(5 years, 5 months ago)
Lords ChamberMy Lords, I am delighted to follow the noble Baroness, Lady Newlove, who made the very important statement today that this is, in a sense, an outstanding issue from her seven years as Victims’ Commissioner that she has had drawn to her attention. I thank her for that work and for this debate.
This seems to me such a long journey. I met some Women’s Aid workers yesterday who are now getting ready for their 45th anniversary next year or the year after. I had to confess that I was at the original meeting that established Women’s Aid, as I was part of setting up one of the very early refuges in Sunderland all those years ago. It makes me feel very old.
The reason I want to speak in this debate is that I still work with Changing Lives, although I am no longer its chair. It does a lot of work in this area, and I act as a friend and informal consultant to the tremendous woman who runs its women’s services. I am also a member of the Joint Committee on the Draft Domestic Abuse Bill and have just chaired a commission in the past year, whose report is called Breaking Down the Barriers, which worked with women and looked at domestic and sexual violence and multiple disadvantage among them. It was particularly looking at and working with women with complex needs. Nearly all these women have complex needs: they may have an addiction; they may be or have been homeless; they may have a mental health problem. Much of this has come from their lifelong experience of abuse, violence and neglect. As a society, we really have not begun to work out properly how we work with women with complex needs, many of which, as I say, have arisen from domestic violence.
The commissioners worked very closely with women with lived experience—which is how we now term this—of violence, abuse and the aftermath of that. We trained them to work as peer researchers: to ask the right questions and handle how they asked them, and then to deal with the trauma that they were hearing from other women. Each of them interviewed about 10 or 12 women in their own locality who had had the same experience. I met with these women about once a month during the period of the commission. Their stories were, as the noble Baroness, Lady Newlove, said, harrowing. But they were also incredibly inspiring. Nearly all of those whom we trained now have jobs, and nearly all of them are feeling really positive about taking better control of their own lives.
When it comes down to it, domestic violence happens because somebody in the relationship wants power. That is why we call it a gendered thing. Yes, men suffer from it as well, and their reluctance to come forward is largely because they feel that this is not the image they should be projecting as men. We have a problem all round, and we need to recognise that there is a gender-specific issue with the victims and offer services which respond to that.
Let me explain a little bit what I mean by that. I cannot go through all the recommendations of the commission—I am already well over halfway through my speech—but the women said to us very strongly that they had been best supported when the first person they met had some understanding of what they were going through and of how they may work. Even if they went to a homeless or mental health organisation, or somewhere else, somebody needed to recognise that it had come from trauma and abuse and that that was at the bottom of their problems. If it is not worked with in a way that recognises this, you will never get to the end you need to get to.
Therefore, we recommend that many more workers on the front line across the services be trauma informed—to be able to recognise what happens and what has happened to someone who is presenting, understand the behaviour and work from there from the beginning. When that does not happen, you never begin to tackle the problems for children or indeed the problems of recurrence of the violence and walking into other violent relationships. If we are to stop it, we have to do that.
Too many organisations do not have that, and nor do they have the safe spaces for women. I cannot tell you the number of local authorities I have talked to which think that the Equality Act means that, if they offer a homeless hostel, it has to be for both sexes. It does not and should not be. Women need safe spaces when they are vulnerable so that they will not be prey to the sort of people who have abused, troubled and traumatised them in the past. Without those gender-specific places, that simply will not work.
I have so much more to say, but I can see that my time is up. We have so much to do but, my goodness, if we do it, those women and children will give us back a lot, because they will know what to do in the most difficult circumstances. If we get it right for them, we will have a much better chance of getting it right throughout our society.
(5 years, 8 months ago)
Lords ChamberMy Lords, these contributions are very brief. I know that many of us would love to talk about a much larger range of women’s activities and contributions across the world.
Today, I will limit myself to talking about a very small part of a commission I have chaired for the past 18 months, which last week published a report looking into the experiences of the most disadvantaged women in this country. They have experienced violence and abuse, chronic poverty and what has become, for them, a punitive benefits system that often compounds their problems. Without support, many such women go on to develop mental health problems and use drugs or alcohol to cope with trauma and abuse. That often leads them into a downward spiral, with some of them even facing the criminal justice system at some stage.
The commission looked into the experiences of our most disadvantaged women. As I said, many of them develop a range of other problems. It is estimated that one in 20 women in England—equivalent to about 1.2 million women—have experienced extensive physical and sexual violence throughout their lives. More than half of these have a common mental health disorder; one in three of them has an alcohol problem; and one in five has been homeless. We worked extensively with them. One of our greatest experiences was being able to pick up and train these “women with lived experiences”, as they are known, as peer researchers. They then interviewed 18 women in their own localities who were suffering from these sorts of disadvantages. They were a joy to work with, and I will come back to this.
Many women who come to this country expect to be safe and protected. They have heard us talk in positive terms about what advantages we have as women. However, their experience when they get here is far from that. Hearing from some of them made me feel ashamed. I want to give just two examples of where we really must address the needs of women who do not have settled migration status.
We were told that the hostile environment had led to women in abusive relationships without settled status fearing to report what was happening to them. They were scared to go and seek help. Often, the abusive partners would say that they would be deported if they did so. Safe pathways to reporting violence against women and girls should be created for all women, not only those of us who are confident about our position in this society.
The second example is that of the whole issue of having no recourse to public funds. This affects people who do not have settled status. Too many are denied support, which means they are unable to access help and support. They are unable to go to a refuge and they are unable to access alternative accommodation. They do not have any money and they are certainly not going to be taken on by landlords. As I say, even many refuges will deny access for that reason. They are unable to get treatment for health conditions or for what has happened to them as a result of abuse. We have to look very carefully at abolishing the rule for women in this position.
There are some really good and practical recommendations in the report—although I would say that—which is entitled Breaking Down the Barriers. I do not have time to go into them all and I hope that noble Lords will take the opportunity to read at least the executive summary.
At both the local and the national level we have to make sure that services and NGOs can work across the silos and meet the needs of individual women. We have to use and employ women with lived experience. As I say, they are a real inspiration. They are the ones who know what it is like and are therefore the best first contact with other women. We also have to extend the use of trauma-informed work. Too many women present but no one understands or recognises the consequences of abuse, so they are pushed from pillar to post, from service to service, and no one deals with the essential first thing: that they have experienced trauma as the result of violence and abuse. We have much to do on this, but it can be done. I hope that we will all work towards making a change.
(10 years ago)
Lords ChamberMy Lords, this is a very important debate, and I regret that we have only one hour. The Ebola crisis is already a medical and humanitarian disaster. Thousands of lives have been lost, and tens of thousands are at risk if we do not act more effectively now. It is particularly tragic because over a decade of progress in Sierra Leone, Liberia and Guinea is under threat. In recent years, for example, Sierra Leone had halved the number of women dying during childbirth, but we now know that that is in reverse.
I am a trustee of a charity, the Africa Governance Initiative, which has teams of people working on the Ebola crisis in Sierra Leone, Liberia and Guinea. They are working alongside Governments and the international community to put in place the systems—command centres, hotlines and so on—to manage the response. They went to those countries to help build government capacity on other issues and reduce poverty. They did not expect to be dispatching ambulances and managing body disposal, but they have done so anyway and I am very proud of every one of them.
The UK Government’s commitments are welcome but I think they have been too slow, and we are not ensuring that there are sufficient doctors and health workers on the ground. There is a real imperative for us to do more on that. I am proud of another organisation that I am a trustee of, Voluntary Service Overseas, which this week—again, a bit late—has put out an appeal to all return volunteers who have a health qualification to volunteer to go and help with Ebola. However, even if every one of the 600 or so who have been asked were able to help, that would not be enough. There is a real imperative for us to get more people on the ground who are able to get on top of this crisis as quickly as possible.
If we do not get hold of Ebola, these very fragile states will become much more vulnerable and their ability to survive and look after their people will be lessened even further.
(10 years, 8 months ago)
Lords ChamberThere are a large number of early years experts in this House, I have to say. However, the noble Earl makes a good point about the need to be inclusive as regards those who stand for Parliament. It is extremely important that we do everything we can to encourage people to feel that it is worth while being involved in politics, worth while standing for Parliament and worth while serving more than one term. We need to look at why some Members of Parliament, especially women, decide after serving one term that they have had enough.
My Lords, I declare my interest as a trustee of two international development NGOs. Does the Minister accept that the Government have a responsibility to set a good example when two-thirds of those in poverty around the world are female and when the voices of women are simply not heard in the decision-making places around the world? What will the Government do to make sure that they lead in ensuring that the voices of those dispossessed women are heard internationally?
I hope that the noble Baroness recognises what DfID and the FCO have done in this regard. A number of parliamentarians from here will attend the Commission on the Status of Women next week in New York, which will seek to take forward the very points that she makes. She is absolutely right: unless you have women front and centre at all levels of their societies, you will not relieve poverty and you will not address inequality.
(10 years, 10 months ago)
Lords ChamberThe noble Baroness may like to know that my honourable friend Lynne Featherstone has a particular focus on assisting those with disabilities in developing countries. The projects being taken forward at the moment are in Somalia, Ethiopia, Kenya, Uganda, Afghanistan and Sierra Leone. There is great determination to make sure that schooling is inclusive, whether it is for able-bodied or disabled children.
My Lords, I am sure the Minister recognises that even at primary level it is frequently difficult to keep young girls in school, partly because poverty means that they are needed at home. What will the Government be doing to make sure that this issue is really addressed in the post-2015 agenda and that we do not assume that, because it has been part of a millennium development goal so far, everything is okay? The reality is that, unless the quality of the education is really good, the family loses faith in the worth of continuing to send a young girl to school.
The noble Baroness is right, and that is one of the lessons from the MDGs. Looking forward beyond 2015, it is not just a case of getting children into school but of making sure that they stay in school. DfID built into its programmes consideration of the results—that is, ensuring that children stay in education and that they learn while they are there, and that teachers and educational programmes are in place. One reason for there being a focus on secondary education is that children are required to have gone through primary education.
(10 years, 11 months ago)
Lords ChamberI pay tribute to my noble and learned friend for what he achieved—using the metric system rather than anything else certainly made things much easier when my kids were studying—and for his candour. I note that the PISA report is extremely long, complex and very interesting. I urge noble Lords to have a really good look at it. If they look at the breakdown on maths, for example, they will see that students in the United Kingdom do relatively better than some countries on uncertainty, data and probability, but are less strong on space and shape. In east Asia, they are doing much better in the other direction.
My Lords, I thank the noble Baroness for her replies. I am interested that she acknowledges that the only way to enthuse young people is with a committed, knowledgeable and enthusiastic teacher. The Government need to do more to recruit the very best. We know that if you get the top 10% of graduates into education, you will do much better. I ask the Minister to look again at the messages that have been given to free schools and academies—I declare my interest as a governor—that qualifications do not matter.
I thank the noble Baroness for her initial tribute. It was very striking to see a steady increase in the number of high-quality candidates entering teaching. That is immensely encouraging, and we have to take it further forward. The proportion of postgrad entrants with a first class or 2.1 degree is now 74%, compared with 61% in 2009. That is moving in the right direction and shows that students recognise that it is worth teaching. The noble Baroness is absolutely right that all of us remember our outstanding, inspiring teachers. The report emphasises that autonomy for head teachers, along with accountability, is crucial to moving things forward.
(13 years ago)
Lords ChamberMy Lords, I wanted to intervene on this group of amendments because I have been trying, without success, to find out how to table an amendment relating to how the new architecture will deal with the most chronically excluded. Some of them will require alcohol services, which we shall come to later, but many of them will require other medical services. In addition, many of them will not have a fixed abode or will not have a fixed abode for very long. Therefore, they will be moving around.
When I asked the chief executive of the Commissioning Board who would deal with these people, I was rather concerned to be told that it would be clinical commissioning groups. CCGs might do so, but I am not convinced that they necessarily will. First, CCGs may well not be very aware of the numbers involved, particularly if they are not inner-city commissioning groups, and they may well not be aware of the complexity of response that such people will require. These will be people who require some medical intervention as well as other forms of intervention and support.
At the moment, much of the medical attention that these people receive is fragmented and is often not the appropriate intervention, and they can be a real nuisance in places such as A&E. The Government need to listen to those in the voluntary sector who say, “We need a new approach to how we work with people with these multiple conditions and we need to make sure that we get it right”. However, the NHS has a responsibility—it does not stand outside this—and this matter will need to be looked at on a wider and more expansive level than simply that of the CCG.
In this country we assume that, because we have GPs, people will automatically be registered with them and will be looked after. However, my experience of working with these most frequently disturbed and disadvantaged people has been that they fall through the net again and again, and somehow we have to make sure that that does not happen. Due to work that I have done in the past and because I am currently involved with a voluntary organisation, I have previously discussed with the Minister ways in which that can be achieved effectively. I do not pretend that it will be easy or that we can simply lay something down in legislation and it will all happen. However, somewhere in the middle of that there is a way forward.
I hope that in considering the amendments—particularly those of my noble friend Lord Hunt—the Government will work on this issue and come back with clarification that this group of people will not fall through a net in the new architecture.
My Lords, I want to pick up on a point that I made on Monday. We are discussing the role, duties and powers of CCGs, and I want to talk about commissioning services. Where contracts are negotiated with existing providers—whether they are within the National Health Service, the voluntary sector or the private sector—it is fairly clear to see how the system will operate. However, I am not clear—and perhaps the Minister can enlighten me—about the role of CCGs in promoting and creating new services or facilities within the NHS.
The example that I particularly want to refer to concerns the provision of new health centres in my own area of east Lancashire. These are new significant capital schemes but they are not the direct responsibility of the hospital trust. Where the responsibility is that of the hospital trust, it will no doubt be responsible for the provision of new capital schemes. Here we have facilities that will be partly occupied by GPs; they may well be occupied in part by community-based services that are now the responsibility of the hospital trust. The hospital trust may wish to make use of the facilities as outreach facilities for day patients, and so on, but they do not fit neatly into the hospital trust. At the moment, they are the responsibility of the PCT. The existing primary care trust in east Lancashire has now approved in principle the provision of three health centres in three towns—Great Harwood, Clitheroe and my own town of Colne. Because of the changes and the fact that the PCT is not responsible in the future, it has now been passed to the cluster of PCTs, which is at a Lancashire level, and will have to be approved by the strategic health authority.
These are all bodies that in future will not exist. Who will be responsible for this kind of capital project within the NHS in future? It is not just a question of commissioning within an existing landscape of provision in different sectors, but a question of commissioning new services and new capital projects that do not fit into the hospital trusts. Will that be done at a national level? Will it be the responsibility of the CCG? Who will be responsible for the provision of finance for this kind of project?
My Lords, I am sorry that the noble Lord, Lord Northbourne, was not here to move his amendment. However, I think that the general principles that the other amendments in this group address are very much what I want to bring to the attention of the House and the Minister. We now know so much more about the development of children. In the 18th and 19th centuries there was a great amount of dirt and other problems in the streets. This aspect of public health was taken up by municipal authorities, which had to build drains and sewerage. It was seen as critical to the future of this country. It also, of course, had an important effect on people’s health.
We now know much more. In my last job in government, I was the Social Exclusion Minister and had the enormous privilege of introducing to this country the Family Nurse Partnership Programme. In learning about that evidence-based programme, which affects the development of children more advantageously than any other single programme in the world, I discovered a little about what neurologists and others now know about brain development. The truth is, if we do not support parents and children in those early months and years, by the time they are three, they are so far behind it will take the rest of their lives to compensate for what they have not had in those early months.
I listened to the debate on alcohol and wanted to intervene. In family nurse partnerships, mothers learn that if you drink alcohol in pregnancy, it will affect the brain of the foetus and therefore the child. It has been incredibly successful, therefore, in giving young women the determination not to drink, because they want the best for their child when it is born. These are all things that we now have a lot of knowledge about.
Recently, I was at a meeting where a neurologist talked about research into the stress put on children and what elements in the body can be measured to tell whether or not there is stress and what can be done about it. Stress can lead to violence and violent behaviour. We know about these things, but they did not know about them in the 18th century, when they began talking about public health. We did not know about it when I was growing up, but we know about it now. That means we have a responsibility to take it into account and build the early development of children into our understanding of public health. We must make sure that we address it. It should not be until we get to extremes, when suddenly somebody notices that a particular child is developing in a difficult way, such as noble Lords have talked about, when children end up in the criminal justice system. We know what will happen to children if we do not pay attention to this: they will end up in the criminal justice system, and they are more likely to end up with an alcohol or drug dependency. We know these things now and, in my view, we have no option but to take account of them as a matter of public health. Therefore, I believe that we have to write that into the Bill.
My Lords, I rise to support Amendments 72A, 81A, 91A, 200A, 201ZA, 327B, 327C, 329A, 331C and 333B—all amendments on speech and communication. I think that Amendment 218A should also have been included because it deals with integration—in this case, for the commissioning groups. I hope that when the Minister deals with that later amendment, he will be able to recall this debate.
I support these amendments very warmly for all the reasons that the noble Lord, Lord Ramsbotham, and my noble friend Lady Wilkins have set out so cogently. I should also, in this very brief intervention, like to draw attention to the excellent BBC film “The Kid’s Speech”—not “The King’s Speech”, although that was very good too—which graphically portrayed not only the crippling effects of stammering on children’s development, as well as on their happiness, but also an integrated way to deal with it, employing educational as well as physiological expertise. I commend this short documentary to anyone who wants to understand why it is so important to help these children properly early on.
The assessment and treatment of speech, language and communication problems must come within public health. I asked the Minister about this when I made a few remarks at Second Reading. However, with that vast marathon of questions, I quite understand that he did not have time to reply, although I hope that he will be able to do so at the end of this debate. The information must be accessible to those with low literacy and poor understanding. Finally, there must be integration not only with the health and social care services but also with education and children’s services, or we shall fail that very large number of children with speech, language and communication difficulties.
(13 years, 4 months ago)
Lords ChamberMy noble friend should feel reassured first and foremost that it is not about just a sell-off. It is about introducing a much wider and more diverse provision of service so that people are able to enjoy a much more flexible response to their needs rather than, as so often, a stringent delivery of services through local authorities. Often as not, my noble friend will find that within an independent delivery service there is always capacity built in. It is often a prerequisite required of those who deliver services when they buy from the public sector to deliver, because it has to be delivered in their service plans in the first place. So I do not have a worry about capacity.
It is important that we are able to ensure that people who are going to use these services will be able to have a greater say in how those services will be delivered, whether those services meet their needs and, if they do not, how we can have recourse to get those services made better in responding to those needs.
My Lords, will the Minister accept that many of us are extremely disappointed with this so-called White Paper? It seems to be a Green Paper because it consults on a range of things without any precision on what the Government’s intent is. When I saw the coalition agreement saying that there would be an opportunity for millions of workers to be their own boss, I was expecting more from a White Paper than simply, “We will continue to support mutuals and the public sector workers in them”. The lack of ambition is staggering.
Will the Government now seriously address the manner in which they can reform and change public services? They are getting a bad name now for their lack of ambition on reform and their inability to deliver it. On things like mutuals, they need to answer the questions put by my noble friend on the Front Bench, particularly around pensions and pension entitlement.
I am sorry that the noble Baroness feels that this does not address public sector reform. Public services are being reformed. This is an exciting and comprehensive paper. I suggest that if she takes the paper away and looks at it in detail, she will see that we are genuinely working across government to ensure that there is a proper reform of public services so that they are delivered to ensure that people have choices, are able to have their needs met and have a say in how those choices are delivered. These reforms will take time because we want the process to be evolutionary and we want to get it right, but it is a build-on to what was happening already. I hope that I leave the noble Baroness assured that we will be working hard with public services to ensure the best delivery.
(13 years, 7 months ago)
Grand CommitteeMy Lords, I, too, congratulate the noble Baroness, Lady Morris of Bolton, on securing this debate. It is not often that we get the chance to debate issues of this nature. First, I should declare the interest of the many organisations for which I act as a trustee. The three that are relevant to this debate are the Tony Blair Africa Governance Initiative, the Westminster Foundation for Democracy and Voluntary Service Overseas. I am on the international board of VSO, which is an enormous privilege.
Inevitably, the priorities in much of the developing world are different from ours. Among many policy-makers in this country, the ageing society is talked about as one of the greatest challenges that we face, with questions of how to adapt our public services and so on to meet the needs of that ageing society. However, in the developing world, the absolute opposite is true. I have had the opportunity to go to several countries in Africa. The challenge faced in Sierra Leone is the number of young people involved in the war who have lost their parents and become incredibly emotionally damaged. The question is how to deal with the sheer number of such children and how to find meaningful work and activities for them. I visited Tanzania to work with an education organisation which is working to improve quality in primary education. It has done remarkably well in increasing the number of children going to primary school, and we congratulate it on achieving much of the millennium development goal on education. However, many girls are being taken out of school to do domestic work and so on.
I could go on but I want to talk specifically about the role of the International Citizen Service—the new programme being introduced by the Government that will begin later this year. Potentially, it can play a very important role in development and particularly in providing opportunities for young people, not only in this country but in developing countries, and I hope that the Government proceed with ICS in this manner. This new initiative will be run in this country by six specialist development organisations led by VSO. All six agencies are currently working in development, using volunteers as their main instruments. It is very important that these agencies’ primary concern is development through volunteering, rather than simply giving people from this country a good experience.
More than most in this Committee, I can give testament to the value of volunteering for individuals in this country. It changed my life; the most important two years in my life were the two that I spent in Kenya. However, that is not enough; we have to approach this with the vision of development. VSO will do it through youth exchange, involving young people from the developing world as much as young people from this country. I urge the Government to keep faith with development and not to be tempted to turn this into what some might call gap-year tourism. It is not that. It needs to be a significant experience in development for children and young people in the developing world. I hope that the Government will learn from VSO about how to do this.