Baroness Merron
Main Page: Baroness Merron (Labour - Life peer)Department Debates - View all Baroness Merron's debates with the Department of Health and Social Care
(9 months, 2 weeks ago)
Lords ChamberMy Lords, it is a great honour to be closing this important debate on behalf of His Majesty’s Opposition. This is a new chapter for our sovereign and our country and, with it, His Majesty brings the optimism and sureness that we need in these times of division and instability—both in people’s lives and across the world.
The Coronation was a visible illustration of the King’s determination to mark his reign as one celebrating the strength of our multifaith nation. For me, it was the greatest honour to make history by being a part of the ceremony, representing the Jewish community, alongside the noble Lords, Lord Patel, Lord Kamall and Lord Singh, who represented other faiths.
In declaring my interests in the register that relate to the Jewish community and in turning to the gracious Speech, I say how warmly I appreciated the acknowledgement of anti-Semitism and the need to remember the horrors of the Holocaust. Recognition of the barbaric acts of terrorism against the people of Israel exactly one month before the gracious Speech, the facilitation of humanitarian support into Gaza and support for the cause of peace and stability in the Middle East all sent a clear and welcome message.
The areas for debate across the days are crying out for the
“competence, optimism, confidence and vision,”—[Official Report, 7/11/23; col. 11.]
underpinned by good governance, of which my noble friend Lady Smith spoke on the day of the gracious Speech. But what did we get? Ambition, not for the country but for this Government to stay in office; little to inspire or give confidence that the Government really understand the seriousness of the challenges that households and our country face; and widespread cause for profound disappointment, as we have heard today and as my noble friend Lady Twycross set out so clearly in opening this debate.
I would like to focus on the health and social care aspects of the gracious Speech. Let me start with something we can receive well. From these Benches, we look forward to the passage of the tobacco and vapes Bill, although at present it seems that the Government still do not know how to tackle vaping. We are sleepwalking into a new generation of young people being hooked on nicotine through vaping, when the Government should have been coming down hard on the industry, starting with banning the branding, advertising and marketing of vapes to children, actions to which Labour has committed. It is worth reminding ourselves that an amendment to the Health and Care Bill in 2021 that proposed getting the ball rolling in this way was voted down.
Professor Sir Chris Whitty has put it very well:
“The key points about vaping … can be easily summarised. If you smoke, vaping is much safer; if you don’t smoke, don’t vape; marketing vapes to children is utterly unacceptable.”
Reports not so long ago suggested that the Government were considering an outright ban, but now they are exploring and consulting on options. I look forward to hearing from the Minister about when we can expect a clear plan from the Government.
I turn to just some of the glaring omissions from the gracious Speech. The NHS workforce plan, on which the gracious Speech leant heavily, has failed to consider social care, even though the two services are inextricably linked. Social care reform needs to be system-wide, long term and joined up around the needs of those being cared for, so that comprehensive and integrated care at home and in the community can be properly provided. But when will we receive a plan to do this? After all, as the noble Lord, Lord Young, remarked, does social care not come into the Government’s category of necessary long-term decisions?
In all this, the role of paid and unpaid carers is crucial, as is that of charities, as highlighted by my noble friend Lord Touhig. So where was the long-term social care workforce plan to overcome the severe staff shortages in the care sector? I venture to suggest that Labour’s new deal for care workers could be an essential first step in tackling the staffing crisis. It will be the first ever fair pay agreement collectively negotiated across the sector.
The gracious Speech could have addressed retention and the issues that contribute to high attrition rates across the NHS workforce, but it did not. I am concerned that this is at a time when a recent NHS survey reports that nearly one-third of staff often think about leaving their job, while the workforce plan also fails to address the maintenance and building backlogs that bedevil the ability to have enough physical capacity with which to deliver services. I note that my noble friends Lady Blower and Lady Wilcox made similar comments about inadequate retention and recruitment plans for teachers, another significant staffing group who are crucial to success.
The Government have promised to deliver their plan to cut waiting lists. But where is the actual plan? We on these Benches stand ready with a commitment to provide 2 million more appointments by paying staff extra to work evenings and weekends, which will be paid for by abolishing the non-dom tax status. Is that something the Government would consider doing? If so, we would be pleased to have provided the inspiration.
Instead, what we have is regressive legislation in the form of the Strikes (Minimum Services Levels) Act. It seems that the Government’s answer to the shortage of doctors and nurses is to sack NHS staff. They say they want minimum service levels on strike days, but what is their plan to provide minimum service levels on non-strike days? Had Ministers not spent months refusing to negotiate with NHS staff, there might not have been more than 1 million operations and appointments cancelled due to strike action this year, and NHS England would not be asking for £1 billion extra from the Treasury. We all want minimum standards of service and staffing, but it is this Government who consistently fail to provide them.
It is significant that so many noble Lords, including the noble Baroness, Lady Hollins, have criticised the absence of a Bill to provide the desperately needed reform of the outdated, untrusted and discriminatory 1983 Mental Health Act. As the noble Baroness, Lady Watkins, so aptly observed, this Bill has been on a wating list for 40 years. Since the Government published, in 2018, the findings of their own commissioned review, more than 200,000 people have been detained under the Act—many inappropriately, including those with autism and learning difficulties—and more than 20,000 people have been subjected to a community treatment order.
A White Paper responding to the review was published in 2021. Last year a draft Bill was published, and pre-legislative scrutiny got under way. A huge amount of valuable and informed cross-party work has been undertaken, with wide consultation among stakeholders. The failure to bring forward those long overdue reforms, including changes to the criteria for detaining patients, is letting down our most vulnerable. This cannot continue.
Health and social care is not the only area of omission. In the gracious Speech there is no legislation to build the homes we need or the education system that people of all ages need, or to tackle the increasing level of persistent absenteeism in schools—which was noted by the noble Baronesses, Lady Gohir and Lady Bull, and many other noble Lords.
There were two general themes underlying the debate today, about which many noble Lords have spoken, and on which I shall conclude my remarks. First, inequalities run ever deeper across our society, whether we look at maternity care, life expectancy, the quality of health throughout life, or detention on mental health grounds. As the noble Lord, Lord Best, said, there are also inequalities in housing availability, affordability and quality. We are seeing an increasing divide on the basis of social determinants, of which the right reverend Prelate the Bishop of London spoke, whether they be because of race or colour, or where people live, their income, their education and/or their start in life.
Secondly, as my noble friend Lady Jay said, one Bill a strategy does not make. The gracious Speech provides a disconnected programme, with no strategy to address the deep-rooted fractures in people’s lives to which my noble friend Lord Howarth referred.
I listened closely to the right reverend Prelate the Bishop of Gloucester, who spoke of the very real impact of disjointed government on victims, families and communities. What a missed opportunity this gracious Speech has been. I can only hope that the next gracious Speech will be different and will grasp every opportunity for change.