believed that education is the best gift to children as it dilutes boundaries and will take children, depending on their capabilities, anywhere in life. There is much more to say but I will limit myself to what I have already said.
As part of my role as a Peer in the House of Lords, it is both a duty and an obligation to focus on inspiring and encouraging young people—irrespective of age, race and background—to engage in various activities that promote inclusion and respect. Given the knock-on effects of the pandemic and the drastic change to the schooling system in response in recent years, and in line with the State Opening of Parliament and the Queen’s Speech, how do Her Majesty’s Government intend to reform higher education and the quality of schools, particularly for students from disadvantaged backgrounds?
Baroness Walmsley (LD)
My Lords, I too welcome the mention in the gracious Speech of the long-awaited draft mental health Bill, but that has been covered extremely well by my noble friend Lady Tyler and I agree with all the points she made, so I will go no further on that.
However, since the Speech, which followed quickly on the heels of the Health and Care Act, we heard at the weekend that the Government intend, with indecent haste, to backtrack on measures for which they have only just got Royal Assent. I refer to the planned restrictions on TV and online advertising of foods high in sugar, salt and fat. Before the ink is dry on the Act, the Government now want to defer implementation for a further year. Can the Minister write to me to say what representations the Government have received on this and from whom?
In Committee, I commented on government amendments to allow the Secretary of State to defer implementation beyond January 2023. I said:
“Given the notice the industry has already had about these measures and the fact that the Government have already deferred implementation, a year from now should be quite enough time. Why do the Government feel they need these further powers?”—[Official Report, 4/2/22; col. 1212.]
The noble Baroness, Lady Penn, who probably did not know what the Government were planning, said that
“the implementation dates for these restrictions none the less remains 1 January 2023.”
She said:
“Amendments 249, 252 and 254 separately introduce the ability to delay that implementation date via secondary legislation, should this be deemed necessary after the Bill receives Royal Assent. We have taken this decision to provide flexibility should emerging challenges mean that implementation from 1 January 2023 proves unworkable. However, I should emphasise that we currently have no plans to delay the introduction of these restrictions.”—[Official Report, 4/2/22; col. 1217.]
It seems I was right to be suspicious.
I ask the Minister: what sudden “emerging challenges” have made it necessary to give the industry a further year’s notice of the restrictions? I presume she meant challenges to the Government’s credibility or perhaps to the leadership of the Prime Minister. It can have nothing to do with the price of gas or a basic food shopping basket, and certainly nothing to do with the health of the nation.
I also asked the Minister some months ago if there was any truth in the rumour going around that the Government planned to ditch the ban on “buy one, get one free” offers on unhealthy foods. I was assured in the strongest terms that this rumour was untrue. Allowing someone to get two enormous bars of chocolate for the price of one will not help them pay their energy bill or buy essential healthy foods for their family. Henry Dimbleby, the author of the national food strategy, said on the radio yesterday morning that it would do nothing to address the nation’s obesity crisis. I also call in aid the noble Lord, Lord Hague, who says in today’s Times:
“These are not ‘good deals’ for our wallet or our health. The whole point of them is to get people used to buying more.”
He called the Government’s backtracking
“intellectually shallow, politically weak and morally reprehensible.”
I could not have put it better.
In the gracious Speech the Government said that they would
“fund the National Health Service to reduce the Covid backlogs.”
That is all very well, but other problems have not gone away. I refer first to the ambulance crisis. Doctors now believe that the wait times are endangering patients’ lives. The problem is the shortage of enough properly trained staff in the right places. The Health and Care Act 2022, as enacted, will not improve the planning and adequate provision of staff. The Minister may recall the all-party amendments for measures to assess and plan workforce needs properly, but the Government resisted. Figures were cited for a shortage of doctors and nurses, but today I give an example from an allied medical profession.
A hospital dietician, who plays a vital role in the treatment and recovery of patients, got in touch with me. Her pay rise has been consistently below inflation for some time. She has no other senior dieticians in her team as they are all off with stress and she is covering their work. She also has to cover for vacant junior posts. Because of savings targets, she must save 20% on her staffing budget. This will mean that she is unable to fill the posts needed for safe staffing levels. Can the Government explain why the system they have chosen for workforce planning is going to help in this situation?
Lord Loomba (CB)
My Lords, like so many of us, I am appalled by the Russian invasion of Ukraine. I will focus on the welfare of Ukrainian refugees, a subject no one has spoken about today. I declare my interest: the Loomba Foundation, of which I am the chairman trustee, has extensive experience of the impact of conflict in many parts of the world, particularly in driving up numbers of vulnerable widows and single mothers with dependent children and the massive upheaval this causes for families and communities. We have seen how this is the predominant feature of the Ukrainian refugee crisis today and we know the range of support that is essential for these mothers to create the stability they crave for their families.
I am deeply moved by the generosity of the British people, including those who have opened their homes to families from Ukraine. However, the current system the Government have put in place simply does not provide enough support for the vulnerable women and children arriving in the UK. In particular, those arriving on the Ukraine family visa scheme do not have enough protection. Some will have suffered terrible trauma and this may make it difficult for their families to cope.
We need to put measures in place so that, if their living arrangements break down, local authorities receive funding to match them with another family or provide alternative accommodation. We also need funding from central government to provide pastoral and mental health support for these refugees. We know that children, as well as adults, who have suffered trauma need the right help as early as possible so that they can start to build a new future in the UK.
The Loomba Foundation and other charities are doing what they can to fill the gaps and meet immediate needs. Barnardo’s, of which I am vice-president, told me about the case of a woman who arrived in the UK from Ukraine heavily pregnant and with just what she and her husband could carry. They came to live with family in the UK but did not have the basic things they needed for their new baby. Fortunately, Barnardo’s was able to give her all the things that new parents need, including a cot, nappies and clothes. Afterwards, the mother emailed Barnardo’s to say thank you. She said: “In this world there are more good people than bad. Thanks to you we are safe and have our little baby.”
As this example shows, charities can make a difference to the lives of vulnerable women and children arriving from that war-torn country, and we are currently finalising a partnership scheme whereby the Loomba Foundation will fund vouchers for Ukrainian refugee families to obtain essential items from any one of Barnardo’s nationwide network of more than 630 shops. Important as such measures can be for individual families, we cannot rely on charities alone to support the Ukrainian families and their British hosts, and I call on the Government to engage with us to help define the wider support that is needed and to provide due resources for it.
Viscount Hanworth (Lab)
My Lords, in the time that is available to me, I wish to make a wide-ranging and cursory review of our education system, comprising secondary education, further education and higher education. There is distress at all levels, which is quite apart from the effects of the pandemic.
In secondary education, there are ongoing disruptions caused by the policy initiatives of the Government and the Department for Education. These are occurring against a backdrop of a severe decline in the levels of remuneration of teachers and a crisis in teachers’ morale. A recent survey has shown that over the past decade, teachers in secondary schools have lost 9% of their real income. They are leaving the profession in large numbers to seek more gainful employment. More than 30,000 teachers are leaving the profession each year. The number of male teachers in secondary schools in England and Wales is the lowest on record. Whereas one might welcome the advancement of women in this profession, the changing sex ratio is symptomatic of greater male mobility, which allows men to leave the profession more readily. Older teachers who are leaving are being replaced by new recruits to the profession, who are often employed in the guise of supply teachers who struggle to achieve permanent placements. Young teachers have thereby become part of the gig economy. This is threatening the future of secondary education.
In further education, there are clear symptoms of distress. Colleges of further education have traditionally fostered the skills that are required by industry and commerce. However, the available funding has not allowed the colleges to adapt to the changing demands of industry and commerce, and the numbers of students completing their courses have fallen drastically in recent years. The decline of the further education sector has gone hand in hand with the expansion of universities. Since 2012, the universities have been allowed to recruit students without limits. Every recruit carries with them a fee income. This contrasts with the funding system of further education, where the numbers are effectively capped at the level of the previous year’s recruitment.
The implosion of the further education sector has also been a consequence of the reforms of the Further and Higher Education Act 1992. This removed polytechnics and colleges of technology from the control of local authorities and allowed many of them to become second-tier universities. Instead, they should have been recognised as equal but different. In the process, they have changed their mission. They have forsaken technical education in favour of degree courses. There is a hierarchy of qualifications in the UK, which is topped by bachelor’s degrees, master’s degrees and doctorates. The technical and industrial qualifications fall below these levels.
The rules in England for the financial support of students largely disbar persons who have achieved higher qualifications from seeking support thereafter to study technical subjects at lower levels. Thus, a university graduate is disbarred from adding a technical qualification to his or her university degree. Compared with other countries, our funding arrangements drive students and providers away from higher technical education. This is prejudicing the nation’s economic prospects.
Universities have barely profited from their freedom to compete for students. The desire to attract students has led to what has been described as an “amenities arms race”. Campuses have been refurbished to include additional and often lavish facilities for students. This has led many universities into financial difficulties. Funds have been diverted from salaries and, over the past decade, academic salaries have fallen by more than 10% in real terms. The universities pension scheme is in dire financial difficulties, and swingeing cuts to retirement benefits have been imposed. This has given rise to angry industrial action.
Since the 1950s, academics have been subject, at the behest of successive Governments, to an increasingly burdensome audit culture that requires them to demonstrate performance on a set of criteria that are manifestly in conflict with each other. They face a research assessment exercise under the guise of the research excellence framework; they are assessed under the teaching excellence framework and a National Student Survey; and now they face the demands of a knowledge exchange framework.
The academic workforce has been casualised. There is no longer any notion of academic tenure, whereby a lecturer could benefit from job security. Increasingly, they are employed on short-term contracts. It requires a considerable educational investment to become an academic, which entails a lengthy deferment of earnings. Given the job insecurity, the poor remuneration and the even worse retirement prospects, it is doubtful whether anyone should be encouraged to aspire to an academic career—unless they believe that prospects will soon be greatly improved.
The prospects for our university sector are not good. In consequence of Brexit, the sector has lost many of its European academics, who have returned home and will be difficult to replace. Universities have lost the research funding of the Horizon Europe programme, and the prospects of collaborative research with our European neighbours have been prejudiced. This is occurring at a time when the Prime Minister is proclaiming Britain as a scientific superpower that is set to become a high-income economy. This rhetoric flies in the face of reality. Unless we can repair our educational system, we will be destined for economic failure and poverty.
Lord Jones (Lab)
My Lords, I thank the Minister for her heartfelt introduction to our debate on the gracious Speech and acknowledge the committed remarks of my noble friend Lady Wilcox, a compatriot from our homeland, the lovely land of Wales. I further acknowledge her fine record of leadership in our local government. It is good to follow the speech from the noble Viscount, a masterly campaigner.
Prime Minister Tony Blair’s best speech was his shortest: “Education, education, education”. If our communities are to experience levelling up, we need ever more successful schooling for the many underprivileged children of the north. We do not know when HS2 will reach Crewe and Manchester, but we do know these children are only young once. They have but a decade to get by. As the great Lady Plowden said 50 years ago in her historic report, for the young it is “time irredeemable”.
If you strain the children, you strain the teachers. There are always consequences. RA Butler enacted his historic Education Act 1944, and for Prime Minister Attlee, a determined Ellen Wilkinson developed it. On my paper round, I read the left-leaning New Statesman, edited by mischievous poltergeist editor Kingsley Martin. He had Rab profiled under the heading, “Rab the Apostle of Inequality.”
British Labour’s guru, he of the future of socialism, CAR Crosland, put the Butler Act asunder. It was the beginning of the end of the network of grammar schools. However, it was also the end of those secondary modern school classroom networks that taught technical drawing, the entry card to the then real apprenticeships, when Britain still had a significant manufacturing base. Incidentally, Tony Crosland had his New Statesman profile with the equally insulting headline of “Mr Gaitskell’s Ganymede”.
The comprehensive came forth for equality, and perhaps Mr Blair’s next speech should be equally short: “Skills, skills, skills”. His son Euan would surely approve. As a young Minister, I asked the inspectorate, and likewise directors of education, to give more attention to the less academic, and one held regional conferences to push the issues. With the octogenarian’s glorious hindsight, I do not think it was a success. When one was dumped from office, the initiative died also.
To this day, the challenge remains. Still, thousands of girls and boys leave high school with very poor prospects. Few employers want them. The pool of real jobs for northerners—of high-class apprenticeships, pensions, security and status—diminishes. Our civilisation can put persons on the moon but we do not crack this problem, and yet we know the name and address of every girl and boy underachieving. It is very wrong. I think it is unjust and unforgiveable. We need better. Our teachers are worthy of a better salary structure and better status. If Finland can do it, Britain can. Levelling up requires a bigger, more self-confident teaching force—and the sooner the better.
Lastly, every Government since that of Mr Attlee in 1945 have expended huge sums of our national treasure on the schools service. All the same, it is clear that inequality of opportunity remains, and this is the fundamental challenge to the concept of levelling up. The great queen, Elizabeth I, Gloriana—and surely Elizabeth II is a great monarch—was told by her first Privy Council, “Your Grace, north of the Trent men know no princes but Nevilles and Percys”. The divide remains and, alas, there is no time to tell of how the tyrant Henry VIII annexed summarily my nation Wales.
Baroness Falkner of Margravine (CB)
My Lords, I too am delighted to speak in a Motion on the humble Address. I need to declare several interests. First, I am chair of the Equality and Human Rights Commission. I want to caveat that by saying that I am speaking in a personal capacity. The only reason I need to say that is because the remit of the EHRC is so wide that one falls into the trap of saying something that impinges on its remit, so I had better get that in. Since I will be speaking on higher education, I also need to declare that my husband is a working academic and I myself have an affiliation with the Policy Institute at King’s College London.
I am extremely pleased that we are finally starting to see some of the recommendations of the Augar review come into play; that is very welcome. I particularly note the Government’s proposals for a lifelong loan entitlement, which will be taken forward in the higher education Bill. I also welcome the emphasis in that on social mobility, as well as the opening up of funding for a greater variety of skills-based training. As someone who completed her last degree when knocking 40—note I do not say my final degree, I just say the last one—I think the principle must be upheld that, as our economy changes, so too must the skills of the workforce.
Far too many people do not have an opportunity for on-job training and recent figures show that this is most marked among people who are not graduates, are ethnic minorities or are older and disabled. We also know from the popularity of online courses that people do indeed want to improve their credentials throughout their lives as a means of personal advancement. But currently, only those able to pay are able to do so. Of course, it is grossly unfair that taxpayers in the workforce are penalised when they wish to take up further learning later in life as a means of changing skills, perhaps towards a different career.
I also support the Government’s aim to retain the UK’s leading role in global league tables, but in this area I associate myself very much with the remarks of the noble Viscount, Lord Hanworth, on the careers of junior academics in particular.
While our higher education institutions are undoubtedly benefited by their autonomy, it is fair to say that students in those institutions have been rather let down by the paltry offering they have received during the pandemic. To burden students with the same level of fees for such suboptimal learning—which still continues in some institutions—is to be deeply regretted. I hope that the Office for Students has taken note of this breach of the contract between the provider and the consumer. Autonomy should not mean a freedom to rip off students when so much public subsidy from taxpayers is involved.
I want to say a word or two about the Higher Education (Freedom of Speech) Bill as well. I too share the Government’s overall concern that free speech is being increasingly impinged upon in our academic institutions. I was not alone in being troubled by the treatment of Professor Kathleen Stock by the University of Sussex in its handling of her case. She was attacked simply for exercising her academic freedom, although Sussex did belatedly try to repair the damage she suffered. I am also aware that she is not alone and that other academics in different disciplines self-censor or avoid challenges in areas where their work might not conform with the existing consensus. I broadly support the principles of the Bill but note that we have heard concerns in the other place that the Bill might go too far in its permissiveness of what I think has been described as “hate speech”.
I want to briefly clarify that point. Hate speech does not have legal meaning, although it is generally understood to be forms of expression that incite violence, hatred or discrimination against other groups or people. Article 10 of the European Convention on Human Rights delineates the law on freedom of expression. Whether or not hate speech falls outside the protections of Article 10 and is unlawful will depend on the context of what is said and when. I would not be overly concerned about measures to protect academic freedom and free speech on the basis that it will be a licence for other types of unwanted behaviour, such as harassment, as those protections will continue to be extant under the Equality Act 2010. As ever, I hope that detailed scrutiny will lead us to a balance, and I accept that competing rights will be engaged in this Bill, and so we shall have to look at it very carefully. On that note, I have to say that I broadly welcome these two pieces of legislation.
Lord Young of Norwood Green (Lab)
My Lords, what a pleasure it is to follow the noble Baroness, Lady Falkner, and my noble friend Lord Jones, who gave me quite a lot to think about. I wish I could find as many good quotes as he did. Five minutes is quite a challenge without hesitation, repetition or deviation—as one of my favourite radio programmes says—so I will focus on just a few issues.
On welfare and universal credit, I say that this House always feels we can never pay tribute. Six million extra universal credit claims were dealt with by the DWP. That is an enormous achievement, and it was done because we have a digital system and achieved because it was led by a dedicated person, Neil Couling, who has enabled this to take place. It is a huge achievement and we just do not pay tribute to it. Is it perfect? No: no system is, but just look at some of the things it is doing. There are 13,000 extra job coaches. What is their purpose? To get people back into employment. We have the lowest unemployment rate for—I do not know—30 years or more. Is that something to celebrate? I would have thought so. Maybe it is me; maybe I have got the wrong end of the stick.
Getting single parents back into work is of life-changing importance. Where generations have not experienced employment, getting somebody into a job changes the whole nature of what goes on in a family. It will mostly be mothers, and children will recognise that going to work is important. I say only one thing to the Government on this that I hope they will take into account: the cost of childcare makes this a challenge. I hope that they will address that.
You could spend two or three minutes on healthcare. We had an unbelievable healthcare Bill. Sometimes the House of Lords is wonderful, but on that Bill I started to despair. We seemed to want to discuss anything but healthcare—modern slavery, organ transplants. The most important things about healthcare are the people who work in the industry and delivering a quality service, where people’s lives are not put at risk as they were in some maternity hospitals. I want a health service where people are following best practice. There are huge opportunities to improve the efficiency of the health service. How can we possibly be in a situation where A&E people are waiting with a patient for hours on end and we cannot solve the problem? Do you think this would have happened in wartime? We would have found a way around it by now. We would have got volunteers in there or something. We would have used our imagination to crack this problem. The Healthcare Minister is not here, but he knows my views on this.
On education, I sometimes despair of the idea that things need to be one way or the other. I am in favour of variety. There are some excellent academies out there that have saved a number of badly failing schools. We have to recognise that. In fact, we did as a Labour Government when it was going on in London, so I do not know why we suddenly think academies are bad and maintained schools are good. They are both good; they both have a role to play, as do free schools. I have not got time to carry on with that.
It is a false debate to say that it is apprenticeships versus degrees. We want both, but I want to improve the status of apprenticeships. I want to be able to go into a school and see an honours board that says so-and-so got their degree and so-and-so graduated with their apprenticeship. We need to reform the apprenticeship levy. We need to fund FE colleges much better than we do at the moment, and some really good points on that were made by my noble friend behind me—I am having a senior moment and cannot remember his name; he will never forgive me.
Nobody has got student loans right. We have not. We have said we are going to abolish them; it will cost us a lot of money if we are. Following the Augar review, that one is not going to work either. What we should be doing is making it part of income tax. It is the fairest thing to do. And if you really have £19 billion or £20 billion to spend, spend it on early years. We know that if we get it right in early years, when those people leave school, hopefully they will be both literate and numerate.
The noble Baroness, Lady Brinton, inspired me to finish on another point when she said that the gay conversion therapy Bill needed to have transgender included. Oh no, it does not. I must congratulate the Government on supporting the Cass review. At last someone has looked into this and realised that giving out puberty blockers as though they were sweets to young people from the age of 11 is the wrong thing to do. I support the Government on that, I thank noble Lords for listening and hope I have given you something to think about.
Baroness Watkins of Tavistock (CB)
My Lords, I am delighted to speak in this debate on the humble Address and draw attention to my interests in the register, particularly those in relation to nursing. I welcome Her Majesty’s Government’s commitments to publishing draft legislation to reform the Mental Health Act. The White Paper sets out proposals to amend criteria for detention under Section 3, excluding people with a learning disability and people with autism unless detention is for treatment of a co-existing mental disorder.
Efforts to reduce detention and so-called warehousing of people with a learning disability have received broad support—understandably so given that, in March 2022, 57% of in-patients with learning disabilities and/or autism had been in hospital for more than two years. However, we need assurance from Her Majesty’s Government that, when the Act is reformed, the rights and needs of patients detained under Section 3 without a diagnosed mental illness will be protected and that, in the absence of safe discharge, continued holding in hospital will not simply be transferred under the frame- work of the Mental Capacity Act.
The Queen’s Speech made fleeting reference to supporting the NHS, and none to supporting social care to manage already pressured services. However, greater investment is absolutely essential. The White Paper proposed a duty on commissioners that requires
“adequate supply of community services”.
Such a legal requirement must be accompanied with sufficient resource to support the mobilisation of service and development of workforce.
The need for improved community support spans different populations, including people living with dementia, which leads me, like others, to ask: when do the Government intend to publish the national dementia strategy? Briefings received from carers’ associations are questioning whether the Government intend to ensure carers’ rights to a minimum of one week’s unpaid care leave. Other noble Lords have spoken on this more eloquently than me. My important point is that supporting carers will reduce unnecessary admissions to hospital and be cost effective.
Leaders in the NHS have made it clear that investment in community services is vital, both to reduce the unsustainable pressures on in-patient services and to provide dignified care in people’s homes. I believe that a minimum wage for social care workers delivering personal care is essential. Do the Government intend to introduce a national minimum wage for personal social care workers and to fund time for travel between their clients’ homes?
Coming, as I do, from a rural village near Tavistock on Dartmoor, it is almost impossible to plan a care worker’s rota without at least 20 minutes of travel between their clients. Central government allocations to local authorities from the levy should have sufficient resources to let contracts that enable payment for travel time.
The new health and social care levy is widely supported by the population. This is in effect a hypothecated tax that the public expect to improve seamless health and social care. Recent reports about standards in some independent care providers where NHS contracts are delivered cause particular concern. Can the Minister advise the House what requirements there will be for ILACS to monitor contracts it lets—for example, in mental health—in addition to CQC monitoring and inspections? It is necessary to take a whole-systems approach that recognises the pressures all areas of care are suffering from and focuses on reducing inequality in delivery. How will the Government ensure a fully funded workforce plan so that we have sufficient competent staff to meet demand for care?
I will speak briefly on the issue that my noble friend Lord Laming wanted to raise. What are the Government’s intentions on tracing the estimated 135,000 “ghost children” who have not returned to school after lockdown? If every child matters equally, there is a child protection issue at stake here. How do the Government intend to ensure the regular attendance in school of all children to promote equitable opportunity for lifelong success?
It is vital that young people going to university who leave with significant debt feel valued in the workplace. We must stop hammering our young. I reiterate a previous request: will the Government consider writing off student fee debt for at least five years for graduates who work in a range of public services where face-to-face contact is essential? These graduates appear to be at significant disadvantage compared with those in the independent sector, where salaries have risen to reflect the cost of regular student loan repayments.
Lord Storey (LD)
My Lords, I remind the House that I am a vice-president of the Local Government Association. I also take this opportunity to welcome the noble Baroness, Lady Chapman, to the Labour Front Bench, and to offer my best wishes to the noble Lord, Lord Watson, who was excellent on the Front Bench: sincere, genuine and hard-working.
The noble Baroness, Lady McIntosh, was absolutely right when she said that all the work had been done by others: as people spoke, I crossed out parts of what I was going to say. All noble Lords have made amazing contributions—you just wish that people had more time—but there were some stand-out moments for me which resonated with some of my own thinking.
The noble Baroness, Lady Stedman-Scott, kicked off the debate, reminding us about British Sign Language and how important it is. Of course, it was the subject of my good friend Rosie Cooper’s Private Member’s Bill in the Commons.
The noble Baroness, Lady Wilcox, said virtually everything that I was going to say, which I found a bit difficult, but she raised the issue of dentists. I can remember when children in school would have a regular—yearly—dental check. What a pity that does not happen any more. Surprisingly, she also said that the Opposition would hold the Government to account with late-night sittings. I hope the votes are more successful at those late-night sittings than they have been in recent months.
My noble friend Lady Brinton rightly reminded us of the difficulty that many families are facing, and again highlighted the need for some sort of emergency Budget or action—particularly, perhaps, on VAT—a windfall tax and other measures to help many families facing very difficult circumstances.
I was quite taken with the noble Lord, Lord Fowler, who talked about AIDS. He commented how wrong it is to say that nobody dies when in fact, in the UK alone, 700,000 people die every year.
My noble friend Lady Walmsley talked about the delay in the obesity strategy and, rather than the Minister writing to her, I hope she might raise it here. I too read the piece by the noble Lord, Lord Hague, in the Times on the U-turn on the obesity strategy: “immoral”, “shallow” and “weak” were his comments.
The noble Baroness, Lady Morris, who I always have time to listen to, quite bravely raised the issue of academic freedom. There is a problem—she is right—and how we deal with it will be the issue. She mentioned teacher retention; currently, 44% of teachers polled say they will leave the profession in the next five years. I really wanted to take up the point about academies, but I do not have time.
The noble Baroness, Lady Finlay, talked about medical students who went to Ukraine to train and the barriers they faced. My goodness, we need them. I do not know whether anybody has tried to phone their GP; I phoned my GP today, it took me 101 recall presses to get through and when I got through to my GP, the receptionist said, “What’s the matter with you?” —whatever happened to doctor-patient confidentiality?—and said they would call me back. The doctor called me back and was excellent; the problem is a lack of GPs and we need to sort that out.
The noble Lord, Lord Aberdare, talked about government action on skills. He was encouraged by progress on apprentices and T-levels and quite rightly asked how it all fits together. He talked about the importance of careers education and said we need to develop a programme of work experience. I could go on. I just want to mention the noble Lord, Lord Jones. Every time I listen to him, I get enthused. I loved the comment that Tony Blair’s shortest speech was his best: “Education, education, education”.
I want to start my contribution by repeating the words of my noble friend Lord Shipley, who said in the debate on levelling up last week:
“I say to the Minister that you do not level up places without levelling up people first.”—[Official Report, 11/5/22; col. 36.]
I want to say to the Education Minister that we do not level up schools without levelling up the opportunities for all children. We spend so much time talking and legislating about structures and the type of schools we want. I personally do not care if it is an academy or a maintained, free, state or independent school. What I care about is that all the children, to whatever school they go, get a first-class education; that they all have the same opportunities and support they need to grow and develop. Yet the Government seem obsessed with school types.
The first three pages of the Bill are entirely dedicated to implementing new standards for academies, yet remarkably manage not to specify what these standards will be. And by the way, after years of ruthlessly dismantling the maintained sector schools, we now find that schools that do not convert to academies are more likely to achieve higher ratings from Ofsted.
I care about the quality of teachers and teaching in our schools. I was interested that somebody mentioned Finland. To be a teacher in Finland, you have to have a master’s degree—and, by the way, you are respected and paid a really good salary. We all remember those special teachers, whether in primary or secondary school, who were able to ignite our imagination, so we should be providing our teachers with the best possible training and with first-class continuing professional development.
Our schools and school pupils have, through Covid, had the biggest shock to the system probably since the Second World War. We must do absolutely everything to help pupils catch up—a point made by the noble Baroness, Lady Wilcox. Yet we have heard time and again as we emerge from the pandemic that schools, parents and pupils are struggling with a lack of catch-up funding. The Sutton Trust found that the vast majority of school leaders are struggling to help children due to this lack of catch-up funding. The Queen’s Speech missed an opportunity to invest in our children’s future. We are calling on the Government, as was proposed by their very own “Catch-up Tsar”, Kevan Collins, to urgently provide the full £15 billion for the catch-up programmes that schools so desperately need.
Let us remind ourselves that virtually every child has been affected during the pandemic, with almost 1.8 million children missing at least 10% of the last autumn term and 122,000 children missing at least half of school time altogether. The pandemic had a huge effect on the well-being and mental health of our children and, indeed, some teachers, yet the Queen’s Speech failed to mention the mental health crisis in our schools. The legacy of the pandemic cannot be a severe mental health crisis that goes unchecked across vast swathes of the country. According to our own NHS, one in six children is currently experiencing a mental health issue—one in six—yet, despite this, there was no more help provided in this year’s Queen’s Speech than in last year’s. We need urgent investment to provide a dedicated and qualified mental health professional in every school or group of schools. No parent should be struggling, as is now the case, to get meaningful and immediate access to mental health care for their child.
The Minister knows that I have highlighted time and again the problems of children missing from our school system, which the pandemic has exacerbated. I do not really understand the issue about daily registration because a register was always marked in the morning and the afternoon. As my noble friend Lady Brinton pointed out, if a child was absent for health reasons you put an “H” with a circle around it in the register and pupils had a particular number. That might be by the by, but the solution is certainly not to punish parents for their sons or daughters not attending. It is to understand and identify the reasons why a child is not in school, including addressing inclusion, mental health and special educational needs challenges. We welcome the fact that councils will be encouraged to adopt a case-by-case approach to absenteeism, rather than a blanket policy of fines. The Government’s zero-tolerance approach to school attendance perhaps makes for a good tabloid headline but risks antagonising parents of children with a medical condition-based anxiety, for whom getting their children out of the front door to school is often a major achievement in itself.
The environment that our children and young people work in is important. In 2010 Michael Gove, as Secretary of State for Education, axed the school-building programme, saying that Labour’s Building Schools for the Future programme was not as efficient as it could have been. We urgently need now to increase the number of school rebuilding programmes from 50 a year to more than 300. As part of their weekly update to the ministerial team, senior officials have cited the problem of deteriorating school buildings. They say that
“the deteriorating condition of the school estate continues to be a risk, with … funding flat for … 2022-23, some sites a risk-to-life, too many costly and energy-inefficient repairs rather than rebuilds”.
Can the Minister urgently advise the House what action the Government intend to take?
Finally, this year the BBC celebrates 100 years of broadcasting. During those 100 years, its contribution to education has been enormous. As a young primary schoolteacher, I well remember Harry Armstrong’s TV science lessons, as well as “Movement and Drama” on the radio. Bitesize increased by 40% across 2021-22, with three out of four secondary schools using it. Tiny Happy People is supporting parents and carers post pandemic in developing the communication skills so desperately needed. The BBC provides outreach and training to schools and FE colleges—not forgetting the 1,000 apprentices, of whom nearly 30% come from disadvantaged backgrounds.
The Bill was the opportunity to broaden the offer of the academic achievement and broader life skills that parents and employers want. It was an opportunity to address widespread well-being problems for children and young people, as well as to give them the support they need to recover lost learning. The Bill has addressed none of these issues, choosing instead to tinker around the edges of the management of schools. Children need catch-up funding, not more upheaval. Like the noble Baroness, Lady Wilcox, we will certainly be holding the Government to account on many of these issues. We will be supportive at times but very robust as well.
Baroness Chapman of Darlington (Lab)
My Lords, it is a pleasure to follow the noble Lord, Lord Storey, and I am grateful to him for welcoming me to my first time speaking in this place on these issues of education, public services and health. It is a real honour to be asked to do this.
Today’s debate has addressed some of the reasons that brought many of us who have contributed into public life in the first place. Your Lordships could really sense that passion across the Chamber all afternoon and into the evening. My noble friend Lady Wilcox of Newport and other noble Lords, including—this is not an exclusive list by any means—my noble friends Lady Morgan, Lady Morris, Lady Andrews, Lady McIntosh, Lady Lawrence, Lady Blower and Lady Warwick, the noble Baronesses, Lady Walmsley, Lady Brinton and Lady Finlay, and the right reverend Prelate made well-informed contributions. So many women in this debate did so and it has been a pleasure to hear them all. However, they all set out the deficiencies in the Government’s plans for education, welfare, health and public services.
What we needed was a Queen’s Speech that rose to the challenge of rewarding the devotion of families, teachers, pupils, patients and carers over the pandemic. It offered none of this, just short-termism and distant promises, with no sense of the urgency or appreciation of the scale of the task that we face.
The tone of this debate has been constructive, but the unmet ambition and frustration with the Government is palpable. The noble Lord, Lord Kirkham, to be fair to him, wants to close the attainment gap and I applaud him for that. However, I gently point out that the Government’s leadership in priority areas has so far been nowhere near that implemented in the London Challenge led by, I believe, my noble friends Lady Morgan and Lady Morris, although there were no doubt many others involved. The Government could step up and deliver for areas like mine in the north-east.
As my noble friend Lady Wilcox of Newport set out so well, the Government’s legislative plan—or lack of—for our children simply does not recognise the urgency of the action that UK schools and universities need. As she said, it is only though world-class skills, training and sustained investment and by changing the way that we think about vocational training—as the noble Baroness, Lady Falkner, and my noble friends Lord Hanworth and Lord Jones said—that Britain can compete in the 2020s and 2030s. The Prime Minister’s rhetoric on lifetime skills is all very well, but the reality so far is very different, I am afraid.
All the evidence suggests that it is in a child’s earliest years that interventions make the most difference, so it is utterly damning for the Government that half of all children starting reception are deemed to be not ready to start school. We will judge the Government on their record and not on their rhetoric—inadequately small measures and token gestures, as pointed out by my noble friend Lady Morgan, and no proper recovery plan. We need sustainable policy and investment, she said, and I agree.
Even when the Educational Endowment Foundation is warning that Covid may have led to a 17% increase in the already vast educational attainment gap between disadvantaged pupils and their peers, there are no proposals to support children’s pandemic recovery. Equally astoundingly, there are no proposals to improve teaching and tackle the exodus of school staff from our classrooms.
Labour would use this opportunity to support every child’s recovery from the pandemic with new opportunities to learn, play and develop, through our children’s recovery plan. We would end the unfair tax breaks for private schools and spend the money on improving education for all our children. By delivering 6,500 new teachers and professional careers advice and guidance for every child, we would provide a brilliant education for every child to equip them with the skills they need for work and for life.
“This is an empty Bill and a discredited catch-up programme,” said my noble friend Lady Morris, calling for standards not structures. You know why the Government are doing this? Because they are out of ideas; they are tired, distracted and unable to champion the needs of our children.
We heard a thoughtful speech from the noble Lord, Lord Addington, on dyslexia and technology, so what about a Bill to look at services for children with those additional needs, to support them, their educators and their parents? New ideas, imagination and a determination to deliver excellence for all children is what we want from the Government—they would have our support—but what we have is an all but empty Bill.
On health, there is only one small Bill. After a decade of Conservative underfunding, the NHS went into the pandemic with record waiting lists and 100,000 staff vacancies. There are 6,400,000 people currently waiting for treatment and 1,600,000 million people waiting for mental health support. The Government’s response? No legislation, no new funding, no details and no timescales. A failure to act for a decade was bad enough, but a failure to act after the pandemic is nothing short of an insult and a ticking time bomb. As my noble friend Lord Young said, we need to find a way.
I should just like to mention to the Minister somebody called Ian Weir. He lived in Darlington and died when he was, I think, 43 years old from a heart condition. He had been waiting for treatment for about a year and a half and died while on a waiting list. It was his death that led the then Health Minister, Alan Milburn, to introduce national service frameworks for heart conditions to impose targets and obligations on providers. Those decisions, that energy, that commitment and that determination to do something are still saving lives to this day.
However, we are now going backwards. Female life expectancy in the north-east is getting shorter, for example. That is shameful. More shameful still, however, is the Government’s passivity in the face of this preventable disaster. As my noble friend Lord Bradley explained, the Mental Health Act has long needed an overhaul. However, as he said, we do not currently have a sustainable, long-term workforce plan, which is necessary for the reforms to work properly. The Government are silent on this critical fact, whereas we would bring in an additional 8,500 new mental health staff to treat more patients and drive down waiting lists. It should please the noble Baroness, Lady Hollins, who made a well-informed and thoughtful speech, that we would guarantee mental health treatment within a month for all who need it and place specialist mental health support in every school, resulting in over 1 million more people receiving support each year and saving money in the long run.
Nearly two years on from the Government promising, as they put it, to fix social care, all we heard in this Queen’s Speech was that
“proposals on social care reform will be brought forward.”
I should hope so but, so far, that simply is not good enough. The noble Baroness, Lady Pitkeathley, is right: we are missing an opportunity to support carers and their families. She made some practical suggestions that would help. The noble Baroness, Lady Jolly, appealed to the Government to act and to rethink how young carers are themselves cared for by local authorities and schools. Too many fall through the cracks at present. The Government could and should act.
It is clear that the Government just do not have an ambitious, coherent strategy to revitalise health, education, welfare and public services. This is a mid-term Government with a huge majority. They should be making bold, difficult choices but are simply not meeting the scale of the challenge, with the UK facing crisis upon crisis in terms of the cost of living, mental health treatment, waiting times and educational attainment. Britain deserves better. We on these Benches want to form a Government. We have the energy, ambition and creativity needed but, until that time, we will use our role as parliamentarians to probe, push and negotiate our way to the better legislative package that our public deserve.
The Parliamentary Under-Secretary of State, Department for Education (Baroness Barran) (Con)
My Lords, I am pleased to be here to close today’s debate on Her Majesty’s gracious Speech. I pay tribute to Her Majesty for her gracious Speech and her 70 years of service in this jubilee year. I thank your Lordships for their thoughtful remarks and contributions throughout this debate; I also thank my noble friend Lady Stedman-Scott for her introduction.
Before I go any further, I pay tribute to the noble Lord, Lord Watson, for his tough but fair work as the opposition spokesman for education. I also warmly welcome the noble Baroness, Lady Chapman, to her role; I very much look forward to working with her on these issues.
In politics, there are some principles that stand the test of time. To paraphrase our greatest leader, Winston Churchill, this Government want
“to draw a line below which we will not allow persons to live and labour, yet above which they may compete with all”
their strength. As he said:
“We want to have free competition upwards; we decline to allow free competition to run downwards. We do not want to pull down the structures of science and civilisation, but to spread a net over the abyss.”
It has been 67 years since Churchill was Prime Minister but his words are as resounding today as they were then because this Government’s legislative agenda, from education, health and public services to economic growth and levelling up, is essential to provide a good standard of living for all and a sense of opportunity for everyone in the 21st century. It is this aim that lies at the root of the legislation we are taking forward, which will benefit the country and all the people who live in it.
Education is one of the Prime Minister’s top priorities, but nobody in this Government is under any illusion that improvements do not need to be made. Too many children still do not get the start in life that will enable them to go on and make the best use of their talents and abilities. Too many children leave primary school unable to read, write or understand mathematics at the required standard. Disadvantaged students are still less likely to achieve the standards we expect for them. As the noble Baroness opposite, the noble Lord, Lord Storey, and the noble Baroness, Lady Lawrence of Clarendon, highlighted so eloquently, the impact of the Covid-19 pandemic was greatest on our most disadvantaged children.
This Session, we have already introduced a Schools Bill to deliver a stronger school system that works for every child regardless of where they live and to bring forward essential safeguarding measures to allow more children to receive a suitable and safe education. The Schools Bill will level up standards and give parents confidence in their children’s education by strengthening the academy trust system, supporting more schools to join strong trusts, reforming attendance measures and delivering the long-standing commitment of a direct national funding formula. I thank my noble friend Lord Lingfield for his welcoming words regarding these measures.
The noble Baronesses, Lady Morgan, Lady Morris, Lady Blower and Lady McIntosh of Hudnall, all challenged our approach to academisation, and we will of course have time to explore this in detail when we come to debate the Bill. However, I cannot stress strongly enough that our starting point was not an ideological one. Rather, we started by asking our ourselves how we reach the aspiration that all of us in this House share for our children. The results from the most successful multi-academy trusts are substantially better for our children at primary and secondary level, and particularly for our disadvantaged children.
I turn now to the points raised by the noble Baroness, Lady Morris, about the fragmentation in the system. We absolutely acknowledge that the system is fragmented at the moment and we very much hope that, with a focus on quality, we can drive a more coherent system that maximises outcomes for our children. My noble friend Lord Kirkham highlighted some of the strengths of multi-academy trusts. In fact, he took at least a minute or two out of my speech, thanks to his remarks.
The right reverend Prelate the Bishop of Durham—along with many other noble Lords including the noble Baroness opposite, the noble Lord, Lord Storey, and the noble Baroness, Lady McIntosh—talked about the importance of excellent teachers for every child. To address the points raised by the noble Baroness, Lady Blower: we are investing in training and professional development for teachers at every stage of their career, and we share her ambition that this should be successful.
I turn now to the questions from the noble and learned Lord, Lord Etherton, regarding citizenship and education. The curriculum already contains content on human rights, the UK legal system and international law, helping people to understand—as the noble and learned Lord put it so clearly—their rights, duties and responsibilities. That curriculum is compulsory at key stage 3 and key stage 4 as part of the national curriculum.
My noble friend Lord Kirkham made a point about the care to be taken when exploring the possibility for individual schools in exceptional circumstances to leave a multi-academy trust. I reassure him that this is exactly the approach that we will be taking.
In relation to teacher recruitment, as the House knows, we are raising salaries to £30,000. We have 20,000 more qualified teachers in our schools today than there were in 2010 and 50,000 more teaching assistants. As noble Lords reflected on, we are also introducing legislation to have a register for children who are not in school. I really hope we will have time, when we come to debate the Bill, to set aside the misunderstandings. I think the noble Baroness, Lady Brinton, used the phrase “naming and shaming parents”, which is the last thing that we plan to do.
We absolutely recognise a parent’s right to choose the approach to education for their children, but equally we need to know where the ghost children are, as the noble Baroness, Lady Watkins, said on behalf of the noble Lord, Lord Laming. There is an estimate that those figures increased by about 30% during the 2020-21 academic year and that is just not acceptable. To reassure my noble friend Lady Eaton, there are substantial measures in the Bill to address illegal schools.
Turning to universities, as my noble friend Lady Stedman-Scott mentioned, we will bring forward further legislation to ensure that our post-18 education system really promotes genuine social mobility, highlighted as so important by the noble Baroness, Lady Falkner. It must also be financially sustainable and give people the skills they need to meet their career aspirations. I will need to write to the noble Baroness, Lady Warwick of Undercliffe, about work with universities but I am sure that will be part of the approach. I thank the noble Baroness, Lady Greengross, for acknowledging the importance of this area.
Our aims, which sit at the root of the Bill, are to make sure that we offer individuals the best post-18 options for them and that they can take pathways which offer really high-quality routes, be those technical or more conventionally academic. I hope that addresses some of the points raised by the noble Lords, Lord Aberdare and Lord Jones, and the noble Viscount, Lord Hanworth.
We also want to meet our manifesto commitment to challenge the restriction of lawful speech and academic freedom. I thank both the noble Baronesses, Lady Morris and Lady Falkner, for their support for the Bill, which we hope will directly address gaps in the existing law, including the lack of a clear enforcement mechanism.
Turning to health, the issues raised by your Lordships were extremely broad-ranging, from social care to the sharing by the noble Lord, Lord Fowler, of his expertise in and insight into the continuing issues around HIV and AIDS. The long-term impacts of medical failures were highlighted by my noble friend Lady Cumberlege, the role of volunteers by my noble friend Lord McColl and the Singapore scheme by my noble friend Lord Naseby, while elements of the obesity strategy were raised by the noble Baroness, Lady Walmsley. This is not to mention refugee mental health, raised by the noble Lord, Lord Loomba, and community health workers, referred to by the right reverend Prelate the Bishop of London. We will need to write to address many of those points.
A number of your Lordships focused on issues around social care. As the House is aware, the Government are implementing a comprehensive reform programme of adult social care, with £5.4 billion of investment over three years from April 2022, funded by the health and social care levy. This issue was raised by the noble Baronesses, Lady Wilcox and Lady Pitkeathley. The noble Baroness, Lady Hollins, rightly focused on the importance of a culture shift in mental health, which I remember debating with her when I first arrived in this House. Hopefully things have moved a little in that time.
Modernising the Mental Health Act is a crucial part of the work we are doing. As your Lordships know, the Mental Health Act allows for the compulsory detention and treatment of people with severe mental illness who would otherwise present a risk to themselves or others. We will shortly publish a draft mental health Bill for pre-legislative scrutiny. The noble Baronesses, Lady Tyler and Lady Finlay, and the noble Lord, Lord Bradley, all asked about the timeline. We are on track to publish the draft Bill this summer and expect pre-legislative scrutiny to begin in the autumn, although timings are obviously a matter for Parliament.
The Bill will take forward the majority of Sir Simon Wessely’s recommendations in his 2018 independent review. It will contain draft measures that will allow for greater patient choice and autonomy and help us address racial disparities that exist in the Act by enhancing patient voice and representation. We are already piloting new culturally appropriate advocacy approaches that take proper account of a person’s background and needs. Importantly, it will make it easier for people with learning disabilities or autism to be discharged from hospital—something the noble Baroness, Lady Jolly, raised.
More broadly, there were a number of questions about staffing in the NHS and social care, including from the noble Baronesses, Lady Finlay and Lady Andrews. As the House will know, there are record numbers of staff working in the NHS, but retaining that experienced workforce is an absolute priority for the Government. Our people plan has a range of actions to improve staff retention, with a stronger focus on creating a more modern, compassionate and inclusive NHS culture.
A number of your Lordships raised the issue of unpaid carers and carers’ leave. We know it is disappointing that the Queen’s Speech did not include an employment Bill for the third Session of this Parliament, but the Government remain committed to carers’ leave and will bring forward legislation on this when parliamentary time allows.
A number of your Lordships, including the noble Baronesses, Lady Watkins and Lady Greenfield, and my noble friend Lord Goodlad, talked about our dementia strategy, in particular in relation to Alzheimer’s. We want every person to receive high-quality, compassionate care from diagnosis to the end of life. This year we will set out our dementia plans for England for the next decade. There will be four planks, which I hope address at least some of the requests of the noble Baroness, Lady Greenfield, in relation to diagnosis, risk reduction, prevention and research.
In relation to women’s health, the sex-based health disparities that were highlighted in the debate today will be addressed in England’s first ever women’s health strategy which we will publish this year. In response to my noble friend Lady Cumberlege’s request, my noble friend Lord Kamall would be delighted to meet her. The Government are committed to improving patient safety and prioritising resources to improve future medicines and medical devices. We would be glad to continue the conversation with my noble friend.
Turning to welfare, which is another issue that your Lordships have touched on today, the Government are reforming the special benefit rules for people who are nearing the end of their life and providing fast-tracked access to certain benefits. The rules being changed in the Social Security (Special Rules for End of Life) Bill have been in place, unchanged, since 1990. As my noble friend the Minister highlighted, the Bill will change eligibility so that those expected to live for 12 months or less will receive this vital support, as opposed to the current six-month rule. The Bill will ensure that thousands more people nearing the end of life can access benefits sooner without needing a face-to-face assessment or waiting period, with the majority of individuals receiving the highest rate of those benefits.
In response to the questions from the noble Baroness, Lady Thomas of Winchester, about speeding up the PIP assessments and payments, we are focused on transforming the PIP claimant journey overall to make sure it is more streamlined and more user friendly by using a range of channels including online and by telephone. My noble friend the Minister would be delighted to meet the noble Baroness if that would be helpful to discuss this further. I thank the noble Lord, Lord Young of Norwood Green, for his generous comments acknowledging the hard work of colleagues in the department and what they have achieved.
Finally, turning to public services and, in particular, procurement, meeting all these ambitions will require us to look at how and where public services are delivered. We believe that the procurement reform Bill will replace the bureaucratic and process-driven EU regime with a simpler and more flexible commercial system that better meets the needs of our country while also complying with our international obligations. Public sector buyers will have more freedom and flexibility to negotiate and design the buying process with suppliers. The Bill will also make it easier to exclude suppliers who are unfit to bid for public contracts.
I will write to all noble Lords where I have not been able in the time available to touch on the important issues raised. I will also link in with colleagues in other departments in response to the questions from the noble Baronesses, Lady Greengross and Lady Warwick of Undercliffe.
I have heard many times this afternoon and this evening the ambition that we all share in this House for this country and for the public services that are so important in its success. I know that I can speak for all my ministerial colleagues in saying that we look forward to working with all your Lordships as we focus on how we implement and refine the legislation in the gracious Speech and make it a reality to address the issues that people in this country face.