King’s Speech

Baroness Blower Excerpts

Thursday 9th November 2023 Lords Chamber

[Baroness Blower (Lab)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Aberdare, particularly because he has covered much of what I might have said, had I had 14 minutes rather than only seven.

Responding to the King’s Speech, the Association of Directors of Children’s Services was mainly concerned by what was not in the Speech. Its president said:

“Unfortunately the speech missed an opportunity to focus on a significant long term challenge affecting children, their health, wellbeing and their ability to learn in school”.


That is, of course, poverty. In saying this, he echoed points made by the National Education Union about the need for a plan to tackle, among other things, the root causes of persistent post-Covid absence, a plan that should focus on the impact of poverty, insecure housing and mental health—all absent from the Speech.

After years of austerity and cuts to school funding, there needs to be a concerted effort to rebuild local authority services, including SEND support and mental health services, to be available to children and families in a truly timely fashion, as well as rebuilding pastoral support in schools. This question of poverty is set against the background of the Joseph Rowntree Foundation reporting that 1 million children are living in destitution in our country, as we were reminded yesterday by the most reverend Primate the Archbishop of York.

The lack of government funding continues to have a major impact on schools and children’s learning. Ministers claim that they have restored per-pupil funding to 2010 levels in real terms. That is not good enough. No net growth in over 13 years represents a considerable squeeze on school resources in all respects. I remind your Lordships that last month, the Government admitted to a £370 million error in their school funding. This will cause further cuts at school level. Perhaps the Autumn Statement will be the moment to reinstate that £370 million.

What might be welcome, as has been referenced by the noble Lord, Lord Aberdare, is the signalled intention to create parity of esteem between academic and vocational education, especially as the OECD continues to report that there is much to do on skills in this country. However, it is not at all clear that the so-called advanced British standard is the answer, not least because it is unlikely to be taken up in Scotland or Wales, and possibly not in Northern Ireland, so is not really British. A better way to encourage more students to achieve would be for the Government—the noble Lord, Lord Aberdare, has already mentioned this—to reverse the decision on applied general qualifications and to continue to fund them. They are a tried and tested qualification which provides a pathway for disadvantaged students into employment or higher education.

The advanced British standard would also face a challenge, in that there are currently insufficient teachers in our schools, with future prospects not looking good. While the Schools Minister Nick Gibb talks about this being the best time to be a teacher, recruitment figures to the profession seem to give the lie to that. The Government recruited only 59% of their target for trainee secondary teachers this year, with a projection of only 50% for next year. Retention continues to be a big problem. Some 25% of teachers leave within three years and about a third within five years, and only 60% remain after nine years. That is not good enough. The Government will say that the number of teachers has increased by 27,000 since 2010, but the number of pupils has increased by close to 995,000. The NEU calculates that that equates to 37 extra pupils for every extra teacher. Clearly, more teachers are needed.

I could give chapter and verse on the number of teachers who are not properly qualified to teach the subjects on their timetable, but I will just say this about English and maths: one in six English teachers and one in five maths teachers has no post A-level qualification in the subject—yet another indication that the advanced British standard may well have problems.

Turning to the state of our school buildings, reinforced autoclaved aerated concrete—RAAC—is, as the NEU says, just the tip of the iceberg of the acute problems caused by the real-terms decline in capital spending of 44% between 2009-10 and 2019-20. The Office of Government Property has calculated that to maintain the school estate in line with best practice—and surely our children deserve conditions in which to learn that represent best practice—the Government should be spending £7 billion a year. The current figure is £2.6 billion, so perhaps that is another idea for the Autumn Statement.

Finally, I return to poverty. A key way to improve children’s capacity to learn would be to legislate for universal free school meals. Hungry children cannot learn. If work and potentially the dignity of work is beyond the reach of many, particularly single parents, because of childcare costs, the Government need to address the fact that what is currently on offer to so many is simply not adequate. What proposals might they have in this direction?

Just before I sit down, where is the long-promised employment Bill?

Urgent and Emergency Care Recovery Plan

Baroness Blower Excerpts

Thursday 2nd February 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. As I mentioned just now, retaining doctors is critical, and pensions are a key issue. We had an excellent debate on this a couple of weeks ago. Again, we are working on all of that with the Treasury. However, as I said then, the simplest thing is that, while I understand the Treasury’s concern about making special rules for special groups and the potential knock-on from that, we can very quickly make sure that, if people are hitting that pension ceiling, they can get the equivalent pay in their pay package very quickly. As a health department we have the ability to do that, to make sure that no one is financially losing out from that. If it does not make sense for them to get it through their pension, they can get it through their salary instead. I am not saying that that is perfect, and more work needs to be done across the Treasury, but we can do that quickly.

[Baroness Blower (Lab)]

My Lords, the Minister has attempted to give a full response on this. However, there is clearly an absolute urgency about the workforce plan, and noble Lords would have been very pleased to have heard something rather more specific about the date on which it would come before us. If it is in draft, perhaps he could go back and say, “Can we speed up the final drafting of it?” The Minister also used the word “realistic” on a couple of occasions. Can he say whether he understands that the workforce plan will not be realistic unless we can pay staff in an appropriate way to make sure that we can hold on to their services, without which any attempts to remedy the difficulties we are facing are, frankly, a forlorn hope? Finally, on virtual wards, can we make sure that there are not people in the digital divide having difficulty engaging with the virtual ward if they have broadband problems and other problems?

[Lord Markham (Con)]

I thank the noble Baroness. Taking those questions in reverse order, yes, it is understood that virtual wards do not work for everyone. At the same time, I am constantly surprised by the data: for instance, the average age of an NHS app user is in the mid-60s—so it is not a particularly young demographic who use this. Obviously, the examples I have seen, particularly on COPD at Watford, show that an older population is using that. However, we absolutely need to make sure that there is not a digital divide from that.

On the noble Baroness’s points on the workforce, she is quite right. We live in a competitive market, and one of the benefits of full employment is that, again, most people who want to work have a job, but one of the downsides is that there is competition for jobs. We have to face up to those realities and be realistic in terms of workforce, in that if you are going to attract and retain the good people, which you need to have as the bedrock of your services, you need to make sure you have an attractive and rewarding place to work. Clearly, that has to be a feature.

Down Syndrome Bill

Baroness Blower Excerpts

2nd reading
Friday 18th March 2022 Lords Chamber

[Baroness Blower (Lab)]

My Lords, I rise extremely briefly to add my support to the Bill and to acknowledge that the question of “nothing about us without us” is very significant.

I began teaching in 1973, and would never have found a child or young person with Down’s syndrome in a classroom in front of me, but things have changed and moved on significantly. When I told my daughter, who now teaches a year 4 class, that I would be in the House of Lords today to hear a debate on guidance about services for people with Down’s syndrome, she said, “That will be really exciting, and so necessary”. One of the things she said to me was, “There just aren’t sufficient representations of the vast range of people that there are in our society available to us to use in our classrooms”. She is a young person who definitely wanted to go into teaching because she felt that it was important to be in a classroom with a range of people with different conditions.

I listened carefully to the noble Baroness, Lady Stowell, and I share her concern that, at a time of constrained resources, there might be a tendency to say, “We have to do this; we don’t have to do that”. But I hope we are better than that. It is so important that we fund the services as they are assessed—that we fund for need, not because a particular person happens to have a particular diagnosis or condition. On that basis, even though this is a small step and there is a risk—unless we fund everything properly—that some people may feel there is privileged treatment, I wish the Bill well.

However, since some of the “relevant” bodies that appear here are school governing bodies, the providers of early years services and academy proprietors, I want to be absolutely sure that the Government will be very clear that all those institutions have a big responsibility to read, understand and follow the guidance. That is an education matter, rather than a medical one.

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely and I invite her to speak.

Health and Care Bill

Baroness Blower Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Lord Addington (LD)]

My Lords, the last shall probably be quickest on this. We have all, as is agreed, said that we need to do something that is coherent. This has not been coherent. We have had committees that met once every full moon, provided everybody had had tea of the right quality that day; thus was their infrequency. Nobody was prepared to ensure that something that was inconvenient for one department was done to ensure that another department fulfilled it. There just was not anything. The Olympics did not manage to make them work together. We need coherent leadership and a price to be paid—accountability—for not doing it. If the Minister can give us that, we will have taken a major step forward. I would of course prefer the amendment that has been tabled, but I will take half a loaf any day over no bread. Can the Minister assure us that there will be leadership and that a price will be paid, publicly paid, for not doing it? Without that, as we know, this will merely become a report with somebody else saying, “They should have had a meeting about it some time”. Let us bin this. I am fed up with making that speech, even though it does usually get me out of a lot of trouble.

[Baroness Blower (Lab)]

My Lords, this is a key opportunity to do something really significant for the health of the nation, from the youngest to the oldest, and for all the groups we refer to as “excluded.” This is a key moment. If the Minister can respond positively to the questions put to him by the noble Lord, Lord Moynihan, he will be doing a very good job for the nation.

[Lord Lucas (Con)]

My Lords, I entirely support my noble friend Lord Moynihan when he asks for proper accountability. That is what drives the few examples of successful cross-departmental co-operation. One of the recent missed opportunities is Defra not picking up on aspects of the Glover report that deal with people getting out into the landscape. To make a difference to that, Defra has to care and it has to be brought to account, but there also has to be a good enough mechanism to ensure that if Defra does propose to do something, someone is going to fund it. That would certainly apply too to schools’ collaboration with local sports clubs. Parents up and down the land want that to happen. But how is that going to be afforded? How is that going to be made to happen? Who is holding the systems accountable? There has to be some system whereby accountability and interest flow through—as my noble friend said, ideally, to Parliament—to make that happen.

I have written to the Minister on perioperative care, which is another example. How does the NHS collaborate with all the other people who might provide the support required for effective perioperative care? They are not in the NHS; it does not work that way. You can have a system that just involves spending the money and ticking the box because that money has been spent; or you can have one with real accountability, in which people care whether you get the results and are measuring that, and who feed that through to someone with a central interest in things. So I am really going to listen to the Minister with great interest on this.

Personal Protective Equipment: Accounting

Baroness Blower Excerpts

Wednesday 2nd February 2022 Lords Chamber

[Lord Kamall (Con)]

That seems a reasonable question, but I hope the noble Baroness will understand that I do not have the answer at the moment. This is very much a dynamic situation. Some of the equipment we have may be deemed to be out of date but may be reclassified as usable after scientific analysis.

[Baroness Blower (Lab)]

My Lords, on page 201 of the Annual Report and Accounts of the Department of Health and Social Care, the Comptroller and Auditor-General says that

“I have been unable to obtain sufficient, appropriate audit evidence to support the valuation of the Core Department & Agencies’ and Group’s onerous contract provisions of £1.2 billion”.

Why is the DHSC unable to provide relevant and reliable evidence, and which Minister takes responsibility for this shambolic state of affairs?

[Lord Kamall (Con)]

Interestingly enough, when I had the briefing with the team from the Department of Health and Social Care, I asked a very similar question about the qualification received from the Comptroller and Auditor-General—the C&AG—on limitation of scope. What it meant was that there was not enough audit evidence available for the C&AG to conclude. This stems principally from the fact that we were unable to perform a full stock-take on all items. So many millions of items were bought at the time, there was so much stock that the department could not yet do a full stock-take. The department does have a robust assessment of the risks, but it was important that we got as much stuff as possible, and it was unable to do a full stock-take of the millions of pieces of equipment.

Social Care Sector: Private Equity

Baroness Blower Excerpts

Thursday 27th January 2022 Lords Chamber

[Lord Kamall (Con)]

I am sorry if people do not agree with that, but the quality of care that patients receive is the most important thing. As of November 2021, 84% of all social care settings were rated good or outstanding by the CQC. For most people, the experience of adult social care has been positive, but, clearly, the pandemic came. To mitigate the risk posed by debt and other financial pressures in the sector, the Care Quality Commission operates the market oversight scheme, which monitors the financial stability and sustainability of the largest and potentially most difficult to replace providers in the adult social care sector.

[Baroness Blower (Lab)]

My Lords, of course the quality of care is very important, but, at the moment, it is being provided at the expense of the exploitation of workers, who are paid £9 to £10 an hour. How many noble Lords in this House would have been happy to live on that for the whole of their lives?

[Lord Kamall (Con)]

The noble Baroness raises an important point about the pay of staff. One of the things that we are looking to do with social care staff is to make sure that it is an attractive career and to persuade all providers to try to pay their staff a more sustainable wage. That is why we invested money into social care. We also must make sure that we get away from the situation where some private providers effectively subsidise state-funded providers, and make sure that they receive a suitable return.

Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021

Baroness Blower Excerpts

Wednesday 1st December 2021 Lords Chamber

Lastly, after 18 months-plus of restrictions, I ask everybody in this Chamber, and the Minister in particular: have the restrictions worked? In May of last year, there had allegedly been 250,000 cases; there have now been some 10 million. What did the restrictions achieve? The vaccines have been fantastic but the restrictions have not achieved very much, except perhaps occasionally to slow down the spread. On that note I will sit down, except to say to my noble friend: this is not a good policy.

[Baroness Blower (Lab)]

My Lords, like the noble Baroness, Lady Noakes, I like to spend an evening at the Royal Opera House. In fact, I have been a couple of times in the past three weeks and noticed from where I was sitting that enormous numbers of people were wearing masks—including one John Major, sitting just in front of me. I cannot see that there is any problem with sitting in the Royal Opera House and wearing a mask. In the area where I sat, there was very high compliance. It is not even just that there have been these announcements. The fact is that there was an announcement from Antonio Pappano every evening before the performance, encouraging people to wear masks. My own view is that it would have been much better if we had never stopped people wearing masks. We would not then have to start every time from a lower base to encourage people to take it up. The noble Lord, Lord Robathan, said that it may have stopped transmission on some occasions. Is that not good? That is what we want to happen.

My second point is about schools. The fact is that schools are not generally well-ventilated buildings. My daughter is a year 4 primary schoolteacher and, for the whole of last year, she had to teach with the windows open. This year, they have come back and again had to do so. It is not easy for a child to learn in a very cold classroom where they have to wear their coats, hats and gloves. It would be so much better if we had managed to get in a programme to bring in ventilation or some kind of air filtration scheme. Although there was a big concern about whether young people would be oppositional to the idea of wearing masks, people I know who are teachers—I do know a great many of them—have found that when you have the discussion with young people, they absolutely understand why it is important to wear masks: it is about protecting themselves, each other and their grandparents, who they may see out of school.

While a great number of things have been done too slowly, the reinstitution of wearing masks has been done in a speedy way. I hope it will continue beyond 20 December.

[Baroness Altmann (Con)]

My Lords, on a personal level, I do not have a problem with wearing a mask. I understand that the Government are in a difficult position, because they are almost damned if they do and damned if they do not on issues of this nature. My concern is that we started off following the science but now seem to be anticipating what the science might show, in the absence of evidence that this omicron variant is any more deadly than previous variants. We seem to be ignoring the fact that, unlike when delta started, so much of the population is now vaccinated; they are therefore protected. The Government should be given enormous credit for the vaccination programme and the booster programme.

Looking at the evidence from the delta variant, as the virus progressed it became much more contagious, as all viruses tend to, but it was much less deadly. The people for whom it was particularly dangerous were those who were unvaccinated. Since we have given everybody who could have an opportunity to be vaccinated the chance to do so, and that some people have—for reasons that they know best—refused to accept the vaccine, it seems there are implications for the wider public in continuing to try to protect those people. I recognise that there are clinically vulnerable people who cannot be vaccinated, which is an issue in itself. But I am seriously concerned about wider society, particularly as the self-isolation rules will not run out until next March and have a psychologically damaging impact on society. They frighten the public and could cause, I believe, significantly higher numbers of deaths from loneliness, mental ill-health and illnesses such as cancer, which the public may be too frightened to see their doctor about, or for which GPs may now again say that they cannot see people face to face, and therefore miss the symptoms.

I hope that this mask-wearing SI will be lifted at the end of the three weeks. We need to trust the public. I agree that we need to help people understand the risks and that they need to consider them, but it is perfectly valid for people to decide that they do not consider the risks too large to stop them seeing friends and family. I have significant concerns about mandating and fining them for not doing things, when we do not have evidence to suggest those are as damaging to the public as we previously considered them to be.

Residential Social Care: Staff

Baroness Blower Excerpts

Monday 6th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I acknowledge the pressure that local authorities are under. We do indeed keep in very close contact with local authorities that have financial pressure; I assure the noble Baroness that we will not be in a position where we breach the Care Act and that we keep very close tabs on the financial support that social care needs.

[Baroness Blower (Lab)]

My Lords, there is a recruitment and retention problem in social care and a problem of youth unemployment. Does the Minister believe that his responses provide a basis for any young person to consider a career in social care, particularly his response to my noble friend Lord Hendy?

Social Care and the Role of Carers

Baroness Blower Excerpts

Thursday 24th June 2021 Lords Chamber

[Baroness Blower (Lab)]

My Lords, I commend the noble Baroness, Lady Jolly, for securing this debate on such an urgent issue. I fully endorse the remarks of other noble Lords about the urgent need for proper pay, conditions and employment arrangements for employed care staff. There is an urgent need for a national care service.

However, in the time available I will focus on young carers. As we all know, much social care is provided informally by family, friends and neighbours. Estimates vary, but there might be as many as 800,000 young carers, some of whom are very young indeed. These children often support a family member, often their mother, who is unable to look after not just themselves but the rest of the family. This might be on a short-term or a longer-term basis, and the emergence of long Covid might well mean an increase in the amount of such care being undertaken by young carers.

Prior to the pandemic, it was estimated that young carers missed as much as 48 days’ schooling. That is more than nine weeks, and it is not at all clear how young children were ever able to catch up. Regrettably, their school experience might also, according to work done by YoungMinds, have been blighted by bullying. In addition, they would certainly have been more tired and stressed by their responsibilities than their peers who are not carers. Moreover, the range of tasks that young carers have to carry out means that they have less time to devote to their homework or self-study, let alone time for social or recreational activities with friends.

This role is a huge responsibility for young carers throughout the country, but it is also a huge and probably underrecognised contribution to adult social care nationally. I hope that many schools and colleges have systems in place to support young carers in their roles, but I fear this may not always be the case. According to YoungMinds, young carers can experience feelings of guilt, anger, anxiety and low self-esteem. With overstretched GP services and children and adolescent mental health services at capacity and beyond, does the Minister agree that access to a qualified school or college counsellor able to offer support to these young carers is the very least support that they should be afforded?

Covid-19: Variant B.1.617.2

Baroness Blower Excerpts

Wednesday 26th May 2021 Lords Chamber

[Baroness Blower (Lab)]

My Lords, Deepti Gurdasani, of Queen Mary University, is quoted as saying:

“We know from media reports there are many outbreaks of the so-called ‘India variant’ in schools but there’s no systematic data. In Bolton … it looks like schools are contributing to the rapid spread of the virus”.


She concludes that, in a public health emergency, it is crucial that Public Health England has the public’s trust. Can the Minister say how appearing to censor scientific reports and removing mitigations, such as the wearing of masks in schools, can create and sustain that trust?

[Lord Bethell (Con)]

My Lords, I do not quite recognise the world the noble Baroness describes. In fact, I would say that the work between Public Health England, schools, local authorities and local infection teams has never been stronger, and it has proved to be extremely effective. The noble Baroness is right that schools are often a source of infection, and we remember well what happened in September. In areas such as Bolton, we are very careful to ensure that infection measures are put in place. I do not accept that there is an issue of trust.