Social Cohesion and Community during Periods of Change

Baroness Fraser of Craigmaddie Excerpts

Friday 6th December 2024 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

I thank the most reverend Primate for his very moving opening to the debate, and I congratulate my new noble friend Lord Sharma on his quite excellent maiden speech. We are extremely lucky to have him on our Benches and I welcome him as a Member of this House.

You do not need to be a member of the International Relations and Defence Committee of your Lordships’ House, as I have the privilege to be, to appreciate how much change and global uncertainty we face. In our committee’s report, Ukraine: a Wake-up Call, we looked at lessons the UK should learn from the war in Ukraine, where social cohesion and cohesion of purpose have played a central role in all stages of the Russian invasion, showcasing them as essential components of defence.

Yet, here in the UK, defence has become something other people do; it is delivered by our Armed Forces, with the action usually taking place in some remote foreign field. This detachment and lack of understanding of what defence really means is becoming apparent in the debate around defence spending. No Government of any colour, it seems, are concerned about announcing increasing spending for the NHS, but the debate about why, how and when we might want to increase our percentage spend on defence is hampered by procrastination and vague promises.

Given that Russian forces have continuously targeted critical national infrastructure in Ukraine, and that here in the UK we experience numerous cyberattacks from malicious actors—only this week the National Cyber Security Centre highlighted the gap between the risks we face and our ability to mitigate them—is it time that we looked to the Scandinavian “all of society” approach, where we ask for more collective preparedness? Both Sweden and Latvia have recently released booklets with information about how civilians should react in a crisis or conflict situation. The Czech Republic has launched grey-zone exercises for the private sector. Germany has a long-standing tradition of social resilience, predominantly through its Technisches Hilfswerk—THW—a federal agency that provides training in disaster relief and boasts thousands of volunteers who provide rapid and efficient technical relief in emergencies anywhere in Germany and often across Europe. These solutions are as relevant in a crisis caused by extreme weather events as they are in a public-health emergency or a conflict.

In preparation for today’s debate, I came across the UK’s equivalent, the website prepare.campaign.gov.uk. I consider myself an interested and relatively well-informed citizen in this space, yet I had no idea before now that this existed. Can the Minister tell us whether they are any plans to develop the Prepare campaign and to raise its public profile? Does he know how many unique visits the website has had to date? He might have to write to me on that.

My experience in the healthcare and disability sectors have illustrated that there are too many areas where our society is not cohesive or well prepared. The right reverend Prelate the Bishop of London referred to the Covid inquiry module 1 report, which concluded that emergency pandemic planning

“generally failed to account sufficiently for the pre-existing health and societal inequalities and deprivation in society”,

and that there was a

“failure to engage appropriately with those who know their communities best, such as local authorities, the voluntary sector and community groups”.

Essentially, our pandemic plans were made by fit and healthy individuals who failed those with pre-existing health issues because of a lack of understanding of what services were essential to them. In my organisation, Cerebral Palsy Scotland, I see such a lack of understanding filter through everyday life, not just emergency planning. Our charity’s mission is therefore to build a stronger, more supportive community for our beneficiaries.

The noble Baroness, Lady Morgan of Drefelin, referred to the NCVO briefing. As it says, charity resilience and community resilience go hand in hand. Local charities in particular, as the noble Baroness said, have deep roots in our communities. Yet these organisations, of which mine is but one, which are delivering essential services that the state cannot provide, are feeling threatened like never before thanks to the increased costs of employment, together with reduced funding opportunities. This will affect beneficiaries as well as public services.

The sector is facing a perfect storm and, as I have said before, I am deeply concerned. We face a situation in which organisations are closing due to cash flow, not because of their effectiveness or their impact. The charity sector is in crisis. If they are not shutting, they are cutting.

Social cohesion and strong, supportive community life are indeed essential, but too often there is a sense of “them” and “us”. This Government, I am afraid to say, seem to think that all things public sector are good, and that those of us in the private, charity or any other sector can just be squeezed a bit more to pay for it. This is unsustainable and short-sighted during challenging times.

Instead, I suggest that strengthening and protecting the UK’s national resilience and its critical national infrastructure is the responsibility of us all. It cannot be left just to government, the public sector or the military. We need a collective understanding of the risks and a collective effort to mitigate them. Only then, I believe, will we strengthen our community life and foster greater social cohesion.

Covid-19: Lockdown Costs and Benefits

Baroness Fraser of Craigmaddie Excerpts

Wednesday 13th March 2024 Lords Chamber

[Baroness Neville-Rolfe (Con)]

As it happens, I listened to Dame Kate Bingham, who we can all agree did such a good job with the Vaccine Taskforce. The decision on the Vaccine Manufacturing and Innovation Centre, which I think the noble Lord refers to, was made by the board of directors, but I should mention all the other things that have been going on to make sure that we have future access to vaccines. There is a 10-year strategic partnership with Moderna; there is an advance purchase agreement with CSL Seqirus; and my right honourable friend the Chancellor announced a terrific investment in a £450 million manufacturing site in Liverpool. All these are informed by what we need to do as a result of the dreadful pandemic.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, unfortunately I will not be in the House tomorrow because I will be giving evidence to the Scottish Covid inquiry on the experience of people with cerebral palsy during the pandemic. Does the Minister agree—this is one of the things that has struck me, as I will be saying tomorrow—that when judgments were made about what services were essential and should not be locked down, what was deemed essential did not take into account some of the most vulnerable in our society? Can she assure me that, whether it is from the Covid inquiry or in any other policy area, we will take note of the experience of all our population for future reference?

[Baroness Neville-Rolfe (Con)]

I very much agree with my noble friend about the importance of looking after the poorest in society and I hope that it will be a focus of the inquiry, particularly in its module on the care sector. More broadly, my noble friend makes good points. The Government did a lot, but the question is how we can do the very best in future.

Health and Social Care Levy Bill

Baroness Fraser of Craigmaddie Excerpts

2nd reading & Order of Commitment discharged & 3rd reading
Monday 11th October 2021 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I refer to my interests as set out in the register. I have no illusions about the mountain that health and social care services have to climb as we emerge from the impact of Covid, and I have no illusions that the necessary steps will require significant funding. Like my noble friend Lord Bethell, I welcome the Bill in that at least it grasps the nettle of an issue that needs to be grasped urgently.

I will confine my remarks not to how the extra funding is raised but to how it is to be spent. First, I would welcome funding for improved health and care services in Scotland. In fact, the Scottish Government have a manifesto commitment to establish a national care service over the next 10 years. I am sure they would welcome a union dividend of more than £100 billion, whatever they might say.

I also know that the other place debated and defeated the amendments to Clause 2 to allocate and give the funds from the Bill to the nations of the UK in accordance with the Barnett formula, but is it really in line with our stated intention to treat the devolved Administrations with respect for the Bill to state where the consequential spending is directed? Please let us not give Ms Sturgeon yet more ammunition to aim at Westminster.

Secondly, the levy perpetuates the status quo as regards spending on health and social care, as many noble Lords have stated. Experience, though, has taught us that investment alone will not be enough to fix the challenges faced by health and social care services. The Prime Minister himself, in the introduction to the Building Back Better document, said that

“when COVID-19 broke out, there were thousands of hospital beds filled with people that could have been better cared for elsewhere.”

That was indeed true, and remains true, but our answer to this challenge is always just to create more beds. We saw great efforts going into the building of temporary Nightingale hospitals, but there was no equivalent for social care or community rehabilitation. Why not? Because, as always, social care is seen as secondary to the needs of the organisation that is the NHS.

If the solution is not just more money, it is also not just more people. The people in the current health and social care system are most definitely a crucial part of this answer, but just wishing for more of them is not the solution either—not least because there are worldwide shortages of supply in some specialisms and it would take years to train the additional numbers required.

I turn to the lessons learned during the pandemic, which is why we are here in this urgent debate. Research from the University of Glasgow and the London School of Hygiene & Tropical Medicine found that many disabled people and their families felt abandoned and that existing structural failings and inequalities were starkly exposed and magnified. Their research concluded that it was the third sector that was best able to adapt to this increased need in the community and to deliver the services and care during the pandemic.

I declare an interest as chief executive of a third sector organisation, Cerebral Palsy Scotland. Third sector organisations reimagined their services very early, often in difficult circumstances with huge funding and personnel challenges. They set about tackling isolation; filled gaps after the closure of daycare centres and community services; supported people to become digitally literate, so that they could access online healthcare; and, in effect, became the mechanism that kept people well and enabled the NHS to respond to the challenges of Covid. In fact, the state became reliant on a strong and resilient third sector. The third sector, therefore, plays a key role in the solutions facing health and social care, yet a few organisations seem to be relegated to the back pages in a list of stakeholders.

The justification for this levy is that we are trying to build back better. It is essential that we do indeed build back better because what we had before was not working. What we saw during the pandemic illustrates what happens when we fail to understand the impact of the withdrawal of services on disabled people and those with long-term health issues. It illustrated that, to keep people out of hospitals, we have to support them to remain well at home. It also demonstrated the importance of ensuring a robust third sector.

The key to the successful deployment of the health and social care levy will clearly be in the details of the much awaited White Paper and the Health and Care Bill, which I look forward to coming before this House. International examples of where integration has worked best have required local delegation and local solutions. In Scotland, we have been trying it since 2014 but, as my noble friend Lord Lansley said, it went from being a very person-centred hope to being one where the free at the point of delivery NHS was merged with the paid-for systems of social care. We are still dealing with the problems that trying to put those two large organisations together have created.

The answers that the Government are looking for clearly lie in fundamental reform of the whole system, not just little parts of it. We cannot just keep spending more and more money to fix backlogs. We must be bold, but we have to take those who use health and social care, those who work in health and social care and all cross-sector organisations that provide health and social care with us. If we do not, all we will do is take the taxpayers’ cash and they will see no real benefits from it.

UK Government Union Capability

Baroness Fraser of Craigmaddie Excerpts

Thursday 1st July 2021 Lords Chamber

[Baroness Fraser of Craigmaddie (Con) [V]]

My Lords, during the debate on constitutional affairs in May, I asked for assurance that the future of intergovernmental relations would be a conversation of co-operation, and my noble friend the Minister gave me that assurance. Two months on, embedding positive working relationships must surely run broader and deeper than simply recovery from the pandemic, important though that is. There are too few post-devolution and post-referendum voices being heard in this debate. Energy is wasted and mistakes are made that are completely avoidable, such as the ridiculous attempt to encourage schoolchildren to sing a song for One Britain One Nation Day just as the Scottish schools had broken up for the summer holidays. Intergovernmental relations should be a partnership and not a popularity contest, but every flag-waving misstep allows the First Minister to use muscular unionism to her advantage.

Too often, consultation is too little, too late, or there is a lack of understanding that a Scottish-based approach, rather than a whole-UK solution, might work better. This mutual respect for the differences of our four nations is essential for improving and developing positive relations. This stance was supported by my noble friend Lord Dunlop in his excellent review, which also found that the prevailing attitude in Whitehall was to “devolve and forget”. The recommendations proposed were “welcomed” by the Government, yet they remain unfulfilled. Why are we stuck with an intergovernmental structure that predates the Scottish referendum and the subsequent transfer of additional powers, with no concrete plans for progress? We must not “devolve and forget”.

This week, Her Majesty the Queen is at Holyrood. She has met both the First Minister and the new Presiding Officer of the Scottish Parliament as well as taking a tour of the Irn-Bru factory. In short, Her Majesty has respected Scottish institutions. As ever, she has set an ideal tone. May I encourage the Government of the United Kingdom to do the same?