(4 days, 18 hours ago)
Lords ChamberMy Lords, with the leave of the House, I will now repeat a Statement made by my right honourable friend the Health Secretary in another place. The Statement is as follows:
“There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold but a right to be cherished and protected. Now it falls to our generation to make the same choice: to rebuild our National Health Service and to protect in this century what Attlee’s Government built for the last. This is the driving mission of our 10-year plan.
In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of the Conservatives’ underinvestment and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the front line; we have recruited 1,900. We have taken almost 250,000 people off waiting lists, cutting them to their lowest level in two years. We have launched an independent commission, chaired by the noble Baroness, Lady Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.
Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our National Health Service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.
We will put neighbourhood health centres in every community, so that people can see a GP, nurse, physio, care worker or therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan so your care is done with you, not to you.
Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract to get more dentists doing NHS work, rebuilding NHS dentistry.
Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow so that a greater share of NHS investment will be spent on primary and community care.
The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to log in to their computers or spend hours writing notes and entering data. Our plan will liberate front-line staff from the parts of the job that they often hate, so that they can focus on the job they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history so they can provide them with the best possible care.
Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.
The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.
The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in a hospital bed. The NHS will usher in a new age of medicine, leap-frogging disease so we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right honourable friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.
Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the front line. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.
I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the front line, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.
We know the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply the best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.
Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The honourable Member for Clacton—Nigel Farage—and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.
We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this Statement to the House”.
My Lords, we on these Benches welcome the Minister to her place. I know that, when I say that we hope that she is not too long in her place and that the noble Baroness, Lady Merron, is with us again soon, she will understand that I say it in the nicest possible way.
From these Liberal Democrat Benches, our unwavering commitment to the NHS remains absolute. We welcome any stated ambition to improve the health service, particularly with a focus on prevention, leveraging technology and moving care closer to people’s homes. However, our support is contingent on plans being genuinely deliverable, properly funded and, crucially, addressing the interconnected crisis in social care. We have long championed that you cannot fix the NHS without fixing social care.
I confess that, as I read the Government’s new 10-year plan, a familiar echo resonated through my mind. Having started my career in the early 1990s as a manager in the health service, much of what is proposed sounds eerily familiar. This plan speaks of a network of new neighbourhood-based care that provides services between general practice and traditional general hospitals. This mirrors strikingly similar initiatives from previous governments—echoing, for example, the advocacy of the noble Lord, Lord Darzi, for polyclinics in 2007.
What does history teach us about such wholesale shifts of care from hospital? It tells us that this inevitably involves running the old and new systems simultaneously, which is, without exception, expensive. Hospitals will continue to perform their essential functions, and their fixed costs will remain. The new community service demands significant new investment in buildings, staff and technology, and there are no immediate savings to fund the shift. Let us not forget the stark reality: we currently lack the capital simply to repair our existing crumbling health estate, let alone build numerous new hubs.
Crucially, for any plan that speaks of shifting care out of hospitals, the most frequent users of the NHS are our elderly population. Keeping them well and out of acute settings profoundly depends on effective social care, yet this essential pillar remains largely absent from this new plan. We search in vain for a decade-long funding and development road map for social care, or for a stand-alone, fully resourced social care strategy. This is a crucial strategic failure, undermining the very foundation upon which this shift to community is based.
Moreover, while the enthusiasm for digital transformation is understandable, the detailed implementation plan of how to do it is absent. The app is a diagnostic tool; it does not provide direct care, it does not give the jabs and it does not provide the treatment. The King’s Fund has shared its concern on this:
“AI scribes can only transform the productivity of the NHS if staff don’t need to spend 30 minutes every morning logging into multiple out-of-date IT systems”.
The fundamental question remains unanswered: how will this be delivered? The plan is ambitious, but it has been launched into an incredibly chaotic delivery environment marked by significant structural change within the health system bureaucracy. The key question for the Government is how this will be delivered. I therefore have a few questions for the Minister.
What precise funding strategy is embedded within the 10-year plan to deliver the necessary reform and integration of adult social care? Given the dual running costs of new neighbourhood health facilities, can the Minister provide a year-by-year financial breakdown of expenditure and demonstrate how these investments will lead to overall system efficiencies and net savings? Will the Minister commit to publishing within the next four months a comprehensive, independently overseen delivery road map for this 10-year plan that details specific year-by-year objectives and names leads and mechanisms for public reporting on progress? While we wish the ambitions well, the key challenge for this Government is how they will deliver and being open and transparent on that.
My Lords, I also start by sending my very best wishes to my noble friend Lady Merron. No one more than me is looking forward to her making a very speedy recovery. I am very pleased to hear from her that she is making good progress, so we look forward to her return. I think it is appropriate that I declare an interest: my son is a GP, which I think is perhaps slightly relevant to the debate before us today.
To recap before I go into more of the details, I emphasise that this plan is different in so many ways to the NHS plans that have come before it. As we have heard, it is a road map for radical reform that is built on three fundamental shifts. Those of us that have been around the health agenda for a while recognise the past aspiration for some of these measures, but there was never a bold, innovative, collaborative plan to take our ambitions forward.
From hospital to community care, bringing care closer to home and making access to GPs faster and simpler is absolutely fundamental, particularly in the current climate—and from analogue to digital, giving staff modern tools and patients the kind of convenience and control they expect elsewhere in their lives. All of us have heard heartbreaking stories of patients who go from one specialist to another, and there is not that join-up. This has to be changed. There is no reason why this cannot apply across all the experiences the public have, regardless of where they are seeking services.
Many of us have been talking about the need to move to prevention in so many areas of life. Where better than people’s health, looking at the root causes of poor health and making healthy choices? It is the easy choice, but at the moment it is not that easy.
The new NHS has patients at its heart, will deliver equity and quality, is devolved and decentralised so that we are more responsive to local community needs and the front line is freed up to harness innovations, and the rules and incentives in the system support clinicians and lead us locally to be able to make the right decisions. This means that there is no simple chapter or section within the plan for individual conditions or groups setting top-down actions. The impact on particular services and outcomes will be through successfully transforming how our health ecosystem works. As we will come on to with the more specific questions, this is very much a work in progress. I am delighted by the reach the consultation has had over the last year. That has informed the debate and the outcome that is seen in the plan, so there have been no surprises. Many people who have been involved recognise what is in the plan.
The plan is backed by £29 billion per annum of extra investment by the end of the review period and, crucially, by a drive to cut unnecessary bureaucracy and empower front-line staff, giving them the tools to do what they do best: caring for patients.
I thank the noble Lord, Lord Kamall, for his very constructive comments; they were exceptionally helpful. Across the House, we all look forward to taking this extremely seriously and moving forward.
Turning to the comments of the noble Lord, Lord Scriven, on social care, he and I share a very positive background in local government, and nothing could be closer to our hearts than working out how we are going to bring the two together. That is fundamental. Both noble Lords made the point very clearly, and we welcome that.
Over the next three years, we will focus on the neighbourhood health approach to those most let down by the current system. That includes older people with frailty and those in care homes. Social care professionals will work alongside NHS staff in local teams, supporting recovery, rehabilitation and independence. We have examples from around the country where this is already happening: services are joined up and the cultural differences between the NHS and local government have been successfully broken down. We need to make sure this is replicated and spread to every part of the country. We need to enable care professionals to take on many more health-related responsibilities, such as blood pressure checks and reducing avoidable hospital administrations. Of course, pay terms and conditions have to be improved through fair pay agreements.
In the longer term, the noble Baroness, Lady Casey, will produce an interim report next week, but it is very much a work in progress.
Sorry, I meant next year—I was just testing that everyone was still with us—in anticipation of the in-depth work she is already involved with. There will be cross-party discussions and a real engagement with stakeholders.
On the single patient record, I will have to write to the noble Lord about how the merging of the different systems will be achieved, but it will very much be about the patient being in control and giving a full picture for staff moving forward. The digital red book for children is absolutely fantastic.
On the shift to the community, as we have made clear, we will initially prioritise those living in areas of greatest deprivation. We will be opening neighbourhood health centres in places where life expectancy is low. There will be principles that we will follow, bringing all the multidisciplinary teams together.
On the fracture liaison service, I will have to respond in writing. I am sorry but I do not have the specific details in front of me.
Returning to the noble Lord, Lord Scriven, and his comments about social care, it is critical that we get this right and make sure that local leaders are right in there, responsible for delivery, proactive, providing a co-ordinated response and building on the work already being done.
On the funding, £29 billion is quite a significant amount of resource to work from. We recognise that there are challenges, and it would be wrong of me to pre-empt the work of the noble Baroness, Lady Casey. But I know she has been encouraged to work with the best of the best, and I look forward to the outcomes.
I have to finish—I am sorry; there is never enough time. Our health system is in crisis, and we need to act now. We must make sure that the NHS continues as a publicly funded service free at the point of use. We need to seize the opportunities provided by all the new technologies and medicines outlined in the plan, go forward with innovation and make sure that the patients are at the heart of everything we do.
My Lords, from these Benches, we too send best wishes to the noble Baroness, Lady Merron.
The stress on prevention in this plan is welcome, but it does not adequately address the commercial determinants of ill health. On every high street there is alcohol for sale which does not have minimum unit pricing, and that is not coming in. There are vape shops and betting shops, and poor quality ultra-processed food is the food available for purchase. Putting the onus on the individual under the name of choice is unfair when they do not have anything reasonable to choose from that they can afford. I really push the Government to look at these broader commercial determinants of ill health.
I was disappointed that palliative care was mentioned only once, because the Commission on Palliative and End-of-Life Care has shown that good care is less costly than poor care. It can avoid inappropriate admissions to hospital and support people to live well. When at peace emotionally and physically comfortable, they can gently let go of life and die gently in the place of their choice, which is usually their home. But for care at home, they need support 24/7. My concern has been that the plan does not really emphasise that there are times at nights and weekends when AI and technology are not the answer. You need a person who is available to come out and provide help and support to someone in the home. I hope that in the neighbourhoods, the 24/7 need will be addressed and that there will not be an excessive reliance on AI, thinking that it will be the answer to everything. I look forward to hearing the response.
I thank the noble Baroness for her questions and for her best wishes to my noble friend Lady Merron—I am sure that she will receive them. I thank her for bringing up the commercial determinants of health, which are critical. I reassure her that, outside of the health scenario, an enormous amount of work is happening. The NHS is going to work much more closely with local government—which has responsibility for trading standards, for example—and other local public services. We have certain things in place. Come the autumn, we will be bringing back the Tobacco and Vapes Bill, for example, with its huge opportunity to create a smoke-free generation. We are restricting junk food advertising targeted at children, banning the sale of high-caffeine energy drinks to the under-16s, and we will be the first country in the world to introduce mandatory health food sales reporting for all large companies in the food sector.
The noble Baroness raised a few questions. I have to be brief to give other people the opportunity to come in, but palliative care is a real priority moving forward. I will leave it there, but I am happy to pick up anything that I have missed with her outside the House.
My Lords, I welcome the Minister to her place and, like others, send good wishes to the noble Baroness, Lady Merron.
I welcome very much, as others have done, the three aspirations in Fit for the Future. I think that they are significant and that they are the right ones. I think they are bold and visionary. However, while I welcome the move from analogue to digital, for me, the document raises significant questions. We are looking to build a National Health Service which cares for whole people, not machines. We need, therefore, to be concerned for physical, mental, emotional and spiritual health, at every stage of life, across the NHS. That demands continuous investment in people, including, of course, chaplains.
I have specific questions around the ethics, governance and provision of technology. Where will process and governance responsibility lie for data storage? Will the Government continue to outsource this to Palantir or another provider, or will we build and maintain the NHS’s own secure provision? I am mindful that our data stored by the NHS is a hugely valuable commercial asset. Where will the ethical debates take place around, for example, the proposal that newborns will undergo wholesale genetic sequencing from birth from 2035, which seems to raise massive issues for our society? The document as it stands, it seems to me, is wholly positive about technology—it is techno-optimism. Will the Minister please balance this by telling us about the safeguards, reservations and governance that the technology needs in order to deliver the human, humane and kind care that we need?
I thank the right reverend Prelate for his very thoughtful contribution. It is particularly of the moment, and I completely recognise everything he said about this needing to focus on people.
We have to look at this technology as enabling better care and freeing up time. How many of us go to the GP and experience frustration at the restriction on the time that we are allowed to spend with the GP, because so much of their time is taken up with admin? Of course, data protection is central. The health service is not the only area where we are looking at systems of data protection, and the normal protection methodology will be brought to bear. We have to make sure that, in governance, there is a much more transparent and open style, which, frankly, we all have to admit has been missing in some cases. This is an opportunity to look at that.
I must admit that I will have to have a conversation about where the ethical discussions will actually take place, but I know that, throughout the professional bodies, these considerations are taken into account all the time. It is fundamental. The direction of travel is to have people at the centre, building the workforce, so that they have the opportunities to thrive and do their jobs to the best of their abilities for their patients.
My Lord, this is a pot-pourri of worthy aspirations, with the most extraordinary sense of déjà vu: hospital to community; sickness to prevention; a patient-driven NHS; league tables; foundation trusts; funding following the patients and outcomes. I was a contemporary of Alan Milburn, and he is behind this; these were all measures that we were discussing long ago. Maybe they have not been sufficiently implemented—and I so welcome the noble Lord, Lord Scriven, asking where the timetable and implementation plan are, and how this is going to happen.
But I must leap forward to the most serious issue of the day. We are all united on the importance of the NHS. It is incredibly difficult to change it, manage it and lead it. How can it be right for resident doctors to be taking industrial action for five days later in July? They have had an incredible increase compared with other members of the public sector, and the Government have said that they will help them on their work conditions. For those who say that their greatest pride is in helping patients, this is a shocking state of events—in a career that people want to join and that has long-term respect. Will the Minister ensure, very specifically, that the department checks up on whether any junior doctor taking industrial action then moonlights in another health authority, or in a private health provision, so that while they are taking industrial action they are also earning, at a premium rate, making up the gap left by the other doctors on industrial action?
As someone who has been involved in the plan, I start by saying to the noble Baroness that although it might echo things that have happened in the past, there is an enormous difference now. There is a depth of collaboration, bringing people together and recognising the different cultures in organisations. Of the 200 bodies that are going to be dismantled, Healthwatch is one; it has been very positive and has contributed to the future plan for how this is all going to look. There has been a step change in how we get out and work with people. It is a very ambitious plan, which I am pleased about. I am also very optimistic, because, quite frankly, too many professionals have gone too close to the edge and they realise what is on the other side if we do not all pull together and do something about this.
We are disappointed about the BMA decision to strike. The majority of resident doctors did not vote to strike, and threatening strike action that could harm patients will set back progress. I assure the noble Baroness that no one on these Benches is welcoming the strike. The basic truth is that, thanks to this Government, resident doctors have received a 28.9% pay rise compared to three years ago, and the highest pay award in the entire public sector this year. The Secretary of State met the BMA yesterday. Although he has made it very clear that the Government cannot go further on pay than we already have this year, he has offered to work with resident doctors to resolve issues they might face around working conditions. It will, of course, be down to their managers to work with staff to come up with a plan to deal with the action that is being proposed.
My Lords, I add my welcome for this 10-year plan. I also welcome my noble friend to her position and send my best wishes to the Minister, the noble Baroness, Lady Merron; I hope she recovers very quickly.
Like the noble Lord, Lord Scriven, I can see some echoes—or important themes—that the 10-year plan picks up. I was particularly interested to think about how the themes in the 10-year plan will dovetail with what I hope will be a new cancer plan that will come out in the autumn. I am particularly interested in how, for example, prompt diagnosis will be promoted. Are we going to think about stratified screening, with faster diagnosis targets, or faster access to clinical trials for patients with cancer, or speeding up access to modern medicine so that we can have those cutting-edge treatments widely available?
All that is set out in the 10-year plan and the investment—particularly the capital investment, which I welcome—leads me to believe that I can feel very optimistic about what is coming down the track in the autumn. I hope the Minister can give me some assurance. After all, one in two of us may go on to develop cancer in our lifetime, and that is an awful lot of the population.
I thank my noble friend for her interest. Of course, the 10-year health plan sets out how we will fight cancer on all fronts. She is quite right that the national cancer plan is going to be published later this year, setting out in detail how we will increase survival rates through early diagnosis and access to better-quality treatment, and how we move forward with care in the community to help with lives beyond cancer. There is a great deal of detail behind this; I cannot go into it now, but I am happy to discuss it.
My Lords, I welcome the emphasis in the plan on community mental health services and the shift towards 24/7 neighbourhood working. But for this to work, it will have to be achieved by significant rebalancing of resources towards community services. The share of overall NHS spending on mental health has fallen for the last two years and is expected to fall again this year. Although I looked hard in the plan for any reference to the mental health investment standard, I could not see it. Can the Minister tell us what is happening to the standard?
I do not have that specific information to hand, but I am very happy to write to the noble Baroness. Mental health is written throughout the plan, for both adults and children. All the work we are doing in schools—opening up access and making sure that mental health is treated in the way that it needs to be—is one of the major commitments that we have made through the plan.
My Lords, the Minister has very kindly said that she will write to my noble friend Lord Kamall about fracture liaison services. I declare an interest as someone with a rather painful bone condition, and I am delighted that they were mentioned in the 10-year plan. In her letter to my noble friend, can she include an explanation as to an implementation plan and when it will be introduced? When will follow-up pump-priming to support the implementation plan be announced?
I would be delighted to add those details to the letter. I am very sorry to hear about the noble Lord’s condition and its pertinence to this part of the debate.
My Lords, I welcome this plan. As some will know, my colleagues and I have been working in this space for over 40 years, trying to encourage a move into our communities of a more joined-up approach. Are colleagues in the health department talking to colleagues about the Planning and Infrastructure Bill? Our work is now right across the country, in many communities, and we still see that lessons are not being learned. You still have major developments where the health centre is at one end of a site, the nurse is at another, the school and the community buildings are somewhere else—none of it is joined up. All this disconnection is at great expense. How, at this important moment, can steps be taken to try to join up these conversations? How can we try to ensure that in the Planning and Infrastructure Bill there are messages from the health service about the important need to enable this?
I am very aware of the noble Lord’s work in this area, particularly on regeneration. As the plan outlines, looking at the new neighbourhood provision, and how to bring different neighbourhood and community services together, gives us a fantastic opportunity to make sure that the whole community is considered—for example, it will look at connectivity with the centres, which has not always been the case in the past. It is a great opportunity and I am very much aware that our colleagues in planning, and MHCLG generally, are involved in our discussions.
My Lords, I recently had a major operation by robotic surgery. It was very successful; I was out and at home within two and a half days. How will the rollout of this happen? For example, I happen to know that the Royal College of Surgeons at the moment offers only one online module on robotic surgery, which seems to me to be not adequate. What conversations are going on to make sure that this can be delivered?
Robotic surgery is one of the areas generating enormous excitement, and I was very interested to hear of my noble friend’s experiences. I assure her that conversations are taking place, and I know that they will be part of the plan when we come to talk about delivery.
My Lords, if so many people want to speak, we should have a full debate on this plan, which is generally welcome. On digital, the plan summarises various digital improvements. There is also a red book for a child’s health, and feedback from Fitbits and data, which is all very good. However, there is no timescale for any of this and no plan to make patient records from GPs or hospitals available and viewable on the NHS app by the patient, as is the case in other countries. When will the Government give patients open access, as opposed to control by NHS professionals?
I hoped I had made it clear that this is the broad outline. Of course, more specific details will come forward and we will have the opportunity to debate them as they do so. The noble Baroness raises important points about challenges as well as great opportunities. I look forward to those debates; I think we are on a very positive way forward. However, I hope everyone understands that this is a 10-year plan for very good reason. We realise the scale of the challenges that face us, and we look forward to getting on with implementation.
My Lords, we are not going to resume until 8.42 pm, so we have four minutes.
(5 months, 1 week ago)
Lords ChamberMy Lords, I start by sincerely congratulating the noble Lord, Lord Lee, on securing this debate. I agree that it has been an enjoyable exchange of views. It is a very important matter and one that does need discussing. As so many noble Lords have mentioned, I recognise his passion as a real advocate for the benefits of retail investment, and I thank him sincerely for sharing his insights with the House. Indeed, my noble friend Lord Davies expressed very well the respect that is held for the noble Lord. Of course, how could I fail to be taken by his comments about Leeds and my former role there? I will not mention the football result from the weekend. I also thank other noble Lords for their contributions this evening. I am sure we can all agree on the importance of encouraging newcomers to engage with the world of investing in the appropriate way. Getting this right will of course help savers make their money work harder, but it will also drive economic growth.
The Government want to see more people taking part in capital markets and benefitting from the long-term financial security that investing can provide. We know that more people in this country could potentially benefit from moving out of cash and dipping their toe into investing. The Government want to see an investment environment that enables the broadest range of people possible to invest confidently and grow their long-term financial resilience, although I recognise my noble friend Lord Sikka’s comments about those who are currently excluded from this area altogether.
As noble Lords may know, the Government are taking forward work to improve the support available to consumers to help with their decision-making when it comes to investing. The Treasury is working alongside the Financial Conduct Authority and the financial services industry to review the regulatory boundary between financial guidance and advice—an area we have heard a great deal about tonight.
The case for change is clear. In the 12 months to May 2022, only 8% of adults received regulated financial advice, as the noble Lord, Lord Lee, mentioned. With the cost of living being high, financial advice and guidance from trusted professionals is critical to help people make their money go further. That is why, at Mansion House, the Chancellor reaffirmed the Government’s commitment to driving forward the advice guidance boundary review, and I welcome those comments.
Together with the FCA, the Government are developing a proposal for a new regime called targeted support, which would allow authorised firms to provide suggestions appropriate to consumers in similar circumstances. For example, financial services firms could suggest that an individual with substantial savings considers opening a stocks and shares ISA. The FCA is currently consulting on high-level proposals for targeted support. This would not only benefit consumers in making better informed decisions but help them engage in UK markets, boost productive investment and support growth.
Our capital markets are at the heart of the UK’s economy and our growth mission. Last year, more equity capital was raised in London alone than in the next three European exchanges combined. The UK is one of the largest centres for international bond issuance, with more than 16,000 active bonds trading on our markets, representing over £4.1 trillion across 55 currencies.
At Mansion House, the Chancellor launched a call for evidence to kick-start the co-design process for the first ever financial services growth and competitiveness strategy. The strategy will focus specifically on how to deliver long-term, sustainable and inclusive growth of the sector. The call for evidence, which closed in December, identified UK capital markets and increasing retail participation as a priority growth opportunity. The call for evidence welcomed further information on how to improve consumer engagement with investing, and the Government are considering the feedback provided.
Alongside our work to set a long-term strategy for UK markets and retail investment, the Government are continuing an ambitious programme of reforms, to make our markets more competitive and ensure that we tackle the existing barriers to retail investment. I am sure noble Lords will be aware of the work that is being done around the listing review of the noble Lord, Lord Hill, and the success that has led to.
The Government legislated to empower the FCA to rewrite the rules for prospectuses. The new regime will be simpler and more effective, giving investors access to better quality information and allowing companies to raise funds more quickly. Access to information is one of the key ingredients to ensuring greater and better retail access to markets. That is why, beyond the reforms to prospectuses, we have legislated to enable the FCA to reform the UK’s retail disclosure regime for more complex investment products. This will ensure that consumers have access to the most useful information—including on risks, costs and performance —to support their investment decisions. The FCA’s consultation is currently open for views, and the Government look forward to seeing the final rules later this year.
A great deal of the discussion tonight has focused quite rightly on financial education, with contributions from the noble Lords, Lord Empey, Lord Leigh of Hurley and Lord Sikka, and the noble Baronesses, Lady Neville-Rolfe, Lady Bowles and Lady Bennett—so many I cannot possibly do them all justice tonight. I want to stress that financial education is central to the Government’s thinking on how we can help prepare the next generation for financial capability.
We know it is part of the school curriculum in all UK nations. In England, it is a compulsory part of the national curriculum for citizenship education at key stages 3 and 4. However, we know that it goes beyond the curriculum; Money and Pensions Service research found that 102 financial education programmes are taking place in the UK beyond those delivered by teachers and practitioners. But the emphasis on developing a financial inclusion strategy has to run alongside this. I know the pressure that is on teachers at the moment in all of our schools, and the extra support that will be needed to make this area of work successful.
We know that 6 million children and young people annually are being reached by these programmes and that there is excellent support, as we have heard tonight. Many of the biggest banks provide free financial education resources, as well as financial literacy lessons to children and educators. In 2023, UK Finance members delivered financial education lessons to over 4.1 million children and young people in schools and community settings, as well as providing training for teachers, which is fundamental. I acknowledge that there is still much more to do, and I am grateful for the comments that have been made.
In closing, I will address some of the specific points raised by noble Lords—although I will confess now that I will not reach all the points that have been made. I am happy to respond to the challenge of the points of the noble Lord, Lord Lee, and will respond in writing to those that I do not reach.
The noble Baroness, Lady Neville-Rolfe, is quite right to note the important role that pensions play in building long-term savings and ensuring that citizens have a secure retirement. She will know that the Government’s pensions investment review is under way. On the specific point she raised, I note that phase 2 of that review will consider further steps to improve pension outcomes and whether further interventions may be needed to ensure that these reforms benefit UK growth. I am sure that DWP and the Treasury will consider any representations that are made.
The noble Lord, Lord Lee, is right, generally, about the whole aspect of financial education and the need to be creative. However, with regard to the specific proposal about the NatWest shareholding, he will not be surprised that the belief of the Government is that it would bring significant delivery challenges, with the additional resources required to implement such an approach likely to be disproportionate to its benefit. Furthermore, this approach would complicate the objective of achieving a full exit from the Government’s NatWest shareholding, as it would leave a portion of NatWest shares in ongoing public ownership.
We have heard various comments tonight from my noble friend Lord Davies and other Members about the concern around the media, and the noble Baroness, Lady Bennett, raised some graphic examples here. We believe strongly that regulation is important to take it through, and that this should not present a barrier to educational information. We also heard a lot about junior ISAs going forward.
I will quickly pick up the point raised by the noble Baroness, Lady Bowles, some of which we have discussed in Grand Committee. It is right that the investment trusts, like other products that directly market to retail investors, must provide tailored disclosure on costs, risks and performance to support informed decision-making. The FCA will use the flexibility provided by the statutory instrument to ensure that disclosure is tailored to reflect UK markets and firms, and to meet the needs of investors. I emphasise that I welcome her contribution to the debate, as well as that of the noble Baroness, Lady Kramer, and I encourage the conversations to continue so that we can achieve the best possible outcomes.
My time is up, and I apologise for not reaching all the contributions that I would have liked to have responded to. I repeat my sincere thanks to the noble Lord, Lord Lee, for his continuing championing of retail investment. I assure him and this House that the Government will reflect very carefully on the points raised by noble Lords in this very thoughtful debate.
Does the noble Lord wish to respond?
(9 months ago)
Lords ChamberI thank the noble Baroness, Lady Neville-Rolfe, for securing this important debate and for her opening remarks. I thank all noble Lords for their contributions. I could clearly spend at least 12 of my minutes on each contribution, so I apologise in advance for the fact that I will not be able to get to everyone. However, there will be many opportunities going forward to discuss this important area.
It is clear that we all agree there are substantial opportunities to improve public health sector productivity and efficiency and that we want the Government to do as much as possible to harness it. This is a complex and cross-cutting challenge involving major culture changes, as the noble Baroness, Lady Neville-Rolfe, indicated at the start, and has the potential to significantly reform the way in which we deliver our public services and improve value for the taxpayer.
In response to the noble Lord, Lord Patten, I think the jury is out concerning working from home. It is clear that there is no one-size-fits-all approach; there is an expectation of a minimum of 60% of office workers working in the workplace, but there are so many aspects to consider.
The Government have been quite clear and open about the grave challenges facing our public finances. Our public services are facing immense pressures, with prisons overflowing, the NHS in a critical state and local government under huge financial pressure. We have also said that we will need to make some tough choices to overcome these challenges.
Alongside those grave pressures, the Government are also aware of the inherited challenge of improving public sector productivity. As we have heard, public service productivity, as at quarter 1 2024, remains 6.4% below pre-pandemic levels. I have to be honest: there was not a plan from the previous Government, and we need to put one in place. We know that the ONS will have a vital role to play in tracking public service productivity. The IFS says that the direct impact of the pandemic cannot explain the continued failure of productivity in these areas.
The Government have already taken decisive action to protect our public services and tackle waste. As an immediate first step in her first month, the Chancellor announced a decisive set of measures to eliminate waste in the public sector and move the agenda forward. The Government accepted the recommendations of the independent pay review bodies to resolve long-standing industrial action across a number of sectors, which obviously brought their own significant economic cost. I do not think that we need to make any apology for taking that swift action, stopping chaos for the public and ensuring that public services get back to operating as efficiently as possible.
Thirdly, the Government commissioned reviews of key public services, including the NHS, to ensure that we fully understand the scale of the challenges that the Government have inherited. However, it will take a long time to truly recover our public services, and it requires a relentless focus on eliminating waste, delivering reform and improving public sector productivity.
A more productive public sector means that we can deliver higher-quality public services, achieving greater value for money, and move towards improving our economy—a win-win for everyone. This is why, in launching the spending review, the Chancellor set out her approach to reforming public services. The first idea is around the mission-led approach to government, changing the way in which government works and allowing different departments to come together and work together to tackle issues of common concern. Most importantly, it is about putting citizens at the heart of the Government’s work and delivering long-term ambitious outcomes that make a meaningful difference to people’s lives. We so often forget that sense of purpose in what we are here to do.
I understand the comments that the noble Lord, Lord Teverson, made about investment. We will allow for separate treatment of investment spending, with investment being recognised as vital to our growth strategy. I thank the noble Lord, Lord Addington, for his very moving speech, as always. This debate, as I said, is about better outcomes for people and making sure that their considerations are brought in at every opportunity.
The next area covered by the Chancellor is around prevention. Preventive public services are obviously better for the public. Early intervention in the life cycle of any problem can be life-changing or indeed even life-saving. That is why the Government will focus on prevention and early intervention to support better outcomes across our public services, reducing the long-term spending pressures facing services such as the NHS, as the noble Lord, Lord Patel, so eloquently outlined, referencing the recent report from the noble Lord, Lord Darzi. It is about intervening early and detecting health problems, resolving them more easily and stopping them from deteriorating and causing more suffering as well as being more expensive to treat. We have a terrible situation while we are not investing in our communities and young people, which is leading to an increased risk of criminality later in life, at incredible cost to the public purse.
We have to acknowledge the comments from the noble Lord, Lord Patel, around capital spend and quality of services, which is absolutely fundamental. How could I not reference the noble Lord, Lord Elliott, a fellow Leeds loiner? I am very pleased to welcome him into the Chamber. I do not have time to address all the questions that he asked, but I steer him towards our “make work pay” commitments and how we will bring partnership work in to deliver on the issues that he so eloquently raised.
The third way in which the Government intend to reform public services is by harnessing the power of digital data and technology across the public sector. Our vision is for a modern, digital and tech-enabled Government who give citizens a more satisfying experience and help to turbocharge economic growth. To do this we have already started conducting rapid pieces of work to identify the greatest opportunity areas in the public sector for digital and AI. This work will help to inform the decisions that we are making at the spending review.
The noble Baroness, Lady Wheatcroft, raised some incredibly important issues around skills, the change in the modern workplace and what we need to bring in to address that, working right through the education system—starting now with children through early years, primary and secondary, and into their college choices. She raised a fundamental point about the damage that—I am afraid—the party opposite did in government with the narrowing of the education curriculum. I can only reference the really important work that has been done by bringing music into schools and the direct relationship with maths skills, for example. Partly because of my background, of course, I stress that we already have many examples of service reform from across local government.
I know first-hand from my time leading Leeds City Council the powerful impact that targeted prevention can have. I am talking about pre-Covid days here. For example, in Leeds, we took the proactive decision to focus on early intervention and support. By doing this, in the area of children’s services, the council not only safely reduced the number of children going into care but made significant financial savings. This is proof of the benefits a prevention-first approach can have for individuals, communities, the taxpayer and, particularly in this case, children and families and the futures they bring together. There are so many other examples of this. We need to look and learn.
In conclusion, a more productive public sector means that we can deliver high-quality public services, achieve greater value for money, and move towards improving people’s lives—a win-win for everyone. It is through targeted action across all of these areas that we will make a lasting improvement to public sector productivity. Of course, the growth mission will be at the heart of everything that we do in this area.
I refer noble Members to the fact that we have an upcoming Budget at the end of this month. We need to look at this carefully. Most importantly, we have the promise of a multi-year spending review early next year. For too long, I am afraid, under the previous Government, all the public sector organisations had to rely on annual projections budgets. It is not a sustainable way to deliver good-quality public services. Value for money is important. Improving quality of life has to be absolutely paramount and needs to be central to the drive for change and improvement that we are striving to achieve.
There will be opportunity for more debate, but the Government are already putting things in place: establishing a new office of value for money; bringing in planning reforms; developing Skills England and, importantly, our industrial strategy; and, as I have said, the importance of the mission approach, particularly in this case the growth mission.
(9 months ago)
Lords ChamberTo ask His Majesty’s Government whether they plan to continue the national £2 cap on bus fares, which is scheduled to end on 31 December.
Making fares more affordable for bus passengers is one of the Government’s top priorities, as we know how important it is for those passengers. The Government are looking at the future of the national bus fare cap as a matter of urgency and considering the most appropriate and affordable approach for the future of the scheme.
My Lords, the Minister must know that if a decision is not made very quickly, almost immediately, the bus companies will not be able to implement the policy from 31 December. Is this another one of those questions which is caught up in the pantomime of chaos in Downing Street? Why should passengers suffer because the Government cannot make a timely decision?
Honestly, I do not recognise any of the pantomime within the Department for Transport. This is one of its top priorities. Extra resource is being put into the department to deal with it. The department knows how important it is that local authorities working with their partners can deliver this and how popular it is. But the noble Lord is right that the scheme finishes in December 2024. The outcome was delayed before the election, but I can assure him that the department is treating this as an absolute top priority.
My Lords, the numbers travelling by bus outside London have declined significantly in recent years. As a priority, we need to get young people back on buses because they need access to those buses for jobs and education. Does the most appropriate and affordable scheme that the Minister refers to include a standard reduced youth fare, or even a scheme for free fares for young people?
The most important aspect in taking this forward is that it is for local determination. The money going to local authorities is not ring-fenced; they are able to look at different schemes for their particular localities. In areas where youth schemes have been brought in, they have been very successful—look at how Greater Manchester is moving forward, with an increase in passengers. I hope we can roll it out across the country.
My Lords, can the Minister say if the Government are taking any particular action with respect to coastal and rural communities? The noble Baroness remarked that young people need access to travel to get to work, and yet the infrastructure is completely destroyed in some of these areas.
Rural communities come up all the time when we are talking about bus services. I have lived in the wilds of the Yorkshire Dales in the past and I know exactly how important it is. But the important thing is that local determination can highlight priorities, and we know how much the bus cap has helped rural communities over the last few months. This is something that will be of great concern as we consider how we take it forward.
My Lords, most of the money that comes to the bus companies in income is derived from the public purse. Will the Minister make sure that we get value for money for the taxpayers and stop bus companies ripping us off?
My noble friend hits on a very sensitive and important issue. Value for money must be driven throughout any scheme that we come up with, and that is one of the top priorities of the work that is happening as we speak.
My Lords, the Minister said that the department was working very hard to get a solution to this important problem. Can she put a better timescale on that, given that there are only a few weeks to go before the current funding scheme comes to an end? Are the Government holding this for a nice, hopeful announcement on Budget Day?
Of course the Budget is an important consideration as we go forward, and we know that it is coming up very soon. I assure the noble Lord that work is carrying on at the moment. More capacity has gone into the department to deal with this; it knows that the clock is ticking and how important it is that a decision is made.
My Lords, the previous Government recognised that in rural areas it is sometimes very difficult to have a traditional bus service. That is why we invested millions of pounds in demand-responsive transport. Will the new Labour Government look favourably on that mode of transport?
At the moment, all options are on the table. The noble Baroness will remember our conversations during Covid about working with the operators and the local authorities. There are so many aspects of this, and nothing is off the table. We are looking at the history and at how we can take things forward.
My Lords, does the Minister accept that, for once, we have had a sensible suggestion from the Opposition Front Bench? Does she agree with me that reducing the £2 fare to £1 and extending it, which would help passengers and bus companies, could very easily be paid for by taking the £2 billion or so needed from the roads budget? This would enable the noble Lord who asked the Question to rattle on again about the war on motorists.
I think it is above my pay grade to talk about the outcome of the Budget discussions that are taking place. This is a critical moment, with the Budget at the end of October. All these factors must be taken into account in looking at value for money and how we can get the best bus services. We must not forget that the reason we are doing this is for the passengers. Buses are so important for our communities. They are lifelines for people going to work and meeting up with their loved ones; they are an essential service which I am afraid has fallen foul of the price of profitability in too many cases.
My Lords, will my noble friend try to ensure that, when a decision is made on what kind of bus subsidy we have, there is a long-term element to it? It is very difficult for bus companies and their passengers if the services, frequency and fares change every few months, as they have done in recent years.
I thank my noble friend for that suggestion. I will certainly pass it on to the department for consideration.
Can the Minister confirm that there are no plans to take away special arrangements for elderly passengers on buses or other forms of transport?
I assume that the noble Baroness is referring to the English national concessionary travel scheme. We have absolutely no plans to withdraw it, reduce it or means-test it.
My noble friend said that all options are on the table, which I welcome. Of those options, would she consider using her influence to ensure better co-ordination between buses and railways? I can give her nightmare examples of a lack of co-ordination. It would smooth things for passengers and improve the use of buses.
I completely agree with my noble friend. There is no point in having a regular train service if passengers cannot reach it by bus. It is always about the consideration of the last mile of a journey. If people get into their cars, they tend to stay there. It is a very important aspect that has been picked up by looking at the bus open data service. Bus companies sharing their data has been an enormous problem—anyone in the north of England knows that that helped prevent us bringing in an Oyster-style ticketing service across the north. It is crucial that we get this right and that all companies are obliged to share the information.
Could I press the noble Baroness further? She has given a very positive answer on concessionary fares for the elderly, but her response does not actually give a commitment to continue the £2 fare. Could she give a more positive answer about the timetable and an assurance that there will be no cliff edge from 31 December this year, particularly for young people and those living in rural areas who do not benefit from the concessionary fare, which has played such a positive role in rural transport?
I hope I made it clear that the success of the scheme is well recognised. We have to look at all aspects to make sure that it is sustainable going forward and that we do not have to return to this in the future. So many people depend on this and it is very popular. Of all the schemes that have come into place, this one is very well known; the public actually know about it and this has led to an increase in patronage. People have changed their habits from using other forms of transport to using the bus. In my view, it has been a real success.
(1 year, 5 months ago)
Lords ChamberI add my congratulations to the noble Lord, Lord Rosenfield, on his maiden speech. I am grateful to my noble friend Lord Watson for securing this debate to allow discussion of this area, which is crucial for enabling future economic growth and prosperity across the UK.
The transition to net zero presents a great opportunity for the UK to realise its ambitions for economic growth, lower energy bills, energy security and jobs. A refreshed industrial strategy will be vital to keep investments on track, ensuring that the UK’s reputation as a global leader does not go further backwards and that essential investments flow into the UK and not just to our global competitors. Businesses are telling us that they need certainty, consistency and clarity as we go forward to deliver our objectives. It is my firm belief that a clear policy framework is essential to enable businesses to work with the Government to deliver the step change we need. Growth in our economy will depend on creating and developing partnerships between the public and private sectors, the unions, our communities, and local and regional governance bodies; these relationships must underpin any strategy approach. They will need to deliver major infrastructure schemes, provide the skilled workforce as required and ensure the supply chains are in place to enable development.
To deliver net zero, the UK will need to become a world leader in producing electric cars, developing hydrogen, and developing and creating further capacity in renewables, as well as delivering our nuclear power potential—and we have had many discussions on the need to invest in the national grid to achieve those ambitions. Analysis shows that many of the clusters of high-value green industries are outside of London and the south-east, which offers opportunities to tackle stubborn interregional inequalities. Developing clean power offers the potential to create good, well-paid jobs across the country to overcome the current piecemeal and fragmented approach that has blighted progress, especially over recent months, with inconsistent government policy announcements bringing despair and irritation to many business leaders. Developing a joined-up, inclusive industrial strategy is essential in tackling the perceived gap between aspiration and delivery, frequently mentioned by the Climate Change Committee and others.
The brilliant Library briefing gives us many examples of how important this is. The last formal industrial strategy was set out in 2017. The need for laying out a new one is obvious and overdue, and I look forward to hearing the Minister’s views on the current situation.
(2 years, 8 months ago)
Lords ChamberMy Lords, I sincerely thank the right reverend Prelate the Bishop of Oxford and the committee for bringing the debate to this Chamber. We have heard from several of its members today. I thank them for the work that has gone into this. I start by declaring my interest as a vice-president of the Local Government Association.
I will start by talking about the crises facing the country related to this agenda. How was I to know that there would be a further crisis today, with the announcement from No. 10 and the loss of the Prime Minister? I say that because leadership in this agenda matters. We need to keep our eye firmly on the ball as we go forward.
With respect to the agenda facing us today, we are all too painfully aware that we face three concurrent crises. The cost of living crisis, including energy bills, continues to affect millions of families and businesses across the country. The energy security crisis was created by a lack of government action over the last 12 years and exacerbated by Russia’s illegal invasion of Ukraine. The impacts of the climate crisis are being felt first-hand all over the world. For all three of these crises, getting to net zero will make a tremendous difference, either by reducing impact or by increasing resilience. Many things need to be done to achieve this, whether by 2050 or by the 2030 target to which the next Labour Government have committed.
The impact of behaviour change, and the actions taken by both individuals and organisations to reduce their energy use, will be significant and an essential part of the journey. Taking people with us will be imperative. This kind of behaviour change does not happen in a vacuum. There are many things that can be done at all levels of government to encourage this change in an effective but not prescriptive way. We have examples from this country and also from Germany, which has seen a dramatic reduction in gas usage as the result of a public information campaign.
We know that the Government have been in the right place on some of this. Last year’s net zero strategy had a subchapter entitled:
“Empowering the public and business to make green choices”,
highlighting the role of those choices in reaching net zero and making a number of positive commitments to act upon this. They committed to exploring and enhancing their public-facing content; to enhancing their Simple Energy Advice service; to supporting businesses, including by exploring a government-led advice service; to increasing awareness of net zero; to empowering both businesses and the public to make green choices; and to making these choices affordable and easy by working with business and industry. However, we know that the Government of last year are not the Government of today—and, until today, we did not know they would not be the Government of tomorrow, either. So, last week, we saw the now soon-to-be former Prime Minister pull a public information campaign to help people cut their energy use, on the grounds of either cost or ideology, depending on who you ask—only, we understand, to U-turn three days later, during Prime Minister’s Questions, a pattern that obviously quickly became a tradition and has contributed to the chaos we are facing today.
Of course, putting it back on the table was the right decision, and the £15 million or so should be seen as a sensible investment, but the lack of leadership in this is frightening. In my city of Leeds, we have a wealth of experience in this area, led by the Leeds Climate Commission. Other local authorities have similar experience to share. We know that successful schemes often need to be driven locally. Alternatives also need to be in place to achieve a modal shift in transport, to inform decisions on change of appliances and fuel sources, and so much more. Without the alternatives, we cannot expect people to change their behaviour.
Motivation other than simply achieving net zero is a great enabler. For example, health concerns contributed massively to the surge in interest in electric vehicles following the scandal of diesel emissions. Most recently, cost of living concerns are driving the imperative and urgent demand for action on energy efficiency schemes, especially for those most at risk of not being able to pay their bills. Accurate, transparent information remains essential in helping people make those decisions. We need leadership at all levels, and I ask the Minister to do everything in his power in the week ahead to make sure that this agenda is at the forefront when the decisions are made that will determine who the new Prime Minister of this country will be.