(1 week, 6 days ago)
Grand CommitteeI very much remember the debate because we worked closely on it. We will look into this and get back to the noble Baroness with a detailed explanation of the issues so that everyone is clear.
My Lords, I thank everyone for their kind words about my introductory speech. I thank the Minister for his detailed response. I say to the noble Baroness, Lady Brinton, that I also worked on the Medicines and Medical Devices Act. Well done for picking up that cross-reference, because my understanding was that tampons, pads and reusable products were not medical devices under that Act. There is a complication there that we need to address.
My Lords, we are still but just over five months in office. Clearly, we have to think very carefully about the actions we are going to take. What I seek to demonstrate to the noble Baroness is that we have the powers and determination. There are a lot of areas that we have to look at, but I think that the Written Statement I read out in relation to plastics shows where we want to go. We want to see real progress in the areas that she has developed.
I thank the noble Lord for his intervention. I think he perhaps misunderstood where I was going with that. It was not meant to be a criticism of this Government—I fully take the point of five months in power. What I was criticising or questioning was the legal framework, which allows the Government to act, whereas in these amendments each proposed new subsection (1) says that the Secretary of State “must” regulate. This is proposing a different kind of framework. It is asking the Houses of Parliament whether they are prepared to direct, within a certain timeframe, that the Government have to take action. I am questioning not what the Government are doing but whether we as a society and a Parliament want to say, “There is a real problem; the Government must take action and that is what the legal framework should be”. That is what each of these amendments does.
While I fully acknowledge that the Minister expressed some good intentions, I have to pick the noble Lord up on the reference to the straws, cotton buds and stirrers regulations. I am afraid that, when I was responding to that regulation, I was accused of being rude. I pointed out that, in 100 years’ time in a plastic- choked world, the generation then will not say, “Oh but they banned straws, stirrers and plastic cotton buds back then in the UK”. It is a very tiny scale tackling of a very large issue.
None the less, I appreciate everything that has been said. I will note that the phrase “precautionary principle” did not appear anywhere. I think that is very relevant here. We will continue the discussion. I very much appreciate the Minister’s offer of meetings to talk about these issues. I would be delighted to take that up.
My Lords, I apologise for interrupting and delaying the Committee, but I did say that we would use our powers to identify products and sectors that require action and that this work would be evidence-led and proportionate.
Proportionate is not precautionary principle. Anyway, I am not going to pick up that. I beg leave to withdraw the amendment.
My Lords, I will be brief. The main point I wish to make initially is that the next time someone complains about your Lordships’ House not giving enough time to pass important legislation, I will reference this debate. However, given the attack that we have just had on the Australian schooner, I have to point out to the noble Lord, Lord Sharpe, that it evolved organically from the community in 1930s Australia as an unofficial measure. It was a measure of change and of the grass roots making decisions for themselves.
The noble Lord may think that his amendment will save pubs in the UK. I point out to him that, in the first quarter of this year, about 80 pubs closed in England each month. That was a 56% increase on 2023. One of the things that has been suggested might be a saviour of pubs—the noble Lord might choke on his pint at this point—is that we live in a world of change, and sales of low or no alcohol beer have exploded in the past few years. It is very hard to take this amendment seriously.
Despite that, I agree with the noble Lord that there are problems with the Henry VIII nature of the Bill and the way that it allows the Government to do virtually anything. However, picking out one particular small point is not the best way to illustrate that.
My Lords, it falls to me to respond to this amendment. Unlike the noble Baroness, I think this is a very serious matter. Of course, the noble Lord, Lord Sharpe, has a track record in this area. I think the final order he laid as a Minister in the Home Office was to extend the licensing hours during the summer’s Euro 2024 tournament for football fans. I cannot believe it, but I think he said it was to
“get properly on the lash”.—[Official Report, 24/05/24; col. 1281.]
The Government are glad that his devotion to the pint continues in Opposition, despite his seeming about-turn on the appropriate use of executive powers. He may like to know that I prepared myself for this debate by sampling pints of beer in a number of hostelries and restaurants over the past few days. I am happy to confirm that I had no difficulty in ordering a pint of bitter—or, indeed, more than one pint of bitter.
The Government rejoice in the use of pints as a measurement. I am less worried about the loss of the pint than I am about the worrying news of a shortage of Guinness. Noble Lords may have seen reports in the media in the past few days that Guinness is being rationed to make sure there is enough available over the Christmas period.
I have made it quite clear that we value the pint; there will be no change. There is no question of using the Bill’s powers to do anything other than preserve the pint. The specific drafting is to allow for changes to legislation on units of measurement, but the reason is primarily to provide powers to fulfil our international obligations and keep pace with updates to the globally used international system of units.
The argument running through the whole debate is that we want flexibility in order to keep up to date with the sorts of situations that the noble Baroness, Lady Bennett, outlined earlier, or with changes happening globally. We are not using this—I do not believe any Government would use this—as a draconian effort to get rid of imperial measurements in the way the noble Lord fears. I hope he will take it from me, as the spokes- person for the Government, that the British pint is safe with us.
(2 weeks, 1 day ago)
Lords ChamberMy Lords, one of the issues is that home owners did not really understand what they were signing up to. In California, for instance, the state enacted a preservation and consumer protection Act, which led to an almost 90% decline in originations. More generally, the Green Deal that the coalition Government brought in shows some of the problems. First, the interest rates on offer were not sufficiently competitive; secondly, it was very complex to make an application; and, thirdly, there were lots of allegations of mis-selling. Given all that, the Government withdrew it. We need to learn a lot of lessons if we are going to make progress.
It is thought that currently owners are deterred from making a major investment in energy-efficiency improvements because they do not expect to live in the home for a sufficient length of time to get the money back through energy efficiency. The whole point about the GFI proposal is for longer-term loans that are assigned to the property, to keep interest rates low and give people a much better opportunity to make this investment.
My Lords, in an earlier Question your Lordships’ House was talking about vocational training and education. However it is funded, can the Minister assure me that ensuring we have the vocational skills and the building skills needed for home insulation is of the highest priority to the Government? That is crucial for the climate, for the health of the nation and for saving households money.
My Lords, I cannot really respond better than by saying that my noble friend answered the point thoroughly. We at the Department for Energy Security and Net Zero keep a close eye on skills needs. In fact, the whole energy sector has great potential for growth in really high-skilled jobs in the future. Since 2021 the department has invested over £28 million in skills and training, which has resulted in 33,000 training opportunities in retrofit, clean heat and energy efficiency roles. I take the noble Baroness’s point and we keep this issue under very close review.
(3 weeks, 1 day ago)
Lords ChamberI hope we are not slipping behind. Clearly, the process that GBN is going through will take a few more months, but I hope the outcome will be a satisfactory conclusion. I cannot comment on the companies involved in the appraisal and the discussions taking place with GBN at the moment, but I take the noble Lord’s point about our defence capability and the supply chain. We are increasingly seeing the civil nuclear and defence nuclear industries working more closely together, and I see that as a very important foundation for the future. I take the noble Lord’s point about the US; it is important that where we have a technological advantage, we make the best of it.
Are the Government going to consider security in the same kind of way?
My Lords, security is one of the key considerations not just on SMRs but on AMRs.
(1 month ago)
Grand CommitteeMy Lords, it has been an interesting mini debate and I am grateful to the noble Baroness, Lady Bennett, and the noble Lord, Lord Fox, for their amendments. I want to remark on the miraculous conversion to regulatory purity of the noble Lord, Lord Sharpe. I can only refer to Luke, chapter 15, which states that
“joy shall be in heaven over one sinner that repenteth, more than over 90 and nine just persons, which need no repentance”.
I am not a crazed zealot but perhaps in my case, with due acknowledgement to St Augustine, “Oh Lord, make me regulatory pure, but not quite yet.”
We have encapsulated a very interesting debate because I think we all accept the really important point raised by the noble Baroness, Lady Bennett, and the noble Lord, Lord Fox. On the other hand, there are issues about the wording of the amendment and the unintended consequences, alongside the fact that we believe that current legislation allows us to do what both the noble Lord and the noble Baroness would require us to do.
Amendments 30, 115 and 125 are intended to reduce waste. They promote recyclability, repair and reuse of products, and seek to mandate that all product regulations made under the Bill would require an environmental impact assessment and provisions related to the right to repair and the circular economy. Amendment 50 of the noble Baroness, Lady Bennett, seeks to achieve similar by making it a requirement that regulations made under the Bill include provisions to promote circular economy principles. The noble Baroness’s amendment then goes a step further, requiring the Secretary of State to issue guidance on such principles within 12 months, and to review and update that guidance at least once every three years.
Under the duty set out in the Environment Act 2021, Ministers and policymakers must already consider the environmental impact of all new government policies. I certainly empathise with the whole concept of the circular economy, on which both the noble Baroness, Lady Bennett, and the noble Lord, Lord Fox, spoke with such eloquence. The Secretary of State for the Environment, Food and Rural Affairs has set the reduction of waste by moving to a circular economy as one of Defra’s top five priorities. In fact, the Secretary of State has convened a small ministerial group on the circular economy and asked his department to work with experts from industry and academia to develop a circular economy strategy. I will feed this debate and noble Lords’ contributions into the ministerial task force.
I understand the importance of the right to repair. The product regulations made under the Bill will cover many types of products, some of which may be inappropriate to repair. That is really part of the point; for instance, cosmetics is one example—the point that the noble Lord, Lord Sharpe, made. The Ecodesign for Energy-Related Products and Energy Information Regulations 2021 introduced measures including requirements for repairability for the first time in Great Britain. Those regulations contribute towards circular economy objectives by increasing the lifespan, maintenance and waste handling of energy-related products. Our aim is to introduce further right to repair measures when regulating individual products under the ecodesign for energy-related products regulations, where appropriate. That is probably the best way in which to approach it, rather than putting a generic requirement in this piece of legislation.
With regard to Amendments 5 and 28, I reassure noble Lords that the provisions in the Bill do not prevent the UK introducing new environmental regulations. Should we wish to set out broader regulations that exceed or differ from EU rules, we already have powers under other legislation to introduce wider environmental protection rules.
I understand the desire of noble Lords to have something in the Bill in relation to these important issues, but there is a problem of imposing requirements where they cannot reasonably be met or duplicate existing policies. I know that is not the intention, but we think that would be the effect of the amendments before us. We clearly want to avoid conflicting or duplicating regulations. In essence, we agree with the principles put forward by the noble Lord and the noble Baroness. We think we are covered by existing legislation and regulations, but I am grateful to them for bringing them forward.
My Lords, I thank the Minister for his response and noble Lords who have taken part in this time-constrained debate. I take some encouragement from the expressions of at least general support. Like the noble Lord, Lord Fox, I look forward to further discussions with the Minister on this issue. That is part of the reason why I tabled a number of amendments taking different approaches and going into different parts of the Bill because of the different ways of approaching it. We are very open to anything that might put in some kind of guard-rail.
If I may say so, the Minister gave a classic Civil Service response: “But it is covered by other legislation”. I point him to the figures I cited about how little progress has been made on waste reduction towards a target that is only three years away. What we are doing now is clearly not enough, and it is not working.
We are talking about the product regulation Bill, and on the point about right to repair and cosmetics, there are obviously different rules to be applied to different products. That is true of any Bill that covers product regulation.
I wish briefly to pick up the points made the noble Lord, Lord Sharpe, who suggested that these amendments might produce a further burden on consumers. If consumers found that their fridge lasted longer, for the kind of period that fridges used to last, that would be not a burden but a considerable advantage. If they were able to fix their mobile phone instead of having to pay a multinational company a large sum of money for a new one, that would certainly not be a burden on consumers. It would perhaps be a rebalancing of the Government acting in the interests of consumers rather than those of giant multinational producers.
We can see clearly that this is a debate that will continue, but in the meantime, I beg leave to withdraw Amendment 5.
My Lords, I say at once that I pay due regard to the Civil Service and the advice I receive, but these are the words of Ministers. There is a judgment here that you do not want to add legislation where you already have it. The point the noble Baroness makes is that the legislation is not being used effectively. The whole point of the Secretary of State for the Environment, Food and Rural Affairs’s task force is to look at the progress we are making and to refocus in relation to the circular economy. I hope the noble Baroness will not think that this is a damp squib of an answer because we take what she says very seriously. Of course, we will be happy to meet her and the noble Lord, Lord Fox, to discuss this important matter further.
My Lords, I reassure the noble Baroness that my fridge is more than 20 years old, and I have a very good mobile-phone repairer.
(2 years, 6 months ago)
Lords ChamberMy Lords, it is a great pleasure to follow my noble friend. I have added my name to her Amendments 60, 61 and 75. I have my own Amendment 62, and my Amendments 69 and 70 seek to amend Amendment 68 in the name of the noble Baroness, Lady Barran, on which my noble friend Lady Blower has already spoken.
I very much support what my noble friend said and could not help reflecting on the previous debate, where the argument was about the extent to which this legislation is forcing single academies to join multi-academy trusts. My view is that although the noble Baroness was explicit on this, we do not really need it, because the system is putting so much pressure on individual academies anyway. The combination of the government policy in the White Paper, the regulator, the regional apparatus and what people can see happening is putting tremendous pressure on those schools. I think that this is a really underhand way of doing it; if the Government have a policy, on this or on another Bill, they should be explicit.
The underhand way in which this is all being done reinforces the points we are making in this series of amendments about the importance of governing bodies. What seems to be happening is that all sorts of secretive talks take place between MATs and the heads of the schools that they want to take over, and left out of these discussions are the parents and staff of the individual schools. They are usually presented with a fait accompli. As my noble friend said, this formal consultation stuff is really an attempt to legitimise a decision that the system has clearly already made. Our amendment seeks to put this right.
In addition to the excellent National Governance Association submissions, the work by the LSE and by Professor West and colleagues, which has looked into the governance of academies in detail, is very striking. I draw the Minister’s attention to the recent instance of what I regard as high-handed action at Holland Park School. Since March, when staff and parents first learned of the governors’ plan to transfer the school to a MAT, they have been seeking dialogue with the governing body to negotiate the involvement of the entire school community in a transparent, accountable consultation. As Ministers know, the school has been through a great deal of turbulence resulting from management changes in the past year or so: the sudden departure of the new head, the imposition of a new governing body and the absence of much of the leadership team for quite lengthy periods. It has clearly been a challenge to maintain a sense of coherence and direction for the children on a day-to-day basis. I have met some of the teachers. I believe that they have worked hard to provide continuity for pupils, but that is put at risk by this kind of unilateral, opaque decision-making and poor communication from the governing body.
This is often reflected up and down the country. The absence of meaningful consultation in the MAT acquisition process is a common theme. There have been numerous examples of high-handed governors ignoring parents and teachers, who have then fought hard to stop the school being taken out of local authority control and turned into an academy or forced to join a multi-academy trust. Public meetings organised by parents and staff, with large attendance, often make it made abundantly clear to the governing body that the larger school community does not want to go down that path, but they are often dismissed by the people making the decisions. Parents, governors, staff and pupils have no official rights to detailed information on the reasons why their school might choose to academise under a particular trust, let alone to have their views taken into account in the process.
As Warwick Mansell has written, the academies policy sees all decision-making as a closed-loop process between central government and academy trusts, with no decision-maker answerable at a local level to the people who depend on the decisions. The comment often made from the Dispatch Box is that we will talk to the academy trust. Once again, we do not hear about maintained schools. Ministers constantly harp on about MATs and point to their achievements—which are many—but they do not point to their defects and they give the sense that maintained schools are second-class entities. I object to that.
The Government’s amendment reads:
“Before a maintained school in England is converted into an Academy following an application … the local authority must consult such persons as they think appropriate about whether the conversion should take place.”
So, as I read it, it is only after you have made the application decision that the consultation has to take place. My argument is that that is far too late. Once the conversion application has been made, effectively the decision has been taken. Asking the parents what they think about it then is, frankly, a waste of time. Seeing the noble Baroness, Lady Shephard, here reminds me of health service consultations, which she will know about over many years: you make a decision and then you put out a consultation. My noble friend Lord Winston will also know about the way that the health service does consultations: you make the decision, you consult on it and then you reach the view that the original decision was right in the first place. For me, that is what the amendment is talking about.
Essentially, with the combination of our amendments we seek to ensure that a consultation must be comprehensive and in a timely fashion with the parents and staff of the school that is subject to the application. As my noble friend said, we are entitled to have it shown how the proposal will benefit children’s education and, most importantly, what alternatives have been considered. I do not think that is at all unreasonable. If the Government are asking us to believe that this is all going to happen by a process of gradual change rather than mandation, I would have thought they would welcome a proper process of parent and staff involvement.
My Lords, I shall speak to Amendment 75, in the names of the noble Baroness, Lady Blower, and the noble Lord, Lord Hunt of Kings Heath. It is a great pleasure to follow the noble Lord, and I agree with pretty well everything that he said. I shall build on it with a practical example.
Amendment 75 says that consultation with parents and staff has to happen before the application to join a MAT. I entirely agree with what the noble Lord just said about the problems with the government amendment. Across many fields of government, not just the health service, the term “consultation” now has an extremely bad odour. That is something that really needs to change, or we need to find a new word or a different process that genuinely addresses the collection and exploration of views before a decision is made. That is not what people think of when you say “consultation” now, but that is the word in the amendment because that is the word we currently have.
I draw the Committee’s attention to the sad and traumatic case study of Moulsecoomb Primary School in Brighton, which is of course of particular interest to my noble friend Lady Jones. We have just seen first-choice applications to the school fall to their lowest level ever after the school was forced to become an academy despite considerable local community, family and parent resistance. Of course I wish the school all the best and very much hope that things work out for it, but we have to focus on what kind of disruption happens both to pupils and to a community if a decision is made that parents and the community are unhappy with. We have seen a number of pupils leave that school and a huge amount of time, energy and attention that might have gone into doing the best possible for the education of pupils going instead into resistance to an ideological decision being made. It is important that this whole set of amendments tabled by the noble Baroness, Lady Blower, and the noble Lord, Lord Hunt, would make this a co-creation and co-production process, not an imposition.
(2 years, 6 months ago)
Lords ChamberMy Lords, I strongly welcome my noble friend’s amendment. I, along with my noble friend Lady Blower, have a number of other amendments in this area.
I want to encourage the Minister to say something about this. Clearly, she has heard all our concerns about Clauses 1 and 3. I just want to suggest that one way through may be to consider the super-affirmative procedure for dealing with the issue of standards. We debated earlier the issue that even an affirmative instrument allows us only a debate. The advantage of the super-affirmative procedure is that it allows both Houses of Parliament opportunities to comment on proposals for secondary legislation and recommend amendments before orders for affirmative approval are brought forward in their final form. The idea of the super-affirmative procedure is that those orders are implemented in enactments where an exceptionally high degree of scrutiny is thought appropriate—for instance, for the scrutiny of certain items of delegated legislation made or proposed to be made under Henry VIII clauses.
Take my noble friend Lady Chapman’s earlier amendment, in which she sought to replicate the standards in relation to independent schools and said that, basically, this would give a much more explicit set of standards to work on. If you combine that with the super-affirmative procedure, you might achieve a greater and more effective way whereby Parliament could scrutinise what the Government seek to do. However, I really do not think that simply having regulations is the way to do it. I urge the Minister to consider this procedure as one way through, because it would give Parliament an opportunity to comment on the draft regulations and the department an opportunity to go away and consider it before coming back with the substantive order. In some ways, this would be a very good way to deal with some of the issues in this Bill.
My Lords, I rise to speak briefly to Amendment 28 in the name of the noble Baronesses, Lady Chapman and Lady Wilcox, to which I have attached my name.
I agree entirely with what the noble Lord, Lord Hunt, just said. However, what particularly attracted me to this amendment was its reference to
“an annual report on the exercise of the powers … and … an annual impact assessment on the exercise of those powers.”
The Minister reassured us a number of times in our debates on earlier groups by saying that “it is not the intention of this Government” to do this or that. The annual review proposed by this amendment would ensure, whatever Government are in power, an assessment of how the law is being used. Given the current powers in that law, many Members who usually sit on the Benches opposite might think that this would be a good idea with a different Government in place.
(2 years, 11 months ago)
Lords ChamberMy Lords, I offer the support of the Green group for all the amendments in this group. My name is attached to Amendments 51 and 87 and it would have been attached to others had there been space. I can only commend the noble Baronesses, Lady Meacher, Lady Tyler of Enfield and Lady Finlay of Llandaff, for identifying a serious lacuna in the Bill and for providing practical, careful and sensible solutions to that.
The noble Baroness, Lady Finlay, said that the Bill was “by adults for adults”. The other amendments in the group address only half that phrase. It addresses the “for adults” part but not the “by adults” part, which is what my Amendment 103A aims to address. Young people are experts in being young people. We may think about the life experiences of a 12 year-old or an 18 year-old, but none of us really knows what it is like to be 12 or 18 at this moment. A phrase often used particularly by marginalised groups is “Nothing about us without us”—given the hour, I will spare noble Lords the Latin version.
Young people are undoubtedly a marginalised group in our society in that their voice is far too rarely heard. As I have reflected previously, they are hugely underrepresented in this place and in the other place. The under-18s do not have the vote. The under-25s in the voting population, for structural reasons that could be fixed but have not been, do not have the same kind of voice.
I entirely accept that, among paediatricians and social workers, there are many older people who have much expert knowledge, but it is crucial that we actually hear. My amendment seeks to address ICBs and sets out that, in statute, there should be an advisory board consisting of young people on every ICB. I believe that this is an important addition to ensure that young people’s voices are heard. It might be said that many ICBs may set up such a structure, but that is not the same as it being statutory, ensured in the Bill with a message from Parliament saying, “You have to listen to these young people’s voices”.
I doubt that I need to address this in detail, particularly with the occupancy of the Chamber for this group, but I want to mention the Children’s Society’s Good Childhood Report 2021, which looked at 10 to 17 year-olds. Among them, one in 15 were unhappy with their lives—the highest level in a decade. We know that children who are unhappy at the age of 14 are significantly more likely to display symptoms of mental ill health, to self-harm or, sadly, to attempt to take their own life by the time they are 17.
As the report makes clear, the pandemic is only part of this story. There is a climate emergency and a pervasive fear about the future that young people have lived their entire lives through. We are talking about people whose whole life experience, virtually, has been since the financial crash. One thing that we know addresses a sense of powerlessness, with all its negative effects on mental and physical health, is giving people a sense of empowerment—that is, a sense that they can take control of their lives, make choices and make a difference. I often see this with young climate strikers.
I believe that the measure proposed by my Amendment 103A would ensure that this group of amendments collectively addresses the two sides of the problem that the noble Baroness, Lady Finlay, identified. I want to take this forward and I invite noble Lords who are interested to talk to me about it. This should be included in the Bill. Let us hear from children and young people and make sure that ICBs listen to the children and young people they serve.
My Lords, I very much agree with the noble Baroness and I support the broad thrust of these amendments. As this is my first intervention on the Bill, I should declare my interests as a board member of the GMC and the president of GS1 UK, the British Fluoridation Society and the Hospital Caterers Association. I am also a trustee of the Foundation for Liver Research.
I support Amendment 51 in the name of the noble Baroness, Lady Tyler. As she said, she, the noble Lord, Lord Bichard, who also put his name to the amendment, and I are members of the Lords Public Services Select Committee, which has just produced a report on vulnerable children. When taking evidence and listening to the arguments, it was sobering to hear that it is now estimated that the number of vulnerable children has accelerated, particularly during Covid, so that more than 1 million children are growing up with reduced life chances. Too many of them end up in our criminal justice system but, despite this, there is no government strategy to deal with vulnerable children.
The result is a lack of co-ordination both nationally and locally. Too many children fall through the gaps. Public services intervene far too late to prevent some of these children from getting into difficult circumstances. Although the amendment deals with only one aspect, it is but one aspect of a more general problem that we believe the Government need to address. The particular problem that we wish the Committee to take account of is the silo working that continues to be evident both nationally and locally, as well as the frustrating unwillingness of public bodies to share data even though it is abundantly clear from both the law and the Information Commissioner’s comments that they are perfectly able to do so.
I do not pretend that passing an amendment to the Bill will change everything overnight, but we look to the Government to be firm in their intent. It is unacceptable for public bodies, many of which have a direct relationship with government, to refuse to share information for all the miserable reasons of tribalism and managers not being willing to let go. We need to do something here.
(3 years, 6 months ago)
Lords ChamberMy Lords, I am glad to follow the noble Baroness, Lady Noakes—I so agree with her. At the moment, Clause 3 gives Ministers a blank sheet to do whatever they wish, and I am afraid that ministerial assurances are not sufficient. One way or another, we need to amend Clause 3.
My principal reason for speaking is to support my noble friend in her Amendments 20 and 21 on skills shortages. It is surely important that any regulatory change is only considered before consultation with the relevant regulators, in the context of how the national body is undertaking work and investment in the domestic sector in order to help alleviate those shortages.
I am particularly interested in workforce issues in the health service and social care. I remind the Minister of a report by the King’s Fund in February this year which said that NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 full-time equivalent staff. Key groups, such as nurses, midwives and health visitors were severely affected. General practice was under strain, with a shortage of 2,500 full-time equivalents, with projections suggesting that this could rise to 7,000 during the next five years if current trends continue.
The regulator for health and social care, the Care Quality Commission, has highlighted workforce shortages as having a direct impact on the quality of care. NHS waiting time standards have been routinely missed for a number of years, which the consequences of Covid will exacerbate.
The Health Foundation, another respected independent institute, says that the UK ranks below the average of high-income OECD countries for the number of practising nurses and the annual number of new nurse graduates relative to its population. Further, about 15% of registered nurses in the UK are trained outside the country—more than double the OECD average.
Workforce shortages are not new in the NHS. They have been a recurring and enduring feature during its 70 years or so. The reasons are complex. A historical reliance on international recruitment may be part of the story. A bias in the UK towards focusing on the Exchequer cost of training doctors and nurses—which is expensive—but not on the cost associated with the failure to train enough staff is another factor. More broadly, workforce shortages are totemic of the short-termism that dominates national policy-making under this Government.
The noble Lord, Lord Patel, will speak at the end of this debate. I hope he mentions his House of Lords committee report from 2017. It argued that the absence of any comprehensive, national, long-term strategy to secure the appropriate skilled, well-trained and committed workforce that the health and care system will need during the next 10 to 15 years represented
“the biggest internal threat to the sustainability of the NHS.”
Amendments 20 and 21 post the way for a national authority to be required to publish a report on how skill shortages are being met and how we are investing domestically to address this shortage and upskill existing staff. I hope the Minister will be sympathetic.
My Lords, I shall speak chiefly to Amendments 20 and 21 in the name of the noble Baroness, Lady Hayter, to which I have attached my name. These amendments are also supported by the noble Lord, Lord Hunt, and the noble Baroness, Lady Finlay, which gives them both cross-party and non-party backing. I have mentioned that all noble Lords received a letter yesterday from the noble Lord, Lord Grimstone, and the noble Baroness, Lady Berridge, with her Department for Education hat on, about the Bill and the skills strategy. Its second paragraph says:
“Let me reassure you the Bill is not a short cut to addressing skills development for the UK.”
We can see that the Government have really understood some of the deep concerns that have been expressed by your Lordships’ House about this Bill.
The letter makes reference to the Skills and Post-16 Education Bill. I am not going to start its Second Reading now, although we have to look at whether ladening people with more debt is the answer to our skills shortage.
Another sentence in the second last substantive paragraph of this letter says:
“To meet demand across certain regulated professions, we need appropriately qualified professionals from both domestic and overseas sources.”
In relation to Amendments 20 and 21 and my earlier Amendment 25, do the Government accept that, particularly for certain key—basic, you might say—professions central to our health and well-being, such as nurses and doctors as a general category, we should be training at least enough medical professionals to meet our needs? That sentence would suggest that that is not something that the Government accept.
I come briefly to a couple of details about these amendments, particularly Amendment 21, which is quite valuable and perhaps adds more than my Amendment 51. They highlight important issues, one of which is in subsection (d), which asks for a report on the number of the professionals in the group being considered who are female and male. It is important that we highlight gender disparities. There has been a lot of discussion about medical professions, but I have interest in both the farming and the building and engineering areas, where we have huge skills shortages and there are very serious gender disparities in recruitment.
As I listened to the noble Baroness, Lady Finlay, talking about the complexities of modern medical approaches, I was thinking of some of the engineers I have been speaking to recently about the complexity of building ventilation, something that Covid-19 has very much brought into focus and which we clearly need to be thinking a great deal more about. There is a high level of complexity and a high level of skill is required; you have to understand each individual room and each individual climatic environment. It is a very complex area and requires very high levels of skills and training. I think also that when we are thinking about agriculture—we will be talking about this in the Environment Bill and in the agriculture Bill—we are talking about agri-ecological approaches and agriforestry approaches, not just one field of monoculture that you whack the plough over and you whack the sprayer over, but very complex management of ecosystems that requires a very high degree of skills that we simply do not have now. It requires training and may require people being brought in.
I also want to highlight, as the noble Baroness, Lady Hayter, did, retention rates. Of course, nursing is the obvious area, but there is also a big issue in medicine that needs to much more attention. This is a really important amendment. The support for it demonstrates that, as does the Government reaction, but I think we need a much clearer picture of what the Government’s overall approach is. Are they determined to meet the challenge of training enough people for our needs?
(3 years, 10 months ago)
Lords ChamberMy Lords, I am glad to put my name to my noble friend Lord Kennedy’s Amendment 182, but I also welcome Amendment 174 tabled by the noble Baroness, Lady Burt. I see the two as complementary. I remind the Committee of my membership of Unison. I am pleased that we are returning to debating these really important workforce issues.
Experiencing domestic abuse can significantly affect a person’s work life as well as their home life. Victims may have to relocate, which impacts on their ability to get to work, and the effects of the abuse may affect their performance or ability to work at all. As I said in the debate on the group of amendments beginning with Amendment 57, domestic abuse is a trade union and workplace issue as much as any other form of abuse that affects workers’ conditions and income. Home and work issues cannot always be neatly separated, and abusive, violent behaviour does not take place only in the home; it frequently crosses over into the workplace, where victims experience stalking, threats, harassment and sometimes worse.
As the noble Baroness, Lady Newlove, just said, work can equally be a lifeline to independence and survival for victims of domestic abuse. They are able to leave their homes to go elsewhere and can maintain a level of income independent of the perpetrator. All victims should surely feel safe in the knowledge that they can take action to put their lives back on track, with their employment secure, and that they are protected while at work. I agree with the amendment of the noble Baroness, Lady Burt, which seeks the issuing by the Secretary of State of a code of practice. I would also like to see a guarantee that employers will be provided with guidance about the provision of paid leave, which is reflected in my noble friend’s amendment. Guidance really does go hand in hand with a code of practice.
Granting paid leave is one of the most effective actions an employer can take to support workers who are the victims of domestic abuse. Time off allows them the time and space to address the impact of the abuse, such as by receiving medical treatment, finding safe accommodation and attending court or police dates. The great thing is that some employers understand this. During the lockdown, we saw the introduction of safe spaces for the victims of domestic abuse by businesses across the UK, including Boots, Superdrug and Morrisons. This demonstrates the huge impact that businesses can have in supporting victims of domestic abuse. Some employers have policies in place that introduce other practical measures. For example, Vodafone plans to offer up to 10 days’ paid leave to victims of domestic abuse and to provide specialist training for human resources managers to enable them to support employees experiencing violence or domestic abuse.
Hestia is part of a coalition of domestic abuse charities and organisations carrying out a programme called Everyone’s Business, which aims to encourage as many employers as possible to consider how they can support employees being impacted by domestic abuse, so there is something to build on. Despite this, only 5% of employers have in place a domestic abuse policy of any kind. A provision in the Domestic Abuse Bill to make it mandatory for employers to provide care and support for employees suffering abuse has the potential to make a significant practical difference to victims and survivors alike. The domestic abuse commissioner supports the inclusion in the Bill of paid leave and guidance, and I hope very much that the Government will give this further consideration.
My Lords, it is a pleasure to follow the noble Lord, Lord Hunt of Kings Heath, and I agree with him that these two amendments, Amendment 174 in the name of the noble Baroness, Lady Burt of Solihull, and Amendment 182 in the names of the noble Lords, Lord Kennedy of Southwark and Lord Hunt, are complementary and, I would add, an essential part of the Bill to make it the complete package. Your Lordships are trying to make the Bill the best that it can be.
I will follow the noble Lord, Lord Hunt, in reflecting on the valuable advice given by the designate domestic abuse commissioner for England and Wales throughout the Bill. That advice noted that, while the BEIS best practice guide offers suggestions and advice that pretty much reflects these two amendments, its recommendations are only voluntary. Yet if we look around the world and, as we so often do, at New Zealand, we see an example of a place where this is part of the statutory provision that gives workers the protection they need.
I note the TUC submission to that BEIS review of this issue. It included something that is probably covered by the amendment of the noble Baroness, Lady Burt, if not explicitly spelled out: the need for flexible working arrangements. We can well understand that, in the turmoil of surviving and escaping domestic abuse, flexible work might well be essential.
(3 years, 11 months ago)
Lords ChamberMy Lords, it is a great pleasure to follow the noble Baroness, Lady Cumberlege, and I join her and other speakers in thanking the noble Baroness, Lady Thornton, for tabling the amendment, which I think is largely intended to start a debate and get some focus on this terribly important issue.
My approach to the whole issue of disinformation about harmful content on the internet is slightly different from those of some of the other speakers. We need to take the same approach as we do with the vaccine, which is to think about vaccination being better than treatment—prevention being better than cure. Ensuring good public communication, information and education about Covid and many other issues is the best possible way in which to take on misinformation, rather than after the fact—after the infection—and then trying to treat it. As soon as one starts trying to combat such messages, it is difficult to avoid repeating them. As any communications professional will tell you, you are then trapped in a difficult cycle of raising the issue up the agenda and raising it up the hashtags.
When we are talking about problems on the internet more generally, we need much broader education on media literacy and critical thinking throughout our education system. That will not help us in the immediate future but, when we are talking about Covid, we can think about the nature of the Government’s communications and public information campaigns that will, in effect, inoculate people against the disinformation so prevalent in cyberspace. We need calm, factual, often quite detailed information that will educate the public about what is going on.
It is telling that we have seen a great deal of hunger among the public for briefings involving senior scientific officers and advisers. Some of them now have their own fan clubs and T-shirts. There is a real hunger for that kind of quality of information with clear scientific facts. That needs to come from all levels of the Government, including the politicians, not just the technical people. Let us trust the public with more information, data and facts, and with more of the difficulties and uncertainties, than we do now.
If one looks at the messaging in countries such as New Zealand and Germany, one can see that the level of detail and facts, and the quality of the information, given to their publics is much better than ours. Nearly every time there is a major government announcement or bit of advice, I see good technical people, senior professors and consultants on social media screaming in frustration about the quality of the presentation, data and messaging. I am talking not just about the shape of the graphs being wrong or whatever; we need to get the whole of government communications much better. That is the best way in which to tackle all these issues.
We all, even those of us with a scientific background, have learned a great deal more about IgG versus IgM versus IgA antibodies. A huge amount of information is out there, as is a hunger among people to find it. We must make sure that the good sources are there. That is the best way to tackle this problem when it comes to Covid and, indeed, much more broadly.
My Lords, this is an interesting debate and I am grateful to my noble friend Lady Thornton. We know that there is a problem with vaccine uptake, which is linked to anti-vaccine sentiment—though not necessarily always.
Looking back over the past few months, I note that there was in November a survey by Savanta ComRes on behalf of ITV News that found that almost 70% of people in the UK would like to receive a vaccination. More recently, in December, the Royal Society for Public Health published a poll showing that 76% of people would take the vaccine but, significantly, that only 57% of people from BAME backgrounds would do so. There was also a lower response among lower-income groups.
No doubt the Minister will give us figures, but my understanding is that the initial results on vaccine uptake are encouraging. However, we cannot be complacent in the face of the pernicious anti-vaccine sentiment around. Even before the pandemic, vaccine hesitancy was described by the WHO as one of the top 10 threats to global health.
We are interested in what the Government are doing. Last month, we debated this issue and the noble Baroness, Lady Evans, the Leader of the House, referred to the work of a central government unit on it. I should like to hear from the Minister about what is happening. We clearly need strong pro-vaccination campaigns, and the majority of people who may be described as vaccine hesitant are not necessarily anti-vaccine. Most people who are hesitant can be persuaded by good public health messages.
However, as my noble friend and other noble Lords have said, there has been a huge amount of misinformation across social media in the past few months. This is obviously cited by survey respondents as an area of concern when it comes to levels of trust in those delivering public health messages. As Scientists for Labour pointed out, since the recovery from the false findings around the MMR vaccine and autism from Mr Andrew Wakefield, the UK overall now ought to be in a good place when it comes to routine vaccine uptake. For example, the HPV vaccine has a consistent uptake of between 80% and 85%, which is an excellent return for a vaccine that is not part of early childhood schedules.
We do not have too much in the way of well-organised anti-vaccine groups, unlike the USA or, indeed, even the Republic of Ireland, so the likelihood is that the UK population will show less hesitancy about recently introduced vaccines compared with other countries. But the level of misinformation out there is high and we have to learn lessons from other recent vaccine scares. Clearly the Government have a huge challenge in making sure that the uptake of the vaccine is as high as possible—which is why I welcome this debate and the amendment, and very much look forward to the Minister’s response.
(3 years, 11 months ago)
Lords ChamberMy Lords, I am really grateful to the noble Lord, Lord Field, and the noble Baronesses, Lady Meacher and Lady Walmsley, for sponsoring this amendment and for the powerful speeches they have given.
Last week, I heard Hannah Deacon talk on the “Today” programme about her son Alfie and the devastating consequences of Brexit and the impact of the inability to import Bedrocan from Holland. I know the Government have been active, and I very much hope the Minister will be able to report progress tonight.
That is the immediate issue, but of course there is then the long-standing issue that, when Parliament agreed to the legalisation of medical cannabis under prescription, there was a distinct impression that NHS patients would receive medical cannabis where appropriate. It is very clear that the NHS is not prepared to do that. The small number of prescriptions and the approach of the various bodies that advise the health service on commissioning make it abundantly clear that, unless Ministers intervene, patients will simply not be able to get these products in a legal way.
I say to Ministers that, with the campaigns, it is obvious there will be increasing noise, increasing concern. They really will have to step in and find a way of getting access to these products for patients. It is inevitable that it will happen, and it is better than they do this now rather than wait for another three, four or five years. I remind them that, when the legislation went through, the Home Secretary at the time said:
“We have now delivered on our promises … we will work with the NHS to help support specialists in making the right prescribing decisions.”
That simply has not happened.
I suggest four approaches: first, the All-Party Parliamentary Group on Medical Cannabis under Prescription believes that the only way to help families at the moment, and to make sure the policy does not stall completely, is to set up a small fund called something like the medical cannabis access fund, which can be used to help those families, until the blockage on NHS prescription eases.
Secondly, we have to come to the issue of research. I know the Minister is frustrated—he repeated this today—because he thinks the companies producing these products should come forward and undertake clinical trials and tests. I am not an expert, but I have listened very carefully to noble Lords and to advice that I have received, which suggests that randomised control trials are very difficult in this area. In that case, surely the Government should revisit the NHS England report, Barriers to Accessing Cannabis-based Products for Medicinal Use on NHS Prescriptions. The report looked at the issue of research, and said that there should be randomised controlled trials but, alongside this:
“NHS England and NHS Improvement and NIHR in conjunction with the specialist network will work together to determine an appropriate alternative study design that will enable evidence generation for those patients who cannot be enrolled into a standard RCT.”
I gather that this has not happened. The Minister really should inquire into this. It would basically be an observational study; it would allow medical cannabis to be prescribed for large numbers of people and for proper research to be undertaken. I suggest to him that it would be a way forward, so that the current frustration of so many patients is responded to in a sympathetic but also practical way.
My Lords, we started this debate today with widespread plaudits to the Government for listening to very strong campaigns to have a patient safety commissioner. Indeed, the noble Baroness, Lady Cumberlege, who has been so instrumental in this, commented on the importance of that person listening to patients. We have to draw the parallels here because we have heard—as a community, as a society, and as a Parliament—from the parents of children who desperately need these medicines but are unable to access them. Those patients are not being listened to. We really do have to ask ourselves the question of why that is happening and what kind of political block or ideological barrier exists so that we are not seeing action in this area when it is so clearly, urgently needed.
When we were talking about a patient safety commissioner, I commented on how effective campaigning has been in that area. There is also a very effective campaign called End Our Pain, which has been working with families trying to access this medicine. It has been doing a great job, but the Government have not been doing their job in delivering on the campaign. I give credit to the noble Lord, Lord Field of Birkenhead, and all the other people who have signed this amendment, which is very much cross-party and across the House. As the noble Lord said, we have a division here—a human rights issue, referred to in the amendment tabled earlier by the noble Baroness, Lady Sheehan. People, or families, who can afford it, are able to access this medicine; those who need NHS support for it cannot. We should not be tolerating that situation in Britain at any time, particularly in 2021.
I have a direct question for the Minister. I have been looking at what assessment the Government might have made of the impact of current policies and the lack of financial support for vulnerable families. I should be happy to be corrected and perhaps told that an assessment is under way, but the most recent information that I was able to find was from September last year, when Liz Saville Roberts MP asked a Written Question in the other place about whether such an assessment had been made—and the answer was no. I will be brief, because the issues have been well set out by the noble Lord, Lord Field, and others. However, I ask the Government what assessment they have made of the impact of their current policies.