International Women’s Day

Baroness Manzoor Excerpts

Thursday 9th March 2017 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, I also congratulate my noble friend Lady Shields on bringing this important debate to the Floor of the House to mark International Women’s Day and on her excellent introduction.

As we have heard, the UN’s theme this year is “Women in the changing world of work”—a title as fitting now as it would have been on the first International Women’s Day more than 100 years ago. Since then, there have been huge steps towards gender equality in this country and in many places around the world, with women increasingly carving out a place in public life and obtaining vital civil and employment rights.

We should be proud of the progress made in this country. We have record numbers of women going to university. Girls are outperforming boys at school and staying in school longer. However, despite the Equal Pay Act 1970, as, I think, the noble Baroness, Lady Donaghy, said, women in the UK still earn 19.2% less than men. A large part of the discrepancy is due to higher numbers of women in part-time work or taking time out of work to have children—but this is not the full story. Women working full-time still earn 9.4% less than men. Equal pay for work of equal value does not ring true when women’s work is still overwhelmingly undervalued and concentrated in lower-paid sectors. Women dominate the lowest end of the pay scale and hold 59% of minimum-wage jobs. This must change. As my noble friend Lady Brady said, businesses are key to this.

My father, who sadly died when I was in my early 20s, always said to me, “Getting a good education is a key. It unlocks doors and nobody can take this away from you”. How right he was, but this is no less important for women and girls living in poverty around the world. As my noble friend Lady Jenkin said, 61 million girls between the ages of 5 and 14 are denied the opportunity to attend school; 15 million do not even get as far as primary school. This is a global disgrace that shows how far leaders are from achieving sustainable development goal 4: inclusive and equitable education for all by 2030.

There is a whole host of reasons for this, including gender roles in the home, violence against girls, forced marriage and early pregnancy. But one blindingly obvious reason remains: education is hugely underfunded globally. UNESCO estimates that an additional $39 billion in education funding will be needed each year to achieve SDG 4 by 2030. The UN theme of women and work focuses specifically on unlocking the potential of women in the workplace across the planet by 2030. We all know that this will never happen if we fail to increase girls’ participation in education, as well as the quality of that education.

As I have already said, the impact of education on improving women’s economic empowerment is unparalleled. This is aided by DfID’s increased investment in family planning services, from £90 million in 2010 to an extra spend of £195 million per year since 2013. This UK aid has enabled 9.9 million more women to use modern methods of family planning—which is key.

UK aid via DfID is key, and I am delighted that the Conservative Government have promised to deliver a decent education to 11 million children, including 5.3 million girls. However, more still needs to be done. Despite UK aid to education, aid to global education has declined in recent years—and so has progress, particularly for the most marginalised girls in the most isolated communities. DfID must ensure that education remains a key priority. It has a great opportunity to demonstrate this commitment through greater support of the Global Partnership for Education later this year. The GPE does fantastic work to strengthen education systems and get girls in school and learning.

Lastly, I will touch on food. Food and good nutrition are the building blocks for further opportunity and educational attainment. Undernutrition can have a devastating impact on the physical, cognitive and mental development of women, girls and the unborn child. When I talk of undernutrition, I am not talking about starvation during famine or war but of often-hidden deficiencies of crucial nutrients, which lead to stunting, wasting and reduced immunity to diseases. In Pakistan, for instance, which I visited recently and to which the UK gives significant aid each year, 423,000 children die before their fifth birthday, and nearly half the children suffer from stunted growth and wasting. Many are young girls.

In addition, 500 million women are affected by anaemia worldwide. This disease, caused by iron deficiency, is responsible for a fifth of maternal deaths. In 2017, women should not be dying simply because they do not have the proper nutrients to sustain their bodies during pregnancy. DfID is undertaking some excellent work to empower women through better nutrition, and UK aid helped to save the lives of 103,000 women in pregnancy and childbirth between 2011 and 2015. But the pressure to improve nutrients in food must continue.

We are asked to be “Bold for Change”. When it comes to improving the lives of women in this country and around the world, we need to be bold. We need to properly finance education and prioritise equity until every girl has the opportunity to succeed. We need to consign preventable mortality in childbirth to the past and give women the nutrition that they need to thrive. If the last 104 years have shown us anything, it is that none of these issues will simply disappear overnight. This year, we must think creatively and holistically about how we tackle the stubborn challenges that women still face both at home and overseas.

We need more concerted global action to meet the needs of women and girls in humanitarian situations. I entirely agree with the Secretary of State for International Development when she says that women must,

“have the opportunity to play a full and active role in business, politics, peacebuilding and shaping the future of their country”,

in order to “achieve security and prosperity”. To my mind, to do anything less is not to care for half of humanity.

EU Nationals in the UK

Baroness Manzoor Excerpts

Wednesday 29th June 2016 Lords Chamber

[Lord Anderson of Swansea (Lab)]

My Lords—

[Baroness Manzoor (LD)]

My Lords—

[The Lord Privy Seal (Baroness Stowell of Beeston) (Con)]

My Lords, the House was calling for the noble Lord, Lord Pearson, before that stronger intervention and then I think it is the turn of the Labour Benches.

Refugees: Unaccompanied Children

Baroness Manzoor Excerpts

Tuesday 10th May 2016 Lords Chamber

[Lord Keen of Elie]

I do not accept that for a moment. This Government have been at the forefront of efforts to deal with the refugee problem not only in Syria but also as it has affected Europe. We are taking further steps, as the noble Lord knows, to deal with the question of unaccompanied children. However, noble Lords will remember that those children who are now in Europe are in relatively safe havens. It cannot be suggested that France is anything other than a safe country. For those children who have a connection or direct family links with the United Kingdom, we are taking steps to ensure that that connection is established properly and that they are brought to the United Kingdom.

[Baroness Manzoor (LD)]

My Lords, there are thousands of children who are going missing or have been sexually abused. They are not safe in Europe; we are talking about Europe. Where are these children going and what is happening to them? There needs to be much greater urgency than there is now.

[Lord Keen of Elie]

We are all aware of the terrible reports that have emanated from Europe about the condition of these children and the fact that their whereabouts in many cases cannot now be ascertained. It is a matter of considerable concern. I reiterate that this Government are at the forefront of efforts to deal with these issues.

Channel Tunnel: Migrants

Baroness Manzoor Excerpts

Tuesday 1st December 2015 Lords Chamber

[Baroness Jones of Moulsecoomb (GP)]

My Lords—

[Baroness Manzoor (LD)]

My Lords—

[The Lord Privy Seal (Baroness Stowell of Beeston) (Con)]

My Lords, I suggest that it is the turn of one of the minor parties. I propose that the noble Baronesses from the Liberal Democrats and the Green Party decide between themselves who would like to give way.

--- Later in debate ---

[Baroness Manzoor]

My Lords—

[Baroness Jones of Moulsecoomb]

My Lords, thank you very much. Could the Minister tell us, for those people who are currently suffering in the “jungle camp” in Calais, what the Government are doing to enable them to get to Britain if they have every right to be here? I have asked this as a Written Question; I had a response but I did not get an answer.

Modern Slavery Act 2015

Baroness Manzoor Excerpts

Monday 26th October 2015 Lords Chamber

[Lord Bates]

There is an interdepartmental ministerial group on modern slavery, which meets and publishes quarterly reports—it published one just last week on its work on supply chains. The Home Office as it should, is ensuring that we lead by example across government in respect of supply chains. Of course, that question is going to be there in the checklist. It is there in a lot of cases already in departments, where they have obligations under human rights legislation to ensure that they check the status of people who are in their supply chain. We will continue to monitor that, and we will certainly continue to report on it.

[Baroness Manzoor (LD)]

My Lords, there is some research saying that nearly 50% of children who are going on to detention centres go missing within their first 48 hours within Europe. What are the Government doing to ensure that these children are not being trafficked?

Women: Domestic Violence

Baroness Manzoor Excerpts

Tuesday 16th June 2015 Lords Chamber

[Lord Bates]

The noble Baroness makes a good point. This is part of an ongoing trial, as she alluded to. Once the trial is completed later this year, there will be an evaluation process, and factors such as how it has been used in domestic violence situations, in particular, will be taken into account in deciding how we move forward.

[Baroness Manzoor (LD)]

My Lords, the ONS figures demonstrate that last year 1.3 million women and over 700,000 men suffered from domestic violence. There is a strong link between poverty and domestic violence. What are the Government doing to tackle that issue?

[Lord Bates]

That is absolutely right. The figures that I have are roughly the same: 1.4 million women and 700,000 men. Clearly, there is a link to people’s economic situation, their educational achievement and their overall environment. That is why we have extended to a further 400,000 families the troubled families programme, which is having a real impact in this area in tackling that type of behaviour.

Queen’s Speech

Baroness Manzoor Excerpts

Monday 9th June 2014 Lords Chamber

[Baroness Manzoor (LD)]

My Lords, the gracious Speech mentioned a fairer society. We have sadly all heard of the scandalous and shocking events that took place at the mid-Staffordshire trust over a year ago, affecting some of the most vulnerable people in our society. Complacency and indifference to complaints was one of the many findings of the subsequent review led by Robert Francis QC. The Francis report called for cultural change, focus on patient experience, and much greater willingness to listen to the voice of patients and people who use the service.

The Government’s response to the Francis inquiry, Hard Truths: The journey to Putting Patients First, was published last year in November. This report demonstrated the Government’s commitment to supporting NHS organisations to create a culture of openness in the NHS, and to supporting staff and patients who raise concerns or complaints. This is to be welcomed, as is the subsequent duty of candour which places a requirement on all Quality Care Commission-registered providers of health and adult social care to be open with patients and service users about failings in care. Also to be welcomed are new leadership programmes for nursing and clinical staff.

These are important commitments, but little has been done to see things through the eyes of patients and the people who use the health and care services. Visibility and ease of accessibility of the current complaints system for the public is generally poor, and there is unnecessary complexity in it. There remains an overreliance on outdated methods of dealing with complaints. Good governance should be much more than following rules. The landscape of complaints handling and related issues of regulation is a very crowded place: who is supposed to do what, I suspect, is fully known and understood only by officials working in the Department of Health.

There are numerous organisations with overlapping roles and responsibilities, such as clinical commissioning groups, NHS trusts, the Care Quality Commission, Healthwatch England, chief inspectors for hospitals, primary care and social care, the Health & Social Care Information Centre in England, NHS England, the Parliamentary and Health Service Ombudsman—who has a dual role and is also, confusingly, known by another title—the Local Government Ombudsman, Monitor, and the NHS Trust Development Authority on finance. No doubt there are others.

In my view this unnecessary complexity has been further compounded as new or additional functions have been bolted on in an ad hoc fashion when failings in service delivery have emerged. This cannot, and is not, sustainable for the long run. It aids confusion and fosters a lack of clear accountability and therefore overall responsibility. Despite this, I recognise that some good innovations have been put in place, but their full potential will be difficult to achieve in an overcrowded field. Besides the burden of bureaucracy there are also significant costs at a time when the NHS can ill afford them.

The Government have a Bill on deregulation that will be coming before your Lordships’ House. I would welcome the Government considering modernising the deregulation framework for healthcare professionals and for users of health and social care services. I agree with the chairman of the Public Administration Select Committee, who said:

“There needs to be a revolution in the way public services are run, and how the public perceives government. As things are, most people believe there is no point in complaining”.

His statement is backed by a report undertaken by the consumer organisation Which?, which highlighted a survey showing that 35% of people who have cause to complain about the NHS choose not to do so. I suspect that the figure may well be even higher.

According to government statistics, there are 10 million patients aged over 65 and 15 million people living with a chronic condition in England. The number of these vulnerable people is rising, and increasingly there is a much greater blurring of lines between health and social care as more people move to receiving care in their home and budgets are pooled.

I, like the Public Administration Committee, urge the Government to create a new, accessible and transparent unified Public Services Ombudsman, which brings together the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman, and to bring together health and social care complaints at the second tier of complaints handling. The Government should also consider establishing a supercomplainant power for Healthwatch England and simplifying the complexities of the regulatory burden. In that regard I agree with the comments made by the noble Lord, Lord Patel. Good things have happened but the NHS, patients and service users deserve more.

Immigration Bill

Baroness Manzoor Excerpts

Thursday 3rd April 2014 Lords Chamber

[Lord Hussain (LD)]

My Lords, when the Government brought in this law, withdrawing the right of asylum seekers who have been here for more than six months to work, I do not know what they intended to achieve, or what they have achieved so far by having that law. It does not prevent any people coming into the country. It is not an immigration issue at all. We are talking about people who are already in this country, asylum seekers whose applications are being dealt with. Through no fault of their own, their applications are taking longer than six months. We are still saying that they should not be able to work.

This law drives people into deep poverty. They are more vulnerable to exploitation. They should have a right to work, like everyone else, and they should be able to feel proud that they are not living on handouts but working for their families. This is one good thing that the children can be proud of as well. Therefore, the amendment moved by my noble friend Lord Roberts should be supported. I support it. I hope that the Minister will look into this and be sympathetic to the cause of the asylum seekers.

[Baroness Manzoor (LD)]

My Lords, I briefly add my support because, although I have listened very carefully to the argument made by the Minister, I genuinely do not understand why people should not be allowed to work for perhaps six months because of the backlog of cases. Perhaps there should be a time limit, so that if someone has not heard about their case then they have the right to work. However, we must think very carefully about what the implications of that may be. As was said by the noble Baroness, Lady Lister, maybe something should be put around that to keep the criteria very visible to the Home Office.

[Earl Attlee (Con)]

My Lords, I think the whole House will admire the heroic efforts of my noble friend Lord Roberts of Llandudno for making just one more try at this issue. I have listened very carefully to the arguments in favour of allowing asylum seekers to work if their asylum claim is not determined after six months instead of the current period of 12 months. I am not convinced that it is sensible. In the Government’s view, the proposed change clearly creates a risk that some people will make unfounded asylum claims in order to take advantage of the more generous employment opportunities. Indeed, the amendment as drafted would enable the person to take any employment of their choice, rather than be restricted to those on the shortage occupation list published by the Home Office.

I agree with my noble friend and with the House about the importance of being able to work. Although paid work might not be permitted except in certain circumstances, voluntary work is allowed, as I explained on the previous occasion when we debated this. My noble friend and the noble Baroness, Lady Lister, talked about the level of support provided. I remind the House that two levels of support are provided, to cover asylum seekers and failed asylum seekers. The noble Baroness asked me to justify keeping the support rate the same since 2011. The Government conducted a full review of asylum support levels last year, in June 2013. The review concluded that the payment levels were adequate to meet essential living needs. They are only to meet essential living needs.

Many noble Lords asked why we do not let failed asylum seekers work so that they can support themselves. It is important to maintain a distinction between economic migration and asylum. Failed asylum seekers, whose further asylum-related submissions have been outstanding for at least one year, may apply for permission to work. This is in line with our obligations under the 2003 EU reception conditions directive. We have considered the merits of reducing this threshold, but such a reduction could encourage those who are not genuinely in need of protection to enter the asylum system for economic reasons.

The noble Earl, Lord Sandwich, asked about the assisted voluntary return package, and my noble and learned friend Lord Wallace of Tankerness said that he will write to the noble Earl on this point. In answer to the noble Baroness, Lady Lister, the desirability of the UK as a destination for economic migrants is not in doubt; one only has to look at some of yesterday’s newspapers. The Government have been successful at reducing non-EEA net migration but EEA migration remains high, as those who benefit from EU free movement come here looking for work. We are dealing with the imbalances in European migration. Throwing open access to the labour market as proposed by this amendment would send the wrong signals, and damage the significant progress this Government have made in controlling migration.

[Baroness Manzoor]

Surely the Home Office would be able to tell the difference between an economic migrant and an asylum seeker. That is why it has the caseload.

[Earl Attlee]

My Lords, if they are a genuine asylum seeker, in some cases it will be easy to determine that they have a good case. Once asylum is granted, people are able to work straightaway. However, if the case is difficult, possibly because the asylum seeker has made it difficult, unfortunately it takes considerably more time to determine the application.

As I was saying before my noble friend intervened, we do not believe that it is worth taking a risk with the progress that we have made so far. It is true that some asylum claims take too long to consider, but the Home Office is addressing the issue. In year 2012-13, 78% of claims received a decision within six months.

It may be generally true that unfounded claims can be considered faster than other claims, but they still need to be considered individually, which takes time and resources. Consideration of these claims therefore slows down consideration of genuine claims, at the expense of people who need international protection.

The current policy strikes the right balance. Asylum seekers are provided with support and accommodation if they are destitute. If their asylum claims are undetermined after 12 months for reasons outside their control, they can apply for permission to work. This is a fair and reasonable policy and we should keep to it. In the light of these points, I hope that my noble friend will feel able to withdraw this amendment.

Immigration Bill

Baroness Manzoor Excerpts

Tuesday 1st April 2014 Lords Chamber

[Lord Wallace of Tankerness]

My Lords, I am almost tempted to say that you are damned if you do and damned if you do not. That 51% included those cases where there was administrative error. If one wishes to drive to improve the quality of decision-making, inevitably the number of successful appeals will go down.

In Committee, concern was expressed about the opportunities for scrutiny of the Immigration Rules. I am pleased to confirm that we are committing to publishing draft rules no later than the Summer Recess. I hope that that reassures my noble friend Lady Hamwee about what I have said in my letter to her. I am happy to repeat that those rules will be the subject of a targeted consultation with key interested parties, including the Immigration Law Practitioners’ Association and Universities UK. We certainly are open to discussions with noble Lords and organisations to which noble Lords consider this consultation should be addressed. The aim of the consultation will be to ensure that all relevant views are taken into consideration before the rules are finalised. The consultation will offer an opportunity for the rules to be scrutinised and potentially amended before they are laid before Parliament in accordance with Section 3(2) of the Immigration Act 1971. Clause 15 creates a better process for all concerned—applicants, decision-makers and the court system. It will help to address the legitimate concerns raised about decision quality.

Amendment 13, which stands in the name of the noble Baroness, Lady Smith, would impose three conditions that would need to be met before the appeals provisions in Clause 15 came into force. The proposed sunrise clause would require: that the Chief Inspector of Borders and Immigration must first report on decision-making for entry clearance and managed migration; that the Secretary of State must be satisfied that decision-making for entry clearance and managed migration is efficient, effective and fair; and that the order to commence Clause 15 must be laid before and approved by both Houses. My noble friend Lady Hamwee raised the possibility that, to be able to do that, we might need to have a shadow operation, which probably would be an administrative nightmare.

I submit that we already have reports from the chief inspector on decision-making in entry clearance and managed migration. In 2013, he reported on investor and entrepreneur applications, concluding that 91% of decisions on investor applications were reasonable. That report recommended that the overseas approach of sharing administrative review outcomes to improve decision quality should be adopted in-country. That recommendation of an approach recommended by the chief inspector has informed the changes which this Bill seeks to implement through Clause 15.

The inspection of entry clearance decision-making in Warsaw in December 2013 of out-of-country administrative reviews concluded that the service was efficient and consistently meeting service standards for completing decisions. In 88% of cases reviewed, the report concluded that the right decision had been reached. We accept that this report made five recommendations for improvement. We have accepted all of these either in whole or in part.

I assure your Lordships that the Home Office takes the chief inspector’s inspections and reports seriously. A dedicated team manages the implementation of his recommendations. In his spot-checking report of August 2013, the chief inspector considered the progress that had been made against recommendations from three earlier inspections and was pleased to see evidence that the Home Office was acting upon his recommendations. We already have evidence from the chief inspector who has looked at the administrative review procedures that are applied at present for out-of-country cases of managed migration. He appears to confirm that, in the cases that were reviewed, the right decisions had been reached. As I have said, in Warsaw that was in 88% of cases.

However, we recognise the concerns that prompted Amendment 13. Therefore, we have brought forward a government amendment which takes a different but effective approach to address those concerns. Amendment 12 in the name of my noble friend Lord Taylor imposes a specific obligation on the Secretary of State to secure an independent review of administrative review. It looks forward and will review new processes. The new clause requires the Secretary of State to commission the independent chief inspector within a year of Clause 15 being commenced to prepare a report on administrative review.

My noble friend Lady Hamwee asked for confirmation that it was intended that the report would be on the first year although commissioned ahead of the first year. As I have said, the report will be commissioned within 12 months of administrative review being implemented. The Secretary of State will ask the chief inspector to complete the report within the first 12 months of the operation of administrative review. In timing the commissioning of the report, we want to strike a balance between a desire for an early report on how administrative review is working and the need to let the process operate for a period before a meaningful report can be prepared. It is therefore intended that the Secretary of State asks the chief inspector to undertake his report once administrative review has been in operation for six months and to complete his report within the first year of the operation of administrative review. The chief inspector should build flexibility into his inspection plans to allow such specific requests.

The new clause requires that the Secretary of State commissions that report and the report must address specific concerns. If noble Lords look at the terms of the amendment, they will note that the specific concerns that the chief inspector is being asked to address are ones that quite fairly reflect some of those raised in your Lordships’ House in Committee—namely, the effectiveness in identifying and correcting case working errors and the independence of the person conducting the administrative review in terms of their separation from the original decision-maker.

[Baroness Manzoor (LD)]

Will the chief inspector look at the substantive elements of the case rather than just the procedural review of the case and whether that has been effective? Will he also assess the merits of the case in the samples that he takes?

[Lord Wallace of Tankerness]

My Lords, I mentioned to my noble friend the report on out-of-country cases in Warsaw in December last year which concluded that in 88% of the cases reviewed the right decision had been reached. You can do that only if you actually look at the subject matter. Therefore, I would fully expect that the chief inspector, in undertaking his report, would have to be able to give some indication as to whether there was greater efficiency and greater accuracy in decision-making. You would have to look at sample cases to see whether the right decisions had been reached.

Amendment 14, in the names of my noble friends, requires the Government to consult on the immigration rules for administrative review. As I have already indicated, the Government will undertake a targeted consultation on the immigration rules establishing administrative review before those rules are laid before Parliament. It is not necessary to place an obligation to consult on the face of the Bill as the Government have already committed to doing so. The proposed new clause also seeks to ensure that administrative review is the subject of an early inspection and report by the Independent Chief Inspector of Borders and Immigration. As my noble friend Lady Hamwee acknowledged, Amendment 12, tabled by the Government, requires the Secretary of State to commission such a report from the chief inspector.

My noble friend raised the out-of-country administrative review note that she received. She saw the same point that I had noticed, which indicated that out-of-country reviews are free. I then noted that the statement of intent, which was published along with the Bill, indicated that there would be a fee of £80. I have queried why that is the case. I understand that a separate charge for an administrative review is incorporated into the visa application charge. To do that for in-country reviews would require increasing visa charges. I rather suspect, given what has been said in a number of other debates, not least with regard to students, that that would not be the most popular course to go down. The review is free, but the cost is already incorporated within the visa charge.

I believe that we have accepted a recommendation emanating from the chief inspector about how administrative review can work. I believe that it will work because we are following up on recommendations that have been made about how these decisions can be made more efficiently. Where we have heard evidence of administrative review working for out-of-country applications, there has been a significant improvement over the 60% of errors that were identified in that period with regard to in-country appeals. Therefore, particularly with regard to the huge difference between 28 days and 19 weeks—I suspect overall that it will be cheaper if one does not have to engage learned counsel—we are proposing something here that will be of benefit not only to applicants but to the general administrative procedure as a whole.

Therefore—I suspect without any success—I ask the noble Baroness to withdraw her amendment and to recognise that the Government have listened to what was said in many cases in Committee. We are putting on the face of the Bill an obligation on the Secretary of State to commission a report from the chief inspector and particularly to have regard to the specific concerns raised in Committee. I therefore hope that she will withdraw her amendment.

Immigration Bill

Baroness Manzoor Excerpts

Monday 10th February 2014 Lords Chamber

[Baroness Manzoor (LD)]

My Lords, the fact that I am not addressing the wider implications in this Bill regarding students, detention caps and the positive contribution immigration makes does not mean that I do not have interest or concern in these important areas. I align myself with comments by my noble friends Lady Hamwee and Lord Dholakia and the noble Lord, Lord Bilimoria.

As many noble Lords have stated, it is widely acknowledged there are significant delays and inefficiencies in the administration of immigration law, and this Bill will need to have greater clarity if it is not to add to this complexity. As the former Legal Services Ombudsman for England and Wales, I know the importance of having in place effective and efficient systems for casework and of ensuring good quality decision-making. Like other noble Lords, I note with some disappointment that the latest statistics at the Home Office reveal that 32% of deportation decisions and 50% of entry clearance applications were successfully appealed last year. This is a high margin of error in casework. Yet Part 2 seeks to erode independent oversight in appeal rights making them difficult to access and curtailing judicial discretion. On present information on the quality of casework, it does not seem fair or just. Can the Minister reassure the House that he will ensure that the current quality of casework will be improved before reducing the opportunities for people to challenge decisions as the current standards in casework are a great concern? As my noble friend Lord Teverson said, it is an issue for competent management.

Clauses 33 and 34 in Part 3 could also potentially create new layers of bureaucracy for the NHS, as well as having some serious implications for race relations in the country. This may have unintended consequences. The clauses as they stand may require individuals to prove their identity before accessing services. In practice, this will invariably include individuals who are British citizens. As the noble Lord said, this may create unnecessary mistrust and suspicion. I would be grateful if the Minister can address these concerns to ensure that the myth does not become a reality.

As someone who has worked in the NHS for many years, I understand why NHS staff are not best placed to check the immigration status of their patients or to check that any surcharge payment was paid when a visa was first granted. Indeed, immigration status changes constantly, and it will be difficult to ensure all patients’ information is kept updated or to make sure that healthcare systems are equipped to understand immigration issues. Nurses’ and clinicians’ duty of care is to their patient and should be entirely focused on assessing and treating their clinical needs.

What about the healthcare and treatment of the children of individuals who have not paid the surcharge who become ill? Can the Minister give some reassurance that children will always receive free healthcare whatever the immigration status of their parents, as is their right under law? Like the Royal Collage of Nursing, the Terrence Higgins Trust and others, I believe that unless there is clear evidence that non-EU migrants are placing a significant burden on the NHS, the main focus should be on improving the current arrangements for chargeable patients. I pose the question: why is this not working now and, indeed, will this Bill improve it? If evidence shows the current system is not working effectively, then steps should be taken to rectify this, rather than applying a blanket approach to charging longer term migrants, who—and I agree entirely with the Royal College of Nursing—if in employment, will already be contributing to the NHS through taxes and national insurance. This is neither fair not equitable, as the noble Lord, Lord Patel, said. However, I welcome the Government’s decision to maintain free access to GP consultations, and maintain the current exemptions to charging, and in future to the surcharge, and to continue to include asylum seekers, refugees and victims of trafficking. But charging for healthcare in Clause 33 and redefining who counts as an ordinary resident—Clause 34—could increase the number of vulnerable people living in the UK. Even though infectious illnesses will be treated for free, having a two-tiered system will create confusion, and could delay and discourage people seeking the most appropriate help or having no help at all. This clearly has implications regarding public health and may end up costing the NHS more, particularly as the surcharge paid by migrants may not find its way into the NHS purse.

The Terrence Higgins Trust states that the current proposals will also have a negative impact on the Government’s efforts to, “reduce attendance and admissions to A&E, reduce undiagnosed HIV, and reduce late diagnosis of HIV”, and “improve long-term health and wellbeing of the population”.

I would be grateful if the Minister would address these issues, as I, like the noble Baroness, Lady Meacher, would prefer answers at this stage rather than having them debated in Committee. I am sure the Government would not wish to create a bigger problem than the one it is currently claimed exists in the NHS, and hope that they move to a more research and evidence-based approach to immigration.