That an humble Address be presented to His Majesty as follows:
“Most Gracious Sovereign—We, Your Majesty’s most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament”.
My Lords, on behalf of all noble Lords, I thank His Majesty for his gracious Speech. I am truly honoured to be a Minister in his Government and to open this debate.
I always said that I wanted to be a different kind of Minister, and today is no different. Over the past few days, I have thought a lot about the sort of speech that I wanted to give. I could not quite make up my mind, but it finally clicked late last night, as I leaned over my five year-old son, Xavi, as he slept in his bed. I thought that, if I am making a speech about the long-term changes that this Government want to make in health, education, housing and welfare, I need to explain what kind of country we want to build for Xavi and his generation—so forgive me if this is a bit unconventional.
As I have told Xavi when he asks me about work, the National Health Service is probably our country’s most beloved institution. It represents how we think of ourselves as a nation: caring, compassionate, and a place where everyone will have their needs cared for at no cost, according only to need. It touches so many lives every day. It saved Xavi’s brother, Sam, when he was born more than 20 years ago and, more recently, it saved Xavi’s grandfather with an emergency operation.
However, it is a health service that faces huge challenges. It is a health service that must care for an ageing population that is growing rapidly and has rapidly growing needs, where it costs five times more to care for 70 year-olds than for 20 year-olds. It is a health service that is still recovering from a once-in-a-generation pandemic, which stretched it more than ever before and created health needs both physical and mental, which even now we are only just beginning to understand. So it is a health service where we need to make decisions for the long-term, to change how it operates and how we approach it, so that it is there for Xavi’s generation and the one after, just as it has been for ours.
That means we will all have to have to take more responsibility over our health, and that government must empower us all to make long-term decisions that benefit our health. That means diagnosing and treating conditions faster, but it must start with prevention. The single biggest thing that Xavi and his generation can do to protect their health is to never start smoking, and this Government are going to help them do that. We are making it illegal for Xavi and his friends, and anyone who is 14 or younger, to ever be sold tobacco. This will save thousands of lives and prevent thousands more people suffering from cancer. Vaping is, of course, much safer than smoking, and it helps many smokers to quit for good, but that does not mean that Xavi and his friends should ever take up vaping. That is why, following a consultation, we will bring forward measures to restrict the availability of vapes to our children, targeting sweet flavours, colourful packaging, eye-catching displays and disposable vapes, making sure that we do not replace a generation of nicotine addicts who smoke with another who vape.
We are not only taking steps to prevent Xavi’s generation suffering major illnesses but steps that will allow them to take more responsibility for their health. Just as we use apps and technology to manage our finances, retail preferences and social lives, they will be able to manage their health using technology, through the NHS app. As we speak, we are loading more features which will allow patients to understand their health needs through accessing their health records, and to navigate and decide whether they are best served by seeing a pharmacist through our Pharmacy First programme, seeing a nurse or a doctor, or referring themselves straight to a specialist at one of our 160 new community diagnostics centres. Patients will be able to make appointments from the app and then get their results directly to their phones. If they need follow-up treatment with a specialist, at a hospital or at a CDC, they will be able to exercise choice to find an appointment that suits them, whether that is seeing a particular doctor, getting care closer to home, or getting a shorter waiting time.
Artificial intelligence and technology are already allowing us to do great things. AI is allowing us to halve the time that it takes to treat people with strokes, making it more likely to recover completely. It is allowing radiologists to read lung and breast scans to detect cancers more quickly and more accurately than ever before. For Xavi’s generation, AI can do so much more. It could help us to discover medicines and cures that have defeated us so far, and it could analyse health records, helping us to join the dots between what links different generations and different conditions, to allow scientists to develop medicines and treatments to target the causes of major diseases.
All the work that we are doing to improve the nation’s health is underpinned by our long-term workforce plan—ground-breaking in its purpose—ensuring that we have the right numbers of nurses, doctors and specialists, and the right training and pathways into the profession, whether that is by expanding degrees, apprenticeships, or more on-the-job development. Underlying all our work is the need to focus our most precious resource, our people, on getting upstream of the problem. Rather than just focusing on hospital treatment centres and primary care, we are focusing resources on prevention and increasing the use of technology.
At this stage, I want to emphasise the Government’s commitment to creating parity between mental and physical heath and to introducing the mental health Bill in the future, when parliamentary time allows. In the meantime, we are taking decisive action. We are eliminating dormitory accommodation, so that people with mental health conditions are treated where they can be best cared for—in the community. We are making sure we have mental health ambulances available to answer 999 calls where we need a mental health response. We are also investing an additional £2.3 billion to support 2 million more people to receive mental health treatment.
As well as building a sustainable future for the NHS for our children, we are making sure it is ready for winter. Average category 2 ambulance response times were over 10 minutes faster in September than in the same month last year—and we are going further. This year, we are investing an additional £600 million into our discharge fund, supporting hospitals to discharge patients when they are ready, with the right support, and stopping patients who do not medically need to be in hospital from taking up important beds and delaying ambulance handovers. We are also providing 5,000 additional permanent staffed beds, introducing 800 new ambulances and using our 10,000 hospital-at-home beds to keep thousands of patients out of hospital.
As well as protecting the health of Xavi and the next generation, we are getting them ready for their futures. We are proud of our education record to date. Xavi and his friends are far more likely to go to a school rated good or outstanding. When we took office, just 70% of schools met this standard; today, that figure is 90%. Our nine and 10 year-olds lead the western world in reading, and our 15 year-olds perform significantly above the OECD average for reading, maths and sciences. However, the parallel nature of A-levels and technical qualifications limits the breadth of young people’s education, stops progression in maths and English far too early and prevents parity of esteem between academic and technical qualifications. Furthermore, we are an international outlier from 16 to 19 in terms of subjects taken and the number of hours taught. The advanced British standard will ensure that, when Xavi and his friends turn 16, they will face a world-class system, placing equal value on technical and academic knowledge, giving them depth and breadth of knowledge to succeed in further study and the world of work.
I now turn to housing and the world that we want to create for Xavi’s generation and those that follow. First, we understand the vital role of housing supply. Since 2010, we have delivered nearly 2.3 million homes, realising dreams of home ownership and delivering decent rented accommodation. We are on track to deliver our manifesto commitment of building 1 million more homes over this Parliament. At some point, all of us, including Xavi, are likely to rent their home, maybe as a stepping stone to home ownership, or maybe for the long term. Whatever the circumstance, we have acted to make renting better and fairer by cracking down on those 400,000 non-decent homes and banning tenant fees. With the Renters (Reform) Bill, we are going further. We will ban no-fault evictions that carry just two months’ notice, empower tenants to raise concerns about the quality of their property and give them greater security. At the same time, we want to be fair to landlords, making it easier for them to evict tenants who display anti-social behaviour or wilfully do not pay their rent.
We also want to help people like Xavi and young people today into home ownership. For some of us, that will mean buying a leasehold property. This Government are committed to improving the experience of the owners of the 5 million leasehold dwellings in England and Wales. We have already capped ground rents in most new leases at very low rates and we will deliver further leasehold reform with the leasehold and freehold reform Bill, which will ban the sale of new leasehold houses. Where leaseholds are required for practical purposes, such as in flats and apartments, we will extend their lease to 990 years and cap new ground rents, with the intention of giving future leaseholders the equivalent experience as if they owned the freehold on their home. We will also launch a consultation to see how we can further improve leaseholder rights. This legislation will fundamentally reform the leaseholder system, ensuring that families have the right fully to enjoy their homes and giving them increased opportunities to pass them on to their children.
While this Government are committed to supporting our society in health, education, housing and living and working independently, I want Xavi to know that we take care of those who need our support—now more than ever with the heightened cost of living. We spend £31 billion on supporting renters with housing costs and £276 billion in total through the welfare system in 2023-24, including providing more than 8 million low-income households with cost of living payments totalling up to £900. For those who need it most, we have increased benefits and the state pension by 10%, in line with inflation. We have made strong progress towards halving inflation by the end of the year, thereby reducing cost of living pressures. I am proud to say there are 1.7 million fewer people in absolute poverty than in 2010, including 200,000 fewer pensioners and 400,000 fewer children.
While we must support people who cannot work, it is vital that we give a leg up to those who can. As well as bringing economic benefits to a person, work boosts their confidence and well-being. The Government have made work pay with the introduction of a national living wage and by ensuring that those earning £12,570 or less pay no income tax or national insurance. These steps led to record employment rates before the pandemic and, last year, the lowest level of unemployment for 50 years. At the same time, there are 2.6 million people who are economically inactive due to disability or long-term sickness. Over a quarter of those who are long-term sick want to work, to the benefit of themselves and the economy. With flexible working and the ability to work from home, we want to help these people into the types of work that they can do, while understanding their conditions. That is why we have launched a consultation to change the work capacity assessment to come into force by 2025 and to provide tailored support for people to safely move into employment, to benefit them, their health, well-being and confidence and, of course, our economy.
I finish by addressing an issue of utmost importance, given the ongoing events in the Middle East. The aftermath of Hamas’s attack on Israel on 7 October demonstrates a clear link between anti-Israel sentiment and anti-Semitism. In the 21 days following this attack, the Community Security Trust recorded more than 800 anti-Semitic incidents—the highest ever recorded in a 21-day period. We know that boycotts and sanctions are divisive and undermine community cohesion. Many target Israel, under the banner of the Boycott, Divestment and Sanctions—or BDS—movement. There is evidence that this movement has contributed to the horrific rise of anti-Semitism in the UK. Yet we have seen taxpayer-funded bodies attempt such boycotts. In 2014, Leicester City Council passed a BDS motion on boycotting goods from Israeli settlements; that same year, Gwynedd Council passed a BDS motion calling for a trade embargo with Israeli settlements; and, in 2021, Lancaster City Council passed a motion in support of the BDS movement.
Taxpayer-funded public bodies should never interfere in foreign policy. That is why this Government have carried over the Economic Activity of Public Bodies (Overseas Matters) Bill into this parliamentary Session. It will deliver on our 2019 manifesto commitment to ban public bodies from imposing boycotts, divestments or sanction campaigns against foreign countries. It will prevent them pursuing divisive policies that undermine community cohesion and stoke anti-Semitism, ensure that the UK speaks with one voice internationally and guarantee that taxpayers only pay for foreign policy once.
Across housing, welfare, health and employment, this Government are taking the long-term decisions to help give Xavi and young people across the country a brighter future. We will create a health system that puts patients first, give more families a quality home, get more people into work and grow our economy. My noble friend Lord Younger and I look forward to hearing noble Lords’ valuable reflections on the measures that I have outlined today on how we can all take the long-term decisions needed to create brighter future for Xavi and all our young people.
My Lords, I start by echoing the opening comments made by the noble Baroness, Lady Merron. It is a great honour for me as well to close this debate on His Majesty’s gracious Speech. I also take this opportunity to echo her points, and the points made by other Peers, on anti-Semitism. It was an important point that she made, and we are all very aware of what is going on in that particular area. I also thank noble Lords for their very valuable contributions and thank my noble friend Lord Markham for opening this important debate with, if I may say so, his very personal approach. As the noble Baroness, Lady Donaghy, pointed out, he did indeed hit the right note.
I am very aware that I am speaking at the end of an extraordinary day—an extraordinarily sad, sombre and emotional day, as we continue to remember the late noble and learned Lord, Lord Judge. Despite his huge loss, as we have seen this afternoon, this House sails on, and there have been a great number of varied and eloquent remarks made, covering at least four departments—so I have a lot of work to do. As noble Lords might expect, there will be a long letter coming, because I suspect I will not be able to cover everything.
My noble friend Lord Markham and I are aware of the plethora of health-related questions that have been raised this afternoon, all thoroughly relevant and important, ranging from end-of-life care, osteoporosis, long Covid, autism, dentistry, smoking—which I will touch on later—and conversion therapy. I will take this opportunity to congratulate the noble Baroness, Lady Burt, on securing her Private Member’s Bill. That is hot off the press for me, so I am sure we will be happy to engage with her on that particular Bill.
On rather a different note, I want to pick up on what my noble friend Lady Verma said. She devoted her speech to a most important subject: hate in schools. She is absolutely right that every child must be able to go to a school where there is always 100% respect for every individual in the school, but also within that community. That includes pupils and teachers. I will indeed pass her points on to the Department for Education, with my own endorsement and, I am sure, the endorsement of the rest of the House. This chimes with the comments made by the right reverend Prelate the Bishop of Gloucester. I listened carefully to her points, which admittedly were linked to prisons but did focus on the very important subject of communities.
At the heart of the gracious Speech—here I might have been lucky, but was not in the end, to have some words from the noble Baroness, Lady Pinnock, but here goes—are long-term decisions that will deliver a brighter future for millions of people around the country, whether by providing greater security for home owners and tenants, getting people the care they need more quickly, protecting the health of future generations and ensuring that every young person has the education they need to succeed, or strengthening society by ensuring that public bodies are focused on delivering for the communities they serve.
I will just go straight in and talk about housing, which was one of the key themes this afternoon. Whether you are a home owner, private renter or social tenant, as a result of actions already taken, more people are benefiting from a secure and decent home. But, as has been pointed out this afternoon, there is more to do. I am acutely aware of comments made by Peers such as the noble Lords, Lord Howarth and Lord Best. The gracious Speech builds on our progress to make the leasehold system fairer and ensure that home ownership is a more affordable reality, while also delivering a new deal for the private rented sector. Banning the sale of new leasehold houses, for example, will help to restore true home ownership, meaning that, other than in exceptional circumstances, every new house in England and Wales will be freehold from the outset.
That brings me to questions that were raised by my noble friend Lord Young of Cookham and a question raised by my noble friend Lady Finn who asked about leasehold reforms and noted that commonhold should be the default for new build. We think the best way forward is to help leaseholders by making existing leases fairer and more affordable. A rapid transition from leasehold to commonhold will not work for everyone, and we are not going to force uncertainty on to people. The Bill delivers what leaseholders need, which is true home ownership experience. We are making it cheaper and easier for leaseholders to purchase the freehold of their building or a long 990-year lease on their property. We are also empowering leaseholders who will be able to buy out their ground rents and take control of their building’s management from the freeholder so that they have greater control of their property, including management fees, as raised by my noble friend Lady Finn.
Through our Renters (Reform) Bill, abolishing no-fault evictions will also give tenants much more security while delivering a fairer deal for responsible landlords, who deserve to know that their rights are protected and their investments are safe. Questions were raised by the noble Lords, Lord Best and Lord Thurlow, and were touched on by my noble friend Lord Naseby. They were concerned that there was no long-term planning for housing. I hope I can reassure the House that we do indeed have a long-term plan for housing because the Government have committed to a new era of regeneration and housing delivery across England with transformational plans to supply safe and decent homes in partnership with local communities. Some £800 million will be allocated from the brownfield, infrastructure and land fund to unlock new homes on brownfield sites. We are also funding Homes England with £550 million and providing investment of £150 million to Greater Manchester and the same to the West Midlands. Additional reforms to the planning system will speed up new developments, put power in the hands of local communities and unlock planning decisions.
I want to pick up on some comments made about homelessness, which I know is a subject close to the heart of the noble Lord, Lord Bird, and which was also raised by the noble Baroness, Lady Twycross, earlier in the debate. We are determined to end rough sleeping and prevent people ending up on the streets in the first place. That is why last year we published our strategy to end rough sleeping for good and have already made an unprecedented £2 billion-worth commitment over three years to accelerate these efforts. This includes more specialist accommodation to make sure people have a route off the streets, including 6,000 move-on homes, through the rough sleeping accommodation programme, which is the biggest-ever investment in housing for people sleeping rough. I am sure the noble Lord, Lord Bird, knows about those statistics.
A point was made by my noble friend Lord Young of Cookham and the noble Lord, Lord Carrington, about cross-departmental work in the area of renters reform. I will just give a very short answer to that. We are very clear we need to proceed at pace with our court improvements, so we are working very closely with the MoJ to make sure that both landlords and tenants can benefit as quickly as possible. However, we are ensuring that an improved court system meets the needs of users and has been thoroughly tested prior to launch. We are also very aware of the overloading of the justice system, and that is something we are certainly working through. If it is any consolation, landlords will need to go through the courts in only a small minority of cases where a tenant does not leave at the end of the notice period.
Moving on now to health and social care services, which is another major theme for this afternoon, the gracious Speech underlines the Government’s commitment to ensuring that people can access the care that they need as well as taking the long-term decisions that will support and protect the NHS for the future. In meeting immediate challenges, we are providing record levels of funding to help the NHS continue to recover from the pressures caused by the pandemic, also a subject raised this afternoon, and to support the NHS through this winter. Last year, we virtually eliminated long waits of two years or more for elective procedures and by June this year waits of more than 78 weeks.
The right reverend Prelate the Bishop of London, who is not in her place, raised the subject of minimum service levels, and I think it was touched upon by other Peers. Our top priority is to protect the life and health of patients and the public. The aim is to keep patients safe, give the public much-needed assurance that vital health services can continue through strike action and ensure that emergency, urgent and essential care are there when patients need them most.
It is for employers to decide what, if any, disciplinary action is taken if workers choose to strike when they are expected to work in order to provide a minimum service level. We hope that employers will be fair and reasonable and take this sort of action only where it is really necessary.
To further reduce pressures, through our primary care recovery plan we are making it easier to see a GP. We are investing an additional £600 million this year and £1 billion next year to reduce delays in discharging patients who would receive better health outcomes outside hospital. Through the first ever comprehensive NHS long-term workforce plan, we are putting staffing on a sustainable footing, ramping up the number of training places for doctors, GPs, nurses and dentists.
I will pick up on a number of perhaps rather negative comments that the noble Lord, Lord Allan, made, supported by the noble Baroness, Lady Pinnock. I think the noble Lord used a number of driving analogies—basically saying that he was concerned about the long-term workforce plan and that it did not nearly go far enough. Perhaps I can give some sort of reassurance to him. The long-term plan for the NHS workforce is the first of its kind in the history of the NHS—so I would argue that it is a brand new, quality car.
The 15-year plan developed by the NHS will put the NHS workforce on a sustainable footing for the long term. The Government are backing the plan with over £2.4 billion over the next five years to fund additional education and training places. Taken with retention measures, the NHS plan could mean that the health service has 60,000 extra doctors, 170,000 more nurses and 71,000 more allied health professionals in place by 2036-37—which I admit seems rather a long way off.
Through the tobacco and vapes Bill, by effectively ensuring that anyone turning 14 or younger this year will never legally be sold tobacco, we will protect future generations from the harms of smoking and reduce future demand on the NHS. There has been—I think it is fair to say I am on safer ground with this—a general welcome for this. I appreciate the comments from the House, with a very personal speech from the noble Lord, Lord Rennard. This was also spoken to by the noble Baroness, Lady Walmsley, and the right reverend Prelate the Bishop of Gloucester. This Bill will also tackle vaping among young people by taking measures currently under consultation, which was mentioned, to reduce the appeal and availability of vapes.
I move on to tackle some points raised by a number of Peers—I am going on a different track here—on the mental health Bill. This was raised by the noble Baronesses, Lady Twycross, Lady Watkins and Lady Bull, the noble Lord, Lord Thurlow, and others. I am aware of the strength of feeling on this. I recognise the disappointment that the mental health Bill was not included in the King’s Speech. I reassure noble Lords that the Government are committed to seeing that mental health is treated on par with physical health. I recognise the time and effort dedicated by the Joint Committee on the draft Bill. We are reviewing its pre-legislative scrutiny report and we will respond to it in due course.
In the meantime, the Government will continue to take forward non-legislative commitments to improve the care and treatment of people detained under the Act. This includes continuing to pilot models of culturally appropriate advocacy, providing tailored support to hundreds of people from ethnic minorities to better understand their rights when they are detained under the MHA. We also show our commitment through the historic levels of investment in NHS mental health services and will invest at least £2.3 billion more funding by March 2024, allowing an extra 2 million people to benefit.
The sharing of data was raised by the noble Baroness, Lady Barker, and my noble friend Lady Browning. Again, to give some reassurance, in June 2022 we published Data Saves Lives, our data strategy for health and social care. We are committed to demonstrating that the health and social care system is a trustworthy data custodian. One of the ways we will do this is by increasing levels of transparency about how data is used, both for individual care and for improving population health, planning, innovation and research. Our strategy set out plans for a transparency hub, the beginnings of which are now live on NHS.UK. We are currently developing phase 1 of a transparency statement for publication in the autumn and winter. This will be followed by a series of large-scale engagement events from 2024 with members of the public.
A number of Peers raised points to do with funding for social care, not least the noble Lords, Lord Allan and Lord Howarth, and my noble friend Lord Young. The Government are delivering a significant reform programme to make progress towards our 10-year vision for adult social care, backed by up to £700 million of investment. We are supporting workforce development, sector digitisation and innovation, and helping people to remain independent at home. The Autumn Statement includes £1 billion of new grant funding in 2023-24 and £1.7 billion in 2024-25, as well as £1.3 billion leading on into the next three years, made available through the social care grant and further flexibility for local authorities on council tax.
Sustained government investment has helped local authorities steadily increase their spending on adult social care, which reached £21.4 billion in 2021-22. This is an average increase of 2.5% per year in real terms between 2014-15 and 2021-22. We are also improving care workers’ skills and supporting career progression, investing in technology and digitisation and adapting people’s homes to allow them to live independently. We have always acknowledged that our reforms will not solve all problems in social care, but they are a significant step in moving us towards a new vision that the whole of government is committed to.
I will touch briefly on osteoporosis, which was raised by my noble friend Lord Lexden, the noble Baroness, Lady Donaghy, and others. Services for those with musculoskeletal conditions, including osteoporosis, are commissioned locally by ICBs, which are best placed to plan and provide services in line with local priorities and funding. NHS England’s Getting It Right First Time programme has a workstream on MSK help, and there are ongoing assessments of the accessibility of fracture liaison services, using data captured in the national falls and fragility fracture audit programme. These will help to reduce inequities in provision. I hope that gives a short answer to that.
My noble friend Lady Cumberlege and the noble Baroness, Lady Walmsley, raised infected blood, on which I will write to the House. Briefly, we will act swiftly in response to the final report of the infected blood inquiry, following the interim payments we have already made. The use of infected blood and blood products was an appalling tragedy and a dreadful failure.
Just as we are protecting the next generation’s health, so too are we ensuring that today’s young people gain the knowledge and skills required to succeed in tomorrow’s world of work and beyond—so I now turn to the education measures in the gracious Speech. Over the past decade, this Government have made significant improvements. Our nine and 10 year-olds are the best in the western world at reading, and the performance of 15 year-olds in England in reading, maths and science is significantly higher than the OECD average.
However, we must do more to ensure that our post-16 approach is more ambitious and internationally competitive in its breadth and depth. By introducing a new advanced British standard—ABS—for 16 to 19 year-olds, we will establish a world-class system that places equal value on technical and academic knowledge and skills by combining the best of A-levels and T-levels into a single qualification.
The noble Lord, Lord Aberdare, the noble Baroness, Lady Wilcox, and my noble friend Lord Lexden asked how we would deliver the scale of reform. Perhaps I can reassure the House that this is a long-term reform, and A-levels and T-levels will remain until it is fully rolled out. We are retaining apprenticeships as the gold standard for young people who want to move straight into on-the-job training. It will need careful development in partnership with students, teachers, leaders, schools, colleges, universities and employers, as well as the public. As mentioned by my noble friend Lord Markham, we will consult extensively and in detail over the coming months on the design of the new qualification, informing a White Paper next year setting out our plan for delivery, accompanied by a programme of stakeholder engagement.
The noble Lord, Lord Aberdare, touched on careers and made important points; I know that he speaks frequently on this subject. We will publish a strategic action plan for careers in 2024. It will be based around the three priorities of a single, unified careers system; skills, training and work experience; and social justice.
School attendance was another theme raised, not least by the noble Baronesses, Lady Watkins and Lady Wilcox. The Government are rightly focused on helping pupils attend school. We have expanded attendance hubs across 800 schools, benefiting over 400,000 pupils. A wealth of wider activity also supports attendance, including £5 billion of investment in education recovery.
I can see that time is marching on quickly. I wanted to focus on my own department, the DWP, which was not raised too much today. If I may, I shall include that in a letter, in which I shall be very pleased to cover many of the points raised in respect of other departments.
Before closing, I remind noble Lords that I will write a letter, which will be quite a long one, on all the points that were not answered by me today; conversion therapy springs to mind.
As His Majesty’s gracious Speech demonstrates, this Government are committed to delivering on the issues that really matter to the people of the United Kingdom, improving lives, prospects and opportunities, and strengthening society in every part of the country now and in the future.