Lords Chamber

Wednesday 20th May 2026

(began 3 weeks ago)

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Lord Kakkar Portrait Lord Kakkar (Crossbench)
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My Lords, I beg to move the >> My Lords, I beg to move the motion. Standing in my name on the Order Paper. Lord Stone of Blackheath the subject of this report resigned from your Lordships House in December last year. Soon after the Commissioner launched an investigation into three complaints, two made by visitors and a third by a member of staff in the Parliamentary Digital Service. The commissioner upheld all three complaints, finding that Lord Jones behaviour in each case constituted harassment.

The commissioner also found that Lord Stone actions towards two of the complainants, who were visiting the estate as his guests constituted sexual misconduct. My Lords, this is the fourth report in which Lord Stone has been found to have engaged in bullying, harassment or sexual misconduct towards staff or visitors. Following the third report on his conduct agreed by all Lordships House in December 2024, he was suspended from the house for six months. In this latest report, the Commissioner, in considering an appropriate sanction, took account not only of the gravity of the latest breaches, but the fact that Lord Stone is a repeat offender who has been unable or unwilling to take steps to improve his conduct, had Lord Stone not already resigned from the House, the commissioner would have recommended his expulsion.

But given that expulsion was unavailable, the commissioner instead recommended that Lord Stone be permanently excluded from the House of Lords estate. The conduct Committee agreed with the commissioner that Lord Stone's presence on the estate, either as a passholder or as a guest, would present a clear and intolerable risk to other members of the parliamentary community. I therefore invite your Lordships to endorse our conclusion that Lord Stone be permanently excluded from the House of Lords estate.

Finally, my Lords, if this report is agreed, I shall write to the speaker of the House of Commons to invite him to impose similar restrictions on Lord Stoneham access to the House of Commons estate. My Lords, I beg to move.

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My Lords under Standing Order 68. No debate is allowed on this motion. No debate is allowed on this motion. I must therefore now put the question. The question is that this question. The question is that this motion be agreed to. As many as are of that opinion shall say content, of that opinion shall say content, not content to the contrary, not not content to the contrary, not content. The contents have it. Are. My Lords, we now come to some instruments previously debated in Grand Committee.

Provision of information, contractual Control and Registered Land Regulations 2026 and one other motion Baroness

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Taylor of Stevenage. My Lords, I beg to move the motion standing in my name on the

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Order Paper. En bloc. The question is that the two motions in the name of Baroness motions in the name of Baroness Taylor of Stevenage. Are agreed. En Taylor of Stevenage. Are agreed. En bloc as many as are of that opinion will say content. To the contrary, not content. The contents have it. Money Laundering and Terrorist

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Financing Amendment Regulations, 2026. Lord Wilson of Sedgefield. My Lords, I beg to move that the

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My Lords, I beg to move that the motion standing in my name on the Order Paper. The question. Is that this motion be agreed to.

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Is that this motion be agreed to. As many as are of that opinion will say content. To the contrary, not content. The contents have it. content. The contents have it. Questions on a statement made to the House of Commons on Monday, the 18th of May on Youth Justice.

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My Lords. We on these benches will welcome

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We on these benches will welcome any. Measures that genuinely and effectively prevent young people from falling into a life of crime. Every young person diverted away from violence and offending is from violence and offending is welcome. The continued reduction in the number of children held in the number of children held in custody is welcome. The fall from around 2800 children in custody in 2003 to approximately 1400 today, reflects significant progress
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Lord Keen of Elie Portrait Lord Keen of Elie (Conservative)
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across successive governments. We also recognise that the nature of offending has changed. Cases offending has changed. Cases involving county lines, online exploitation, organised gangs and exploitation, organised gangs and serious violence are often more complex than those faced by the complex than those faced by the justice system. A generation ago. But my Lords, while some of the But my Lords, while some of the government's individual proposals in this White Paper may sound reasonable in isolation, a deeper concern runs through this paper.

Once again, the government is at risk of confusing rehabilitation with the dilution of accountability. My Lord, the White Paper is right to identify young people not in education, not in employment, not in training, as being at heightened risk of offending. But if the government is serious about prevention, they must confront the economic conditions affecting young people across the country. The most effective intervention for many young people is not another review. It's not another pilot scheme, it's not another bureaucratic framework.

It is to deliver an economy that can provide them and their families with stability. My Lords, there is a reference in the White Paper to reshaping the justice system. The paper records the government's proposal to undertake what it describes as a fundamental look at the role and purpose of the criminal courts for child defendants. This work will consider whether an entirely different court processes should apply not only to children, but potentially also to vulnerable adults and to young adults.

This does raise material concerns if the government wishes to reform sentencing policy to reduce reoffending. That is one debate. But gradually reshaping the philosophical foundations of our criminal justice system itself is quite another. The government appears to be intent on treating long standing justice structures, not as constitutional safeguards, but as obstacles to be removed or redesigned. We have already seen proposals to weaken jury trial and other proposals designed to keep offenders out of prison. Now, Ministers appear to be questioning whether traditional criminal courts themselves remain appropriate for wider categories of offenders.

But where does such a process end? Accountability and punishment are being steadily downgraded within a system increasingly defined through the lens of vulnerability. And at that point I turn to the issue of victims and indeed of public confidence. My Lord, the government proposed further consultation on the Victims Code, including consideration of a separate code for children. Once again, this government is drawn towards creating new frameworks and pursuing new consultations, rather than improving the operation of an existing system.

If there are gaps in protections for child victims, then strengthen the existing code. And if the noble Lady, the Minister believes the current code is unfit for purpose, why was that not addressed during the passage of the Victims and Courts Bill? Just a matter of weeks ago? We must break from a constant cycle of consultation, a constant, constant cycle of restructuring. Improving outcomes is not synonymous with endless consultation and the expansion of bureaucracy. The government's underlying philosophy to justice is laid bare, perhaps in the sentencing proposals.

In this paper, for example, it explicitly rejects vehicle theft as deserving of a custodial sentence. No matter how many vehicles an individual may have stolen. Now, we don't argue that custody should follow in every case, but sentencing in all cases, youth and otherwise, must reflect individual circumstances. The issue before your Lordships is whether the government still believes custody serves any meaningful deterrent or punitive function. The message increasingly appears to be that more or less young offenders should remain in the community and once young offenders remain in the community, the government now stipulates in its White Paper that it does not intend to make electronic whereabouts monitoring mandatory.

So my Lords offenders are not to be placed in custody, but nor are they to be monitored and the public is right to ask. In these circumstances, where is the balance between rehabilitation and public protection? The Lords. The White Paper also touches upon the issue of remand in respect of young offenders. But, my Lords, the average number of children on remand in England and Wales at any time is now about 183, and some of those may be on remand for their own protection.

So I do wonder to what extent that is really a major or material issue for consultation at this stage. The White Paper then turned to the issue of the age of criminal responsibility, and it is a concern to see that there is a specific section in the proposals on this issue and the idea that it should be a raised age. The government state that it will consider a wide evidence base before making a decision on this important issue.

I do wonder if the intended consultation will consider the opinion of the noble Lady, the Minister, who declared less than two months ago and I quote, raising the age, risked removing an important safeguard in those exceptional cases where serious offending does occur and setting the threshold too high may have unintended consequences, including the potential for older offenders to exploit younger children who fall below the age of responsibility, unquote. We look forward to considering the scope of the consultation that is, to follow the fact this issue now appears in the White Paper inevitably raises questions about the government's intention.

Ministers may try to present this as a neutral review of evidence, but many may recognise that this is yet the soft link, the soft launch of yet another policy reversal, and once again under the veil of consultation, the government is moving further away from the important issue of accountability within the justice system. My Lords, in conclusion, of course, we support the objective of reducing youth offending and preventing young people from entering a life of crime. Early intervention and diversion have important roles to play within any functioning justice system, but rehabilitation cannot come at the expense of accountability.

This government appears to view punishment, deterrence and public protection as outdated concepts to be eroded rather than as essential pillars of a justice system, a system in which offenders are neither placed in custody nor monitored. When out in the community, where courts themselves are the subject of constant redesign, and where accountability is repeatedly softened under the language of reform, is not a system in which the public will be able to retain confidence, my Lords.
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Lord Marks of Henley-on-Thames Portrait Lord Marks of Henley-on-Thames (Liberal Democrat)
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My Lord, the success in reducing the number of children in custody has been a great achievement, and we should still. >> Be concentrating.

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Be concentrating. On further bringing down that number. And that success has been number. And that success has been largely achieved through the work of the Youth Justice Board, in which my noble friend Lord McNally played a major part during the coalition. We note the commitment to reform of the Youth Justice Board, but such reform should be constructive and committed to rehabilitation and reform, turning lives around whether or not the Youth Justice Service is, at some stage in the future, housed within the MoJ.

My Lords, the statement rightly emphasises how often the criminal conduct of children and young people is the result of instability, trauma and neglect, accompanying violence, addiction and abuse among those around them. But we must also address those factors that lead to black children being so much more vulnerable to ending up in the criminal justice system. And the statement is right about that, as David Lammy was when he did his review in 2017. On these benches, we have long sought to address these issues, but the government now rightly highlights new hazards facing children and young people and leading to crime.

Online harms, criminal grooming through social media and exposure to extremist content. The £46 million to be invested in the turnaround programme is, of course, welcome, and the statement is also right to call for early and effective intervention. But the likely success of new and recent measures cannot yet be assessed, including parenting orders, youth diversion orders, youth intervention courts or reforms to the out of court resolution service. But all these measures will take resources and the amount is difficult to quantify.

So can the noble Lady, the Minister, say a little bit more about the resourcing of the reforms promised? How, for example, was the £46 million figure assessed? My Lords, in proceedings on the sentencing Bill. Now the Act we discussed the extra resources needed for the probation service and others, not only for extra handling of early release tagging and post-release supervision, but also to improve both the quantity and the quality of the supervision of offenders and the help. The probation service necessarily provides to the courts.

So how, we would ask, is the need for resources to be kept under review, and what extra resources may there be to meet a need that is currently unforeseen? Is there sufficient flexibility to avoid the increases in offending that inevitably follow from Under-resourcing? My Lords, spending in this area is largely spending to save. Given the massive direct and social cost of crime and particularly of reoffending. Annexe A to the White Paper rightly sets out 11 what it calls golden questions for further research, saying there are key evidence gaps.

My Lords, what plans has the government to fill those key evidence gaps? Finally, my Lords, the age of criminal responsibility is at last to be reconsidered. And I remember the noble Lady defending the present age of criminal responsibility. I disagreed with her then and I do now. And I note the noble and learned Lord, Lord Keen's endorsement of her former views. There's also to be reform of the childhood criminal records regime, or that too is mooted and is welcome.

We have long argued that to criminalise a child at the age of ten, five flies in the face of all the evidence on developmental reform that it's inhumane and wrong. My Lords, I do ask because this is an all party and an all public issue. How will this consideration proceed? Will there be formal, public or all party consideration? I certainly look forward to discussing these do.
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Baroness Levitt Portrait Baroness Levitt, The Parliamentary Under-Secretary of State for Justice (Labour)
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Yeah, >> Yeah, >> Yeah. >> My Lord, I thank the noble and

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My Lord, I thank the noble and learned Lord Low Lord Keen and the noble Lord, Lord marks, for the points that they've made on this important issue. And I will turn, important issue. And I will turn, if I may, to the specifics of some of them towards the end of this short address on Monday, the Deputy Prime Minister set out in the other place a bold new approach to youth justice, and we intend to build a system that intervenes early, responds more effectively and does more to turn young lives around.

By doing all of these things, we are fulfilling the first duty of government, which is to protect the public. Because, my Lords, the evidence is compelling. About 80% of prolific adult offenders began committing crime when they were children, and cycles of criminal behaviour can start early, become entrenched and, if left unchallenged, become harder to break. If we fail to tackle them, we don't only fail those children, we fail the victims who and the communities which suffer the consequences.

Every child we divert from criminal behaviour now not only saves a victim next week, next year, but also possibly in our grandchildren's generation. My Lords, diversion from lower level offences remains the most effective response, and we will be setting out plans to reform the out of court resolution framework later this year. This is most emphatically not us being soft on crime. Rather, it is a firm, fair and consistent approach that steps in sooner and addresses the underlying underlying causes of offending before the behaviour escalates.

But where children do offend, there must, of course, be swift and meaningful intervention. But that said, short custodial sentences for children are associated with high re-offending rates. More than two thirds of those given a short sentence offend again. So basically, my Lords, by repeatedly locking these children up, we are locking them into a cycle of repeat offending, and they are highly likely to become the prolific offenders of the future. My Lords, protection of the public is very much at the forefront of our minds.

Custody will always be necessary for the most serious and dangerous offences and offenders. But it is not just about sentencing, but also about where children are placed whilst they await trial. We know that for many children, even a short period in custody can deepen the problems that led them to offend in the first place. It breaks their their contact with education. It can break their contact with their families and cause all sorts of problems. And that's why it's our ambition to cut the number of children who are remanded in custody by 25% over this Parliament.

And in order to do that, but to keep the public safe, we will invest £5 million in intensive community placements and stronger bail support. And these are measures designed both to protect the public and to give children a genuine chance of changing course. We will also pilot youth intervention courts, intending that they should take a problem solving approach, looking at the causes of offending by tailoring the approach to individual circumstances, and these will be focussed on the children who are most at risk of reoffending.

Early evidence from the similar intensive supervision courts in the adult system upon which these are loosely based. It's encouraging and we're going to draw on this whilst continuing to adopt an approach that reflects children's needs. This will include judge led reviews as part of a child's sentence, and judges will play a key role in monitoring their progress. The government appreciates that this will place additional pressure on the courts and as your Lordships are of course aware, we are taking action to address capacity through the Courts and Tribunals Bill.

My Lords, as far as the Criminal Records Review is concerned, this review is about ensuring that the system strikes the right balance between protecting the public and supporting rehabilitation. Stable employment is a crucial factor and where individuals who have committed crimes, as children have demonstrated, turned their lives around. It serves neither them nor the wider public to impose unnecessary barriers to opportunity. As my Lords, this will be a targeted package of reforms, which may include considering how long childhood offences should be disclosed on basic checks, and whether there are certain offences that should remain disclosable for life.

For example, when applying for roles. Working with vulnerable people, both the noble and learned Lord Keen and the noble Lord Lord Marks raised the issue of the age of criminal responsibility, and my words were quoted back at me by the noble Lord Lord Keen. I don't resile from them. I used words such as may and risk, and I made the point that we would always listen and would always keep under review. The review of the Age of Criminal Responsibility is not our review, it's the Bar Council's review.

I don't think anybody is suggesting that once that review has reported we should not look at it, we will look at it and then we will make a decision. We are evaluating it. As far as the question of resources is concerned, the government is committed to putting money into these matters. That is why this is a bold reform. One of the things that the government has done is committed a further £50 million a year for three years for the turnaround programme, which seeks to intervene upstream of criminal justice interventions.

We will also, by taking the funding issues in relation to the youth justice system and the Youth Justice Board, and I notice that in his place is the noble Lord Lord McNally and of course the noble Lord, Lord Clarke, both of whom have had a great deal to do with the issues of this over the years, and I'm grateful to see them both there. The noble and learned Lord Lord Keen has ranged far and wide in his criticisms of the government's approach to many matters across criminal justice and other areas as well.

We are criticised for consulting in relation to this, but I'm not going to apologise for it. It is the approach of this government to take an incremental approach to reforms that we're bringing in, bringing things in cautiously and making sure that we act on evidence rather than on ideology or whim, so that we know that what we're doing will actually work before we roll it out nationally. And as far as doing things such as consulting on wider issues of concerned, I stood in this place on Monday at this Dispatch Box while I was criticised by the noble Lords fellow frontbencher, the noble Lord, Lord Wolfson, for too much legislation.

Well, this is not legislation, this is consultation and reform and that's why we're doing it. The bold approach this government is taking on youth justice is about ensuring that the system intervenes earlier and more effectively. We want to get children and young people back on track so that we can protect the public. And to achieve that, we are following the evidence on what works, and I look forward to engaging with your Lordships over the coming months. As the government finalises its plans.
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Baroness Levitt Portrait Baroness Levitt, The Parliamentary Under-Secretary of State for Justice (Labour)
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Well, the noble Lord makes two points. I'll do my best to answer points. I'll do my best to answer them. As far as 25% of fewer children in remand on remand is children in remand on remand is concerned, that's not a number that we will take out on an arbitrary basis. It's a target. That's what we're aiming to do to reduce by 25% the number of children who await trial in custody. And the way we want to do that is by strengthening the bail provisions.

And that's why there's a commitment of additional money in order to do this. So we can look at things like bail, fostering arrangements in order to ensure that children don't go into custodial institutions, because we know what a terrible effect, particularly very short periods can have on them when they are there. By breaking all those links that I was talking about earlier, about links with families and with education. As far as the issue about. Racial disparities and the disproportionate effect is concerned, it is a great anxiety to us that that still remains the case, that certain cohorts, those are normally black children and mixed heritage children are disproportionately represented in the justice system and also in the custodial estate.

I absolutely take the point about involving parents, and that is the reason that we are exploring the question of of parental orders and seeing if we can expand them, because this is not about criminalising parents, but it is about making the point that these are children. They are children. Sometimes they look like adults, but they are children with everything that's engaged in that, they need parents to help to guide them. Certainly I have experience as some parents in the youth court who would like to be more involved, but the child in question rejects that.

It may be helpful to them for them to be able to say to the child, I'm sorry, I am doing this because the courts told me, I've got to. There's a parental order in place. We absolutely agree that the all of these are critical factors, and that is why we are looking at diversion. Rather than simply locking children up all the time.
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Baroness Levitt Portrait Baroness Levitt, The Parliamentary Under-Secretary of State for Justice (Labour)
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We all agree they should be well educated and we all believe in the concept of rehabilitation. But concept of rehabilitation. But there has to be a limit in a liberal and permissive policy in the criminal justice system. I had the criminal justice system. I had the privilege to serve on the British Transport Police Authority for four years, and one of our key for four years, and one of our key areas of concern was county lines. Without proper monitoring and without the possible sanction of a custodial sentence, what is the sanction to the preventative sanction to prevent criminals engaging children and young people in crime, in drugs, in a life of crime going into the future? If there is not the sanction of a custodial sentence for those young people, is there not a risk that these reforms may result in more young people being drawn into that lifestyle? And isn't that something that the government should really

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seriously take into account. Really seriously taking it into account, which is why we are account, which is why we are investing more than £34 million this year into the County Lines programme, which has closed over programme, which has closed over 3000, more than 3700 county lines and led to 10,100 arrests. So and led to 10,100 arrests. So absolutely, we take it seriously. But the important point here is that we are tough on crime but smart on prevention of crime.

There is no point in continuing to do things that plainly do not work. They don't protect the public and they're bad for the children as well.
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Baroness Levitt Portrait Baroness Levitt, The Parliamentary Under-Secretary of State for Justice (Labour)
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Well, it is very good news about the reduction of the number of the reduction of the number of children involved. In fact, it's an even greater reduction than the noble and learned Lord Low Lord Keen said. He said that there are Keen said. He said that there are now only about 1400 children in custody. It's actually only just over 400, so it's even better than that. The noble Lord will recall that a few moments ago, the noble and learned Lord Lord Keen repeated back my words from when I was standing here dealing with the age of criminal responsibility before.

I can certainly reassure him. We absolutely do not have any plan to change the age of criminal responsibility. What we're going to do is let the Bar Council report, and then we will look at what that report says. We know that it is fraught with risks. I can recall the noble Lord, Lord Bailey, making a very powerful speech about the risk of, in effect, meaning that gangs could recruit children with impunity if you either raise the age of criminal responsibility or indeed wipe their criminal records clean.

All of those are things that we will bear in mind when we look at this. The clue is in the word consulting, which is, of course, the thing that we get criticised for doing by the party opposite and.

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Welcome the plan. Will the noble Lady join me in recognising the role that young offenders institutions play, and could she update the House on the recruitment and retention retention of those
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Baroness Merron Portrait Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
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thanking noble Lords across the House for their engagement and thoughtful scrutiny of both of these pieces of legislation, which have delivered significant acts of Parliament and what I would describe as significant acts of describe as significant acts of change for the better. These two acts are amongst the most important acts are amongst the most important steps for improving public health in decades. Cornerstones of the government's commitment to reduce inequalities in this Parliament and my Lords, this Gracious Speech sets out how we will go even further to make our country stronger and fairer through a renewal of our public services.

And I hope the noble Lords will welcome the progress the government has made since taking office. In respect of the Health service, including action on waiting lists now down by half a million, whilst the number of people waiting less than 18 weeks for planned care now stands at 65.3%, which is up from 59%. We also see ambulances responding to strokes and heart attacks arriving five minutes five crucial minutes faster compared to last year. And we have met our manifesto commitment to recruit an additional 8500 additional mental health staff three years early, and underpinning everything, we have set out a new direction for the future of healthcare through the ten year health plan, we're reforming the NHS to make it fit for the future.

We are shifting from sickness to prevention, from analogue to digital, and from hospital to community, as noble Lords have regularly observed, we do face an uphill battle, which is also what the noble Lord Lord Darzi found in his independent review. One of the noble Lords conclusions was that passed legislation was too rigid and overly specific, and that had the effect of increasing bureaucracy and diluting accountability over time. And of this, my Lords, we have certainly taken heed.

So I want to welcome, as I hope, noble Lords will. I want to welcome the health Bill outlined in the Gracious Speech, an important part of the delivery of our ten year plan. In summary, the Bill will cut bureaucracy. It will improve patient safety through a single patient record. It will ensure that patients receive care that is better tailored to their needs, when and where they need it, and it will help us to make the shift from sickness to prevention while improving patient safety and patient experience.

And importantly, it will also put more resources into the front line through the abolition of NHS England. Noble Lords know only too well that far too often patients experience care that is fragmented and inaccessible. Patients and carers find themselves telling a story, their story time and time again. Every time they meet a new clinician, every time they meet a new healthcare professional. This isn't just an some kind of inconvenience, it actually adds to the strain on people when they least need it.

And it also risks the safety and the quality of services. And alongside this, with that integrated data, the NHS misses opportunities to diagnose and treat people early, leading to many left seeking urgent care once their health has deteriorated. It is common sense, I believe, that we note that when clinicians do not have all the facts to hand, they simply cannot make the best decisions to support the interests of patients, and we equally cannot expense. We

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I cannot sensibly expect patients and carers to keep track of all the different documents from of all the different documents from all the different specialists, for all the different appointments in all the different appointments in all the different providers. So the health Bill creates a statutory basis for the NHS to bring patients basis for the NHS to bring patients health and social care records into one place, enabling people to access their own health record securely through the NHS app.

So my Lords, we are actively shifting the NHS from analogue to digital and we are empowering patients to make informed decisions, as well as giving them more choice and more control. Putting patients at the heart of care does mean devolving decisions to a local level in order to meet the specific needs of the local population, where different services can better integrate around the needs of the patient. That's why integrated care boards will directly commission a greater proportion of NHS services.

However, there are, of course, some aspects that must and are best done nationally where that's the case. We need to ensure that arrangements are efficient, that they have clear and strong accountability to Parliament and, my Lords. The current system of two national bodies overseeing the NHS, the Department of Health and Social. The Department of Health and Social Care and NHS England fails both of those tests and. That is why the responsible responsibility for all but the most specialised commissioning functions will be transferred to integrated care boards, including primary care, dentistry, ophthalmology and pharmacy commissioning.

Integrated care boards are best placed to integrate care as local strategic commissioners, and we are empowering providers through foundation trust reform, giving them more flexibility to design and deliver healthcare around local needs. And so we will bring NHS England the functions of it within the department. In other words, we are abolishing NHS England. My Lords, through and across other departments of government, we are acting to continue to make the country fairer through MCHLG. We have already taken decisive action to fix the foundations of the housing system through the Renters Rights Act.

We are strengthening security for 11 million tenants. We have ended the unfair system of no fault evictions and given people greater stability in their homes. Alongside this, the Planning and Infrastructure Act is making it faster and simpler to build the homes and the infrastructure our communities need. The English Devolution and Community Empowerment Act ensures that power moves away from Whitehall, giving people the right to make decisions about the things that matter to them, where indeed they do matter.

And we have made £78 billion available in the latest local government finance settlement, which is a 6.1% increase from the previous year, and the Gracious Speech of this year brings forward reforms that make it easier for people to have a say, to own and to stay in their own homes, and to see their local areas and local voices improved. As outlined in the Gracious Speech. The representation of the people Bill will protect the integrity of our elections, and it will inject new vigour into our democracy by tightening the rules on political finance, by improving transparency, by introducing tougher measures to tackle the intimidation of candidates and electoral staff, and by extending the right to vote to 16 and 17 year olds.

The biggest expansion of the franchise in over half a century. And, my Lords, we are not just giving young people a greater say in our democracy through the Commonhold and Leasehold Reform Bill, we are protecting their rights when they take their first steps onto the property ladder by fixing abuses and ensuring Commonhold replaces leasehold by default. This bill will make owning a home fairer and the provisions more transparent, because far too many leaseholders face unregulated and unaffordable ground rates, they face unjustified permissions and administration fees.

They also face unreasonable or extortionate charges and conditions imposed with little or no consultation. So this bill will cut unfair charges. It will give people more control over how their buildings are run and ensure they cannot lose their home for minor disputes or unexpected costs. Alongside the ongoing implementation of these reforms to the leasehold system, which are already in statute. The Bill makes progress towards ending the feudal leasehold system so that future homeowners can buy with greater confidence and fewer hidden costs.

It will cap ground rents for leaseholders today, and it will set a divisive, a decisive path, not a divisive path, I emphasise towards eradicating them, ending this exploitative practice of money for nothing. And my Lords, many leaseholders as we know and have debated many times, are also trapped in unsuitable homes that they are unable to sell. And it is, my Lords, a disgrace that, nearly nine years on from the appalling tragedy tragedy at Grenfell Tower, there are still people in this country who live in buildings with unsafe cladding.

So the Building Safety Remediation Bill will deliver on our commitment to fix the cladding crisis and, crucially, make those responsible pay towards fixing the problem that they caused so that residents can feel safe in their homes and are no longer stuck in property, property that they cannot sell or move on from. There will be clear legal duties to fix buildings and penalties for those who fail. Because, my Lords, everybody deserves to live in a decent, safe, secure and affordable home.

Yet too many families in need of a social rented home, a languishing on local authority waiting lists, being forced to struggle in the private rented sector or in expensive temporary accommodation. So we have committed to invest £39 billion in social and affordable housing program over the next decade, with a further £3.6 billion to tackle the root causes of homelessness. And we are going further. The Social Housing Bill will help more families to access a safe and affordable home.

It will protect the homes that we already have and give tenants greater security, particularly those who need extra support, such as victims of domestic violence, and it will keep homes in the social sector through sensible reforms to the right to buy and ensure that where they are sold, the public purse is protected. This government is putting the social housing sector onto a secure and sure footing, and my Lords, we will continue to keep our promise to transfer powers out of Westminster so the Overnight Visitor Levy Bill will grant new funding, new revenue raising powers to local leaders as a step towards a new era of fiscal devolution in England, so that places can raise funding locally and invest it back into the services and spaces that people use every single day.

Mayors will have to will have the power to raise and invest money into projects that improve their areas, to raise living standards and to support economic growth. And they will be able to decide for themselves and not rely on central government to do it for them. So, my Lords, if I had to summarise these reforms, I'd say they're about something in some way simple but also deeply fundamental. They are about ensuring that more people can live in a safe, secure home.

They support better health, stronger communities, and a growing economy. And to that last point, this growth also depends on world class infrastructure. And our economic security depends on a strong transport network, whether that's roads, rail or runways. And so the Department for transport is driving economic growth and transforming how people travel, making journeys greener, safer and healthier for all, as well as making them more available. We're delivering a more integrated, reliable and future focussed transport system by improving connectivity, strengthening capacity and making travel more affordable.

We're doing this by modernising rail, by investing in better roads and empowering local areas to shape the transport services that they need. And we're setting a long term vision for how people and places connect and drive in order to drive the transition to net zero. My Lords, for too long, passengers have had to put up with unreliable services, with confusing fares and no single body accountable for delivering a railway that works. So I'm glad to say the Railways Bill puts an end to this by establishing Great British Railways.

A new publicly owned company with sole responsibility for delivering for passengers and freight operators, whether it be through simplifying the complex fares and ticketing system, whether it's through developing a timetable that actually works, or whether it's through ensuring the needs of local communities that they are no longer ignored, GBR will deliver that. The bill also establishes a powerful passenger watchdog to ensure passengers are consistently championed at every turn. In addition, the Northern Northern Powerhouse Rail will create more reliable, more frequent services between the north of England's great cities so that more housing and better access to jobs, services and culture will all have opportunities to grow.

And as part of our drive to literally move forward, the civil Aviation, Consumer Protection and Regulatory Reform Bill strengthens consumer rights and promotes fair treatment of passengers. We are also making sure these rights are properly enforced by equipping the Civil Aviation Authority with direct powers to take action. If airlines or airports fail consumers. Whilst the bill will promote economic growth through better infrastructure and improve aviation safety. In addition, my Lords, as set out in the Gracious Speech, the Highways Financing Bill will help unlock will help to unlock private investment in major road schemes.

It gives the government more ways to fund building and to maintain large scale road infrastructure projects, whilst reducing the burden on the taxpayer. My Lords, this Gracious Speech will give us the tools that we need, the tools we need to build a stronger and fairer Britain. I and my frontbench colleagues look forward to taking these measures through your Lordships House, and look forward to working with noble Lords on all sides of the House. It is only fair for patients to expect world class healthcare that works around their needs.

It is only fair for families to expect safe and affordable housing, and it is only fair that young people should never be cut off from opportunities, no matter

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move. My Lords, can I begin by thanking the noble Lady, the Minister, for the clear way in Minister, for the clear way in which Noble and learned introduced the debate. And, my Lords, we all know that our country faces know that our country faces profound and growing challenges in health and social care. And as the Leader of the Opposition made clear in her response to the Gracious Speech, in the other place, we are entering a period of deep structural pressure that will test structural pressure that will test the foundations of our system.

His Majesty's loyal opposition will engage constructively with the government's proposed reforms, but it is essential that the government reassures patients that any changes
17:14
Lord Kamall Portrait Lord Kamall (Conservative)
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will improve the quality of care, will protect patient safety and their privacy, and will avoid their privacy, and will avoid costly disruption. Our system of healthcare, especially the NHS, is caring for more people than ever caring for more people than ever before and while people may be living longer, too often they spend their later lives and later years their later lives and later years in poor health. Increasingly, patients present not with a single condition but with multiple complex and interlocking needs.

Multimorbidity is no longer a challenge for the future. It is a challenge for now, and it's reshaping demand across primary care, hospitals, community services and social care. That pressure is compounded by the wider state of the nation's health. Healthy life expectancy has fallen, meaning more health, more years lived in ill health, a sustained greater demand for services, and a heavier a heavier strain on an already stretched workforce. And, my Lords, in the drive to improve our health by reducing obesity, for example, successive governments have relied heavily on top down or trickle down state led interventions such as sugar taxes.

But often this has not they also agree that community led bottom up approaches are far more effective than top down state interventions. And at this point, I should declare my interest as a professor of politics and international relations at Saint Mary's University, where I teach an MBA module in healthcare policy. And I'm helping with the new medical school, which will accept its first trainees this year. And I also run seminars and supervise students at the Vincent Centre for the Public Understanding of Economics and Entrepreneurship at the University of Buckingham, which also has a medical school, but with which I have no relationship.

My Lords, unfortunately, successive governments have failed to pay enough attention to the successes of community led projects. Let me give you an example. BritBox, which gives families the ingredients and a recipe card with instructions to help them to cook healthy meals together. The recipe cards have been designed to be child friendly, with more pictures and simpler wording, and often it is the children who encourage their parents to join in preparing the meals as a family. BritBox aims to the box of healthy ingredients to cost around £5 to feed a family of four.

This helps not only budgeting but changing heat and eating habits and tackling obesity. And so while the government repeats its mantra from hospital to community, on which there is widespread agreement, can the noble Lady, the Minister, or the noble Lord Armstrong, tell a noble Lords what plans there are for the Department to work more closely with existing projects that are already tackling many of these problems in their own communities, and how we can expand the role of these projects in the community.

And at precisely the moment that the NHS needs resilience, it is constrained by workforce shortages, delayed discharge, driven by fragility in adult social care and urgent and emergency care performance that reflects a system operating too close to the edge and the continuing risk of industrial action, which the recently departed Secretary of State promised to end, only add further to uncertainty for patients and staff alike. The news last week that waiting lists had fallen is welcome in principle, and the noble Lady, the Minister, referred to this.

However, I subsequently read in the Health Service Journal that the majority of the improvement in March was driven not by genuine progress, but by a record spike in unreported removals. And when I asked a written question on the reasons for patients being removed from the waiting list, the government replied, quote, the department does not hold the data showing the reasons patients were removed from the waiting lists. Really? So how did the government decide which patients to remove from the waiting list if it doesn't have the data on why they were removed? There has to be have to be a reason for these patients to be removed.

So can I ask the noble Lady, the Minister, could I urge her to go back to the department and give a more credible response so we understand the reasons for removals? Now let's turn to the King's Speech and in particular, the NHS Modernisation Bill. On the face of it, some proposals are welcome. A single patient record, clearer accountability and local systems, and a simplified approach to patient safety. Any reform that reduces duplication, improves efficiency and, above all, improves patient care and outcomes deserves to be.

However, a successful. As successive governments of all colours have found, good intentions do not by themselves guarantee better outcomes. The government's approach is not without risk, and the history of NHS reform. That structural change can impose substantial costs and disruption if not designed carefully and implemented safely. We have seen major programmes such as Epic create unforeseen problems in interoperability and access to information, and we see now cyber incidents can rapidly undermine clinical and operational capacity, as happened with the Synovus cyber attack recently.

Now, the health care landscape is now an extraordinarily complex network of providers, partnerships and systems with interdependent responsibilities. So reform driven from the centre must reflect that reality and diversity. A single patient record may have real potential, but it will only succeed if it is delivered with clear standards, accountability for implementation and robust cyber resilience. It must also earn the trust of patients, especially in how their data is protected. Failing to do so will incur the wrath of civil liberties organisations and reduce patient trust.

In my time in the department, I supported the initiative of officials to consult organisations such as Med Confidential, and while I expected the officials to be sceptical, they actually agreed and said we actually agree with many of the med Confidentials asks. They are reasonable and deliverable. Let's make sure we have that same relationship of trust between the civil liberties organisations and the department, and while reducing duplication between the Department of Health and Social Care and NHS England will be supported by many noble Lords, abolishing an institution is often more difficult than creating one, especially since NHS England currently coordinates a vast range of activity that underpins clinical practice and the patient experience and outcomes.

So when the NHS modernisation Bill reaches this House, we would look to the government to provide clarity on three points the timetable and cost of transition, the continuity of national functions, planning, performance of oversight, specialist services and digital delivery and how they'll be maintained without interruption, and how their stated ambition of decentralisation and devolution is reconciled with the transfer of substantial powers to a central department. My Lords, I want to set out a few areas where we will seek greater engagement from the government between now and the introduction of that bill.

First on the on the shift from prevention to from treatment to prevention, which we know will also agree with, we support the idea that the most effective way to reduce pressure on the health system is to tackle problems at source, to prevent ill health. Where we can intervene earlier, where we must, and reduce demand on GPS, hospitals and emergency care providers where appropriate and safe to do so. And while public health has a role to play in this, it will be important that the noble Lady, the Minister's department and local authorities to work with many of these local community organisations that I refer to when it comes to.

I've already mentioned Bright Box when it comes to healthier, healthier diets, but also many noble Lords will be aware in their own. Wherever they live, of local community projects, working in social prescribing, working in music and in wellbeing. And we've seen, especially in general debate on the mental health bill, we discussed how the increase in recurrence or the increase in incidence of mental health issues across the population. And quite often it doesn't have to be medication. Sometimes that's appropriate, but it could also be somebody social intervention, music, art therapy a.

ET cetera. And we know that in many cases these can help people feel much better. And without the need to go to hospital in the first place. And there are many organisations up and down the country. And I would urge the government not to always seek the solution in treatment in that way, but actually prevention by increasing wellbeing, we also need a credible workforce and staff retention plan, something we sadly realised too late when in government, and the continued risk of industrial and concern that shortages in some clinical roles are putting patient safety at risk creates a deeply worrying picture.

Now, across the country, patients who choose to use NHS live with a fear that a long awaited appointment, operation or procedure may be cancelled at short notice and against the backdrop of an ageing population, leading to increased pressure on the public purse. The UK faces the challenge that while we probably have more doctors and nurses than before, is it realistic and affordable to just keep recruiting more staff to try to keep pace with demand? One way that the former Secretary of State wanted to address this issue was through the increased use of technology.

Now, one of my frustrations during my time as Minister for technology, Innovation and Life Sciences was that much of the technology to improve prevention and diagnosis is already available, whether it be better use of the mobile phone camera to send high definition photos or scans to be analysed by health professionals, or wearable technology to monitor patient health. But one problem is that there is no front door for start ups and scale ups in medical technology. With the potential to transform healthcare. We need a front door or a one stop shop to sort out the sales talk from those who claim to have a solution, but actually have nothing more than a minimal viable product to those who actually have a potentially transformative tech solution that could be adopted and make huge changes across our system of health care.

Another problem is that current suppliers of technology are often reluctant to work with start ups, and quite often erect technical barriers to adoption of solutions that they did not offend. When I was a Minister, I had lots of emails on this subject, and now, as a shadow Minister, I get emails on this subject. There are people offering real solutions, potential that could transform health care. But the existing suppliers find an excuse not to interoperate. And we also need the department to be wary of vendor locking, especially in the development of the federated data platform and the obvious phrase on everyone's lips when it comes to tech is the potential of AI.

It has a huge potential to help analyse data sets and to help clinicians make more informed decisions. But we must ensure that there is a human backstop immediately available when there are problems. I am sure noble Lords have many of you have been caught up in online or telephone customer service, what people call doom loops, where you're unable to actually reach a human. Now, while some companies may get away with this sort of customer service or lack of customer service in healthcare, timely human

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intervention could make the difference between life and death. We are here.

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My Lords. During my time in this House, I have heard noble, noble Lords on the government benches say that the state can't do it all. So that the state can't do it all. So the role of partnerships with non-state providers will be crucial here. And while our system of here. And while our system of healthcare is often used as a political football to score points, I hope, particularly in this annual I hope, particularly in this annual Lordships House, we may be able to find some room for consensus.

I think back to when my father was a bus driver and a member of the Transport and General Workers Union, and when my mother had to wait to be seen by a specialist on the NHS, my father's subscription included treatment at the Independent Manor House hospital. So my mother was able to be seen by a specialist there. Now, today we know that many trade unions offer private health insurance or health plans as part of their membership package. So in seeking to improve the supply of healthcare in a sustainable way, I wonder if we can find some consensus and agree across the political divide on an increased role for non-state providers, including mutuals such as Benenden healthcare charities, friendly societies, cooperatives and private non-profit providers.

Now, I recognise there will be some political disagreement over private for profit providers, but I wonder even there, if we could find agreement where there have been used to increase capacity and to reduce pressure on the National Health Service. And let me be clear, this is not to diminish the role of the NHS, which is treasured by people across the country of all political persuasions, but we need to consider how to reduce pressure on the NHS and the public purse, while increasing capacity and patient choice.

Now I've tabled written questions on the role of mutuals and health in healthcare, and hope that I'll be able to work with noble Lords and all benches to encourage more of these organisations to play a greater role in our system of health and care. And we also need to be realistic about labour shortages. We know that after the war it was mostly Commonwealth citizens who came to this country to rebuild our public services. But we live at a time when the government, the politician and the populist party are making sceptical noises over immigration.

Given this, we need to have a serious, grown up conversation about where we find the young people to fill the vacancies that health and health and social care, but also to pay taxes to fund the public services for an ageing population. Is it realistic to find them from only among the current UK population, or do we need to acknowledge that we need some immigration? And how we do we do that in a sensitive way, without invoking accusations of domination being made by some national politicians? So coming back to today's debate, where we considering housing and transport as well as health, my noble friends Baroness Boycott and Lord Jamieson and my noble friend Lord Moylan will say more on housing and transport.

But I hope the noble Lady, the Minister and the government recognise the connection between health and place. I see the noble Lord Mawson was in his place earlier who talks about this a lot. The government had an opportunity in the King's Speech to go much further, reflecting that relationship, to adopt a genuinely place based approach which looks not only at healthcare services but at the environments in which people live, work, travel and act. The evidence is clear sustained improvements in health will not be delivered by the Department of Health and Social Care.

Acting in isolation, it requires a rounded approach across housing, transport, planning, education, work and local government and perhaps other departments too. And finally, we've heard time and time again about the pressures in social care are directly affecting secondary care capacity. I look forward to the contribution of the noble Lady Pitkeathley, who talks about this often delayed discharges, poor hospital flow and workforce shortages in adult social care all feed back into the NHS, leaving beds occupied by patients who are medically fit to leave that cannot be safely discharged.

If the government's modernisation agenda is to rely on local integration through Icbs and a more joined up patient records, then that must be matched by a clear and credible plan for social care. If we don't fix social care, we don't really fix the wider health system and without one, social care will remain one of the most limiting factors on the NHS ability to recover. My Lords, let me end by taking a step back from policy. The patient, as ever, has to remain at the centre of our concern.

His Majesty's opposition will work with the government when it comes to improving quality of patient care and outcomes, creating a system of health and care which is responsive, responsible and effective. We need a system that's robust, efficient and accessible, a service in which people feel empowered to seek help and able to do it when they need it, and confident that they will receive their treatment in a timely and effective way. We need to move away from the 1940s model of trying to get hold of your GP so that they can sign a prescription or refer you to a hospital.

Technology and a diversity of health and social care organisations can help with this transition. These benches stand ready to support the reforms where they remove needless duplication or bureaucracy, where they improve outcomes and experience of patients, and where they strengthen our system of health and care to meet the demands of the future.
17:30
Baroness Thornhill Portrait Baroness Thornhill (Liberal Democrat)
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I, too, would like to thank the noble Lady for her very sincere conviction and clarity with which she gave her introduction. My Lords, I rise.

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From these benches. To speak to the housing issues

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To speak to the housing issues in the Humble Address, and will save a lot of the detail for the various bills. So I hope you don't various bills. So I hope you don't think you're going to get let off too lightly, and knowing full well that my noble friends will address that my noble friends will address the issues of health and transport in greater, in greater detail. Now, listening to the housing measures in the Gracious Speech, I was struck by a rather familiar feeling, the sort you get when you get handed a glossy brochure.

You know the one. The sunlit streets, the happy families, everything finished and perfect. Not a wheelie bin or an old banger in sight. It all looks excellent until you actually visit the site where the picture is somewhat different. And I am afraid that with much of what we have before us, the gap between the brochure and the build still looms rather large. Now let me be fair. There is much to welcome. There is energy and there are bills already in motion to support the ones that are coming forward.

And for me, there is a real recognition. Recognition that housing is not just another policy. It is actually the issue for millions of citizens and for the economy of the whole country. But as someone who has spent years trying to get homes built, I was dubbed the pro-development mayor. I have learned this, that housing policy is not judged by what it says on the paper. It is judged by what gets built, where. So my test is simple will this deliver more homes and particularly more social homes at the pace needed to turn the tide and at an affordable price? Now, it must be said that the sector on the whole has been very pleased.

Long term funding for social housing. At last. Very welcome. You cannot build homes on short term thinking. A stronger Homes England sensible powers to provide land for social homes and community facilities. Vital unlocking land matters. The provisions in the Social Housing Bill supporting those fleeing domestic abuse are close to my heart and genuinely important. Housing should always be part of the solution and not a barrier. And there has been progress on the remediation of homes with cladding.

At last, the campaigners will stay, but the date of 2029 will still feel a long way away. But let's close that brochure and look at the reality. There are over 1.3 million households on waiting lists, over 130 000 households in temporary accommodation, including thousands of children, a shelter has put it the devastating result. This is the devastating result of a severe shortage of social rent homes that is the benchmark. So we welcome the Social Housing Bill and its broad policy direction.

But sadly, at its heart, this is mainly a right to buy reform bill necessary, absolutely necessary. It reduces discounts, tightens the system and seeks better replacement. Our policy is to allow councils to make their own decisions in that regard as to whether what would suit them. But this is at least in the right direction. But let us be clear slowing the loss of homes is not the same as building new ones. It plugs the holes in the bucket, but at the moment the bucket has very little in it.

It does not yet deliver the step change in supply that we need. This brings me to one of the biggest gaps affordability. There is very little said about affordability. This is not just a housing crisis. It is an affordability crisis for those needing social housing supplies too low for renters, rents are too high, and for first time buyers, ownership is too far away. We must build more homes. We can build more homes, but if people cannot afford them, the problem simply moves rather than disappears.

In the private rented sector, people have been squeezed from both sides, high rents but no realistic route into ownership and local housing allowance no longer matches. Market rents in many areas. Is the government considering changes in the welfare system to support housing, or will we be continuing to expect people to bridge a widening gap that simply should not exist at all? Our concern that a lack of a real route to a real route to delivery, because this is where ambition and there is no lack of ambition from this government meets reality.

Planning departments are overstretched with around 80% 80% under-resourced. Recruitment plans are welcome, but they do not yet match the scale of the gap. Perhaps the Minister has an update on the promised target of 1400 new planners by the end of the Parliament, but you cannot accelerate delivery if the system that approves development is running short of people, which kind of takes us to construction. There are 140,000 vacancies currently in construction. There is an ageing workforce, with many due to retire in the next few years, and far too few apprentices coming through.

Now, there is a cross-party consensus about the need for more homes, as we actually seem to vie with each other to announce higher targets. But targets don't build houses, builders do, plumbers do, carpenters do. And we don't have enough of any of them. My Lords, we should not forget SME builders who are often the backbone to delivering the homes we need. What is the government doing to support these businesses which are crucial to delivering their ambition? They are often the ones that deliver smaller sites faster and more flexibly and very locally.

And yet they face tight margins, rising costs, complex regulations, always their own, and difficulties accessing land and finance. The system, as we have it now, increasingly works for the bigger players, not the smaller ones. And that matters. And I hope it matters to government because if we squeeze out SMEs, as has been happening year on year, we reduce capacity and slow delivery. Now on the leasehold reform, we feel the direction is generally right, but we are nowhere near the destination yet and there seems no sign of that.

Commonhold is clearly not is not clearly the default. Conversion remains complex and everyday issues like service charges and property management practices remain only partially addressed. The legislation seems geared towards future development and comes at the expense of existing leaseholders, particularly those in flats, leaving them trapped in a harmful two tier system. A two tier market further devaluing their homes and leaving them dependent on predatory freeholders and unregulated management agents whose interests are diametrically opposed to their own.

Two glaring omissions that we would be seeking to fill. So we have the promise of reform for some, but we agree with the Prime Minister, who, after the election said incremental change just doesn't cut it. But this is incremental. And then, my Lords, there is the much welcome remediation bill. This is a test of whether subsequent governments meant what they said after Grenfell. Nearly a decade on, thousands and thousands of buildings still require work. Progress has been made, but nowhere near fast enough.

The Public Accounts Committee has called it far too slow. Campaigners speak of people trapped, unable to sell, facing rising costs. Living with uncertainty lives on hold until the work is completed. Not promised, not planned but completed. We have not honoured that promise that was made of never again. But promises of everything done by 2029 still seem a long way off. If you're one of those people. And finally, my Lords, the last missing disappointment. Now, let's be blunt and realistic.

Public protest is often the reason for held up delivery, and those of us in local politics will know that only too well. People are wary of any changes and unconvinced of the positives about development. And this is despite their children not being able to live in the town, the village or the city in which the parents live. So why is it? Could it be homes built without infrastructure, promises not delivered? Fears of overcrowding of major services like schools and GP surgeries, or even somewhere to park? These are real fears and concerns that have built a lack of trust.

And unless we rebuild that trust through better design, real engagement and delivering what is actually needed and promised, we will not build at scale and take communities with us. Indeed, the government's policy direction to solve this problem is to take decision making away from communities. Despite the rhetoric in the introduction and upwards towards combined authorities, mayors and. When I read my planning email this morning, I believe that there are further plans to give more decisions to council officers and not to councillors.

Now, I can understand why this is. I really can, but this isn't what we need. As with many of the issues that are facing society at the moment, we actually need real leadership at all levels and not just Ministers who do say what needs to be said, but actually from local MPs and councillors of all parties, including mine. My Lords, we will support the government where we believe they are in the right direction and yes, we will do the usual urging faster and further and in some regards certainly challenge omissions.

Otherwise there remains a gap between what is promised and what is delivered, and what is missing is not intent. It's not activity, and possibly not even resources, though more is always sought and welcome. What is missing is certainty of delivery at the scale and the pace that is required. It's all about whether people have somewhere safe and secure and affordable to live. And right now it feels like we've got rather good at producing the brochure. We just haven't delivered the houses.

But I'm actually sure that the Minister

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is as impatient for this as we are. My Lords, before we move on, I just want to remind noble Lords on all sides that there is an advisory limit to speeches of five minutes. limit to speeches of five minutes. If we can stay within that, that would be great because obviously we want to finish at a reasonable time this evening, and we've got to show

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this evening, and we've got to show other people who are speaking a bit of respect. Thank you for that notice before

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Thank you for that notice before I got up, but my Lords, I'm going to speak briefly about the health
17:43
Lord Patel Portrait Lord Patel (Crossbench)
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bill when the brief few minutes I have. The bill is a light in legislation, 72 clauses, 48 pages, legislation, 72 clauses, 48 pages, but it has 143 pages of schedules. One wonders that most of the powers might therefore be through s eyes and guidance. And that's what we have to explore. My Lords, I'm have to explore. My Lords, I'm going to concentrate my remarks based on the notes that we produced by the government following the Gracious Speech. It is customary, as noticed over the last three days, that most noble Lords offer their alternative legislation to the one that the government is going to bring, as evidenced by the 300 plus noble Lords who have spoken by close of business tomorrow.

I'm going to refrain from doing that and stick to what is in the legislation and follow the notes that have been circulated. Only this morning, my Lords, I listened to a podcast. The podcast was about health and social care. It was recorded just a few weeks ago, and the person that was interviewed was Andy Burnham. Some of the things that he reflected on the podcast are in the legislation, but he focussed mostly on social care and prevention in the wider sense.

I don't want to predict the future, but I wonder if we will have another bill in time to come following that podcast. But I put that aside, sticking to the bill and the noble, I'm grateful to the noble Baroness, the Minister Baroness Merron, for introducing the health aspects of the bill, and I'm going to pick up some of the points she made. First one is the abolition of NHS England. Now, except there was a disconnect between NHS England and the Department of Health and Social Care that needed to be addressed, and I think this bill tries to do that.

But in doing so, it also gives wider and deeper powers to the Secretary of State and Ministers to the point of ability to intervene both locally and nationally. Now, that might be a good thing if the leadership recognises that any intervention has to be for the benefit of the patient, but that will have to be tested in times to come. So that would be my comment about an anxiety about that. That's not my fault. I hope it isn't.

It also strengthens the local democratic accountability in health system. By mayoral nominees on the integrated care boards. In some areas, like Manchester, these are referred to as health commissioners. So if the responsibility for the mayor or representative is to focus on the local health care and the regional health care and drive the I'd I. S commissioning powers to. That way, then it will be most welcome. There are other issues about CQC now being responsible for patient safety has not improved quality of health care in all.

All his time. There are issues about recognition of the patient voice taken away from the health watch and put it into the Department of Health by a health service patient voice director. I don't know that could be regarded as a patient voice. There are issues about, in my last minute or so about the patient record, single patient record, which I commend, which is universally accepted to have a patient record that goes from GPS to hospital to social care.

But there are issues about curation of this data, use of this data, who has the ownership? The ownership now appears to be in the hands of the department and the Minister and not the patient. We have to explore how this will then be put into terms of how this data is released, and who to end its relationship with. The NHS data platform, which is contracted out just now to to organisations like the Palantir. So this is an important issue to explore in depth, which I hope we will do at the Committee stage.

There are issues about Icbs and their role now as a Commissioner of Services and the representation on their boards, which requires further exploration, because it appears that the local authority representation might now be removed. So, my Lords, I will engage with this Bill constructively with a view to be helpful and not be in any way to resign, because I think the ten year health plan is a good document, and the ten year cancer plan to drive the improvement in health care.
17:48
Lord Bishop of Chelmsford Portrait The Lord Bishop of Chelmsford (Bishops)
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My Lords. Gracious Speech that will improve different parts of our housing system. The housing affordability system. The housing affordability crisis threatens to unravel the unwritten social contract that if you get a decent education and then work hard, you should be able to earn enough to save for a deposit, buy a home, get married, start a family, and provide stability for your children until they can do likewise. While these proposed bills are important and worthwhile, I urge the government to use this forthcoming legislation to address the most acute part of the housing crisis the affordability of homes, whether for rent or for purchase.

The Social Housing Renewal Bill represents an opportunity to build more decent, affordable homes. Will the noble Lady, the Minister, consider how? Consider allowing councils access to low interest, long term development finance on the same favourable terms as those given to housing associations? It's important to complete the legislation in the Leasehold Reform Bill and get it right, so that it delivers a fairer system and justice to those leaseholders who have been, who have suffered gravely at the hands of unscrupulous freeholders.

At the same time, we need to recognise that legislative nuance may yet be required to preserve the heritage value of certain historical estates. My Lords, there is a fundamental moral case for correcting the imbalances, distortions and injustices in our housing system. Firstly, the growing inequality between those with housing equity and those without the former have seen their unearned housing wealth grow inexorably, whereas those whose income is derived solely from their labour. Watch the bottom rung of the housing ladder slowly receding from their grasp.

Secondly, the lack of labour mobility people struggle to relocate to where new jobs are emerging, which puts a drag on economic growth, productivity and incomes. Lastly, long term damage is even more insidious. Prolonged high housing costs delay family formation, and fewer children are born. Would be parents can't afford to stop work to raise a family unless one of them is a high earner. The consequences of demographic decline can be severe, including a shrinking workforce, a growing old age dependency ratio and severe pressures on health and social care provision for an ageing population.

My Lords, the second point I want to make is that there is a real danger that vital qualitative aspects of the housing that we need will be sacrificed in pursuit of arbitrary numerical targets. I would encourage the government to promote the language of building homes, not units, creating communities, not developments and places, not housing estates. We also need to ensure the foundational infrastructure is delivered in a timely way. Good design also creates the shared green spaces where both nature and residents can thrive.

The report of the New Towns Task Force underscored this priority. Can the noble Lady, the Minister, provide assurance that the New Towns Unit is giving as much emphasis to the qualitative aspects of delivering new towns as to the quantitative. The Church of England is ready to support the soft relational side of placemaking as we strive to offer a Christian presence in every community. We can provide schools, social housing and management of community centres. Our network of volunteers can offer a welcome and attend to the spiritual and social welfare of the residents, together with other grassroots charities and faith organisations, we can help build the relational networks that shape the character of any new community.

I hope that we won't allow the pressure for action, acute though, it is, to deter us from creating a housing system that our children and grandchildren will thank us for.
17:53
Baroness Pitkeathley Portrait Baroness Pitkeathley (Labour)
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My Lords. >> In my 29 years in this House, I've spoken in many a debate on the health provisions in many a health provisions in many a Gracious Speech, and I've longed for the day when I could rejoice in the plans set out for a new deal on social care. But sadly, I'm still waiting. So I have to start by saying that whatever improvements His Majesty's Government makes in the way health care is delivered, it will not be effective, as we hope, unless we tackle the elephant in the room of the great grave shortcomings in social care and their inevitable juxtaposition with NHS care.

However, there are many things to welcome in this modernisation Bill. In the past, I've had calls to complain that the NHS did not pay sufficient attention to the contribution of unpaid carers, nor seek to meet their needs as well as those of the patient. This time I'm pleased to say that carers rights to involvement are threaded throughout the Bill in relation to services commissioned by the Secretary of State and by Integrated Care Boards, where Icbs have acquired the involving responsibilities of local health watches.

Carers have clearly been included and are on the face of the Bill. The creation of a single patient record across health and social care is also greatly to be welcome, and should reduce the needs for carers to repeat information on behalf of the parent they care for. As the Minister has reminded us, I've lost count of the number of times I've been told by patients and their carers, why is it every time I meet a new person dealing with my relatives care, I have to start from scratch and give them all the details? Why on earth don't they pass the details on to each other? When I chaired a committee in your Lordships House about integration between health and community care services, it was clear that integration was controlled as much by professional attitudes as by patient need, and that data sharing was hindered by cultural and perceived, often inaccurate, legal obstacles.

Often, there was a misguided sense of protecting patients by not sharing data, when patients themselves always assumed that the information had been shared. So the move to create a single patient record is welcome. Indeed, as part of wider plans to digitise the NHS, it really will be a game changer. Patients will receive safer, quicker and more accurate health care. And of course, for clinicians, it will mean they have accurate data about a patient in one place. On the subject of patient information, I just want to put in a plea for sharing information with carers when appropriate.

Too many carers who take huge responsibility and indeed often administer NHS procedures for those for whom they care are denied information about the patient's condition for reasons of confidentiality, while fully appreciating and understanding this, you cannot expect a carer to take 24 over seven responsibility for the care of someone, and then deny them access to information that would greatly help them in providing that care. So I must ask the Minister whether the single patient record will also allow access for the unpaid carers who provide the bulk of care.

I mentioned Healthwatch earlier, though, acknowledging the variety of quality of local health watches, they did provide a valuable source of gathering varied and rich data about communities and their needs. Now that these responsibilities are being transferred, we must. As this modernisation Bill goes through Parliament, ensure that the voices of patients and carers are heard loud and clear in the new system, and I would be glad to receive reassurance that the Minister remains committed to this. As Lord Kamall has reminded us that the opposition remains committed to.

I started with reference to the ongoing elephant in the room social care, and I will end by saying that although frustrated by waiting for any definite proposals made by the Baroness Casey review, I am heartened by the things I have heard the noble Baroness say thus far, and look forward very much to the outcomes from the national conversation which she is initiating. I understand this has been slightly delayed, and I wonder if the Minister could confirm the timetable for this very important development.
17:57
Lord Young of Cookham Portrait Lord Young of Cookham (Conservative)
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It was a pleasure to follow. >> It was a pleasure to follow. Pitkeathley. >> And on social care. She is absolutely right. On housing the absolutely right. On housing the government's target of 1.5 million homes is not a policy. It is a homes is not a policy. It is a dream. By their own calculations, they are already 400,000 adrift in London. We need 88,000 new homes a year. Last year they finished 6000. Now, while I welcome all the. Plans to speed up planning, much of which is done in place, that is not the problem.

The number of sites with planning permission, but not yet built on, is more than 1.5 million. The problem is not potential supply, it is demand the builders won't build if there isn't a buyer. And if there isn't a buyer, it's not just the market buyers who are hit, it's the people wanting social homes as well. Following what the right reverend predators just said on affordable homes, half the social homes are built through section 106. They are built on the back of the market homes.

If we don't get the market homes, we don't get the social homes, and that hits those who are in real need. In her statement on December the 17th, 2024, the noble Baroness, Lady Taylor, said this of the problems facing the country I quote and to our shame, as a nation just shy of 160,000 homeless children are living right now in temporary accommodation. My Lords, a year later it had risen to 176,000. Now we need to kick start both markets, the market for market homes and social homes.

And we urgently need some successor to Right to Buy for first time buyers. Most renters want to buy the average rent. The average rent is higher than the average mortgage payment, but without access to wealthy relatives, a lot of renters simply can't afford the deposit. And that is where we need urgent government action in conjunction with the financial institutions and the developers, to find a successor to Homebuy. And I note in passing, the government made a profit of £1.3 million on home buying.

On remediation. I warmly welcome the announcement of the appointment of Lord Rowe to chair the building safety Regulator, and I commend him on the progress he's made in reducing the backlog for new high rise homes. But there's a real, real challenge. Post Post-grenfell. Almost nine years later, over half a million people are still living in flats with a fire risk. Less than 20% of buildings over 11m high with unsafe cladding have actually been fixed. Now the remediation bill puts a little meat on the bones of the government's remediation acceleration plan, but there is still a range of issues on which leaseholders and I have been campaigning.

Non cladding defects are not comprehensively funded. Non-Qualifying leaseholders continue to face ruinous costs. Developers in the developer remediation contract are, in far too many cases, doing the bare minimum and marking their own homework. Safety risks are being reassessed as tolerable, with buildings left half safe, building insurance premiums remain eyewatering leaseholders are still having to pay for waking watches. Shared owners still face problems they can't sell because they're registered. Social landlord won't buy, so they're having to sublet funding for under 11m buildings with the same sort of cladding as Grenfell.

We've had an announcement in July 25th, but still no details, and the Bsr's remediation improvement plan is yet to have an effect on high rise buildings, with the median approval time now at 46 weeks and leaseholders and residents are pushed from pillar to post, scrambling for simple answers about their homes. Now, in opposition, Labour did understand that accelerating remediation without fixing the structural problems that I've mentioned would not work, and they recognised that remediation had to be comprehensive and independently overseen, with leaseholders and residents at the centre.

So put simply, some leaseholders in some buildings are protected from the costs to fix some safety defects. My Lords, that is simply not good enough. I look forward to working with this government, as I did with the last one, to do justice to leaseholders who are in no way to blame for the

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misfortune that confronts them. My Lords, my. Contribution today.

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Contribution today. Considers the housing aspects of the King's Speech. And I will. Be echoing some of the points

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Be echoing some of the points made by the noble Lord, Lord Young of Kirkham. I declare housing interests as in the register, interests as in the register, including chairing the Northern Housing Consortium's Renew initiative to boost local economies initiative to boost local economies through housing led regeneration. There are three bills here that
18:03
Lord Best Portrait Lord Best (Crossbench)
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relate to the ongoing acute shortages of of decent, affordable shortages of of decent, affordable housing. These bills complement the government's efforts currently thwarted by adverse market thwarted by adverse market conditions to secure the 1.5 million new homes this Parliament. Although the Government's Homes Although the Government's Homes England programme of 39 billion for new social housing over the next new social housing over the next decade does represent the largest input of funding for the sector since 2010. A lot more still needs to be done.

All three new bills are very welcome and I offer a comment on each. First, the Commonhold and Leasehold Reform Bill, which will address key aspects of the current leasehold system, which is in desperate need of radical change. The bill's omission is the absence of sufficient action to improve the performance of managing agents of blocks, of leasehold flats, and to weed out the worst operators. The housing Minister has promised requirements for mandatory qualifications, but sadly, government has not brought forward measures to create any code of practice to raise standards enforced by a proper regulator of property agents.

Second, the remediation bill, the so-called Grenville Bill, tackles the slow speed to date of removal of unsafe cladding, the cost of which should fall to those manufacturing it and specifying its use. This saga has, to date, taken almost ten years to find resolution, with work on unsafe cladding in high rise buildings being completed on only a third of known cases. We must hope, as the noble Lord, Lord young mentioned, the that the new legislation, supported by the noble Lord Lord Roe and the Building Safety Regulator, which he chairs, will finally fix the crisis and those who have behaved appallingly and it does seem criminally, will be brought to justice.

Third, the Social Housing Bill continues government's attempts to boost the amount of social and affordable housing. Against this backdrop of 176,000 children in temporary accommodation where their health and wellbeing is suffering so badly, among this bill's measures is important. Extra support for domestic abuse survivors to remain in their homes. And then there is the greater protection of precious existing social housing from further loss through right to buy purchases. We would have over 2 million more social homes. But for

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the sales under Of this giveaway scheme, and some 40% of the homes sold are now in the hands of private landlords, charging up to three times the previous council rents, with the cost falling largely on the taxpayer. No wonder few local authorities have been building new homes when they've known these can be bought cheaply, sold on by their be bought cheaply, sold on by their occupiers. Trying to run the bath with the plug out. My Lords, I do see a big omission from the Social housing Bill.

However, in the absence of any reference to regeneration of existing outdated social housing stock, not least the worst of the 1960s, tower blocks and prefabricated buildings. Little Awaab Ishak, who died from the effects of mould growth, lived in substandard 1960s social housing. Tougher regulations are now requiring social housing providers to take more urgent action, and a sensible settlement has been agreed for annual rent increases. But rental revenue will not stretch to paying for serious renewal and replacement.

This urgent need for regeneration matches the necessity to build new homes and deserves more government attention. My Lord, these, my Lords, these three bills all take us in exactly the right directions, and I commend them with the proviso that I foresee there might be some useful, modest amendments for your Lordships to

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consider in due course. My Lords, I rise. To speak in this debate about an issue millions of our fellow issue millions of our fellow citizens suffer under a system that exists not by accident, but by design. Housing, His Majesty told us, is a source of insecurity for many people. That is perhaps the most restrained description. most restrained description. Restrained description of the leasehold system one could offer in this House. Some 91% of owner
18:08
Baroness Shah Portrait Baroness Shah (Labour)
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this House. Some 91% of owner occupied flats in England are leasehold. 1 in 5 properties in England. Nearly 5 million homes are also leasehold. These are not fringe numbers. They represent the daily lived experience of millions who do not truly own their homes. And so it is right that is included in the Gracious Speech. Before I turn to the scandal of what leasehold has become, I want to say something about building homes in the first place because it is a matter.

I have direct experience as a Cabinet member for regeneration for eight years in Brent. I know what it takes to bring homes forward at a scale. Building homes is not a technocratic ambition, it is a moral one. The government's commitment to 1.5 million homes in this Parliament is right and necessary. But here is a truth that experience teaches. It is not simply enough to build homes. We must ask what kind of homes they will be and on what terms will people hold them.

We must ensure the homes we build do not become the instruments of a new injustice. As this previous. As. As this is precisely where. Sorry. And this is precisely where leasehold system. By its hardest. The majority of new homes are delivered at scale will be flats. That is the arithmetic of house building. And if they are sold as leasehold, as has been the default for generations, then every new home that we build is a potential new entrant to a system of tenure that is unjust.

We cannot build our way to a fairer housing market while maintaining an unfair tenure at its heart. And it is young people who bear the sharpest cost of both of both failures. For a generation of young people, aspiration of home ownership is not being deferred. It is being extinguished. The Institute of Fiscal Studies found that home ownership among 25 to 34 year olds stood at 55% in 1997. By 2017, it collapsed to just 35%. Since 2005, home ownership rates have fallen for every age group except those aged 65 and over.

Whose house? Whose rate has actually risen by 7%. We are building a country in which housing wealth accumulates with age and inheritance, not with work and aspiration. That is an intergenerational injustice. And when these young people finally do reach a property ladder, often through a flat, often their only realistic option, they find themselves not met with, not met, not with security, but with ground rent, service charges, and a tenure that gives a cost of ownership without the without the control. The government estimates that over £600 million was paid by leaseholders in ground rents in 2025 alone.

For a young person already stretched across a 30 plus year mortgage and a huge deposit, that is not a minor inconvenience. It is further extraction from those who can afford at least the government manifesto committed to bringing the feudal system to an end. This is structural reform of a system that has for generations denied working people the full fruits of home ownership. Capping the bill will cap ground rents, banned leasehold flats and leasehold for new flats, and making commonhold the default and commonhold.

The bill is at its most radical, and most just flat owners will hold their rents as freeholders, managing the building collectively as equals. No absentee overlord, no arbitrary charges approved without scrutiny. As the chief executive of the Property Institute has observed, this model already operates in most countries across the world, including Scotland. The government are proposing revolution instead, not not proposing revolution, but instead to join the rest of the civilised, property owning world. 5 million leaseholders across England and Wales are waiting for this legislation, and the government has an electoral mandate to act.

I would add only one note of caution. The Property Institute is right that empowered common holders must be supported by qualified professional property managers, and that resident empowerment must not outpace protections against an unregulated sector. This housing. This House will rightly scrutinise those safeguards with care. But let us be clear what this woman represents. The government is committed to dismantling this archaic and iniquitous system. Not overnight, not recklessly, but decisively and for good. For every young person currently saving for a deposit they fear will never be enough.

For every leaseholder paying rent on land that they thought had been bought, and for every family in a new build flat, discovering the tenure that was sold does not deliver the security they were promised. This bill will matter. Building more homes is essential, but building them fairly is non-negotiable.
18:12
Baroness Neuberger Portrait Baroness Neuberger (Crossbench)
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I rise to welcome. interest as chair of University College London Foundation, NHS trust and of Whittington Health, and I want to express my gratitude to the King's Fund, to the Health Foundation and colleagues at both my trust, to whom I pay great tribute for all the work they do and many others for their briefings and conversations. And I want to welcome the bill. But there are a lot of bugs. I completely agree with the noble Lady Baroness Pitkeathley about the absence of the mention of social care.

Where is social care? We were expecting to see it in this king's speech and there is nothing. So, alas, that's the first point where there's a big. But secondly, in abolishing NHS England and transferring its powers to the Secretary of State in the Department of Health, that's fine, and in many ways very sensible. But the detail is slim. And let us be clear we tend to go through phases in the NHS of restructuring. Moving the deckchairs is something health secretaries like to do.

Despite this government having said it wasn't going to do it, but bringing powers back to the Secretary of State without a clear way of keeping a public eye on what is going on, is clearly a cause for concern. We await the detail, and I would be very grateful if the noble Lady, the Minister, could spell out for us where accountabilities, independence and the public interest will lie in this new system, all the more so when so many powers are transferring from NHS England to the Secretary of State, including the ability to direct local NHS organisations.

These powers risk Ministers being given too much power over the day to day, with too little power lying in the hands of patients and the public. And that's all the more important given the decision or the intention, anyway, to abolish Healthwatch, a stronger replacement than what is currently on offer will be needed. The NHS is a public service deeply rooted in our communities, and many of us are even more worried about what this means for the patient and public voice, given the lack of clarity at best about governors with whom we at University College Hospital have worked extremely well and I pay tribute to them.

We are seriously concerned that their role will not be compulsory in the new in this new future, with no adequate patient and public voice replacement. Third, and this is the compliment, the single patient record. I think we're all thrilled about that, actually. But even there, the devil is in the detail. We know there's a long history of NHS I.T. failures which have been quite expensive. Who's going to be in charge? What will be the safeguards and will the government recognise deep concern amongst staff and the public about Palantir as the noble Lord and my noble friend Lord Patel has already said, Palantir, an organisation that the Department of Health has brought in.

But where disquiet is widespread and expressed at our public meetings, and how will privacy and security be guaranteed with a company that's not UK based? We need far more detail, trust and patient staff and the public will be essential for the plans to succeed. Then there are the changes to the local management of the NHS, with the revision of the Integrated Care Boards membership, it might well help simplify the system, but the changes also risk undermining partnership working, which is needed to improve health and care.

So removing, for instance, mandatory local authority representatives from Icbs could make things worse, and bringing in mayors is really not enough. Lastly, there are the things that we were expecting to see. I had expected to see something on the role of the new Advanced Foundation trusts, and we do need to understand something about the proposals to cap some trust spending, including foundation trusts and maybe even advanced foundation trusts, in order to use the cash to support other cash deprived trusts.

Could the Minister clarify? Could she also tell us what really lies within this new bill about neighbourhoods and integration? To sum up, I and many others were delighted to see much of what is in this bill, but were puzzled by some of the changes by more power going to the Secretary of State and by the lack of a patient voice. I do hope the noble Lady, the Minister, can provide some clarity and indeed some comfort.
18:17
Lord Bradshaw Portrait Lord Bradshaw (Liberal Democrat)
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My Lords. >> I have had a long career in transport, particularly in the railways. I can remember the day they were first nationalised. I they were first nationalised. I worked in the industry in good and bad times, in the good times. For example, when I was chief operating manager at Crewe. Over 90% of the trains on the West Coast main line ran on time. Day after day. Money was tight, but we managed the newly publicly owned railway faces radical change, which I welcome.

Running Railways is a job for railway professionals, not civil servants, regulators nor armies of lawyers, financial manipulators and consultants often paid a lot of money producing poor standards of punctuality and also poor financial management, as we see in the case of HS2, which was not designed or built by railway professionals. This is about to change radically. I hope the Minister will endorse these sorts and say that the integrated railway, which he envisages, will result in consistently better performance for users and for taxpayers.

Could he confirm a changing role for the rail regulator and that Great British Railways was strategically planned network access to make best use of the network, and that the limited capacity we have available, and hope in time to improve? Does he believe that freight deserves a better deal, particularly as train loads and speeds increase? Does he believe that the curse of the bus substitution is something we can look forward to? Because people always prefer to stay in a train as long as they have reasonable notice of what is happening.

Will the Minister turn his back on the blame game and concentrate all efforts by operators and engineers on putting right yesterday's failings? The next day, or as soon as possible thereafter? I believe the recently appointed managing directors are doing this already, and will be keen, as will their staff, to run the best operated of the franchises or whatever they're going to be called divisions or whatever they will be. What is the future for open access operators? What changes does he think need to be made to safety regulation and to the needs of the mobility impaired? Railways are a long term industry and planning and timescales are necessarily long.

We need a financial frame that work that supports this, not year to year planning. Does he share my view that the railway that we need to set our sights on in 2040, when Scotland and London will be half an hour closer together? One mainline route will always be open between important centres and my last. I want to finish by something I heard last night when the Chelsea Flower Show came to its conclusion of the awards.

The best exhibiting show was exhibited by a lady who's won 19 gold medals. But she said creating thing like this, like creating a decent railway, is all down to team effort and I hope the novel the Minister will endorse that when he comes to speak.
18:22
Lord McLoughlin Portrait Lord McLoughlin (Conservative)
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Applause. It is a. Lord Bradshaw and to acknowledge his expertise and also his dedication to the rail industry. dedication to the rail industry. And when I saw that I'd been drawn to speak after him, I knew that by the time we came to that part of the time we came to that part of the debate, we'd be on the transport section of this particular afternoon. And I'm I'm grateful to him for being the first speaker to take us into transport. As far as the loyal address is concerned, my Lords, the government had put GBR in its legislation in its manifesto, so it was obviously going to happen.

It is interesting to note that there have been since privatisation of the of the Railways franchise on the railways. There had been a Labour government for 14 years, and it decided to stick with the system that it inherited. It decided to stick with that system it inherited, I think, because it knew it was working, because prior to prior to privatisation, there were 700 million passenger journeys on our railways. During the period of privatisation, that went up from 700 million to 1.7 billion.

That was pre the pandemic. And what we actually saw, we saw private investment taking in the railways. I remember when I first got elected, the last place anybody would want to spend any time was Saint Pancras Station. It was a dump. It was awful. It lacked investment. It lacked investment because nobody was investing in the railways. And of course, if you're competing against the health service for public sector money and you're competing against education and you want to put money in the railways, guess which comes last? It's the railways.

And I do raise my concern about that and what may well happen, but I'm sure in the new utopia that we're going to get as far as GBR is concerned, we're going to see no delays and everything is going to be fine in the future. Well, in your dreams and in the government's dreams, and I think it is a great pity that they are not going to be using the expertise of getting private investment in one of the things, as the Secretary of State for transport, when a new franchise was coming up for renegotiation, the detail that was gone in the extra services, which were lobbied for by local members of Parliament and the like, was something which was encouraging and more services were provided.

And I do worry about the conglomeration of it all as to whether we'll get that sort of dedication into those individual services, and we'll see that that happen. But I'm sure it's going to happen. My Lords, I did want to just make a little reference as well to HS2. It disappoints me immensely that we've got ourselves into such a mess on that particular project. Now, yesterday the Secretary of State said she was angry and she was angry, and she singled out four prime Ministers.

Not surprisingly, there were no prime Ministers of the Labour Party which were singled out, but just conservative prime Ministers. So I did actually go and just look at the original command paper which was given to Parliament. And who was it signed by? Gordon Brown and Lord Adonis, who started this particular project? The Labour Party started this particular project. And so a just a bit of how did we get it so wrong? How was it? How has it been possible for such.

What I think is an important and national scheme for it to have gone so wrong and been so deliberate. But that's not the first time railway particular subjects have gone. Because if you go to page 12 of what is still a very relevant document and a very good document, I would say it says that the West Coast Route modernisation project cost 8.9 billion. Don't forget this is 2010 cost 8.9 billion, took almost a decade. It delivered fewer benefits than originally envisaged and caused serious disruption to travellers and to businesses at significant economic and social price, in addition to the cost of the project itself, getting rail infrastructure right, as the Minister knows, probably better than most, is not something that happens overnight.

It does take time and it does take a commitment over a longer period of time. There is also other bills in the Gracious Speech Gracious Speech, and I just want to possibly give the Minister one quick win on the Highways Finance Bill. And when it comes to Highways Finance Bill, how about a clause in that particular bill which says to any utility company that has traffic lights on roads over the weekend, particularly a roads, has to pay £50,000 a day to leave those traffic lights in position over that weekend.

I'm pretty sure if there was such a a charge on them, they'd get them down fairly quickly over those weekends and the motorist would be very, very pleased indeed. They are growing like mushrooms like we've never seen before.
18:27
Baroness Watkins of Tavistock Portrait Baroness Watkins of Tavistock (Crossbench)
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Lord, it's a pleasure to speak. the proposed legislation regarding social housing and health as outlined in the King's Gracious Speech, because I believe they're Speech, because I believe they're so inextricably linked. I declare my interest as chair of Look Ahead Housing Association that delivers not only housing, but social care for people with mental health and learning disabilities. The government's committed to several housing plan reforms in future parliamentary sessions, and has done so in the past as referred to earlier.

But they they need particular changes in relation to Commonhold as a default tenure for new flats. This is excellent news, but leaves many tenants in leasehold flats in very difficult situations regarding increasing costs. As other noble Lords have said, the proposed remediation Bill is intended to accelerate the removal of unsafe cladding and strengthens protections for residents. This is absolutely essential to ensure works are completed swiftly. However, the proposals are unclear about protecting current tenant owners encouraged to buy shared ownership with housing associations prior to the recent changes in legislation.

These individuals remain accountable for significant costs, illustrated only yesterday in the news about tenants of properties in the former Olympic Village, which illustrate the significant stress and challenges many people are facing regarding these issues. Can the Minister explain how this particular issue will be resolved under the new legislation? Any new social housing has to be built so that it is designed that families can live safely and healthily in their homes. It remains a scandal, as others have said, that we still have children living in hotel rooms with parents.

With the uncertainty of temporary accommodation that creates associated mental and physical health problems. What is the government's timescale for ensuring that no child remains in temporary accommodation for more than a month, thus enabling them to stay in the same school for significant periods? I welcome the announcement that the legislation is to be introduced to abolish the NHS, NHS England and believe that significant costs can be redirected into patient care. However, the Bill appears to omit reference to parts of the health care system most noticeably, most notably the need to provide NHS dentistry more equitably across England, and doesn't make significant reference to the fact that the new Mental Health Act will need to be implemented and that this will be costly.

Can the Minister explain where responsibilities for such services, particularly specialist services, will be held in the new system at the Department I, and what information is going to be provided on the role of regional teams? Like others, I warmly welcome the single patient record. The introduction of new digital platforms is to be commended and will make access to information more swift, much swifter for every health and care provider with regard to individual patients. However, much of the NHS is commissioned and provided by providers that are not part of the main NHS.

For example, acute mental health services, radiology reviews and category surgery are provided in independent services commissioned by the NHS. What is the intention of government in terms of independent providers having access to, and the ability to add information to the single patient record? I suggest that this is an issue that will need careful exploration and possible amendments to the Bill to ensure both the protection of information of patients records and the need to ensure information on assessment and treated from all services paid for by the NHS can be used and incorporated into the single patient record.

Finally, my Lords, as the noble Lady, the Minister said earlier, the last session passed vital legislation on public health measures for future generations on tobacco and vapes. I am concerned that this session makes no reference to the important issue of alcohol harms, and what might be done to improve this scenario. It would be helpful if the Minister could comment on whether a minimum unit price for retail sales, not those in hospitality, may be considered to reduce the health damage caused by alcohol abuse and addiction, and the associated costs of treatment in our health service.

My Lords, I.
18:32
Baroness Scott of Bybrook Portrait Baroness Scott of Bybrook (Conservative)
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Declare my interest as the Vice President of. >> Association and Vice President of the National Association of Local Councils, my Lords Housing Local Councils, my Lords Housing appears to be taken a back seat in the government's agenda for all the the government's agenda for all the talk of 1.5 million new homes. We heard no mention of that target in the King's Speech when we asked for a progress update last month, we were instead referred to a written answer from February.

Can we have those updated figures now, please? How many dwellings will be completed this coming year? According to the department's official statistics, an estimated estimated 342,100 net additional homes have been delivered in England between the start of this Parliament and March this year. At this rate, it will take over five and a half more years to meet the target of 1.5 million homes. The government must not shy away from these facts. When will we see an improvement in the figures? My Lords, we conservatives delivered 1 million new homes over the last Parliament and had a plan to build 1.6 million homes in the next, despite 14 years in opposition, Labour did not and do not have a plan to meet their less ambitious target.

We knew this and my right hon. Friend the Leader of the Opposition. In the other place, when she was a shadow housing secretary, told the then Secretary of State that she had been stitched up by her colleagues. We support the delivery of more housing, but my right hon. Friend in the other place offered our help, which throughout these recent bills my Lords, have not been taken up. Instead, this government's choices of top global, of top global pressures have left us with high energy, labour and regulatory costs pushing up the overall cost of house building and leaving many consented sites unviable.

Time and time again on the doorstep, we heard of young people's desire to own their own homes. Too many are trapped in the rental sector and even there the government is not helping the supply of rental properties. Smaller landlords in particular are exiting the market. What is the government's assessment of this trend and the impact on the supply of rental properties? The Renters Rights Act is now in force, and we already are seeing the consequences of this bill.

Build to rent developers are affected, too, and the Act is expected to increase the number of rent appeals even further. Is the data on the average time for property chambers to process rent appeal cases now being collected, and what does it show? So far? The government has also committed to capping ground rents through the Commonhold and Leasehold Reform Bill, and we look forward to this bill and looking at these these ideas in detail. But in the meantime, my Lords, what action is planned in relation to service charges which are being getting higher and higher every single year? My Lords, we are all seeing also seeing long waiting lists in social housing.

Thanks to this government's choices to increase employer national insurance and taxes on business, unemployment has now risen to 5% and even worse, youth unemployment especially is increasing, with 1 in 6 young people being unable to find a job. Young people have no hope of getting on the housing ladder under this government. Where, my Lords do they go? This government risks creating a vicious circle where more and more people are forced to look to social housing. Yet, shockingly, around 33,000 new social tenancies each year are going to households where the lead tenant is not a UK national.

The government is spending around £4 billion a year to deliver about 30,000 new social homes annually, meaning that spending on affordable homes on the Affordable Homes programme is going entirely. My Lords, on housing Non-nationals my Lords, how is this sustainable? Housing is a major policy area which is fundamental to solving the cost of living crisis. However, we are not seeing it prioritised in this debate and we need a constructive policy environment to tackle these issues.

Not not just policy tweaks nor arbitrary state interventions which do not fix problems at source. This House deserves to see proposals for genuine solutions, as well as clear figures to ensure we see actual delivery. And I really look forward to the noble Lord. The minister's response thanks.
18:37
Lord Jordan Portrait Lord Jordan (Labour)
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My Lords, as a life President of Rospa, I welcome the opportunity Rospa, I welcome the opportunity today to speak on an issue that crucially affects us all the growing crisis of preventable growing crisis of preventable accidents. It's not receiving the attention or urgency it deserves, and people are dying because of that. Accidents are not rare or isolated incidents. They're the leading cause of avoidable deaths and injuries in the United Kingdom. They happen in places where people should feel and be safest in their homes, their communities, and doing the ordinary things in life.

Research from the Royal Society for the Prevention of Accidents shows that around 23,000 people die each year because of accident, while close to a million. Yes, a million are admitted to hospital. More worryingly is that the accidental death rates have risen by more than 40% over the last ten years. This is not a temporary spike. It's a sustained increase that highlights that there's a major flaw in how the country approaches accident prevention. That flaw is a lack of a coherent national strategy for reducing accidental harm.

At the heart of the problem is that responsibility for preventing accidents is fragmented across government departments, agencies and systems. Valuable work takes place, but it's leaderless and disconnected. This point was clearly reflected in the recent Westminster Hall debate on accident prevention. The Minister for Local Transport highlighted a range of welcome initiatives already underway. We heard of the good work on safety in transport, housing, workplace in products and fire prevention all important in their own right. But what came across clearly was that responsible for accident prevention exists in separate departments but lacks an overarching framework.

Bringing it together. Let's look at falls, the leading cause of accidental death and serious injury, particularly to the elderly. And as everyone in this chamber will know, the devastating impact of all can have on older people. Prolonged hospital stays, loss of mobility, isolation and an end to their independence and wellbeing, costing the NHS and social care system £6 billion every year. And we've seen the cost that inflicts on families emotionally, practically and financially. Yet this harm, this cost, is preventable and the place to focus on is in the home, the place where most of these accidents occur occur, the Minister said.

Everyone has the right to live in a safe home. Creating safe homes means homes designed and maintained with safety and accessibility in mind. It means coordination with health and care services. Identifying risks early. It means GPS and community nurses and local services being able to intervene before serious injury occurs, prevent preventing accidents cannot be the responsibility of central government alone. It requires central and local government departments, employers and charities to work together. Governments can make it happen.

A national accident prevention strategy would give the coordination and leadership needed to connect existing safety efforts, identify gaps, improve accountability and reduce unnecessary duplication of work across different departments, all ensuring the precious time and resources are used as effectively as possible. My Lords, the Labour Government has a proud history of leadership in safe health and safety. The 1974 Health and Safety at Work Act put an end to the devastating toll of injuries and death that, for 150 years had plagued the world of manufacturing.

I know that a national accident prevention strategy could and would have the same impact in reducing the unacceptable and unnecessary number of accidental deaths and injuries that plague us. Now, let us have a national prevention strategy now.

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My Lords, I am pleased to speak. In this. Debate on the Gracious Speech

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Debate on the Gracious Speech and to welcome the focus on public sector reform and delivery. This is also my first. Intervention since I was appointed the chair of the advisory, Conciliation and Arbitration Service. As your Lordships know, Acres is an independent of government and provides impartial advice and provides impartial advice and support to both employers and workers. I am acutely conscious in my new role of the need for me to maintain and protect acres, independence and impartiality. With that in mind, I will not be voting on any measures relating to employment law, labour regulation or any areas in which my doing so might be misconstrued as impacting
18:43
Baroness Jones of Whitchurch Portrait Baroness Jones of Whitchurch (Labour)
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on Acas impartiality. And I also refer the House to my declaration in the Register of Interests. My in the Register of Interests. My Lords, the Gracious Speech sets out the government's plans for further reform of critical public services. The public sector improvements proposed are far reaching and proposed are far reaching and impactful, but I would argue that their only deliverable with a strong industrial relations strong industrial relations framework which rejects the outdated models of perpetual conflict and finds a new consensus.

In 2025, the UK lost 740 000 days to industrial action. Whilst this is significantly lower than the post Covid bump of over 2.5 million per year, it's much higher than ten years ago. And as we know that conflict costs GB employers at least £28 billion a year. But my Lords, all the evidence shows that the most sustainable business improvements are made where workers and their bosses make changes together. This has been the experience of a huge number of employers and unions who have built robust modern systems of dialogue and partnership.

Our challenge now is to bring everybody else up to those standards. For example, the great. The creation of Great British Railways is a real opportunity to reset industrial relations in the transport sector. Good workforce relations are going to be key to its success. I welcome the announcement of a long term rail network strategy, but I hope my noble friend the Minister, recognises that the workforce needs to be part of that strategy from the start, underpinned by a framework of strong collective industrial relations.

And my Lords, this isn't just a problem in collective disputes. Research commissioned by Acas tell us that about 44% of people who work in the transport and storage sectors experience individual workplace conflicts in the past year. That carries a real cost to business through absenteeism, presenteeism, low retention and disengagement of staff. So does the Minister recognise that there are huge financial and operational advantages in creating a modern industrial relations framework in the transport sector, which can prevent conflicts developing in the first place? My Lords, good workplace relations are equally critical to the success of the health and social care sectors.

In fact, in this sector, employers research shows that there is a clear link between positive workplace relations and patient outcomes. There is more we can do to improve industrial relations across the NHS and the new adult social care negotiating body is a positive first step. This is bringing employers and unions together to tackle pay conditions and retention, and I'm pleased to report that Acas is supporting this work and the wider reforms. But the fact remains that there is a higher incidence of conflict in health and social care sectors 447 44%, compared to 44% overall.

A higher prevalence of discrimination claims and individual disputes are even more likely to end up being decided in employment tribunals. My Lords, the lessons from these examples is that our nation depends upon workplaces in both the public and the private sectors being efficient, responsive and innovative, with positive relationships between workers, leaders and their unions. However, we've seen a marked decline in the skills and the knowledge and the confidence needed to underpin relationships at work and manage conflicts early.

So I would like to propose a simple reframe of good industrial relations based on three principles firstly, collaboration and partnership. Treating each other with mutual respect as negotiating partners rather than adversaries. Secondly, balancing interests that deliver the prize of economic growth, improving productivity and better working lives. And thirdly, proportionality where formal action is used only as a last resort to mitigate the harm it aims to rectify. So I hope my noble friend the Minister recognises the prize that can come from reshaping industrial relations for the new challenges we face, both in the public and private sectors, which can ultimately build an economy which is stronger because it works for all.
18:48
Lord Jamieson Portrait Lord Jamieson (Conservative)
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My interest as a councillor in Central Bedfordshire, as my noble friend Baroness Scott of Bybrook friend Baroness Scott of Bybrook said, we have a housing crisis and nowhere is that clearer than in London. The noble Lord Livermore London. The noble Lord Livermore often speaks of 14 years of conservative government. Well, after ten years of a Labour mayor after ten years of a Labour mayor in London, does this government really believe the situation in the capital is improving? There are 13,000 rough sleepers in London, up 10% this year.

That represents around a quarter of the English total. More than 75,000 London households are in temporary accommodation, over half the English total, and there are 341,000 households on London waiting lists. Many private renters in London are paying over 50% of their rent, sorry of their income on rent. Now, despite all of this, house building in London continues to fall. Latest figures show that in quarter one of this year, only 937 new homes were registered. That's a drop of 84% in the last decade, and well below the target of 88,000 homes a year.

Affordable housing starts in London have fallen by almost 80%, to around 4500 last year. Now, we have consistently argued on this side of the House to prioritise and facilitate building on brownfield land in London, yet the government has failed to deliver. Now, of course, we need safe buildings. Of course we need quality homes. But how many more costs and delays can development developers absorb before they stop being viable? A recent analysis from Ackroyd and Lowrey showed bill costs to have increased 80% in the last decade, whereas house prices are only up around 14% and in some cases, the average London build costs now exceed average selling prices, adding layers of bureaucracy and costs in the pursuit of the ideal home is resulting in no homes at all.

London councils spend more than 4 million daily on temporary accommodation. So what is the government's and the mayor's justification for managing this crisis rather than solving it? London doesn't lack demand. It does not lack sites, it does not lack potential funding. We need to remove the blockers. We need a system that delivers homes quickly, at lower cost and at scale. My Lords, moving on. We have previously debated Right to Buy reinvesting proceeds from right to buy into a new home provides two homes in the place of one home.

And my Lords, it can be done. Many councils, including my own at Central Bedfordshire, have successfully used right to buy proceeds to build more homes than were sold. And not only that, it's enabled a focus on more specialist accommodation for the elderly, for those with disabilities and earlier someone mentioned temporary accommodation, all of which were in short supply. Now this is a pragmatic solution reinvesting to build more homes. My Lords, getting on the housing ladder is increasingly difficult and out of reach for many.

It's not only the deposit, it's higher mortgage rates, driven by the economic policy of this government, help to buy us gone and stamp duty relief for first time buyers has been reduced. When I bought my first home, you bought what you could afford. Usually something small, usually somewhat somewhere less fashionable. Then over time you moved on. That's how people got started. That was how communities regenerated. That's how Staircasing works today. Much of that progress is wiped out by stamp duty and fees.

For many families, moving home now comes with a tax bill the size of a deposit. This is not how we support the economy for aspiration. My Lords, if we are to address the housing crisis this country faces, we must solve the London housebuilding crisis. We need a practical system that builds more homes and helps people back on to the housing ladder. Thank you.
18:52
Baroness Jones of Moulsecoomb Portrait Baroness Jones of Moulsecoomb (Green Party)
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My Lords. I'd like to ask the government why we have five days of government why we have five days of debate on the King's Speech, but we have no mention of the environment. It's not including the issues to It's not including the issues to cover, and I'd like to point out that the conservative government always put the environment down as an issue that should be debated. an issue that should be debated. But here Labour has failed as as they always do on the environment. In his speech, the King actually said, my government will remain a leading advocate for tackling climate change and that's complete nonsense.

Absolute nonsense. There are no plans in any of the bills mentioned that will actually help the environment, that will help, help nature and actually help people to enjoy the environment. According to the Natural History Museum's Biodiversity Intactness Index, the UK ranks 189th out of 240 countries and territories for how intact its nature and biodiversity remain. Can a country truly claim to be a global climate leader while its own nature crumbles? Paul Designer, friends of the earth senior nature analyst, explained the gap between the UK's green rhetoric and the grim reality of its biodiversity collapse.

Just 53% of the UK's original nature is left intact, far below the index's safe limit of 90% and the global average of 79%. The United Kingdom has always prided itself on being a green and pleasant land, a nation synonymous with rolling countryside, abundant wildlife and, of course, environmental stewardship. Yet beneath this postcard perfect image lies a startling reality. The UK is now one of the world's most nature depleted countries, and as the 2030 deadline approaches, Britain's natural wealth lies in ruins.

The UK government tracks approximately 50 different biodiversity indicators, and the 2025 results paint a troubling picture. Indicators still heading in the wrong direction include the size of fish in the North Sea, the status of pollinating insects that's bees, hoverflies, moths and bird numbers on farmland and in woodlands. So perhaps the noble Lord, the Minister can probably the plans to move these figures in the right direction. I do accept that we don't have an environment Minister on the front bench. Perhaps I can have a letter explaining that.

And then, of course, there's a global threat. We've recently had a Ministry of Defence Committee report headed by Lieutenant General Richard Nugee, a former senior British Army officer and leading voice on climate and national security, who told us that the report clearly states that climate change is now a core national security threat. This is because we have ice melting at a frantic rate in Greenland, an incoming record breaking El Nino event, and species going extinct faster than Labour voters.

This all affects our safety. It's obvious this government doesn't really care about rural areas, the countryside, nature, our waterways and all that green stuff. They just see newts, hedgehogs and bats as annoying things that get in the way of their bulldozers. I wish this had been a king's speech designed to revive the country, one designed to help people, especially those who are living in poverty. But instead it's a set of policies that they hope will stop Keir Starmer being evicted from number ten.

Will any of these government policies deal with the endemic problem of corporate greed that forces up the cost of living and our tax bill, especially the fossil fuel companies who are greedily helping to destroy our planet? Will any of this legislation make fares cheaper by ensuring the rolling stock of our railways is owned by us, rather than rented? Will it become easier for people to leave their cars behind by opting for a superb public transport system? And please don't give me that guff about electric vehicles, because there's a cost to them as well.

Absolutely. Will the water industry be taken into public ownership, or will bill payers continue to pay billions of pounds supporting a business model that relies on pumping raw sewage into our rivers and onto our seashore? Will taxpayers continue to pay the bulk of the housing benefit budget to private landlords, or will we start a mass building program for council houses so that the public's money goes directly into providing well-built homes at reasonable rents with green spaces that the residents can enjoy? I can't see any of this happening.

If Labour are looking for a reset under a new leader, then we really ought to start with rent controls. Our new Green Party mayors and council leaders want the power to set rents that work for people in their area, and Greens understand that the poorest in society need clean air and green space as much as the richest do. In short, I'm cutting my speech extremely short. In short, this government urgently needs some tuition from climatologists and green economists, and I would be very happy to put them in touch with the best.
18:57
Baroness Linforth Portrait Baroness Linforth (Labour)
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My Lords, it gives me great pleasure to speak in this debate on the gracious speech delivered last the gracious speech delivered last week by His Majesty the King. Although I profess I do have first time speaker nerves, my remarks can concern the overlap between children in school and wider societal health. I'd like to suggest to the government a simple, cost effective solution that I believe would reduce the spread of sickness and improve health and save money. My subject, Clean Air for schools, could have also been discussed in the debates on education and the economy.

Good government is joined up. It doesn't exist in individual Whitehall departments. The health improvements that come from providing clean air in public spaces have wider benefits. Breathing poor quality air is a risk to children's immediate and long term health. It is now accepted that outdoor air pollution is a problem. Less appreciated is that indoor air can be up to five times more polluted than outdoor air. The pollutants that can be present in our indoor air include particulate matter, as well as biological aerosol, such as airborne viruses, mould, fungal spores, pollen, bacteria, etc.

quite apart from increasing sickness, elevated levels of pollutants have also been shown to affect a child's ability to focus. Now linked to diminished performance in exams, children spend most of their time in schools, but with densely packed, poorly ventilated classrooms, it's where they are most likely to pick up sickness. A recent study tracked 816 students and staff across a school year, and found that at least 85% had a virus detected and 80% had an illness episode. The study states schools are an important setting for infectious disease transmission, but they don't have to be.

A brilliant campaign called Clean Air for kids has started in my home city of Bristol. It was started by a Bishopston resident, Ruth Brooker, when her son was going through cancer treatment, and she wanted to get him back to school. Or, as many parents would say, back to the germ factory. Ruth's campaign is now going nationwide, beyond just Bristol. Another good thing originating from my great city. Her campaign is simple. It is to add an air filter to each school classroom and regularly open windows to reduce the number of coughs, colds and Covid 19 infections that kids and their teachers catch at school, which then spread into the community.

It's a cost effective solution. The Liberal Democrat spokesperson in the other place, recently estimated that installing air filters in schools in England would have a one off cost of around £140 million. While Sky news reported that supply teaching costs in state schools and academies in England last year were 1.4 billion, running costs are low to the Clean Air for kids campaign has calculated that over the 20 year lifetime of an air filter running all day in schools during term times, including installation and running expenses, it would cost less than a tenner per child per year to provide pupils and staff with clean air about the same cost of a coffee and a cake.

This simple solution would pay for itself many times over very quickly from the savings from supply teacher budgets. The problem is that very few schools, local education authorities and academy trusts can afford the upfront cost of installation. But the government could easily, with political leadership, we could transform the lives of schoolchildren, their teachers and their families by improving the quality of indoor air. Additionally, a programme of installing air filters to reduce the spread of sickness in schools will stop others becoming sick, too.

It will improve productivity, help the economy and drive growth while protecting the NHS and taking the pressure off benefit budgets. It would have huge wellbeing outcomes which in themselves will improve society. We drink two litres of water and breathe in 11,000l of air every day. We wouldn't want our children to drink dirty water, so why would we let them breathe dirty air indoors? Would the noble Lord, the Minister, share with the relevant Minister and write to me? Or even better, meet with me and Ruth Brooker to discuss this further.
19:02
Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (Liberal Democrat)
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My Lords, my remarks today focus mainly on health and its poor relation to social care, which had relation to social care, which had no mention in the Gracious Speech. But I also comment very briefly on some defence and national security some defence and national security issues, which will be centre stage tomorrow. As we've heard, the modernisation Bill will abolish NHS England, make changes to the duties of integrated care boards and create the framework for a single patient record. In essence, it pulls many of the functions back into Whitehall, including some transferring some powers directly to the Secretary of State, whilst recognising the improvements that the Minister set out when opening this debate.

I have to admit, to some disappointment, what feels like a largely technocratic bill focusing on structural and digital reform and accountability arrangements, rather than on improving patient care and outcomes. My Lords, with the exception of data integration, there is very little focus on improving social care or mental health provision, both badly needed. And as we say throughout the mental health bill, we need to see major investment in preventative and community services. If the three big shifts in the ten year plan are to be realised, the absence of social care from the legislative programme referred to by so many speakers reinforces my view that the government gives this low priority and fails to recognise the need for a fully joined up health and social care reform programme.

My Lords, we can't just wait for the Casey Commission's final recommendations. We need action now. We also urgently need a new mental health strategy with a strong focus on community services, early and early intervention. The government has recently issued a call for evidence which I welcome. Indeed, the government is more than welcome to borrow from a wealth of ideas and evidence in the Liberal Democrats recent policy paper entitled Whole Person Mental Health. It includes a new offer for young people protecting by law the share of the NHS budget, which is spent on mental health, and the introduction of mental health check ups for adults going through major life events.

Whilst I welcome in principle, as so many others have today, the move to join up health and social care records to avoid the frustration of patients having to keep repeating their medical history. Many questions remain about how this is done and how privacy concerns are addressed and trust built with patients. But my Lord, the proposed abolition of Healthwatch is a matter of huge concern to me, and one I shall be following very closely. In short, any successor arrangements must have a strong, independent element to ensure an authentic, patient voice is heard.

Where Healthwatch worked well, it also provided unsolicited feedback on matters of real concern to patients and help bridge the gap where trust between local communities and the healthcare system is fractured. The current proposals for Icbs and local authorities to take over the local responsibilities of Healthwatch feel unworkable to me. So could the Minister please explain how this will deal with the much needed co-ordination between health and social care? In my book, it will simply exacerbate the divide. I am also concerned that the very large footprint of Icbs will make them disconnected from local communities.

As I said, at the heart of the bill lies the abolition of NHS England. But I sense a real disconnect between the narrative that says you can't run the NHS from Whitehall and need to devolve decision making, which I agree with, whilst simultaneously bringing more powers back to the centre and the Secretary of State. Two quick examples of this are the proposed new cap on NHS Foundation trust spending limits and the need for appointment of all chairs and non-executive directors of these trusts to have Secretary of State approval.

The rhetoric and the reality of this bill don't add up. My Lords, on health inequalities, I'm sure we are all deeply concerned by the widening and deepening inequalities in healthy life expectancy between the most affluent and deprived areas. I think it's scandalous that there now there's probably 20 years separating these two extremes. And yes, the bill contains a duty on the Secretary of State to reduce disparities in health. But where is the programme of action to tackle the wider social determinants of health inequality and improve the nation's health? This bill should be seen as an opportunity to do just that and indeed improve support for unpaid carers.

Finally, my Lords, a healthy population is essential if we are able to protect our shores, effectively strengthen our national security against the growing number and severity of threats we face and increase our national resilience. This was all set out very cogently in the Joint Committee on which I serve. Recent report on the UK's National Security Strategy. So given the rising global tensions and rapidly changing geopolitics, we urgently need to see the government's long overdue defence investment plan and far more detail on the target to spend 1.5% of GDP on security and resilience.

I hope that relevant Ministers will respond to both

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these points in tomorrow's debate. My Lords. Modern transport infrastructure

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Modern transport infrastructure is not simply about moving people from A to B, it's about economic from A to B, it's about economic growth, productivity, housing delivery, social mobility and delivery, social mobility and national competitiveness. Too often, transport is viewed as a cost. In
19:07
Baroness Dacres of Lewisham Portrait Baroness Dacres of Lewisham (Labour)
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transport is viewed as a cost. In reality, it is one of the greatest investments a nation can make. From my time in local government and as chair of London Councils, Transport and Environment Committee, I have seen the transformative impact that investment in transport infrastructure can have on communities, businesses and local economies. Reliable and integrated rail infrastructure does more than just improve journeys. It increases the labour market access, boost productivity and creates the confidence needed for investment.

The creation of Great British Railways provides an opportunity to deliver a more integrated, reliable and passenger focussed railway network that supports growth and connectivity across the country. Business invests when connectivity is strong, people seek work where transport is reliable, developers build homes where infrastructure exists and local economies thrive, where communities are connected. Investment in transport infrastructure also generates benefits far beyond the immediate area in which the project is delivered. One example of this is the Bakerloo line upgrade and extension.

I have consistently argued that this is not simply a London transport project. It is a national growth project. For too long, parts of south east London have experienced lower levels of transport investment, despite the enormous economic and housing potential. The benefits and returns on investments are clear. The transformative and shovel ready infrastructure project will unlock 107,000 new homes, 150,000 new jobs and £1.5 billion GVA to the national economy. Those are not simply transport statistics.

These are indicators of economic growth. Transport infrastructure changes the geography of opportunity. It determines whether someone can realistically access work, education, training or culture with a within a reasonable journey time. For many communities, better transport is not simply a convenient thing. It is a game changer. Transport infrastructure helps to ensure that people from all communities can access jobs, education, training and opportunity and share in the benefit of economic growth. The economic benefit would not stop at London's borders.

The project would support engineering and manufacturing supply chains across the United Kingdom, including rail manufacturing jobs in Goole, in Yorkshire and beyond. Modern public transport infrastructure is also essential to reduce reducing congestion, improving air quality and supporting sustainable economic growth. But infrastructure requires long term thinking and partnership between national government, local governments, businesses and regional leaders. Does my noble friend the Minister, agree that long term certainty around infrastructure investment is essential to giving businesses, developers and local authorities the confidence to invest, plan and deliver growth? My Lords, transport infrastructure is ultimately an investment in people, opportunity and national renewal.

If we get this right, we will not simply be modernising transport networks. We will be unlocking growth, expanding opportunity and helping to build a fairer and more prosperous country.
19:12
Baroness Eaton Portrait Baroness Eaton (Conservative)
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My Lords, it is a pleasure to follow Baroness Dacre in this debate, and I declare my interest debate, and I declare my interest as a Vice President of the Local Government Association and also the Government Association and also the part owner of rented property in West Yorkshire. It is a West Yorkshire. It is a disappointment that the Social Housing Renewal Bill will see the further curtailment of right to buy something I firmly oppose. Getting people onto the housing ladder should not be perceived negatively and I pay tribute to private sector organisations like Rent Plus UK that are building affordable housing and getting young homeowners onto the property ladder.

You cannot make a modern day case for capitalism if people don't own capital. It is why socialism always seems to state funded housing as the option, because it gives the state more control. As a former leader of Bradford Council, I. I recall inheriting a housing revenue account from a socialist administration which was. Millions in deficit with housing repairs and was out of control. My point being that legislation is all well and good, but poor management and governance on the ground will always be the barrier to the delivery of decent social housing standards.

While there is a case for the construction of more social homes, namely that the state can reduce its housing benefit bill, potentially rising to £71 billion by 2020 2050. With the increase in social housing stock. I do hope that the bill goes some way to address some of the key challenges occurring in social housing. I hope the Social Housing Renewal Bill will pave the way for local authorities who retain housing revenue accounts to have equal access to the £2.5 billion of low interest loans announced in the spending review of 2025, which is currently only accessible for social housing providers.

Second, and because of the renters right Bill, there needs to be a general acceptance that more renters in the private sector will be pushed into the into social housing, with the lack of private rental supply. Given that the bill will be pushing more landlords out of the market. Consequently, councils may need to recruit additional staff and upskill the existing workforce. Future new burdens of funding must be upfront, realistic and multiyear. Landlord penalties are unlikely to cover costs.

Councils must have the right powers, skills, capacity and funding to enforce the new laws effectively and provide much needed security for private renters. Separately, and while I appreciate this, may not fall onto the face of the bill, I was pleased to hear that the Law Commission is soon to initiate a new project on the. On the disposal of land to the Crown Estate, and whether other bodies will be able to take on this land. If the Law Commission has finalised its work before the Bill enters this House, I would very much hope that the government might consider the ability for Sgt Land to be handed over to local authority housing revenue accounts, as opposed to the Crown Estate.

The Crown Estate is sitting on many brownfield sites, which could easily be unlocked to local authorities for the purpose of building social housing, and I hope the Minister will be closely following the work of the Law Commission and making representation on behalf of local government. A pleasure. To follow. Baroness Eaton My Lords, I welcome.
19:16
Baroness Donaghy Portrait Baroness Donaghy (Labour)
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The reference in the Gracious Speech to the continuing modernisation of the NHS and I'm speaking today about the government's commitment to the 2.5 government's commitment to the 2.5 million women in England living with osteoporosis, and to ask where that commitment now stands. Fracture liaison services are the gold standard for stopping osteoporosis in its tracks before it becomes catastrophic. Where the where they exist. Patients who suffer a first fracture are caught, assessed, placed on medication and supported through a structured programme interrupting the cycle that would otherwise lead to further breaks, lost independence and, in too many cases, premature death.

The government committed to making these services universal across England by 2030, and it was a commitment which was warmly received. Since that day, women living with osteoporosis have heard that commitment 63 times in Parliament, in the media and in government documents, including, most recently, the renewed renewed Women's Health Strategy. And yet, no implementation plan has been published. No timetable, no milestones, no dedicated funding. The result is institutional paralysis. 60 new services are needed.

None have opened. And in that time there have been 4000 deaths. That fracture liaison services could have helped to prevent. That's why over 60 organisations are calling for this rollout to happen. This coalition spans women's health groups, rural colleges, trade unions and the world of business. But this coalition is growing increasingly concerned, and the government simply repeating the pledge is no longer sufficient to allay those concerns. The Society of Radiographers has warned that rollout must begin this summer for the 2030 target to remain achievable.

These services cannot be created overnight. They require recruitment, staffing and commissioning in some areas. Local plans have been put on hold waiting for national direction. I make a straightforward plea for transparency. If there's a reason why the government can't move forward right now, please tell us when the plan will be published. Tell us if Ministers still believe the plan is deliverable by 2030, the 2.5 million women and 700 000 men living with osteoporosis, and the sector that supports them, look forward to an answer from the Minister.

My thoughts as we enjoy day four of the debate on the King's Speech. I'll concentrate my remarks on health, although inevitably that's inextricably linked with housing. And I'm very happy to endorse the remarks of the noble Lady, Baroness Donohue. Lord Donoughue because what she says
19:20
Baroness Wheatcroft Portrait Baroness Wheatcroft (Crossbench)
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about osteoporosis is absolutely right. It needs tackling and looking for something positive to looking for something positive to say. As an opening, I welcome the commitment to a single patient commitment to a single patient record. Any objections on the grounds of data privacy must be overcome by the sheer common sense overcome by the sheer common sense of the proposal. Qualms over data ownership are genuine. Palantir is ownership are genuine. Palantir is a business with tentacles into strange places, and it's right that they should be explored, and we should find means of keeping them at bay.

But my GP is in Westminster, has easy access to tests that are done in Chelsea and Westminster Hospital, but the same cannot be said about tests done at Tommy's Saint Thomas's Hospital, which is actually closer to the surgery or indeed guy's. Now, my Lords, in an age of data being easily transported, the river really shouldn't be an obstacle to efficient communications in the NHS. The single patient record has huge potential benefits, but it's the major bright spot as far as I'm concerned in the King's Speech, the NHS must modernise.

But does that really require yet another massive shake up in the long term? It may be the right thing to do, but at the moment it's really not what the NHS needs. It was Lord Darcy who asked us to just imagine if all the effort and resource that had been poured into dissolving and reconstituting NHS management structures had instead been invested in services for patients. Those words were echoed by the new health secretary less than two years ago.

But now Wes Streeting has given us one parting gift and that's another NHS upheaval. I believe it will cause confusion and discontent in an NHS which is already wrought with tension. However, on the truly vital issue of social care, the King's speech was almost silent. As others have remarked, this is a terrible omission. The lack of a proper social care system is a massive problem for the NHS. It was July 2011 when Andrew Dilnot proposed an answer to what was even then seen as a desperately urgent problem.

His report was knocked into the long grass and whenever the issue rolls back, it's not back again. This time, the government opted for the increasingly popular answer to any tricky problem and asked the multi-talented Baroness Casey to lose it in a forest of consultations. So I would like to add my voice to those who are asking, what is the timetable for something to emerge from all these consultations? When will we at last see something positive happening on social care? My Lords, while the talking continues, NHS beds are being blocked by elderly people who don't need acute medical care, but they do need social care.

Maybe they live in unsuitable accommodation, maybe they have no access to the continuing care they need. Some lack family able or willing to take on some caring responsibility, and some are petrified at the prospect of being consigned to what's known as a care home, not least because of the massive bills this can entail. Dilnot proposed a type of insurance scheme that would cap the amount any individual would have to contribute today, with most care homes run by the private sector and the for profit element dominating.

When will people really decide that private equity, with its high leverage and desperate need for income, is not the place for care homes to be entrusted? So people remain in their hospital beds while others queue up behind them. A year ago, a report of the House of Commons Health and Social Care Committee highlighted the problem. It was costing at least 1.89 billion a year. Then the figure has gone up. We need something to

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happen now. It's a pleasure to follow the noble Baroness Wheatcroft, and I noble Baroness Wheatcroft, and I agree entirely with her on what she said about social care and the need said about social care and the need for a timetable. It is a very omission from the government's programme. I want to speak mainly programme. I want to speak mainly about health. The NHS modernisation Bill, contained in the Gracious
19:25
Lord Dodds of Duncairn Portrait Lord Dodds of Duncairn (Democratic Unionist Party)
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Speech, promises to reduce inefficiency and place power and resources in the hands of frontline NHS organisations and Lord Darzi review, which has just been mentioned, described the system too rigid and complex. Overcentralised and unclear lines of accountability. The government's intention is to transfer NHS England's functions into the Department of Health and Social Care, and the wider system to reduce bureaucracy and free up resources to be reinvested in the front line. And here I want to sort of compare what has happened in the devolved arrangements in Northern Ireland.

Just by way of illustration, many of the very same criticisms led the then DUP health Minister in Northern Ireland, Simon Hamilton, in 2015 to announce the abolition of the Health and Social Care Board, which was responsible for regional commissioning of services, managing resources and performance management. My responsibility for the Stormont Health portfolio has passed on now to other parties, and the board did eventually close in March 2022. There has been reference to a 50% target for reduction in staff from merging when NHS England closes, but unfortunately that has been far from the outcome we have seen in Northern Ireland.

Inexplicably, the Health Department in Northern Ireland now has more than 1200 staff at Stormont, exceeding the combined number across both the Department of Health and the Health and Social Care Board. Prior to the board's dissolution. The department's new strategic planning and performance group alone comprises an extraordinary 500 people. Administrative costs of 305 million and management costs of £264 million, both from two years ago, each exceed their respective totals for the HSC board and the department jointly in 2021, 2022 and previous years prior to the closure of the board.

Much of the rationale for removing the Health and Social Care Board was to reduce and streamline the bureaucracy, which we heard the government talk about in relation to its plans for NHS England. Yet the process in Northern Ireland and the same kind of approach has somehow ended up in a situation where a number of staff and costs have grown. And it's just something that I think it's worth people keeping an eye on and see what lessons can be learned from that devolved experience.

And certainly if lessons can be learned, they should be communicated back to the Northern Ireland Executive. The government is also proposing, as we have heard, that the NHS harnesses digital technology and unlocks the value of health data with a new single patient record bringing individuals information together into one place to improve patient safety and experience. In Northern Ireland, we have a single digital care record for every citizen created via the encompass programme, which went live in the final two trusts, the Southern and Western Trusts, 12 months ago, and this provides patients and service users the ability to view and update their health information online, wherever and whenever they like, via my Care the Patient portal.

It makes it much easier for health and social care staff to view key information about their patients, both in a clinical setting and whilst working in the community. Bringing together health and social care records. As may be proven somewhat simpler in Northern Ireland, given our integrated trust compared with the local government responsibility for social care here in Great Britain. Unfortunately, however, the Northern Ireland electronic record does not incorporate GP and primary care data, so we will watch with interest the progress that His Majesty's Government makes on this front and clearly integrating primary care data would present a significant further step forward.

I just want to say in closing, my Lords, that I want to see the government in this parliamentary session do more in fixing end of life and palliative care. I think it's really a position where all older people should be able to die with dignity, comfort and choice. We are at a crucial point given the where we are with the assisted dying bill and attempts to introduce that, that we must see a government commitment to really change the provision for palliative and end of life care.



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Yeah, yeah. Loads. I would like to take the

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Loads. I would like to take the debate back to transport. No great surprise, I suppose, and I certainly welcome the speech of my noble friend, the Minister's noble friend, the Minister's introduction, when she listed all the different bills that were going to be discussing in in this current to be discussing in in this current session. Northern Powerhouse Rail
19:30
Lord Berkeley Portrait Lord Berkeley (Labour)
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great idea. Civil aviation, great GB rail. Well, we started that. But of course she didn't mention HS2 because it's not there's no legislation required. We don't think at the moment. And after the think at the moment. And after the Secretary of State's announcement yesterday that the costs were going yesterday that the costs were going to exceed £100 million, billion pounds, I mean, sorry, there's a figure that I told along with Michael Bing. I told the Department of Transport for several years, but all they said was they strongly denied the figure and they don't recognise my figures.

Well, the answer is now they do. But Lord McLoughlin, in his speech of half an hour ago, it was quite right that this project was started by the Labour Party under Andrew Adonis. And I remember having strong arguments with Andrew at the time. He said, we've got to have the best in the world, got to go fastest. It's got to be most comfortable, all in a straight line, linking Glasgow and Edinburgh with and many cities in between with London.

And by the way, we're going to start in London, I said. Why? Because the existing railways out of London London area were a hell of a lot worse, bad, worse quality than they are around London. He said yeah, well, the business case is better if you start in London. And of course that's probably true, but that's not the right reason. Anyway, it just trundled on to I don't know how many years of Tory government and the Secretary of State has finally got angry.

In her press release yesterday, regretting the taxpayers, communities, contractors, workers have been swindled by the failure of government. And she's right. The whistleblowers and other professionals, the landowners, have all been silenced by some pretty horrendous NDAs. And one wonders what the Cabinet Office, the Department of Transport and the Treasury have been doing because they're all implicated in what may turn out to be a massive cover up on costs or even fraud. And the one particular thing which I find surprising is that Ministers normally require a required to give permission for projects to exceed budgets by.

I think it's called a ministerial direction. Now, this project has exceeded its. It's six times its original budget very roughly, but I can find no record of any ministerial direction. So somebody's been asleep at the wheel, I think probably intentionally. But we mustn't only blame the civil servants because Parliament has failed to. And Parliament, MPs and peers. And we're all guilty of it. Sometimes we love going to London faster, regardless of cost. And when you point out that actually the local services are used by many more people to go to schools, colleges, shopping or whatever, visiting friends.

Yeah, but it's important to get to London. You've only got to look at the service provided by CrossCountry trains, which is must be one of the worst ones to to see that doesn't go to London, which is a big mistake. And my noble friend Baroness Dacre outlined some of the needs for better information. Sorry, better rail infrastructure, which is local. And she's absolutely right. So my Lords, lessons to be learned. Minister, the Minister is Secretary of State yesterday said going on to Euston, but I've not seen any plans.

The boring machines are going. But normally when you build a tunnel, you know where it's going to end up. And it's a bit unclear here. We've had a big debate about the type of trains to be used, and the fellow called Chris Gibb, who is highly experienced in the West Coast Main Line traffic, he suggested a much better solution for which he's been sacked, which is again, no great surprise. So, my Lords, there are lessons to be learnt.

I hope that the new government, when it starts building the Northern Powerhouse and everything else, will learn those lessons and keep it small and keep everything within budget.
19:35
Lord Davies of Brixton Portrait Lord Davies of Brixton (Labour)
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It's a pleasure and honour to >> It's a pleasure and honour to take part in this interesting, if wide ranging debate. I'm just going wide ranging debate. I'm just going to focus my remarks on the issue that was raised by my noble friend, that was raised by my noble friend, the Minister, in opening the debate, the bill, the single patient record proposal, which is going to be part of the NHS modernisation Bill now on my iPhone. I found that just make that phone on my phone.

I have the NHS app from the NHS, I have the patient access app from my local practice, and I have the my chart from Saint Thomas. Guys. I wish they talked to each other. I'm also, it's worth saying, a participant in in Biobank. So they've got my data as well. And the burden of what I'm going to say now is that while I very much welcome the proposal to have the single patient record, I don't believe that Palantir is a suitable place to secure our health information, our health data.

Now, in truth, I'm probably a bit late because people are already involved through the NHS Federated Data platform. But the use their involvement is tightly constrained. What's being proposed here? If the data were given handed over to Palantir, would be a very different situation, which raises not just technical issues but constitutional, ethical and democratic matters. First, we need to understand the nature of the organisation. It was founded on a single premise that vast quantities of data, properly analysed, confer decisive commercial advantages.

Now it's it's it's customers have have historically been the CIA the NSA in the states and the US Department of Defence. It's its software has been used in ways which. To my view, fall outside UK norms. This is an incidental. To the company. It's at the heart of what that company does. So the second issue of concern is that the commercial incentives are deeply troubling. It's important to understand that it's not just the data that they benefit from, it's the links, the the, the structure, the way in which the system works is where the real money is to be made.

The data is just a means of moving towards the knowledge of the system upon which we are based. The third problem is, is well known. It's the issue of dependency. We've seen this all too often. Once you adopt a particular software approach, you are very heavily locked in. And so if you were to be involved, we would be locked in. It's not something simple to walk away, which to me makes it clear that we need to have an in house solution.

It's not beyond the capacity of an organisation the size of the NHS to develop its own software in-house, protecting national interests. Fourth, there are questions about the governance framework. A particular concern is that, as a foreign organisation does US surveillance law compel Palantir to disclose NHS data to American intelligence agencies? I think we need a clear and unambiguous. Position on that. And finally, there's an argument of principle. Health data is not a resource to be managed by whoever submits the most competitive tender.

It's generated in moments of profound vulnerability, illness, birth, death and mental crisis. The relationship between the patient and the health system rests on a compact of trust, and the

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involvement in Palantir severely breaking that trust. Well done.

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Well done. My Lords, was, of course, I welcome the Gracious Speech of the King. I would say the lack of some attention to the needs of this country is staggering. I could speak about HS2, which allegedly marked, according to Lord Davis, a Lord Adonis allegedly marked on his heart. I don't think it's true, but heart. I don't think it's true, but never go. I'm actually going to speak on welfare, which is not in the speech. It seems to me that welfare should be top of the list of concerns this government, but it appears it's been ignored.

It seems to me that pursuing voters welfare has been treated this way because of opposition from backbenchers who may be pursuing voters in their own constituency. This is deeply regrettable, and the backbenchers concerned should be invited to explain themselves to their constituents. The problem is that very important issues are being sacrificed because of some constituents complaining. For instance, the increase in getting rid of a two child benefit is frankly embarrassing when we acutely need the money spent on
19:41
Lord Robathan Portrait Lord Robathan (Conservative)
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defence, and another issue that has not been raised in the speech is that of defence. Yes, there's talk of defence. There's no real mention of defence. There's no real mention of it in the speech. I raise this issue endlessly with the last government. I have to say that government. I have to say that things have got appreciably worse since the general election two years ago. It's all very well talking about an armed forces bill, talking about an armed forces bill, but this does nothing to protect the state.

What we need is a defence investment programme that we are promised under noble Lord Robertson's excellent paper. And today I hear Wes Streeting was calling for it in the Commons. There's much more that I could raise that should have been in the Bill. For instance, there's no mention of the anti-Semitism, which is very frightening for Jewish people. These things may be embedded somewhere in other legislation, but frankly, they need to be expressed. In the speech, his Majesty raised his supportive position very well by visiting Golders Green, and we actually express more clearly the British people's resistance to anti-Semitism in the country.

I grew up on the edge of north west London, where probably 1 in 6 of the boys at school were Jewish. I can honestly say that there was no genuine antisemitism in my school, although we did resist resent the way they got extra holidays off their Jewish faith. If I can digress slightly, there was one young man who was sitting around discussing what their fathers done in the war, and this young man said, my grandmother, why an Iron Cross? He was Jewish, a Solomon.

And I think it's quite interesting. Nobody held it against him. Similarly, it's obvious there's a lot of talk of more regulation where actually we need less regulation in general, masses of regulation does nothing for this country, and it seems to me that we could be better served with less regulation and a greater respect for law and order. There are 37 bills in the speech. I understand that some of the bills will only increase bureaucratic time wasting structures on people's lives. We all talk of reducing the burden on civil servants, but here there are a few of the bills which may further the bureaucratic nightmare a European Partnership Bill, a Regulating for Growth Bill highways finance Bill is examples of yet more bureaucratic stuff to keep civil servants and the public busy, and the education for all bill is not going to improve the output of our schools.

Most people would say that the noble Lord Gove's educational reforms are actually working, and now they're being destroyed by the government. There will be more legislation and no actual new actual improvement. I could wax lyrical about giving 16 and 17 year olds the right to vote. As I recall, my daughter, aged 16, saying that she knew insufficient about government programs, as did her school friends. It seems to me that the Northern Ireland Bill looks to be needs to be looked at very closely.

I see some unionists have been opposed to any form of immunity, I understand that, but the truth is that only the nationalists and the IRA benefit from ongoing repercussions that were discussed 28 years ago. Having served in Northern Ireland, I can say that the British Army and the RUC behaved generally quite well, and that government must see that some current attitudes found the government are likely to lead to the IRA winning the war, which I do not believe the government would wish to see.

On that note, I will cease speaking. Just say that I think this is a missed opportunity with far too much detailed legislation, which will just add to the burden of this government and not improve the lives of the people

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that we serve. My Lords, health is wealth. The

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My Lords, health is wealth. The last parliamentary session saw laws enacted that protect some of the enacted that protect some of the most vulnerable in society and give them more opportunities to do well in life. Removing the two child in life. Removing the two child limit, abolishing no fault evictions, raising pay for the evictions, raising pay for the nearly 3 million workers on minimum wage. These may not seem like health measures, but at their heart they are. There is so much to commend in the government's agenda set out in the Gracious Speech.

Improving special educational needs provision, protecting and helping grow our social housing stock, and taking the necessary steps to improve our NHS. Stand out for me
19:45
Lord Babudu Portrait Lord Babudu (Labour)
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as areas which, done right, can make our country healthier and help make our country healthier and help our economy to grow faster. I will spend my limited time though, on what it feels as just beyond, yet within the reach of the government's agenda. As currently set out, I will focus on set out, I will focus on prioritising prevention. As mentioned by the noble Lady, Baroness Tyler of Enfield Baroness Tyler of Enfield Prevention, helping people stay in good health instead of treating them once they're out of it has to be the way forward and prevention is rightly at the heart of the government's ten year health plan.

But we've known for generations that prevention beats treatment, yet we've still got an NHS that's geared and tooled up to be a sickness service. NHS modernisation is, by all accounts, hard to do well and, as others have noted, often doesn't change what it's intended to. But one of the greatest opportunities we have with the government's proposed changes is to make much more prevention possible. Organisations like demos and the Health Foundation have made compelling cases for ring fencing, more preventative spending and adapting relevant accounting standards so that it can be properly appraised and reported against.

Whilst changes at the top of the health service are lamentable for several reasons, I think a great advantage of having a former Chief Secretary of the Treasury serving as the Secretary of State for Health and Social Care is. We can finally crack what is needed for the Treasury to enable preventative spending in departmental budgets in a similar way to how capital expenditures ring fenced. And by prevention, I do not mean spending more screening letters to people at greater risk of certain conditions. Important though, that is, I mean tackling our damaging food environments, poor air and often poor housing stock.

I mean supporting people to stay in work instead of allowing them to fall out of it due to preventable ill health. It may sound obvious once I say it, but where and how you live shapes your health. And too much of our population lives in places bombarded with junk food advertising on incomes that make healthier food unaffordable, breathing air that routinely breaches WHO air quality limits and in cramped, damp and mouldy homes that exacerbate various health conditions. And, crudely speaking, not too crudely, the poorer you are and the darker your skin, the more likely you are to be at the sharp end of most of these inequalities.

I won't run through all the numbers, but the government's own estimates are that food related illness caused by diet costs the UK £74 billion annually, including 11 billion to the NHS. The Royal College of Physicians estimates poor air quality in the UK is killing 30,000 people a year and costing the UK £50 billion a year. These are outrageous harms at outrageous costs and they are happening on our watch. If we can deliver on the ten year health plan, we can roll back some of these harms.

This is a packed legislative agenda. We will have to use our next parliamentary session to bring a Clean air bill, a race and disabilities bill and assuming its needed legislation to enforce mandatory reporting of the healthiness of food sales. But if we can use this session to crack the prevention puzzle, we will be well on our way. My Lords, before I close, I'd like to also speak briefly about putting people's voice at the heart of issues affecting them. The health Bill proposes major changes to how we ensure patients have a say in their health.

I know from my experience in south London that many local health watches have been doing really important work. I think in the proposed changes, we have a great opportunity to consolidate a fragmented system and strengthen accountability to patients. But I would counsel the government to ensure that patients views at the heart of shaping the changes, not just heard. Once patients start experiencing changes that may not work for them.

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My Lords, I'm delighted to follow the noble Lord Lord Babudu speech, and I apologise in advance because I'm going to be reiterating because I'm going to be reiterating some of his excellent points. We spend over £2 billion a year on the spend over £2 billion a year on the NHS, 40% of our day to day spending, and yet it never seems to be enough. As our population ages, as chronic illness increase as ever, more adults leave the workforce or never even enter it as a result of long even enter it as a result of long term sickness, spending pressure will rise further, and our capacity for funding that pressure will fall.

So the first point I wish to make to your Lordships is that improving the NHS, while necessary, is not sufficient. Even a superbly efficient healthcare service could be overwhelmed by an ever sicker society. So I was delighted to hear the noble Baroness, the Minister, emphasise the importance of prevention earlier when she opened this debate, and I'd urge the government to be bold. I agree that we need improvements in air quality. As noble as the noble Lady, Baroness Linforth reminded us inside and out.

To tackle respiratory and cardiovascular disease, we need restrictions on social media to protect young people's mental health, and we need a serious strategy to tackle alcohol harms. As the noble Lady Baroness Watkins set out earlier. In short, my Lords, we need a healthier population, not just a better NHS. The second point I wish to make is that, unfortunately, redrawing the boundaries of NHS bodies will not automatically give you a better NHS. I understand why the government wants to abolish NHS England and I accept the valid arguments for doing so.

But as the King's Fund has observed, and those of us in government for the 2012 restructure can attest, reorganisations take far longer than you think, end up costing far more than you anticipate, and leave you with a distracted and demoralised workforce. Change does not materialise because legislation transfers duties from one set of public servants in the NHS to another set of civil servants in the Department of Health and Social Care, change does not materialise because you replace joint local health and wellbeing strategies with new neighbourhood health plans.

Change materialises when Ministers and officials work collaboratively with clinicians and managers to deliver a coherent plan over a number of years. I welcome the increase in patient satisfaction with GP access that we've seen under this government, and I commend Ministers and officials for all the work they have done to deliver this. I'd also point out that some of these improvements began with the primary care recovery plan, published in 2023. I say that not to claim credit for the previous administration, but to point out that meaningful change really does require sustained focus over time.

So I hope that the Minister, the noble Lady, the Minister, will ensure that she doesn't get lost in the legislation and instead is able to keep sight of the operational improvements that the public really care about, including the very urgent tasks of making maternity services safe and fixing social care. In addition, I think there are two further elements we need to see if the government wants to meet its objective of NHS renewal first. A longer term capital strategy. The NHS has a capital budget of around £13 billion, yet we do not have a sufficient objective assessment of need.

There is no reliable mechanism for efficient allocation and there are too few incentives to ensure assets are used productively. That needs to be fixed. Second, a credible long term workforce plan. I was disappointed to see the 2023 workforce plan abandoned, but I look forward to seeing its successor. And like the government, I hope that AI will improve productivity, but I would not recommend hope as the basis for a workforce strategy, and I'd encourage the government to listen to the Health Foundation's advice and avoid both.

Overstating the time technology will save, and underestimating the staff and management capacity needed to implement it. My Lords, turning to the details of the health Bill itself, there'll be plenty of opportunities to debate this at length, but I do want to mention my concerns that despite the rhetoric of devolution, this bill in fact represents a significant centralisation of power within the department and a reduced role for local authorities. I'm also concerned about the impact of the abolition of of Hscb on patient safety, and I look forward to discussing all these details, all these issues, in more detail.

However, there is a major opportunity here, as many other noble Lords have mentioned, and I share the noble Baroness, the Minister's hope that the proposed single patient record, combined with wider technology reforms, could be truly transformative for this country. For years we have aspired to achieve a digital NHS and now the government has an opportunity to truly create one. But success will depend on public trust and clinical buy in. I hope that the government will learn from the failures of the last 14 years, and in particular GDPR and Care.data, as well as the recent cyber attacks that deliberately targeted very sensitive healthcare.

Data. Privacy and security must be built into this project from the start. There's much more to do to improve both public health and the NHS itself, but I hope we can make meaningful progress this session, and I look forward to working with other noble Lords and the noble Lady, the Baroness, the Minister

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across the House to do so. My Lords, it's a pleasure.

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To follow the noble Baroness Shawcross-Wolfson, and, my Lords, I welcome the gracious address and a number of its important measures contained therein. In particular, I support the NHS Modernisation Bill, support the NHS Modernisation Bill, the Northern Ireland Troubles Bill, which rightly seeks to place victims and survivors at the centre victims and survivors at the centre of this difficult, vexatious legacy, and the European Partnership Bill,
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Baroness Ritchie of Downpatrick Portrait Baroness Ritchie of Downpatrick (Labour)
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which offers the prospect of renewed economic cooperation and renewed economic cooperation and prosperity, and indeed. Personally, I continue to believe that closer alignment with the European Union alignment with the European Union is essential for our long term future. I also welcome the Social future. I also welcome the Social Housing Renewal Bill, access to secure affordable housing is not secure affordable housing is not simply an economic issue. It is fundamental to personal health, family stability and overall well-being. But I would like to concentrate, like many noble Lords right across the chamber on health itself.

And I welcome the government's commitment to rebuilding public services after years of strain and fragmentation, as was evidenced by the previous government, the NHS modernisation Bill. My Lords, presents a real opportunity to restore coherence to the system. Unlike the noble Lord, Dodds has already said, we already have that single chart in Northern Ireland for each of our patients. But the sad reality is it doesn't reflect GP services or your contact with the GP or primary care.

But at the heart of this NHS Modernisation Bill, the issue is simple people want timely access to care and treatment. They want shorter waiting lists, faster diagnoses and services that work seamlessly together. Previous reforms back in 2011 12 created unnecessary fragmentation, something we have seen clearly in areas such as childhood vaccination programs, which we are currently examining in the Specialist Committee on Childhood Vaccinations, and their complexity has undermined delivery, and that must be addressed.

I have

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been Contacted by. Like many noble Lords by a range of organisations including Parkinson's UK, the Royal Osteoporosis Society and groups representing those with chronic skin conditions, all highlighting skin conditions, all highlighting the same issues. Long waiting list, gaps in care and inconsistent access to treatment. And I do hope that the structural issues highlighted in the NHS Modernisation Bill can help to address those particular matters. Parkinson's UK, for example, has emphasised the importance of a fully integrated system.

The move towards a single patient record could transform care by ensuring that those with complex long term conditions receive coordinated treatment across multiple services. However, they rightly stress that essential NHS England functions must not be lost in transition. They also highlight the critical importance of clinical expertise, particularly in neurology. Given that 1 in 6 people in the US in the UK lives with a neurological condition. Expertise must remain, my Lords, at the heart of decision making.

So therefore, I would ask the noble Lord, the Minister, how will the government ensure the key clinical advisory roles are retained within the new system, and what assurances can be, given that the Time Critical Medicines programme will be delivered in full for patients with Parkinson's? Delays in medication are not just inconvenient, they can be life threatening, but also prevention must remain a priority. Fracture liaison services are a clear example of where early intervention can prevent further harm. These services identify patients after a first fracture, begin treatment and reduce the risk of reoccurrence.

When will the government publish a clear rollout plan to ensure universal access? By 2030, an issue that was raised in previous debates. My Lords, I am confident that this government is committed to rebuilding and strengthening our NHS. The direction is right, but obviously delivery will be the key. We must ensure that reform leads not only to structural change, but to real, tangible improvements in patients lives.

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I know there is much that is good in the measures in the King's speech, and certainly much that is well intentioned. But I am left with the uncomfortable feeling that overall, the contents of the speech overall, the contents of the speech do not. In a phrase often used by the noble Lord, Lord Hennessy, rise the noble Lord, Lord Hennessy, rise to the level of events. I have some sympathy with the situation in which the Prime Minister and the which the Prime Minister and the government find themselves.

Paradoxically, they are shackled by
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Lord Butler of Brockwell Portrait Lord Butler of Brockwell (Crossbench)
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their overwhelming victory in the last general election. The result is that the huge majority in the is that the huge majority in the House of Commons contains a large number of backbenchers who have no number of backbenchers who have no prospect of ministerial office, and who are alarmed by the prospect of tough measures which will harm tough measures which will harm their popularity in their constituencies and damage their constituencies and damage their prospects of re-election. So effectively, the government's back benchers become part of the opposition to the hard decisions which the government needs to take to achieve its objectives.

A section of the Gracious Speech which I warmly welcome is the passage heralding proposals to strengthen the delivery, accountability, innovation and productivity of the civil service and to safeguard its impartiality and core values. My Lords, I have never concealed my view that measures are always needed to bring the Civil Service up to the mark. Civil servants operate with other people's money and lack the profit incentive which exists in the private sector. On the other hand, I believe that we are fortunate in having in this country a deep rooted tradition of public service, and that our civil servants do their best to achieve the government's objectives.

If they are effectively led in the recently appointed head of the Civil service, Dame Antonia Romeo, I believe that we have someone who is capable of giving that leadership. I particularly welcome the inclusion of the word impartiality. It's sometimes forgotten that, like the judiciary and the armed forces, the civil service is an independent service of the Crown and not the possession of any single set of politicians. If a Minister loses confidence in a civil servant, he or she is entitled to take action.

But it should be dealt with by the head of the civil service and not through summary dismissal by a politician without due process. My Lords, I expressed at the outset of my speech my regret that the contents of the Gracious Speech do not rise, in my view, to the level of events. I fear that the same can be said of our political discourse generally. The government's present disarray is easy meat for opposition parties and the media.

But this is not a game. The dangers which the country faces both nationally and internationally seem to me very serious. This year we are 50 years on from the 1976 IMF crisis. The circumstances then were in some ways similar then as now. We had suffered an oil price shock, although with different origins. In some circumstances, in some respects, the circumstances in 1976 were worse, with both inflation and unemployment rising simultaneously. A balance of payments in deficit and our reserves perilously low.

Today, our level of national debt is unprecedentedly high, and the cost of government borrowing is at an uncomfortable level. The experience of the Truss government shows what happens if the markets lose confidence. My Lords, we should remember Prime Minister Callaghan's speech to the 1976 Labour Party conference when he said, I tell you in all candour that the opposition that the option of spending our way out of a recession no longer exists. Today is a moment for the same realism and courage.

Our country urgently needs political leaders, both government and opposition. Similarly, to get serious and rise to the level of events.
20:05
Baroness Young of Old Scone Portrait Baroness Young of Old Scone (Non-affiliated)
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In other words. It was a great privilege to follow the speech that privilege to follow the speech that we've just heard. I hope we will all ponder on it. I'm going to be a bit more frivolous about about this contribution. When I saw the notice of the King's Speech debate of the King's Speech debate arrangements come out, I kind of felt a bit like Cinderella with everybody going to the ball except me. And it wasn't only me who noticed the fact that there was no slot for DEFRA or the environment given for responding to this King's speech.

There were external commentators who also remarked upon it, as well as several people with from within the House. And though there were opportunities to talk about energy, there was no opportunity to talk about the deaf issues, including the clean water bill and the important environmental issues arising from the Regulating for Growth Bill, as well as other general environmental implications of the overall programme of legislation. And above all, there was no chance to ask DEFRA Ministers questions. So I asked the library and they came back and said that I was correct in my recollection.

I've been in this House for 29 years, and they confirmed that in the last 30 years, I didn't ask them to go back any further. That there had been a an allocation of a day to DEFRA or its previous incarnations in every Queen's Speech or King's Speech debate in the last 30 years. So I'm concerned, perhaps the Minister could account for the decision to drop Defra and the environment, though he may quite rightly say, is outside his departmental responsibilities, which is precisely the point I'm making.

I'm concerned, in case the emission signals a diminution in government's mind of the importance of the environment, especially since recent National Trust polling has shown that nature is a major source of pride for the public, second only to the NHS. And despite the pressures of life, 83% of the public say that restoring nature is as important or top priority to them personally when polled. The public also said that weakening nature protections are as unpopular as cuts to the winter fuel allowance were.

So I look forward to the Minister's explanation as to why there was no DEFRA day. But Cinderella will go to the ball. I can talk about housing and I want to make two. Please. First of all, alongside the commitment to more social homes, can we make sure that we enable smaller sized renewable energy generators, especially community ones embedded in their communities and their development, to sell their power to local homes and indeed, to businesses? It's been encouraging that DESNZ Ministers have expressed positive intentions on this.

Investors and community organisations on the ground are eagerly awaiting to see new rules being put in place. So can the Minister say whether we will see this as part of the Energy Independence Bill? My second plea and I declare an interest as chair of the Forestry Commission, is that I welcome the Social Housing Renewable Renewal Bill and particularly the commitment to build more, more social homes. But it's not only an opportunity to ensure that more people can live in decent, safe, secure and affordable homes.

But along with the overall target of building 1.5 million homes, offers further opportunities for public benefit. We look at how these houses will be built. Some statistics, for example, the construction sector is currently responsible for 39% of global emissions. Houses built using timber reduce reliance on high carbon concrete and steel. Wood has absorbed CO2 as it grew and then locks it up for the duration if used in buildings. We have a magnificent example on the premises in the hammer vaulted timber roof of Westminster Hall, whose 660 tonnes of wood has sequestered for 625 years, a CO2 equivalent to the average annual emissions of 300 internal combustion engine cars.

So that's just one example of the great amounts of wood in this Palace of Westminster. Wood, of course, is also a natural insulator, reducing energy needs. And we've got an example from over the border, because in Scotland, 92% of all houses are timber framed. In England, that's only 9%. So we do need to copy the success of the Scots. Not a sentiment I often describe. In addition, 40% of UK woodlands are currently under-managed and increasing properly certified timber in construction creates a direct economic incentive to bring more woodland into active, sustainable management with benefits to biodiversity, productivity, employment and long term carbon sequestration.

So can I ask in conclusion, the Minister, what plans there are to use the push for increased social housing to also drive implementation of the government's timber and construction roadmap, which was published in 2025? And will he join with me in commending the Department of Education, who are actively pursuing engineered timber module solutions for the next generations of schools? And could I ask the NHS to also follow suit?
20:10
Lord Black of Brentwood Portrait Lord Black of Brentwood (Conservative)
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My Lord, I welcome the emphasis in the Gracious Speech on renewing public services, modernising NHS and supporting long term economic security. They are the right ambitions, but they will only matter to patients if they matter to patients if they translate into practical reforms to prevent ill health, reduce pressure on hospitals and help other people. on hospitals and help other people. Help people stay independent. The noble Lady, the Minister, will not be surprised that I'm going to concentrate today on one such issue fracture liaison services, as did the noble Lady, Lady Donaghy, with whose excellent speech I completely agree.

My Lords, these bone clinics identify people with osteoporosis after a first fracture, ensure they are assessed and treated, and help prevent the subsequent devastating fractures that would otherwise follow. That matters because osteoporosis is one of the most urgent threats to our ageing population, causing half of women over 50 and one fifth of men to suffer fractures. The end result of untreated osteoporosis is a broken hip, which kills a quarter of sufferers within a year, and a huge burden on the NHS, as around 7% of NHS beds are occupied by people with fragility fractures.

My Lords, there is also a stark inequality dimension because people from deprived areas have a 25% higher risk of fractures. Safe, effective medication costing just around £1 a week, exists to stop this and to save lives. But today, FLS are missing in half of NHS trusts and that position has not shifted since the general election in 2020. For the new government pledged to roll out FLS to every area of England by 2030, and I applauded them for that, the then Secretary of State, Wes Streeting, said the roll out plan would be one of his first acts in government.

But my Lords, we are still waiting. As a result, over those two years, 4000 people. 4000 people have died needlessly following hip fractures that are prompt. Rollout of FLS would have prevented Ministers, including the noble Lady Baroness Merron, who is hugely supportive of this cause and I am very grateful for that, have reiterated their pledge. No fewer than 63 times in Parliament and the media. As the noble Lady, Lady Donaghy said, yet still no progress. The government's recent investment in replacing 14 bone density scanners is absolutely welcome.

Bravo. But a scan is just a scan. It does not start patients on medication or help patients adhere to their treatment through regular review. The vital elements of the FLS model that reduce fracture rates by 40%. My Lords, this isn't a partisan issue. Every political party backs the rollout, but as we've heard, there are no implementation plans, dedicated resources or milestones. Many organisations and advocate for FLS fear the commitment exists on paper but won't be delivered in practice. And if that's accurate, the cost.

My Lord, my Lords are grave. Over 2000 people die each year following hip fractures that FLS prevent. Since the election, the NHS has already spent an estimated 150 million treating fractures. FLS could have prevented double the cost of FLS rollout. On any credible path to implementation, we would have expected 24 of the 60 NHS trusts missing FLS to be covered by now. Today that number stands at zero. Worse, the lack of a national plan is impeding local areas from pushing on with their own FLS whilst awaiting central direction.

My Lords, we are now at a moment of truth. The Society of Radiographers warns rollout must begin by summer 2026 if the government is to have any chance of meeting the goal. It's now an urgent implementation challenge, not a distant timeline. A commitment without a delivery plan is not good enough. If Ministers truly intend a nationwide rollout for these services by 2030, surely there can be no objection to publishing a timetable for delivery? Could the government be frank with the House? Does the Department of Health, in view of all the evidence it has before it, believe the 2030 deadline remains one deliverable and two feasible without dedicated funding? Ministers have rightly championed a shift from sickness to prevention.

Osteoporosis is a clear test of whether that ambition translates into practice because, my Lords, if we cannot act here, is difficult to see where we will act. My Lords, the new Secretary of State, the noble Ladies colleague, has the rarest of opportunities an easy win in a very difficult brief that will save lives, save money and tackle stark health inequalities. What? As I say, my Lords, is not to like. The policy is agreed. The model is proven. The sector is ready and raring to go.

What we need now is not another promise, but action, a timetable, resources and the start of delivery. I hope we might get that commitment this evening.
20:16
Lord Truscott Portrait Lord Truscott (Non-affiliated)
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My Lords, I very much welcome the reference to housing in the Gracious Speech, particularly the Gracious Speech, particularly the commitment to long term investment in social housing and to reform the leasehold system, including the leasehold system, including the capping of ground rents. I declare an interest as a landlord, leaseholder, former renter and co-chair of the all party Group on Leasehold and Commonhold reform. Labour's manifesto pledged to end the injustice of leasehold and in the 2024 King's Speech, His Majesty's Government said it would take steps to bring the feudal loophole system to an end.

HMG has my full support in that the noble Lord Lord Gove, guided through the Leasehold and Freehold Reform Act in the dying days of the last government. He is to be. He is to be commended for his tenacity. Hmgs Commonhold leasehold Bill aims to make Commonhold the default tenure a long overdue reform. It will improve the current system for the 5 million existing leasehold properties, bolstering fundamental rights including enfranchisement and the right to manage capping ground rents at £250 and other measures.

Alongside that, the Social Housing Bill, aiming to boost the supply of social housing, protect existing stock and strengthen protections for tenants and reduce bureaucracy so providers can build more homes, is also extremely welcome. The last 47 years have been a disaster for social and particularly council housing, stimulated by the Right to Buy scheme, which, while hugely popular, sowed the seeds of today's housing crisis. The housing market for potential home owners and renters has never been worse in my lifetime. The calculation is a simple one.

There is not enough affordable housing to buy or rent. Thus, while HMG housing efforts are to be applauded, it is necessary to have a reality check. Almost two years into this government, very important aspects of the Leasehold Reform Act 2024 have still not been implemented. The act was meant to make it cheaper and easier for existing leaseholders in houses and flats to extend their lease or buy their freehold. There has been a commitment to abolish marriage value, but to date, my Lords, we have witnessed interminable consultations and legal challenges.

To an extent, I have sympathy with the government. The modern way of governing seems designed to foster delay and challenge, to the point that it's very difficult to get anything much done. Consultations on every conceivable subject and the fear of judicial review stymies the will of Parliament at every turn. Just ask the Tories over their ill fated Rwanda policy. This must change by laws if government is to make progress with its programme. I think back to the Labour government of 1945 to 51.

Those reforms at that pace would be impossible today. And of course, there is much to do in the housing field alone. We still await a register for short lets to cover the hollowing out of long term rental properties in our towns and cities by platforms like Airbnb. Although a register is not a substitute for proper regulation. We need proper regulation of property management companies, as we heard from the noble Lord Lord Best earlier, which are currently unregulated despite often managing millions of pounds.

Some of these companies are appallingly managed, totally unqualified and rip off their clients. Hmg's proposed plan to build 1.5 million more homes than invest £39 billion over ten years in social housing is to be admired, but there are serious doubts that it can be done. As things stand, the 1.5 million target is already slipping and housing delivery is falling. Our population has increased by 12 million people since the mid 1990s. Housing supply is not keeping pace with demand and this is the real problem.

Not avaricious landlords facing escalating costs. The private rented sector has shrunk by 250,000 in 12 months. Where are the 1 million additional private rental homes required by 2030, according to Savills? Where are they going to come from? HMG needs to incentivise councils, housing associations and developers to build private and social housing on brownfield sites and encourage the PRS to grow, not shrink. For that to happen, the economy needs to flourish. The Bank of England and HMG should listen to what the IMF said this week.

Instead of pandering to the banks to increase their profit margins, the BOE does need to hike, does not need to hike interest rates, and may even need to cut them. Finally, yes, the country wants change, but it wants good change. Not bad change. What everyone really wants to see is improvement in their lives. That is the job of this government.
20:20
Baroness Wilcox of Newport Portrait Baroness Wilcox of Newport (Labour)
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My Lords. I'm grateful for. opportunity to reflect upon its implications for transport across our United Kingdom. I also pay tribute to the House of Lords Library for its excellent preparatory work. Transport is not just about infrastructure, it's about opportunity, connectivity and fairness. It determines whether people can access work, education, health care and community life. And nowhere is that more important than in my homeland of Wales. The King's Speech sets out an ambitious programme of change.

The task is now for this ambition to translate into communities across the United Kingdom, because for the public, what matters is simple not what is promised, but what actually improves their daily journey. Let me begin with the proposed Railways Bill and the creation of Great British Railways. The intention to simplify a fragmented system is welcome, and the case for change is clear. But success will not be judged by structure, but by outcomes. Passengers in my native South Wales will rightly ask, Will services be more reliable? Will journeys be quicker? Will connections improve? Change must be measured in punctual trains, better connections and shorter journey times, not in organisational charts.

And it is vital that these changes work for every part of the United Kingdom. It means genuine partnership with the nations and regions, ensuring investment is fairly balanced, which hasn't always happened in the past. If it's truly a national railway, it must deliver for every nation, not just some parts. On road safety, the government's proposals have the potential to make a real difference. And measures that save lives must always be supported. As we've seen in the 20 mile per hour rail rollout in in Wales.

However, we must recognise the realities faced in many communities because in rural Wales, driving is not optional. It's essential. Change must therefore be proportionate. Protecting safety while maintaining independence, particularly for older people in our communities. I welcome the government's intention to address micromobility in cities such as Newport and Cardiff. E-scooters and similar devices are already well in use. So clear and balanced regulation is needed to support sustainable transport while maintaining public safety. Similarly, modernising the law on powered mobility devices is both necessary and timely.

For many people, these are important and vital to maintaining independence. My Lords, what links all of these issues is the need for integration. Transport policy must work as a system and not in silos. In Wales it means better coordination between rail and bus services so that there are seamless journeys. It means recognise the importance of cross-border travel, particularly between South Wales and the west of England. More people move between Cardiff, Newport and Bristol every day than between Liverpool and Manchester.

Connectivity, therefore, doesn't stop at borders and nor should transport policy. The real test is not whether we change the system, but whether we improve the services. And this house has an important role in ensuring that ambition is matched by accountability through careful scrutiny. We can help to ensure these proposals achieve their full potential. Above all, we must keep our focus on the people who rely on these systems every day the commuter, the business owner, the rural resident. For them, transport is not abstract.

It's essential. My Lords, I look forward to working constructively with colleagues to support our government's reforms and to ensure that they deliver real and lasting improvements across Wales and across the United Kingdom. Good morning. Can you hear, my Lords, recently? Excuse me. Recently, my work has focussed on two aspects of prevention of ill health and health inequalities. In 2024, I chaired a
20:25
Baroness Walmsley Portrait Baroness Walmsley (Liberal Democrat)
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one year special inquiry into food, diet and obesity, and this year I'm chairing one into childhood chairing one into childhood vaccination rates in England. Apart from clean water, these are two of the most effective measures for preventing ill health. Both are in line with the government's ten year line with the government's ten year plan and its determination to raise the healthiest generation of children ever. However, there was children ever. However, there was little in the Gracious Speech about implementing these commitments.

However, many of the things we need to do will require secondary legislation rather than primary legislation. So I'm looking forward to scrutinising a lot of regulations in the coming year on food policy. Things are moving too slowly. Mandatory reporting of healthy food standards promised last year is still awaiting publication of consultation. The ban on less healthy foods being advertised before the 9 p.m. TV watershed and online, is having limited effect because of the watering down of the rules to allow brand advertising.

This loophole is currently being imaginatively explored by the food industry. The new nutrient profiling model will require secondary legislation to detail how it will be applied. Consultation is underway on this to. We still await the technical consultation on Strengthening the Soft Drinks Industry Levy, the sugar tax, the ten year plan promised to ban on the sale of high caffeine energy drinks to under 16 year olds. However, progress on this has stalled, although it was announced in the previous.

King's Speech and consultation was published in 2025. I welcome the government's proposals on the review of the School Food Standard and consultation has been launched, but I look forward to seeing the proposed changes to the requirements for School Food Regulations 2014 as soon as possible this year. Meanwhile, on our high streets, action for salt and sugar has found massive unnecessary amounts of salt in popular popular sandwiches. In one sandwich alone, more than an adult's daily limit. This is only one example of the unhealthy food which dominates our food system.

All of these matters on all of these matters, the government needs to be bolder. My committee recognised that the food industry makes a lot of profit, some of which it spends on lobbying government, and we recommended that policy on food should always be made independently in the interests of public health, followed by consultation with industry about how to implement the government's policy. This has not been happening under the previous government. Good food policies were significantly watered down and delayed by up to four years.

I would urge the government not to do a deal with supermarkets by delaying healthy food regulations in exchange for capping food prices, as is rumoured. It would be against public health and damage the NHS and be very short sighted. So can the Minister confirm whether the rumour is true? Yes or no? I turn now to the single patient record. Health data is currently a shambles, with numerous different systems that can't talk to each other. This brings risk to patients and barriers to planning.

There are undoubtedly issues about privacy, security and ownership of the data, which will be debated when we discuss the bill. My current committee has heard in public oral evidence that there are serious issues about vaccination data. Although most childhood vaccinations are delivered and recorded within GP practices, some take place elsewhere. This information is often not brought together into a single record. Some people may not be registered with a GP, or there can be difficulties in transferring information from one GP to another.

This information is vitally important for the care of that child and for national data and commissioning planning responsibility for commissioning vaccination services is now to be given to large footprint, cash strapped ICB clusters. But where will responsibility and accountability lie nationally? The challenge will arise as to how outreach to under-vaccinated local communities with different characteristics can be designed and managed. Far away, in the headquarters of a large ICB and whether it will be funded sustainably.

However, there may also be a benefit as the Icbs may be able to smooth the transition of information across the life course from maternal vaccination to early years and the secondary school age programme, and onwards to the adult

**** Possible New Speaker ****

offer. We shall see. It's with great pleasure. I follow the noble Lady Baroness follow the noble Lady Baroness Walmsley. I, I want to offer something of importance, which I something of importance, which I believe is true in all women. A newborn child around has around 1 newborn child around has around 1 million eggs at birth in her ovaries, but by puberty, most of those microscopic eggs have already those microscopic eggs have already disappeared, often leaving some 300,000. According to our laboratory calculations.

This loss continues in all women throughout childbearing life, and by the age of 45, few viable eggs are left in the ovaries, and the chance of getting pregnant spontaneously, then, is less than 2% per month. No medical treatment prevents this loss of eggs, so egg freezing is increasingly used to preserve female fertility. Frozen eggs are
20:31
Lord Winston Portrait Lord Winston (Labour)
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stored in liquid nitrogen, but unlike freezing embryos, which is highly successful, egg freezing is highly successful, egg freezing is much more difficult for technical and scientific reasons. I haven't time to explain. Egg freezing is a time to explain. Egg freezing is a massive industry, mostly in private clinics. Many women are being encouraged to freeze their eggs to encouraged to freeze their eggs to have much chance of success. Eggs have much chance of success. Eggs must be collected and frozen to have in early reproductive life before a woman is 30 or at the latest, 35.

Information over the last 15 years or so from the Human Fertilisation and Embryology Authority shows reports all these data to Parliament in some form or another. IVF is used to use frozen eggs to become babies, so therefore this is relevant to the Hfea work. About eight years ago. The authority claimed that the chance of a woman getting pregnant with her frozen eggs was around 13%. Sadly, this estimate was grossly inaccurate because their report only counted the transfer of embryos derived from frozen eggs to the uterus.

But there are many steps in egg freezing before embryos are created. Freezing itself has a failure rate, as we'll see in a second, as do many early stages, which are not being recorded. To get enough eggs from the ovary, they must be reasonably mature eggs. They have to be produced by using fertility drugs, which gives increasing doses not without some risks. However, some eggs don't freeze well and and do not mature properly. At least 20% that are frozen certainly do not thaw normally.

Already, there's an increase of damage from the thawing and they are. Then when they have gone through this process, they are then exposed. If they are normal to sperm, but they may not fertilise if fertilised. Many do not develop into embryos. And finally, of course, others may have chromosomal abnormalities which cause aneuploidy, and some of these may in fact result in other cellular abnormalities, which prevent the chance of being a normal embryo. The Hpa's latest figures from the last ten years record about a quarter of a million eggs currently in store, 263,692 eggs have been frozen and stored so far.

A roughly some 34,000 eggs have been used for the treatment of women in the recent five years. 2010 years around these 34 eggs. They were then used for IVF and 2949 embryos were then formed and transferred. Therefore, that gave a pregnancy rate of 609 women getting pregnant, around a 20% success rate. But there are at least 93 miscarriages, 15% of the pregnancies. So after thawing 34,000 eggs, the real success rate of egg freezing, my Lords, is a pregnancy rate of around 1.7% only, and this, of course, has not been told to the women.

There's not fully reported in the actual numbers of live births. We don't know precisely the state of these embryos. We don't have follow up. We don't have information about any serious side effects from the actual treatment which may occur. And recently, the Hfea say they no longer keep such needed statistics, and it might take up to 18 months for the the Minister to get information. My Lords, egg freezing means a great profit for private clinics. Patients usually pays around £5,000 for treatment, sometimes more for each treatment, sometimes over £10,000.

Some clinics have boasted to me, and I've had this on record, that they get better than a 60% pregnancy rate. After egg freezing, more than achieved by sex in a comfortable bed. I hope the noble Lady, my friend, my noble friend, the lady, the Minister will write to me about these deeply distressing statistics. They are currently largely hidden from women, who are frequently told by clinics that they should take an effective insurance plan to improve their chances of for for their future well-being and for their happiness.

This is not good information by

**** Possible New Speaker ****

Lords. Pleasure to follow the noble Lord Winston. My Lord. London's housing crisis is no longer a warning sign. It is a full blown warning sign. It is a full blown social failure. And the truth is the government and the Mayor of London both are failing the people London both are failing the people of this city. So while politicians issue press releases and make grand announcements, ordinary Londoners announcements, ordinary Londoners are being priced out, pushed out and left behind. One in every 50
20:36
Lord Bailey of Paddington Portrait Lord Bailey of Paddington (Conservative)
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Londoners is homeless or living in temporary accommodation. Over 100 000 children are growing up without 000 children are growing up without a stable home. I want you to think about that for a minute. At least one child in every London classroom is homeless. This is not merely disappointing, it is morally disappointing, it is morally unacceptable. And while this crisis deepens, London boroughs are deepens, London boroughs are struggling with a £5.5 million bill every single day spent on managing temporary accommodation money that is spent on managing a problem, not solving a problem.

My Lords, the single biggest failure in London housing today is simple enough homes are not being built. The government says London should deliver 88,000 homes per annum, but last year London only delivered 32,000 homes. Not even close. Even the mayor of London's own lower target of 52,000 homes, was missed by a wide margin. This is not a small shortfall. This is systematic failure and Londoners are paying the price. Rents are exploding, families are overcrowded, young people cannot buy, and working people are forced to live and work further and further away from the communities in which they grew up.

At the same time, private private rental lettings are down nearly 40% over a five year period. Average rent average rents are now £2,280 per month. The average house price per month. The average house price in London is £542,000. The mayor of London endlessly talks about housing targets, but housing targets do not. Home families houses do, and Londoners can now clearly see the gap between rhetoric and delivery. But I want to move on to short term lets. Another glaring omission from the King's Speech is proper action on short term lets action across London, entitled.

Across London, entire neighbourhoods have been hollowed out. Residents are regularly dealing with noise, anti-social behaviour, waste, transient occupancy and in some cases, criminal activity. Meanwhile, permanent housing stock is disappearing from London's local communities. Councils need real powers, not token gestures. Mandatory registration, real time platform data sharing, punitive fines for rogue operators and proper enforcement funding. That is why, my Lords, I've introduced a private member's bill coming before this House on the 18th of June because communities deserve protection too.

And if this government will not act decisively, Parliament should push them to do so. I want to move on to stamp duty. My Lords, Britain's housing market is jammed shut and stamp duty is one of the reasons for this. It punishes aspiration. It traps older people in homes too large for them. It prevents growing families from moving, and it blocks younger people from taking their first step on the housing ladder. That is why Kemi Badenoch, leader of opposition, was right to propose the abolishment of stamp duty on family homes.

Research shows that up to 2 million people would consider downsizing if stamp duty was removed. If only half of them did this, that would be over 1 million additional homes that would come back onto the market. That is how the government can get movement. Again, not slogans, not headlines, not fantasy targets, actual movement, actual homes, actual opportunities and wider economic boost to local economies could be up to £1.2 billion for local tradesmen and local professionals. So in conclusion, my Lords Londoners are tired of excuses.

They are tired of hearing promises without delivery targets, without targets, without homes and announcements without action. This crisis is destroying aspiration and social mobility. In our capital city. Young people cannot buy, families cannot move. Councils are overwhelmed and children are growing up in, in up in homelessness, in one of the richest cities in the world. That should be a disgrace to all levels of government. We need radical housebuilding, functional rental markets and policies that reward work and aspiration.

Because housing is not a luxury, it is the foundation on which stable lives are built.
20:41
Baroness Nargund Portrait Baroness Nargund (Labour)
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Pleasure to follow the noble Lord Lord Bailey. I thank my noble friend the Minister, for her friend the Minister, for her excellent introductory speech earlier. I have spent nearly 40 years working in the National years working in the National Health Service. I have seen it at its best compassionate, innovative, its best compassionate, innovative, life saving and I have seen it. When the system fails, when patients fall through gaps that should never exist. That's why I welcome the NHS Modernisation Bill, part of a wider national mission to move health care from hospital to community, from analogue to digital, from treatment to prevention.

I welcome the provision to give flexibility to integrated care boards for addressing local needs. It has the real potential to address the deep health inequalities that scar our society. But we must ensure we must ensure that there is going to be no creation of postcode lottery. I also welcome the abolition of NHS England and reducing bureaucracies. At the heart of the Bill is what I believe is the most transformative proposal. The single patient record. First, we should remember care is not simply an outcome on a spreadsheet.

It is whether patients feel seen, heard, unsafe NHS trusts use multiple electronic record systems that often cannot communicate to one another. Millions of patients are treated every year without clinicians having access to their full medical history. That is not just an outdated infrastructure, but it is a risk of harm. As a doctor, I can tell you this happens too often and unequally. The most vulnerable in our society, those with mental health conditions, those with disabilities, those without any family at their bedside are most likely to fall through the gaps.

The single patient record offers the opportunity to change that. Fundamentally it is. It can fundamentally change patient experience, improve clinical outcomes, operational efficiency, and also financial performance. Commons it can narrow the gap between those whose histories are known and those whose are not known. It is, at its core, a tool for equity. Above all, it means patients are no longer carrying the burden of stitching together their own care. I particularly welcome the decision to begin its implementation through maternity care.

Too many maternity complaints involve failures in communication between services. The consequences can be fatal, and having one report described a pregnant woman with bipolar disorder and a history of postpartum psychosis whose psychiatric history was not properly communicated between services. She did not receive the specialist care she needed and died by suicide during pregnancy. That was a preventable systems failure, and the single patient record has the ability to prevent such tragedies. My Lords, we must also ensure that significant treatments, both NHS funded and non NHS funded, taking place in the independent sector, such as IVF and assisted conception, should also be in the single patient record.

It is essential to ensure continuity of care, to protect patient safety and to build a clearer national understanding of complications and long term outcomes of fertility treatment. We must not miss this opportunity. In this context, I declare that I am a board member of the Human Fertilisation and Embryology Authority. Can I ask my noble friend, the Minister, for her support in making this happen? My Lords, the single patient record will save lives in time. It will also save money by reducing complications, complaints and medical legal costs.

Other countries have already shown what is possible. In Denmark, linked health data has strengthened clinical care while driving world leading research used responsibly with the publics and Healthcare Professionals Trust. This could position our country as a global leader in life sciences. My Lords, if implemented well, this bill has the potential not simply to modernise our NHS but to humanise it, to create a system in which patients are truly known, not as isolated episodes of care, but as whole people, a system that reflects the founding principles of our NHS that every person matters equally and deserves care that is joined up, dignified and humane.

I very much look forward to contributing to the bill when it arrives in your Lordships' House.
20:47
Lord Kakkar Portrait Lord Kakkar (Crossbench)
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It's a great pleasure to follow the noble Lady Baroness Nargund, the noble Lady Baroness Nargund, and in so doing, echo her remarks about the remarkable and customarily imaginative and enthusiastic way in which the noble Lady, Baroness Baron, has introduced Merryn, has introduced this debate. In so doing I declare my own interests as chairman of King's Health Partners and of the King's Fund, and it will be, of course, the NHS modernisation Bill that I will contribute the majority of my remarks.

But before so doing, I would like to touch on one other bill that has appeared in the Gracious Speech. That is the peerage removal Bill, and here I declare my interest as chairman of your Lordships Conduct Committee and as a former chairman of the House of Lords Appointments Commission. My Lords, this is an important Bill because it touches upon many important constitutional principles. It's designed to address an issue, as stated in the Gracious Speech, with regard to a question of the standing and reputation of your Lordships House.

But in so doing, there will need to be very careful consideration of how any statutory provisions touch upon the procedures and processes agreed by your Lordships House with regard to the question of conduct, whether, indeed, any such provisions will extend your Lordships provisions for assessment of Conduct to extend beyond conduct related to parliamentary activity and to conduct outside your Lordships House, and indeed, your Lordships will need to understand in some more detail the mechanisms by which it's proposed that, if enacted, the Bill will function.

Will it function as a function of your Lordships House, i.e. a question of resolution by the House, or will it function through the creation of an additional body outside what would be normally considered the processes of a self-regulating chamber? In addition, my Lords, it's going to be very important to understand what other opportunities might be reflected in terms of the passage of such a measure, in particular, whether provisions of an advisory House of Lords Appointments Commission ultimately put on a statutory basis so that all nominations, be they political or to the independent crossbenches, are subjected to the same evaluation in terms of individual propriety and suitability.

And these are important questions. No doubt that your Lordships will be able to consider when the law. When the Bill comes for consideration in your Lordships' House. I'd now like to turn to the question of the NHS modernisation Bill, and as the noble Lady stated, His Majesty's Government began their term in office by undertaking a very detailed and forensic examination of the condition of the NHS and identified it to be in a state of some crisis. It's therefore important that any measure of such substance as the measures in this proposed Bill are judged against not only the standard of addressing that particular crisis urgently, because I think all noble Lords would agree that time is now running out and that we do need to take serious long term decisions to achieve what was first described with such eloquence and clarity in the report, led by my noble friend the noble Lord Patel, a special select committee that reported in 2017 on the long term sustainability of the health and care system in our country, and that report made a number of recommendations.

I shan't rehearse all of them with your Lordships this afternoon. This evening. But there are two important ones there that, regrettably, don't appear to have been addressed in the measures that are proposed in the NHS modernisation Bill. The first was the need to bring together health and social care into a properly coordinated system, which ensured that the ultimate sustainability of our health care system was secured. And as we have heard earlier in this debate on the Humble Address so far, it's not been able it's not been easy to identify how the measures in this bill are going to achieve that particular objective.

The second is to secure an appropriate investment not only in innovation, innovation and technology, but in the development of the workforce to ensure that that innovation and technology can be adopted at scale and pace across the NHS to achieve the objectives that we all recognise are vitally important. Through those measures to secure sustainability for the NHS. And one last point the measures here do centralise once again an awful lot of power on the basis of a need for accountability in the hands of the Secretary of State for health and the Department of Health and Social Care.

It's proposed thereafter to transfer some of those powers back to Icbs that will become strategic commissioners of health care at a local level. The understanding of those mechanisms, and indeed the willingness and determination of the Department of Health and Social Care not to use those powers to control, but rather to facilitate, will be an important measure that will need to be understood fully.

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bill. Well. Thank you. Well done. My Lords.

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My Lords. It's a pleasure to follow Lord Kakkar the health measures outlined in the Gracious Speech raise profound questions about the future profound questions about the future direction of the National Health Service. Much of the focus of the proposed NHS modernisation Bill appears to centre on the abolition of NHS England and the transfer of
20:53
Baroness Bray of Coln Portrait Baroness Bray of Coln (Conservative)
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its powers directly to the Department of Health and Social Care, and ultimately to the Care, and ultimately to the Secretary of State. This is being presented as a move to simplify decision making and improve accountability. Ministers argue that if the public are dissatisfied with the performance of the NHS, with the performance of the NHS, there should be no ambiguity about who is responsible. In theory, a more direct chain of command could reduce duplication and speed up reform, but there are serious concerns that cannot be ignored.

NHS England is not simply another layer of bureaucracy. It was created to provide a degree of operational independence from day to day political control and, importantly, to help ensure that the voice of patients remains central to how services were designed and delivered. There is also concern about the future of local Healthwatch organisations, which play an important role in representing patients and communities at a local level. If these bodies are weakened or removed, along with the NHS England, as is proposed in the Bill, there is real risk that local accountability and patient representation will be diminished even further.

Removing these structures risks concentrating too much power in the hands of Ministers, while weakening independent advocacy for patients. At a

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Time when waiting lists remain high, staff morale is under strain and many patients struggle to and many patients struggle to access timely care. This reorganisation feels disconnected reorganisation feels disconnected from the real pressures facing the NHS. Structural reform in itself NHS. Structural reform in itself does not shorten ambulance delays, increase GP appointments, recruit more nurses or improve social care more nurses or improve social care provision. There is a danger that yet another major reorganisation consumes time, money and energy that should instead be directed towards improving frontline services.

The NHS has already undergone repeated restructurings over the past two decades. Each one has promised efficiency and better outcomes, yet the core challenges remain remarkably similar workforce shortages, uneven access to care, rising demand and chronic underinvestment in prevention and community services. Many people will therefore ask whether abolishing one organisation and transferring powers elsewhere is truly reform or simply rearrangement. There is, however, one potentially positive proposal within these plans, which has been mentioned widely this evening.

The ambition to create a single patient record across the NHS. If implemented properly, this could make a real difference. Too often patients must repeat the same information to different parts of the system, because records are fragmented and incompatible. A shared patient record could improve communication between hospitals, GPS, mental health services and social care, reducing delays and improving safety. Equally important, giving patients direct access to their own records could empower people to take a greater role in managing their own health.

But even here, the detail matters enormously. Public trust will depend on strength, on strong safeguards around privacy, data security and consent. Patients must be confident that their information is protected and used appropriately. Technology should support care, not undermine confidence in it. The key question is this will these reforms genuinely improve patient outcomes? The NHS does not simply need another structural overhaul. It needs investment in staff, modernisation of services, stronger primary care, better integration with social care, and a relentless focus on performance, productivity and patient experience.

Without that, changing organisational charts risks becoming a distraction from the urgent work that patients and healthcare healthcare professionals need most. The public judge the NHS, not by who holds authority in Whitehall, but by whether they can see a GP when they need one, whether ambulances arrive on time and whether treatment is delivered safely and promptly. That is where the real test of these proposals will lie.

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My Lords, I should start by declaring my railway interests, as I'm speaking a lot about the Railways Bill in my remarks this evening. All these interests are evening. All these interests are unpaid. They include. Presidency of the Heritage Railway Association and of the Cotswold Line Promotion Group, and a member of the Railway Heritage Designation Advisory Board. And I'm also a member of the And I'm also a member of the National Railway Museum's Advisory Board, and I chair the Great Western Railway Stakeholder Board.

I particularly want to commend all those who are making such a success of, of, of rail 200, the 200th anniversary of the opening of the world's first passenger railway between Stockton and Darlington in 1825. It is rightly being celebrated throughout Great Britain and Northern Ireland, and allows us all to celebrate just how much railways have contributed to the nation's happiness, health and
20:58
Lord Faulkner of Worcester Portrait Lord Faulkner of Worcester (Labour)
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prosperity. Rail 200 exhibition train, which is called inspiration, train, which is called inspiration, is conducting its nationwide tour and will be doing so until this summer. If noble Lords haven't summer. If noble Lords haven't visited yet, I do urge them to do so. It's likely to be at a Heritage Rail Heritage railway close to Rail Heritage railway close to where they live. Curated in partnership with the National Railway Museum, Inspirations Railway Museum, Inspirations exhibition, carriages are a great celebration of what the railway has done for everyone, and I particularly congratulate my noble friend Lord Hendy of Richmond Hill for the part he has played in making rail 200 such a success for.

I congratulate him for his commitment to the heritage sector and most important of all, for his determination to ensure that we as a country appreciate and stand a country appreciate and stand behind our railways. He and I were. He and I were invited and much appreciated. Thank you. Lord Hendy and I were invited to join the celebrations. For the 75th anniversary of the railway this week, but our duties here made it impossible for us to get away to North Wales.

I'm sure he'll want to join me in sending our congratulations to that wonderful little railway. I've spoken before in your Lordships House about the huge contribution heritage railways make to the regional economy, to tourism and in the preservation of engineering skills. And again, thank noble Lords in all parts of the House and the government for supporting my efforts and those of the noble Lord, Lord Parkinson of Whitley Whitley Bay, for making it legal for. Amendment to the Employment Rights Act. For young people to work and volunteer on heritage Railways.

I'm told this is already having making a great difference. It is a small change but a very important one. The value of the national rail system cannot be exaggerated. They have long played a vital part in shaping regional economies and communities, bringing a sense of community cohesion as they transport people from A to B. They enable people to get to work, to school and university, to see friends and family, to go shopping and to go on holiday. There's so much more that they could be doing, particularly in improving the environment, by attracting much more heavy freight off the roads and onto the railway.

I know that my noble friend the Minister has already received representations from the rail freight sector and being given practical examples of what could usefully be done. I appreciate the debate on the Gracious Speech is not the right place for discussing detailed amendments to the Railways Bill, but I hope the Minister will be able to give an assurance that he and his officials are studying carefully the freight industry's representations on matters such as access arrangements for non Great British Railways operators and the freight growth target set for Great British Railways.

I'd like to finish on a positive note, particularly on Monday. Direct services between Bristol and Oxford calling at bath, Chippenham and Swindon were introduced by G W and launched by the Secretary of State. The service runs every two hours and was only made possible because of the capacity improvements. Network rail have made at Oxford Station. Does my noble friend agree that this is exactly the type of thing we should be seeing train operating companies and GB are doing in future.

They are responding to market demand, looking at new routes and growing revenue to help reduce taxpayer subsidy. It's also important to demonstrate that the rail network isn't totally London centric, and the success of this service will enable new housing opportunities and new job opportunities. It's connecting incredibly popular tourist destinations in Oxford and Bath, and will have superb connections to East West Rail when that opens for passenger service. I'm sure there are many other examples of where we can grow the railway in future and have particularly forward to my noble friend speech.



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Here. I want to address the parts of the Gracious Speech aimed at the Gracious Speech aimed at improving the NHS. Attempts to reduce bureaucracy and duplication in the NHS with the health Bill are in the NHS with the health Bill are welcome if they can be successfully delivered. However, we have seen little progress in more than a year little progress in more than a year since the abolition of NHS England was first announced, with it still recruiting hundreds of roles, his recruiting hundreds of roles, his pay bill increasing and I fear that it may be diverting attention away from frontline services.

In that
21:03
Lord Mott Portrait Lord Mott (Conservative)
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vein, there are four areas I will focus my brief remarks on today. focus my brief remarks on today. First, my Lords, I turn to cancer and in particular, rare cancer. During the last session, we saw During the last session, we saw significant progress with the Rare Cancers Act. This is not a partisan issue and I was proud to support that legislation. But there is no silver bullet and improvements in treatment options for some rare cancers have not significantly improved for decades, so we cannot let the momentum stall.

We need further improvements, including improved pathways for the approval of innovative treatments and faster genomic testing. I urge the government to ensure that rare cancers do not slide down the department's priority list, simply because recent legislation has been passed, and that we remain focussed on getting new treatments to patients in need. Prostate cancer is another issue that I have campaigned extensively on, and I know it is is a cause shared by many noble Lords and members in the other place.

Early diagnosis is the difference between a treatable condition and a terminal one. Yet 1 in 5 men who receive a diagnosis do so, so late to be cured. Despite this, and it being the most common cancer in the UK, we continue to see a postcode lottery that determines a man's survival chances. And we still do not have a national screening programme. I urge the government to commit to a more proactive, modernised screening programme and to consider the evidence gathered by the APPG on prostate cancer, of which I am an officer, including in the excellent recent report on insights from primary care, potentially saving thousands of men every year.

Thirdly, I turn to the state of maternity care. It is no secret. It sadly remains a national disgrace that half of all NHS maternity units in England are currently rated as either requires improvement or inadequate, after a new assessment framework was introduced in 2024. Two thirds of the services rated since were inadequate or requires improvement, and not one has been outstanding. This is a failure of safety for mothers and newborns who deserve much, much better. While it is disappointing that there was no explicit mention of maternity safety in the King's Speech, the House must ensure it is not forgotten.

We await the independent review by Baroness Amos with high expectations, but the government must be prepared to act on those findings immediately, not simply add them to the list of more than 700 existing recommendations from previous reviews. Whether the answers are legislative or operational, mothers must be able to trust the care they receive. Finally, I want to turn to the challenge of late diagnosis of and poor support for people with ADHD. At a recent meeting of the APPG on ADHD, the tragic death of Matthew Locke was discussed.

He was diagnosed with ADHD far too late. His condition was missed by the system on multiple occasions, and this ultimately led to him taking his own life. We need to do more, much more to help those with ADHD. So Matthew's experience and those of his parents, Richard and Christine, are not repeated by many more families. So will the Minister commit to look again at the excellent work done by the NHS England ADHD Task Force to see what can be implemented without delay.

My Lords, these four areas do not get the same attention as headline measures to tackle waiting list, but each one represents areas where patients deserve better and will ultimately save lives. And I urge the Minister to take this contribution in the constructive manner it is intended, so that they get the attention they deserve within the health system and.
21:07
Baroness Thornton Portrait Baroness Thornton (Labour)
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My Lords, I am, as ever, honoured to be speaking in the Gracious Speech today in the debate of the Gracious Speech, and I want of the Gracious Speech, and I want to address two issues which I think are related. They are social care, and they are the procurement of people focussed services, both central to the delivery of the NHS ten year plan and also the future of social care. I need to declare a couple of interests. I am also honoured to be the chair elect of the Social Care Institute for excellence.

I am patron of Social Enterprise UK and a Senior Associate of E3M working with the leadership of social businesses which are currently delivering public services. I think we must all welcome the commitment of the proposed NHS Modernisation Modernisation Bill to ensure that the people of the voices of people using care and support directly inform the services they receive. We need patients and those who have lived experience to be the voices in design and the delivery of Neighbourhood Health and the National Care Service.

So my first question to my noble friend, the Minister is how will the government ensure people's lived experience, shapes service design improvement and accountability? And importantly, if they do that, how will they do it? If Healthwatch is abolished? Because although Healthwatch watches, although not the only means of capturing lived experience, I mean Sky amongst others, is very expert at this. But surely the abolition. Thank you. The abolition must be something in the air here.

The abolition of an independent, separate body to gather and report patient care and carer user experience. However uncomfortable that may be from time to time, does it smack of the NHS marking its own homework? I think I'm reflecting the concerns of many organisations and I think we can predict this is a matter for some discussion when we reach that part of the legislation. My second question concerns the importance of social care as an equal partner in the health and social care infrastructure, because given the moving piece of NHS reorganisation, the Casey Review, the local government reorganisation, I think is important.

And I ask my noble friend the Minister, to explain, and I'm happy if this is in a letter, is how will the government ensure that social care is treated equally within NHS reform and before the Casey Commission report, how will they ensure action to strengthen Social Care's role in the prevention, independence and community support? How otherwise will it be possible to deliver neighbourhood health? Turning to the commissioning of community services to support vulnerable people, surely this should be vastly different from buying marketized goods and commercial services.

And I'd like to thank E3M Stoneking and particularly Sandra Hamilton for the research and thinking about this. Today, 80% of social care social services contracts are delivered by private, for profit actors, and 50% of children's residential system is dominated by six private equity actors, with profits in excess of £45,000 per child per annum. My Lords, this cannot be a good use of taxpayers money. Surely the key words in people focussed procurement should be collaboration, not competition. People focussed open book with pre-determined reasonable profit margins, and there's no reason why any purpose aligned private company cannot do this to as much as a social enterprise or a charity.

So my question to the government is that while some are working to maximise the significant little used flexibilities available under the light touch regime, how will the commissioning regime change? When and is there? There is a need for a new, distinct regulatory regime for people focussed services. 75% of local authority budgets are spent on people focussed services using marketing purchasing processes that are not fit for purpose. Caring for our most vulnerable citizens is not a market opportunity to exploit.

It's a statutory public service system desperately in need of some long term stewardship. Thank you.
21:12
Lord Mawson Portrait Lord Mawson (Crossbench)
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My Lords. In response to the >> My Lords. In response to the Gracious Speech, I want to focus on health. This government's policy to move more services out of hospitals move more services out of hospitals into local communities is the right direction of travel. However, NHS England's Neighbourhood Health Centre guidance deserves a clear eyed response. After three decades working across primary care, grassroots community regeneration and social enterprise, my colleagues and I at the Bromley by Bow Centre find ourselves holding two different views at the same time real optimism about what this programme could become, and deep frustration about the journey and destination described in the current roadmap.

My Lords, the Bromley by Bow Centre has been working in this space for 42 years. We built the first integrated working model of what we think the government is proposing, and we are now responsible for 55000 patients on four sites in east London and have grown with the public and private sector partners, a national social business working on placemaking projects across the country. I declare my interest. We have focussed on practice in the micro because we know the clues to the macro lie there.

The Neighbourhood Health Centre programme signals a genuine institutional commitment to moving health care closer to communities. The ambition to create 250 centres by 2034. The multi-disciplinary model, the acknowledgement that health cannot be delivered by clinicians alone. These point in the right direction. At its best, the NHS framework is an invitation. The problem is that it is written in the language of compliance rather than liberation, and is simply not radical enough. There is an implied acknowledgement that good health is principally driven by social factors, but an underpinning assumption that a successful NHC will be defined by how it more efficiently organises multidisciplinary teams in a single building, rather than how it might meaningfully pass the ownership of health resources into the hands of local communities.

What the guidance gets right is the recognition that health is produced in communities, not just delivered by clinicians. The Neighbourhood Health Centre framework could, if NHS England has the courage to allow it become the vehicle through which a generation of community entrepreneurs, many of them GPS finally getting the platform, the estate and the institutional backing they have always lacked. The Bromley by Bow Centre was one early example of what becomes possible when you refuse to draw hard boundaries between health, community, enterprise, the arts, green space and human connection.

We were not unusual in our instinct. We were unusual in having the space and partners to act on it. NHS could give many more organisations this same opportunity, but the case for flexibility is not simply ideological. We have known for decades that 80% of health outcomes are driven by social determinants, a programme that creates impressive buildings staffed by excellent clinicians and allied professionals, but fails to address this. These upstream factors will make a marginal difference at best. The problem is that the guidance is shaped overwhelmingly by a statutory NHS centric worldview.

The illustrative design briefs for new neighbourhood health centres captures this problem precisely. Rooms with narrow purposes, square boxes, places for professionals to drink coffee but no art making spaces, no messy spaces. Not a curved wall in sight. Buildings one health colleague described as prisons. The consequence of this type of top down thinking is a dominant, multidisciplinary clinical model, with social factors treated as peripheral rather than foundational. These will be places to go for appointments, not places you belong to.

The emissions. I was telling in the guidance the creative arts entirely absent despite a substantial evidence base for their foundational and consistent role in good health outcomes, social enterprise and business. Some of the most innovative health generating work in the UK has been done in this space. Missing community ownership of assets. The words point to local power. The structures point to central control. Green space and horticulture a remarkable omission given the evidence on their broad therapeutic and transformative value.

Ask the less funding for non-clinical services. Social prescribing is promoted while its funding base is eroded, and the resourcing of non-statutory services it refers into are being decimated. Perhaps it's not too late. NHS England has a choice. It can insist on fidelity to the template and create 250 well resourced and shiny MDT polyclinics that improve access to statutory services. Or it can explicitly invite and resource flexible interpretation. My Lords, the modern health world is everybody's business. It is no longer the private domain of the NHS and its clinicians.

Such a model is totally financially unsustainable. My Lords, the challenge for this government is, is it going to create a health landscape based on last century thinking or a modern entrepreneurial culture in which everybody plays their part? This is the big opportunity to truly join up government systems on the ground. Let's hope we don't miss it.
21:18
Baroness Pidgeon Portrait Baroness Pidgeon (Liberal Democrat)
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This has been a. Really important. important. >> Debate on three fundamentals to our society health, housing and our society health, housing and transport. My noble friend Baroness Cass Baroness Thornhill talked in detail about the housing aspects in the Gracious Speech and concerns that proposed legislation does not go far enough, and that there is the absence of a coherent delivery plan. But Lord Young of Cookham and Lord Best and Baroness Laing of old Stone also set out some serious challenges in the area of housing, but I will build on the excellent contributions from my noble friends.

Lord Bradshaw. With his decades of railway experience, Baroness Tyler and Baroness Walmsley. In terms of transport, these benches support high speed rail to Manchester and other northern cities to increase capacity, unlock local rail improvements and boost the economy. Now clearly getting Northern Powerhouse Rail from Simply Talk, which we've had since 2014 when it was launched to spades in the ground, passengers on trains and on rails is absolutely critical. So can the noble Lord. The Minister advise which version of Northern Powerhouse Rail the government is committing to, and by when passengers will be able to travel on any new lines as part of this project.

And furthermore, I think, can we have some assurance that this is the end of U-turns and broken promises for our northern cities, desperate for that greater connectivity? What learnings from the challenges around delivering High Speed Two, which were highlighted earlier by Lord McLaughlin, the Railways Bill establishing Great British Railways as a single accountable body to unite track and train management, is a key part of the work of the noble Lord, the Minister and on these benches we remain concerned that some proposals within the legislation may increase the potential for micromanagement and a power grab by a Secretary of State, but our main focus is on passenger centred railway, which looks at growing the number of passengers and incentivises increased travel by rail, ensuring an affordable, reliable and accessible railway and I look forward to continuing to work with the Minister on this important Bill and hope we can see some amendments to deliver that ambition for passengers and Baroness Wilcox of Newport rightly pointed out, this must deliver for all parts and deliver connectivity.

One concern for many people is the state of our roads and pavements, and whilst the Highways Financing Bill looks to introduce a way to unlock private capital investment into major road infrastructure, we on these benches wish to be assured that this does deliver genuine value for money for taxpayers, and lessons must be learnt from previous experiences, particularly in the case of Thames Water, where the model allowed the prioritisation of investor returns over public benefit. I hope the noble Lord, the Minister, can assure the House on this matter.

I'm really pleased to see in the Gracious Speech a draft taxi and private hire vehicle bill. Having worked closely with the noble Lord, the Minister, on the recent devolution legislation and helped to secure some provision for stronger enforcement across the country, it became increasingly clear that a fundamental review is needed to bring the legislation into the 21st century. There are many concerns about the fragmented system that operates today, and I look forward to the planned consultation and engagement with drivers, the sector and passengers to increase safety and accessibility in this growing sector.

Perhaps the noble Lord Hermer can advise whether autonomous vehicles will be part of this pre-legislative scrutiny, given their growing presence and the timeline for the consultation. The Civil Aviation Bill may only be a short bill, but modernisation needs to work for all our communities and our environment. Recognising that noise and air pollution has a significant impact on people and indeed nature. We will be looking at this carefully to ensure the guardrails are in place for our communities who are affected by airports as they currently exist, let alone those who will be impacted by proposed expansions, which we clearly oppose, such as Heathrow and Gatwick.

But lacking from the Gracious Speech, was detailed about legislation to regulate and legalise e-bikes and e-scooters, which seems to us to be a missed opportunity, so we'd like to hear more on that. But let's turn to the health Bill, the NHS modernisation Bill. We've had some really strong contributions across the House on this bill, including Baroness Watkins of Tavistock and Baroness Neuberger, and as we've heard, the Bill will abolish NHS England as well as key organisations such as Healthwatch and the Health Services Safety Investigations body, and it will create the framework for single patient record, but that the government's solution is to pass responsibilities from one group of civil servants to another, we believe, misses an opportunity to improve services for patients and the health of our country.

I think, as others have highlighted, Baroness Shawcross-Wolfson and Baroness Bray patients will feel little difference, really. And these reorganisations cost a lot of money. They take time, they lose memory from the workforce and ultimately they won't change the front line patient experience. And we have seen this time and time again over the last few decades with different restructures. And I say this as a former NHS employee who has lived through many of those re-organised bodies, health and care services, as we've heard, remain under significant strain.

More than 6 million people are still waiting for care, and performance is well below the standard that 92% of patients should start treatment within 18 weeks. And as my noble friends Baroness Tyler and Walmsley have outlined so clearly, a real NHS reform Bill would fundamentally rewire the NHS and would have social care, mental health services, general practice and prevention. At its heart, we need to stop so many people having to go to hospital and help them leave more quickly when they do, and that does mean accessible local services in the community, including social care and a new focus on early intervention, which we've heard much this afternoon to stop people getting so sick, and what seems to have united many contributions, including Baroness Nargund, is a single patient record.

You know, we will consider carefully the plans for a single patient record. But as we've heard, people are tired of having to reconfirm their medical histories over and over to different medical and other professionals. So we would welcome different parts of the NHS and social care having access to that same patient information. But this has got to come alongside new privacy protections through a new health data charter. And the proof is clearly going to be in the detail. And I think we look forward to working with you to get that right.

But we also have deep concerns over the abolition of Healthwatch and HSS IB, alongside Lord Patel and others. We have concerns about this. Let's take Healthwatch for example. The government is stripping patients of their voice in our NHS rather than being able to go crucially to an independent body and express how the NHS could work better for them. Patients will now have to give feedback, whether it's to their local trust or via icbs or councils, and we don't think department or a director within the department is good enough, or has that independence that's required to ensure patient voices are genuinely heard, and the decision to scrap the health service safety investigations body is also a major concern, and we think it's fraught with risk.

A trusted and efficient safety investigation process is the best way of restoring trust, learning from system failure and preventing costly public inquiries. So we hope the government will reconsider those proposals. But as Baroness Pitkeathley articulated, the elephant in the room and Lord Kakkar also flagged this is social care. The glaring absence from this legislative programme, and it's clear it's not just from these benches and across the House, but from others such as the King's Fund. That said, I quote, interim action should not wait for the KC Commission's final recommendations.

And actually, the King's Fund goes further and comments that, and I quote, the legislative programme lacks ambitious action to tackle some of the other biggest causes of ill health, including obesity and alcohol harm, or to address deep health inequalities across the country. This raises questions about the government's promised shift to prevention will be delivered and and Lord Babudu focussed on prevention as well. In his contribution, and Lord Mott highlighted the need for screening for prostate cancer as a way of prevention.

So perhaps the noble Lord, the Minister could comment on that area. You know, with focus on reorganisation, there will be limited immediate difference to how patients experience health services, which is a huge concern. How does this bill address the deep rooted concerns about capacity and access to frontline health services, and including mental health and social care services? That is the area we would like to see the focus of legislation, rather than rearranging and rebranding civil servants and NHS organisations.

But this legislative programme is very full and we, on these benches will be scrutinising each bill in great detail to ensure that the passenger, the resident or the patient are truly at the heart of the government's proposed legislation.
21:28
Lord Moylan Portrait Lord Moylan (Conservative)
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Yes. interesting and wide ranging debate. I hope noble Lords will forgive me if I confine my remarks to the transport aspects of the debate. There were a number of interesting speeches in respect of transport. I don't propose to respond to all of them, but I would like to single out the remarks made by the noble Lord, Lord Berkeley, who I think deserves a rather doleful prize, having been, for now over 15 years, the Cassandra figure wandering across the stage from left to right, periodically telling everyone that HS2 was going to cost £100 billion.

There's a great deal of blame to go around in respect of HS2, but none of it none of it falls at the door of the noble Lord. Cassandra eventually has to be shown to be right, and now we know that he has been right all along. My Lords, I want to start by referring to the circumstances rather than the content of the gracious speech, because I think it's fair to say that it was frankly painful to see His Majesty peering over the top of his speech at a Prime Minister standing below bar, of whom nobody knew whether he would still be in office 24 hours later.

How is it actually come to this after less than two years, when Disraeli referred to Gladstone's front bench as being like a range of exhausted volcanoes, he was at least acknowledging that they were volcanoes. We have been inflicted with something more like a row of molehills from which the moles have departed, and the rapidly leaving ranks of Ministers who are flooding out are now saying quite openly that the government was wholly unprepared. The Labour Party was wholly unprepared for government.

How have we got to this stage? We have a solution at hand. However, a ready solution, Mr. Burnham, and what is known as Manchester ism. Now I've looked into Manchester ism and it's very relevant to this debate, because what it boils down to is a transport policy. Manchester ism is essentially the fact that Mr. Burnham has taken control of the buses and put a £2 fare cap in. Now it's worth saying that the £2 cap was, of course, a conservative policy, and it was the conservative policy to continue it.

And it was the Labour Party who put it up to £3 in every other part of the country. But then we think about the mechanism by which Mr. Burnham has taken control of the buses in Manchester, and let us remember that it was a conservative government that gave him the powers to do so. The mechanism he has used to take control of the buses is, of course, a franchising system in which the buses are still owned and operated by private companies.

But he sets the fares and the routes and the timetables. In other words, it is a system wholly copied from what has been operating in London since roughly the 1980s. One could almost call it London ism, in fact. And of course, who was it who in the 1980s, in the 1985 act created that system in London? It was, of course, Mrs. Thatcher. We might even say that it comes down to being called Thatcherism. But there's another paradox here as well, because that very system of franchising, where contracts are let on a concession basis to private companies to provide the bus services, is exactly the system that the noble Lord, the Minister has vehemently rejected in relation to the operation of the trains for him in his Paradise.

The trains have to be owned and run by Great British Rail, and there is to be no room at all for any sort of competition, except where it exists already. And that makes me wonder, since we know where we're coming from, whether the noble Lord. The Minister, has yet made the pilgrimage to Wigan to knock on a few doors and perhaps make enquiries of Mr. Burnham if he still backs fully. The Great British Railways Bill with this mechanism, which, of course, is not part of the mantra Manchester approach at all.

And there's more to say about that, actually, this great British Railways bill, because another thing that's going on is that overnight the Labour Party has become a party that wants to rejoin the European Union. Now, Mr. Streeting, I'm putting Mr. Starmer aside as being what might be described as a short dated stock. Mr. Streeting wants to join the European Union, and he says so. Mr. Burnham also wants to join the European Union, but he'd prefer not to say so.

And yet the one thing that is absolutely not compatible with being a member of the European Union is a great British railway structure in which there is no competition allowed, except, I grant you, temporarily for existing open access operators, because it is completely incompatible with the EU Railways Directive to exclude competition. And indeed, if we did rejoin the European Union and Deutsche Bahn or SNCF, or one of the private Italian railway companies turned up and said that they would like to run a service on the Great British Railways tracks, and we were to refuse them.

On the basis of this bill. We'd find that the whole principle of the bill would collapse immediately and we would lose the case under European Union law. So there we are. We have the bills, but we don't really know anything about the direction of travel and what is going to happen under an imminently new Prime Minister. My Lords, we have a civil aviation bill. It replaces the EU regulation of airlines and airports in including consumer protection. We welcome that.

But the way in which regulations are to be made is going to be an entirely private matter for the Civil Aviation Authority. Now, I don't think the government has got the message. We voted Brexit to get rid of unelected bureaucrats making laws for us. We had, but at least we had parliamentary scrutiny. We had an array of European Union committees here in your Lordships House who would look at those laws before they were implemented? None of that. There would be no parliamentary scrutiny of these new regulations made by the Civil Aviation Authority and, to some extent by the Secretary of State.

That cannot be an acceptable bill, and it is one that we are going to say that we are we are unhappy with. As a matter of principle, though, the substance we can support. But the mechanisms are not, are not appropriate. My, my my my noble friend. Lord McLaughlin spoke warmly about the Highways Finance Bill. Now, we do support the idea of finding new mechanisms for financing the building of roads, but I'm I'm really puzzled, and I do want the noble Lord to address this.

If not today, then later, when we get to the bill as to why the regulated asset base model is an appropriate way of attracting private finance, given that we know from experience elsewhere that it tends to go, it tends to encourage over specification and gold plating, and anyway is designed for assets for infrastructure where assets are incrementally added, such as they might be at Heathrow, rather than for building a road or a bridge, which presumably once built, is built and one isn't periodically adding to it over time.

So that is something else that we're going to want to look at. Finally, I come to the Northern Powerhouse Rail Bill. Now both the noble Lord, Lord Berkeley, and the noble Baroness, lady Pidgeon, spoke in favour of this. In fact, they spoke in terms as if it were likely to make Northern Powerhouse Rail happen, as if it's pushing its forward. I don't want to raise the noble Lord Lord Barclay's anxiety level, but as is explained in in the document produced by the by the government, this bill, the Northern Powerhouse Rail Bill, is actually only a renamed high speed rail.

Crewe to Manchester bill. It's a bill introduced by the conservative government. It was carried over into the last parliamentary session. Nothing was done with it. It's being carried over into the current parliamentary session. It doesn't build Northern Powerhouse Rail. It simply creates certain powers to take land for the purpose of building the parts around Crewe and Manchester, which are necessary for Northern Powerhouse Rail. There's no objection to this bill from from our side, as I say, it was our Bill originally the objection to it, but anyone who thinks that the government is building Northern Powerhouse Rail, there isn't a penny available to build Northern Powerhouse Rail unless the government unless the noble Lord.

The Minister is going to tell us that that's what is what is coming up. My Lords, I do have to congratulate the government on acceding to the Conservative Party campaign, not to increase the fuel duty. That's a small win and something we can call it a win win for both of us, I think, in that case, and I want to conclude by referring to something which is there is no legislation provided for. It's not in the Gracious Speech, but is an important matter, and that is the electric vehicles mandate.

The electric vehicles mandate is already destroying our automotive industry and is going to ruin the country in many, in many ways, destroy many jobs. But that's in relation to cars. But that's not enough for the government. It wants to extend it now to HGV. And I would only say to the government, I would say that they really must think very carefully about this. And indeed electric HGV, there simply isn't enough, enough electricity, electricity in the system to maintain them.

The government has to move very, very cautiously on the electrification of HGV. I hope that if not today, then soon there'll be an announcement from the government that they're going to reflect on whether this is something they really want to push forward. My Lords, we have had a gracious speech put forward, written for His Majesty the King by by the Prime Minister, Sir Keir Starmer. We do not know, as we debated, who is going to be the Prime Minister a few weeks from now, we do not know as a consequence who the Secretary of State for transport, or indeed the Secretary of State for health, or who the Chancellor of the Exchequer is going to be a few weeks from now.

There is a degree of unreality about this debate, but I'm grateful to all noble Lords who've taken it, taken part in it and treated it very seriously. And I look forward to hearing the noble Lord, the Minister, perhaps try and give some gloss to all of this that makes sense of it to the rest of us.
21:41
Lord Hendy of Richmond Hill Portrait Lord Hendy of Richmond Hill, Minister of State (Department for Transport) (Labour)
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My Lords, it's an honour to be closing today's debate on behalf of His Majesty's Government. I extend my thanks to His Majesty for his my thanks to His Majesty for his gracious speech and to all noble Lords for their thoughtful, thoughtful contributions, except perhaps for the last one, which I shall mostly ignore. I began by echoing. I begin by echoing what the noble Baroness, Lady Mirren, said in an admirable opening speech. She set out clearly and concisely the scope of the government's programme for the second sessions in the area of health, housing and transport.

And I'm grateful to her not only for her clarity, but also for being a valued friend and colleague. As with the noble. Noble Minister for housing, Communities and Local Government on the front bench of this House, as my noble friend Baroness Merron was in health, I'm immensely proud as as she was in health. I'm immensely proud of the progress this government has made, particularly in laying the foundations of better public services and in particular in transport, transport and the railway has been my life's work.

So it's a privilege to be part of the biggest transformation in over 30 years of the railway. We've also enabled a quiet revolution in bus service provision through the Bus Services Act and and and have opened a real opportunity for British innovation with the Sustainable Aviation Fuels Act. I am grateful to all noble Lords Lordships Lords in your Lordships House for their contribution on these acts. Turning to the debate today, I was wondering yesterday and the day before how my noble friends closing these debates would cope with so many varied contributions, and now I have to do the same.

I will do do my very best. But I am reassured that noble Lords who have spoken with such knowledge and passion will raise all their points in the passage of the bills which are which are in the gracious King's speech. Before I talk about the bills themselves, I'd like to address a variety of other matters raised by noble Lords today, and I should start with the noble Lord Butler, who spoke widely and wisely, and in particular about the Civil service. I'm delighted that he commended the new Cabinet Secretary and his views on impartiality.

Of course, supported. Lord spoke about the peerage removal bill. He will. We will take careful note of what he said both tonight and. And when he speaks on the bill itself. Lord, my noble friend Lord Jordan spoke about accidents, and whilst I can't say that he will take his. We will take his argument up about an approach across. Across government. He can be. Rest assured that individual parts of government. Take this. Take this subject extremely seriously, my noble friend Baroness Jones of Whitchurch spoke, spoke widely about the.

About the huge desirability of industrial harmony through dialogue and partnership. I echo that and and in terms of the progress on the railway towards Great British Railways, we will pursue it. And I'm pleased that she welcomed the new arrangements in social care. Baroness the noble Baroness Jones of Moulsecoomb and the noble Baroness Young of Old Scone, raised the absence in the subjects for debate of the environment. I can't account for that, but what I can say is this government is very serious on this subject.

And just three examples. The pursuit of net zero, the vigorous action by my noble friend Baroness Hayman of Ullock on the. On farming and the environment and the pursuit of more freight by rail, are all individual examples of the government's care about the environment. In the future I will get I will I will ask Baroness Hayman and my noble friend Baroness Hayman to write to the noble Baroness Jones. Further on that subject, the. My noble friend Baroness Linforth raised clean air in public spaces for kids.

I'll have to again defer to my noble friend Baroness Hayman of Ullock on that subject. The noble Lord Robathan made a wide ranging speech on various subjects, but he did raise anti-Semitism, where I can't believe that he can't see a very strong response from this government to the recent outrages to the Jewish community, the noble Baroness Walmsley spoke passionately about food standards. The government thanks her for for her work in this area, and I'm hoping that I've covered most of the subjects, which don't really appear to be covered by the main subjects in this in this debate today, moving to health, I think the very first thing to say is that this government has already taken serious action on waiting lists.

They're down by half a million. The number of people waiting less than 18 weeks for planned care is now 65.3%, up from 59%. And ambulances that responding to strokes and heart attacks are arriving five minutes faster compared to last year. And we're meeting our manifesto commitment to recruit an additional 8500 additional mental health staff three years early. So that's a foundation which we're not yet satisfied with. But it's but it's it's it's a reasonable start. And the objectives of the, of the NHS.

Bill were, have been debated by many contributions today, my noble friend Baroness Nargund and my noble friend Baroness Ritchie of Downpatrick both fully supported the bill. Others took a view that actually there was some care needed to be taken about how this. How this huge change in the abolition of NHS England should be should be done. In particular, Baroness Noble, Baroness Shawcross-Wolfson Shawcross and Wolfson and the noble Baroness Bray, and we know. Also note the noble Lord carcase.

Important points on this subject. It is a large step, and this government is committed to doing it wisely, carefully and and properly. The noble. My noble friend, my noble friend Lord Babudu, and the noble Baroness Shawcross-Wolfson talked about prevention, which is, of course important, and one of the. One of the principal features of the government's policy, and the noble Lord Carmel and. And the noble Baroness Watkins talked about the connections between health and place. As it happens, the Secretary of State for health in the other places, making a major speech on this tomorrow the.

There was a lot of discussion about the single patient record, data security, careful use and comprehensiveness. Noble Baroness Bray the noble Lord Patel, who was particularly helpful. And note, my noble friend Baroness Pitkeathley, the noble Baroness Tyler. The noble Baroness Walmsley, and my noble friend Baroness Nargund all had support of it, and I listened. We listened with interest to the noble Lord Dodds. With the experience of Northern Ireland. My noble friend Lord Davis talked about the particular circumstances about Palantir.

We are reviewing the Federated Data Platform contract in advance of the break point. The single patient record is different. It will be supplied through contracts with multiple suppliers with no single supplier dominating. No decisions have been made about who those who those will be. My noble friend Baroness Donaghy and the noble Lord Black of Brentwood talked about osteoporosis and the. And the Fracture Liaison services. The government is committed to rolling out fracture liaison services everywhere by 2030. And my noble friend Baroness Merron is well prepared to respond to any new issues in.

In that respect, the noble. My noble friend Lord Winston talked about egg freezing. I am singularly qualified to deal with this subject in any practical way, but I know that my noble friend Baroness Merron has listened very carefully to everything he said, and she has committed herself to to write to him. Similarly, the noble Lord Mott spoke about cancers and about. And about maternity services. And. My noble friend Baroness Merron heard that carefully, too, and he's acting on it all ready.

And then lastly, noble Lord Mawson talked about his Bromley by Bow experience actually, as a. As a matter of coincidence, he's. He's shown me around the very thing. And of course, it is a very. It's a very obvious long term experience for government to take to, to, to take interest in so far as health goes so far as the. Sorry, I'm start again so far as the Department of Health and. Communities and. Local Government goes.

The first thing to say is the social Housing Bill. The government believes everyone deserves to live in a decent, safe, secure and affordable home. The bill will provide much needed social housing stock, give affordable housing providers the clarity and confidence they need to build more social homes and better protect tenants who are victims of domestic abuse by providing them with greater security and stability. The bill delivers on the manifesto commitments to prioritise the building of new social rented homes and better protect our existing stock.

A number of noble Lords supported supported the concept of the Bill. Unsurprisingly, there was some criticism of it. We would say to the noble Baroness Eaton, for example, that that rent renting is has been. Proportion of people in rented accommodation is stable and has been since 20 1314, and there's been a 3% increase in available homes in quarter one, 2026 and buy to let loans have increased by 14%

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in in a year. So it's Not evident that there's there's

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Not evident that there's there's that that that reduction, the noble Baroness, the noble Lord Bailey of Baroness, the noble Lord Bailey of Paddington, talked about stamp duty but didn't explain where the £11 billion it would cost to abolish it billion it would cost to abolish it came from. And the. The government is working with the Mayor of London on an emergency housing package to enable rapid delivery. Of what? Of of of what? London. What London needs in leasehold reform.

A number of local noble Lords Lord Young of Cookham the noble Lord Best. The noble Baroness Shah, the noble Baroness Watkins and noble Lord Truscott commented on various aspects of leasehold reform. When the Bill comes forward, I'm very confident that they will have much to say during the passage of the Bill, but the government believes it's moving in the right direction to deal with what a number of noble Lords this evening have called have called variously up to scandalous and.

And the right Reverend prelate, Bishop of Chelmsford is right, which is that people, people are entitled to a home that young people are entitled to, to have the certainty of knowing where they're going to live. And there are powerful arguments for housing reform. And I hope that the right reverend Prelate is convinced that the government is going to move in the right direction. The noble Baroness Thornhill referred to social housing. My noble friend remarked that actually the 39 billion that the government has allocated in that to that subject will certainly help, help provide it.

And and she also referred to SME builders, where the £16 billion National Housing Housing Bank started on the 1st of April, and it includes provision for financial support and loans for SMEs in, in, in the housing market, the noble Lord best was very powerful about the about the all all of the aspects of the of the bills that are being brought forward. And I'm sure that he'll make some very valuable contributions to the discussion. The bills, when, when, discussion.

The bills, when, when, when they arrive. Just have to sort, sort these papers out. Moving on to the for transport bills, the Railways Bill will deliver on the government's manifesto. I was enormously encouraged by hearing from the noble Lord Bradshaw who all of us with any connection with the railways are. And respect somebody who was there when the railways were nationalised in 1948 is has some pretty good experience of of what's going on. He is right. Running railways is a job for railway people.

And actually the the intention of this bill is not as can be characterised, but is, is is wrongly characterised as giving any more powers to the Secretary of State, both the Secretary of State and. I want less power because the railway deserves to be run by people who understand how to make it work better, which is what passengers want. Lord, I, I, I have the greatest respect also for the noble Lord McLoughlin. But all I would say to him is that we're not starting from where he would like us to be.

We're starting from where we are at the moment and from where we are at the moment. Actually, the railway needs an injection of vigour in order to get reliability better, in order to drive up patronage and drive down costs, and that's been seriously absent in the railway post-COVID, even though it's run by. Allegedly vigorous private sector operators. The the my noble friend Baroness Dacre and my noble friend Baroness Wilcox both talked about the the benefits of transport investment.

And of course, they're right. Transport is not an end in itself. Transport is the means by which you create growth, jobs and homes. The noble Baroness Dacres has talked about the Bakerloo line extension to Lewisham, which is up to the Mayor of London to make the case, and I know he'll do so. She talked about long term finance, and this government has given that mayor the first long term financial settlement for some considerable time, in order that he can both spend the money better and decide where it should go.

My old friend Baroness Wilcox talked about it in terms of Wales, where actually this government has put in something over £400 million of of railway investment into Wales, creating new stations in South Wales and better services in North Wales. And I think that is an example of the working together to create benefits throughout throughout Great Britain. And of course, my noble friend Lord Faulkner of Worcester talked about. I'm very pleased to to join him at 75th anniversary of In preservation.

It was the world's first preserved railway, which is great. But he also talked more substantively about encouraging freight, which the government is extraordinarily keen to do. Freight will will form a part of the Railways Bill and a commitment will be made to freight growth in the railway. He also referred to the new service between Bristol and Oxford. And I would say that actually that was an example. Post post Covid in in in getting towards the new era of actually collaboratively working together to produce new services.

And I'm sure that Great British Railways will, will produce more of them. If I turn to the high speed rail bill as it's described in the in The Gracious King's speech, it is it is currently headed. The high speed rail. Manchester to Crewe Bill and the noble Lord Moylan is right that it was put forward by the previous government. However, since the previous government summarily cancelled phase two of HS2 between Birmingham and Manchester, the Bill has languished and.

And is now being is now being re-activated because, contrary to what he said, the government is funding Northern Powerhouse Rail. In fact, this is the first plan for railways for the North of England, which is properly funded and part of that bill is necessary to create the new line between between Manchester and and and Liverpool. In the meantime, the TransPennine upgrade, which is funded and which is currently in delivery on time and budget, is will improve connectivity across the Pennines and improvements east of the Pennines.

The railways in Yorkshire will come sooner because they don't need new railways, but there is a credible plan for the whole of for the whole of Northern Powerhouse Rail. I'm very happy to take the noble Baroness Pidgeon through the plans in order to describe precisely what they are. And the fact is that they're funded and there's a considerable amount of money in this spending review in order to move forward with them. The noble Lord Barclay, my noble friend Lord Berkeley, and noble Lord Moylan referred to HS2.

The. The Secretary of State for transport in the other place made a statement about HS2 yesterday. It is a scandal, I'm sure, that he, noble Lord Berkeley, can be satisfied that he did tell us it would cost a lot of money. He did tell us it would cost a lot of money. The difficulty. But but but what? I'm not sure he told us quite is that the thing has been hideously mismanaged by a series of, of, of, of governments and, and management and boards of HS2.

And that is the lesson to be learned. The lesson to be learned is not to do these schemes but to do them properly. TransPennine upgrade is one example of a scheme that is being done properly and is and is on time and. And actually it isn't true that Britain can't do these things. What is true is that is that as the as the as the. The review recently set out, you should be slow to start these projects, decide what they are and then quick to build them.

And this one was the other way round. The specification is obviously done by zealots. Part of it is incapable of being delivered because it's so technically advanced and that was wrong when it started. And and, and we're having to put it right now, the highway financing bill, contrary to the noble Lord Robathan, is not a bureaucratic bill. It's a it's a it's a it's a perfectly decent proposition about how to fund the Lower Thames Crossing and other future major road schemes.

Baroness, the noble Baroness Pidgeon is right that it has to be genuine value for money for taxpayers. We're not proposing to do anything at all like Thames Water for very obvious reasons, and we will debate why the regulated asset base is right for this class. As. As the noble Lord Moylan pointed out during the passage of the bill, absolutely no doubt. Then the Civil Aviation Bill, which has a number of powers, including much better powers for consumers. The noble Lord Moylan is right to say that it replaces EU legislation.

He's pointed out to me on numerous occasions recently in dealing with Statutory Instruments, that the powers to do that run out very shortly and and the Civil Aviation Bill is necessary to replace them. But we will debate to what extent it's desirable or necessary to have the the Civil Aviation Authority making some rules when we get there. The government's view is that actually it's quite it's quite reasonable to delegate some of these powers to a competent authority, leaving some others to the to the authority of the Secretary of State.

I'm very pleased that the noble Baroness Pidgeon raised micro mobility, and we. This House has debated micro mobility, e-scooters and and and the like a number of times in the last in the last nearly two years now, although it didn't feature in the Gracious King's speech, it is our intention to consult before the end of this year on what we do about micro mobility. The noble Baroness knows what a range of different sorts of regulations there are throughout Europe.

We've shared that information with her and indeed, I hope, with others in the House and in your Lordships House. And if we haven't, I'm very happy to share them. There's a huge divergence of views about how to regulate these things. So we do need to properly consult over them before we get there. The noble Baroness Pidgeon also referred to the taxi and private hire draft bill, which was in the Gracious King's speech, and I take this opportunity to pay tribute to her about the collaboration which we had in order to make the that relevant part of the English Devolution Bill serve the immediate purpose of better regulation of of taxi and private hire out of area working that really isn't isn't enough.

So this draft bill, which will need a lot of discussion because circumstances vary throughout the United Kingdom, is, is, is absolutely necessary. I am tempted to just respond to the noble Lord Moylan on a couple of his points, because why not? Why not? Why not? He referred to the £2 fare cap. But of course, what he didn't say is that the previous government did institute it, but they didn't fund it much past the election date. And, and the the the other point, of course, is that the the very successful form of bus franchising.

Yeah.

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How is Andy Burnham managed to fund it then? I'm sorry, how is fund it then? I'm sorry, how is Andy Burnham managed to fund it

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then in Manchester alone. So the the process by which bus franchising was established in Manchester was absolutely torturous. Though it was. He was enabled to it Though it was. He was enabled to it to it he was enabled to do it. And the purpose of the bus services Bill is to make it easier to do. But the results are spectacularly good. That's all I'd say. I haven't been watching the clock. My time is up, I should say. I should say that my noble friends Baroness Merron and Baroness Taylor have been listening carefully to the whole debate as I have, and they'll be as well placed as I am to take all the issues raised by noble Lords forward.

The Gracious Speech marks the next phase in our plan to deliver national renewal across housing, health and transport and this government is putting better public services first, and we are promising to do. We have promised to do what these bills set out and

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we will do them. My Lords, I beg to move. The debate be now adjourned

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The debate be now adjourned until Thursday. The 21st. Of May. Is that this debate be now again

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Is that this debate be now again adjourned until the Thursday, the 21st of May.

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21st of May. I beg to move that the House do now adjourn.
14:30
None Portrait Oral questions: Paternity leave to the self-employed
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